Candido Riccardo, Gaiotti Sara, Giudici Fabiola, Toffoli Barbara, De Luca Federica, Velardi Valerio, Petrucco Alessandra, Gottardi Chiara, Manca Elena, Buda Iris, Fabris Bruno, Bernardi Stella
Department of Medical Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy.
SC Patologie Diabetiche, ASUGI (Azienda Sanitaria Universitaria Giuliano Isontina), 34128 Trieste, Italy.
J Clin Med. 2023 Sep 19;12(18):6052. doi: 10.3390/jcm12186052.
(1) Background: Oral semaglutide represents the first oral GLP-1 RA approved for the treatment of type 2 diabetes mellitus (T2DM). This real-world retrospective study aimed at evaluating its effectiveness and tolerability in the treatment of patients with T2DM when patients switched from a glucose-lowering agent to it and when it was added to the usual therapy. (2) Methods: Adult patients with T2DM taking oral semaglutide and followed in the ASUGI Diabetes Center were identified with the use of electronic medical records between October 2022 and May 2023. (3) Results: A total of 129 patients were recruited. The median follow-up was 6 months. Be it as a switchover or as an add-on therapy, oral semaglutide significantly reduced HbA1c and BMI. Switching from DPPIV inhibitors to oral semaglutide was associated with a significant reduction in HbA1c and BMI, switching from SGLT2 inhibitors was associated with a significant reduction in HbA1c, and switching from sulphonylureas was associated with a significant reduction in BMI. The median HbA1c change was associated with baseline HbA1c. SBP significantly decreased in the add-on group. Oral semaglutide was well tolerated. (4) Conclusions: This study shows that in the real-world setting, oral semaglutide is effective and safe as a switchover or as an add-on therapy for the treatment of T2DM.
(1) 背景：口服司美格鲁肽是首个获批用于治疗2型糖尿病（T2DM）的口服胰高血糖素样肽-1受体激动剂（GLP-1 RA）。这项真实世界回顾性研究旨在评估在T2DM患者从降糖药物转换为口服司美格鲁肽治疗以及将其添加到常规治疗中时，该药物的有效性和耐受性。(2) 方法：利用电子病历识别出2022年10月至2023年5月期间在ASUGI糖尿病中心接受口服司美格鲁肽治疗并随访的成年T2DM患者。(3) 结果：共招募了129例患者。中位随访时间为6个月。无论是作为转换治疗还是联合治疗，口服司美格鲁肽均能显著降低糖化血红蛋白（HbA1c）和体重指数（BMI）。从二肽基肽酶-IV抑制剂（DPPIV）转换为口服司美格鲁肽与HbA1c和BMI显著降低相关，从钠-葡萄糖协同转运蛋白2抑制剂（SGLT2）转换与HbA1c显著降低相关，从磺脲类药物转换与BMI显著降低相关。HbA1c的中位变化与基线HbA1c相关。联合治疗组收缩压（SBP）显著降低。口服司美格鲁肽耐受性良好。(4) 结论：本研究表明，在真实世界环境中，口服司美格鲁肽作为T2DM的转换治疗或联合治疗有效且安全。
