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Switch-to-Semaglutide Study (STS-Study): a Retrospective Cohort Study.

Matthias Hepprich^1,2, Daniela Zillig³, Manuel A Florian-Reynoso⁴

¹Clinic of Endocrinology and Metabolic Disorders, Cantonal Hospital Olten, Baslerstrasse 150, Olten, Switzerland. matthias.hepprich@usb.ch.

Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders

|February 22, 2021

Summary

Switching type 2 diabetes patients to semaglutide from other glucagon-like peptide-1 (GLP-1) receptor agonists significantly improved glycemic control and reduced body weight. Both equipotential and stepwise dosing strategies were effective and well-tolerated.

Keywords:

Antidiabetic drug GLP-1 analogue Observational study Semaglutide Type 2 diabetes

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Area of Science:

Endocrinology
Metabolic Diseases
Pharmacology

Background:

Limited data exists on optimizing treatment for type 2 diabetes when initial glucagon-like peptide-1 (GLP-1) receptor agonist therapy is insufficient.
The efficacy of switching to semaglutide for improved glucose and weight management in this patient population requires further investigation.

Purpose of the Study:

To evaluate the effectiveness of switching patients with type 2 diabetes from existing GLP-1 receptor agonist therapy to semaglutide.
To assess the impact of this switch on glycemic control (HbA1c) and body weight.

Main Methods:

Retrospective cohort analysis of 77 patients with type 2 diabetes switched from a stable dose of any GLP-1 agonist to subcutaneous semaglutide.
Primary endpoint: change in glycated haemoglobin (HbA1c) at 6 months. Secondary endpoints: changes in weight, BMI, heart rate, blood pressure, and adverse events.

Main Results:

A significant reduction in HbA1c from 8.4% to 7.3% was observed at 6 months post-switch.
Median body weight decreased significantly from baseline (98 kg) to 93 kg at 6 months.
Both equipotential (79%) and stepwise (21%) initiation doses of semaglutide improved outcomes, with side effects reported in 36% of patients.

Conclusions:

Switching to semaglutide from other GLP-1 receptor agonists is an effective strategy for improving glycemic control and reducing body weight in type 2 diabetes.
Both equipotential and stepwise dosing approaches for semaglutide initiation are viable and well-tolerated treatment options.