The FINANCIAL — Novo Nordisk on February 23 announced the headline results from the fifth phase 3a trial for semaglutide, SUSTAIN5. Semaglutide is a new GLP-1 analogue, which in the SUSTAIN trials is administered subcutaneously once weekly.
The double-blinded trial investigated the efficacy and safety of 0.5 mg and 1.0 mg semaglutide compared with placebo as add-on to basal insulin alone or basal insulin in combination with metformin, after 30 weeks of treatment in 397 people with type 2 diabetes.
The trial successfully achieved its objective by demonstrating that people treated with 0.5 mg or 1.0 mg semaglutide achieved a statistically significant and superior improvement in HbA1c of 1.4% and 1.8% respectively, from a mean baseline HbA1c of 8.4%, compared with an improvement in HbA1c of 0.1% with placebo. Additionally, the end of trial insulin dose for people treated with 0.5 mg and 1.0 mg semaglutide was reduced by 10% and 15% respectively, compared with 3% for the placebo group, according to Novo Nordisk.
61% of the people treated with 0.5 mg semaglutide and 79% of the people treated with 1.0 mg semaglutide achieved the treatment target of HbA1c below 7% set by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), compared with 11% of the people treated with placebo.
From a mean baseline body weight of 92 kg, people treated with 0.5 mg and 1.0 mg semaglutide experienced a statistically significant and superior weight loss of 3.7 kg and 6.4 kg respectively, compared with a weight loss of 1.4 kg for people treated with placebo.
In the trial, semaglutide appeared to have a safe and well-tolerated profile. The most common adverse event was nausea. Nausea was reported by 11% of the people treated with 0.5 mg semaglutide and by 17% of the people treated with 1.0 mg semaglutide, compared with 5% of people treated with placebo. Severe or blood glucose-confirmed symptomatic hypoglycaemia was experienced by 8% and 11% of people treated with 0.5 mg or 1.0 mg once-weekly semaglutide respectively, compared with 5% in the placebo group. The discontinuation rate due to adverse events was 5% and 6% for people treated with 0.5 mg semaglutide and 1.0 mg semaglutide respectively, compared to 1% for people treated with placebo.
“We are excited about the results of SUSTAIN 5, showing superior efficacy in glycaemic control and weight loss with semaglutide administered once-weekly in patients inadequately controlled on basal insulin” says Mads Krogsgaard Thomsen, executive vice president and chief science officer of Novo Nordisk. “The results from the first five SUSTAIN trials support the potential for broad usage of semaglutide in people with type 2 diabetes, as results have been consistent when exploring people with both early onset as well as late stage type 2 diabetes.”
Novo Nordisk expects to announce headline results of the final SUSTAIN trial, SUSTAIN 6 in the first half of 2016.