Changes in HbA1c and Body Weight in US Adults With Type 2 Diabetes and Chronic Kidney Disease Who Received Oral Semaglutide
Author(s)
James Amamoo, MSc, MSPH1, Yan Wang, ScD2, Hongjiao Liu, PhD2, Manasvi Sundar, MPH2, Yan Song, PhD3, Lin Xie, MA, MS1, Sherif Mehanna, MBBS, MBS1, Josh Noone, PhD1, Caroline Swift, MPH, PhD1, Matthew R. Weir, Sr., MD4;
1Novo Nordisk, Plainsboro, NJ, USA, 2Analysis Group, Los Angeles, CA, USA, 3Analysis Group, Boston, MA, USA, 4School of Medicine, University of Maryland, Baltimore, MD, USA
1Novo Nordisk, Plainsboro, NJ, USA, 2Analysis Group, Los Angeles, CA, USA, 3Analysis Group, Boston, MA, USA, 4School of Medicine, University of Maryland, Baltimore, MD, USA
OBJECTIVES: To assess changes in HbA1c and body weight in US adults with type 2 diabetes (T2D) and chronic kidney disease (CKD) treated with oral semaglutide.
METHODS: Adults with T2D and CKD who initiated oral semaglutide between September 20, 2019, and June 30, 2023, were selected from Optum’s de-identified Clinformatics® Data Mart Database. Baseline characteristics were assessed during the 12 months prior to oral semaglutide initiation, and patients were followed up until the earliest of discontinuation of oral semaglutide, initiation of any other new antidiabetic medication, the end of continuous claims enrollment, or death. HbA1c and body weight before vs. during oral semaglutide treatment were compared. Changes in HbA1c and body weight were described at Month 12, with trajectories evaluated using mixed-effects models in the overall cohort, and in subgroups of those 1) ineligible for sodium-glucose cotransporter-2 inhibitor (SGLT2i) due to advanced CKD stages, and 2) for whom SGLT2is were suboptimal as indicated by treatment switching or augmentation with oral semaglutide after having received SGLT2i during the baseline period.
RESULTS: A total of 15,539 patients initiating oral semaglutide were included, among whom 74.1% were aged 65 or older and 52.0% were female. The mean HbA1c was 8.1%. 6.5% of the patients were ineligible for SGLT2is, and 33.7% had suboptimal treatment with SGLT2is. Decline in HbA1c (12-month mean change [95% confidence interval]: -1.00% [-1.10%, -0.92%]) and body weight (-3.84 kg [-4.68, -2.99]) were observed at 12 months after initiation of oral semaglutide. Similar trends in HbA1c were observed in the two subgroups, and a similar decline in body weight was observed in patients with suboptimal SGLT2i treatment.
CONCLUSIONS: Improved glycemic control and reduced body weight were observed among real-world patients with T2D and CKD treated with oral semaglutide.
METHODS: Adults with T2D and CKD who initiated oral semaglutide between September 20, 2019, and June 30, 2023, were selected from Optum’s de-identified Clinformatics® Data Mart Database. Baseline characteristics were assessed during the 12 months prior to oral semaglutide initiation, and patients were followed up until the earliest of discontinuation of oral semaglutide, initiation of any other new antidiabetic medication, the end of continuous claims enrollment, or death. HbA1c and body weight before vs. during oral semaglutide treatment were compared. Changes in HbA1c and body weight were described at Month 12, with trajectories evaluated using mixed-effects models in the overall cohort, and in subgroups of those 1) ineligible for sodium-glucose cotransporter-2 inhibitor (SGLT2i) due to advanced CKD stages, and 2) for whom SGLT2is were suboptimal as indicated by treatment switching or augmentation with oral semaglutide after having received SGLT2i during the baseline period.
RESULTS: A total of 15,539 patients initiating oral semaglutide were included, among whom 74.1% were aged 65 or older and 52.0% were female. The mean HbA1c was 8.1%. 6.5% of the patients were ineligible for SGLT2is, and 33.7% had suboptimal treatment with SGLT2is. Decline in HbA1c (12-month mean change [95% confidence interval]: -1.00% [-1.10%, -0.92%]) and body weight (-3.84 kg [-4.68, -2.99]) were observed at 12 months after initiation of oral semaglutide. Similar trends in HbA1c were observed in the two subgroups, and a similar decline in body weight was observed in patients with suboptimal SGLT2i treatment.
CONCLUSIONS: Improved glycemic control and reduced body weight were observed among real-world patients with T2D and CKD treated with oral semaglutide.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA6
Topic
Study Approaches
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Urinary/Kidney Disorders