Oya Junko, Shimizu Mika, Kubota Ryo, Suda Rika, Nagkagami Tomoko
Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
J Diabetes Investig. 2025 Apr;16(4):608-614. doi: 10.1111/jdi.14391. Epub 2024 Dec 20.
AIMS/INTRODUCTION: This study aimed to evaluate and compare the effectiveness of oral semaglutide after adding to or switching from incretin-related drugs by assessing the changes in HbA1c and body weight (BW) in participants with type 2 diabetes in clinical settings.
A total of 368 participants were divided into groups according to antidiabetic medications before oral semaglutide treatment; incretin-related drug-naïve (naïve), switching from dipeptidyl peptide-4 inhibitors (DPP-4i) or glucagon-like peptide-1 receptor agonist (GLP-1 RA) groups. Adjusted mean changes in HbA1c and BW at 6 months after oral semaglutide administration were compared among the three groups. Similar analyses were performed in the GLP-1 RAs group between GLP-1RAs before switching.
Mean change of HbA1c in DPP-4i and GLP-1 RA groups was -0.67% (95% confidence interval [CI]: -0.79 to -0.54) and -0.13% (95% CI: -0.40 to 0.15), respectively, which were significantly smaller than incretin-related drug-naïve group; -0.85% (95% CI: -1.08 to -0.62). Mean change in BW between the naïve and DPP-4i groups had no differences; however, these changes were lower in the GLP-1 RA group than in the naïve group. Mean change in HbA1c between pretreatment with GLP-1 RAs had no differences; however, the mean change in BW in the dulaglutide group was significantly higher than that in the injectable semaglutide group.
Oral semaglutide reduced HbA1c levels and BW after adding or switching from other incretin-related drugs in Japanese participants with type 2 diabetes.
目的/引言：本研究旨在通过评估临床环境中2型糖尿病患者糖化血红蛋白（HbA1c）和体重（BW）的变化，来评价和比较口服司美格鲁肽在加用或从肠促胰岛素相关药物转换后使用的有效性。
根据口服司美格鲁肽治疗前的抗糖尿病药物，将368名参与者分为几组；未使用过肠促胰岛素相关药物组（初治组）、从二肽基肽酶-4抑制剂（DPP-4i）转换组或胰高血糖素样肽-1受体激动剂（GLP-1 RA）组。比较三组在口服司美格鲁肽给药6个月后HbA1c和BW的调整后平均变化。在GLP-1 RAs组中，对转换前的GLP-1 RAs进行了类似分析。
DPP-4i组和GLP-1 RA组的HbA1c平均变化分别为-0.67%（95%置信区间[CI]：-0.79至-0.54）和-0.13%（95%CI：-0.40至0.15），均显著低于未使用过肠促胰岛素相关药物组；-0.85%（95%CI：-1.08至-0.62）。初治组和DPP-4i组之间的BW平均变化无差异；然而，GLP-1 RA组的这些变化低于初治组。GLP-1 RAs预处理前后的HbA1c平均变化无差异；然而，度拉糖肽组的BW平均变化显著高于注射用司美格鲁肽组。
在日本2型糖尿病参与者中，口服司美格鲁肽在加用或从其他肠促胰岛素相关药物转换后可降低HbA1c水平和体重。
