Weight loss induced by semaglutide once weekly contributes to improved health-related quality of life and treatment satisfaction

Background and aims:Semaglutide, a glucagon-like peptide-1 analogue for the once-weekly subcutaneous treatment of type 2 diabetes (T2D), provided superior glycaemic control and weight loss vs comparators in the SUSTAIN clinical trial programme. Weight loss is recognised as an important outcome in the management of T2D. This post hoc analysis assessed if weight loss was associated with improvements in patient-reported health-related quality of life (HRQoL) and treatment satisfaction in SUSTAIN 2-5 and 7.Materials and methods:The proportions of subjects who achieved weight loss responses of ≥5% and ≥10% in the semaglutide arms were pooled across the trials (N=2,808; comparator data not evaluated), and presented both overall and by dose (semaglutide 0.5 mg or 1.0 mg). Changes in HRQoL (measured by the Physical Component Summary [PCS] and Mental Component Summary scores of the Short Form-36 Health Survey version 2® [SF-36v2®]) and treatment satisfaction scores (measured by the Diabetes Treatment Satisfaction Questionnaire, status version [DTSQs]) were evaluated in subjects who achieved ≥5% and ≥10% weight loss vs those who did not at end of treatment (30, 40 or 56 weeks). Norm-based scoring is used for the SF-36v2®, setting the general population mean to 50 for each domain; higher and increasing scores indicate better health. The standard DTSQs scales range from 0 to 6 on a 7-point Likert scale, where 6 indicates the highest treatment satisfaction and 0 the lowest, with the exception of questions on the perception of hyper- and hypoglycaemia, where 6 indicates the lowest treatment satisfaction and 0 the highest.Results:Overall, 51.0% and 17.4% of subjects achieved ≥5% and ≥10% weight loss with semaglutide (pooled groups). Significantly greater improvements in most of the PCS components and the overall PCS and DTSQs scores were reported by subjects achieving ≥5% and ≥10% weight loss vs those not achieving these responses in the semaglutide 1.0 mg and pooled semaglutide groups (Table). The DTSQs perception of hyperglycaemia improved in each weight loss and semaglutide group, while there was no change in the perception of hypoglycaemia in any group.Conclusion:Weight loss induced by semaglutide 1.0 mg was associated with improvements in PCS domains of the SF-36v2®, overall treatment satisfaction and perception of hyperglycaemia across the SUSTAIN 2-5 and 7 trials. These data suggest that weight loss may be an important factor determining HRQoL improvements during T2D treatment with semaglutid</p

Improved treatment satisfaction in patients with type 2 diabetes treated with once-weekly semaglutide in the SUSTAIN trials.

AIM: To investigate treatment satisfaction with semaglutide, a once-weekly glucagon-like peptide-1 receptor agonist, versus placebo/active comparators in the SUSTAIN clinical trial programme. METHODS: In SUSTAIN 2-5 and 7, the Diabetes Treatment Satisfaction Questionnaire was used to evaluate patient-perceived treatment satisfaction, hyperglycaemia and hypoglycaemia. Post hoc subgroup analyses were conducted to explore the effects of gastrointestinal adverse events (GI AEs), weight loss (≥5%) or achieving glycaemic (HbA1c < 7%) targets on treatment satisfaction. RESULTS: Overall treatment satisfaction increased from baseline to end of treatment with all treatments across trials. Improvements were significantly greater with semaglutide versus comparators/placebo in SUSTAIN 2-5 (all P < 0.05), and generally greater in patients who achieved versus did not achieve weight loss and glycaemic targets, often with greater improvements with semaglutide 1.0 mg versus comparator/placebo in both weight loss groups. In SUSTAIN 7, improvements in overall treatment satisfaction were generally similar between semaglutide and dulaglutide, irrespective of weight loss or glycaemic control. In SUSTAIN 7, changes in overall treatment satisfaction score were generally lower in patients with versus without GI AEs at week 16 (except dulaglutide 0.75 mg), but similar by week 40. Perceived hyperglycaemia was significantly reduced from baseline to end of treatment with semaglutide versus all comparators/placebo (all P < 0.05). No differences between treatments were observed for perceived hypoglycaemia. CONCLUSIONS: Semaglutide was associated with significantly greater (SUSTAIN 2-5) or similar (SUSTAIN 7) improvements in overall treatment satisfaction versus comparators/placebo. Improvements in overall treatment satisfaction were generally greater in patients achieving versus not achieving treatment targets. Clinicaltrials.gov: NCT01930188 (SUSTAIN 2), NCT01885208 (SUSTAIN 3), NCT02128932 (SUSTAIN 4), NCT02305381 (SUSTAIN 5) and NCT02648204 (SUSTAIN 7). EudraCT: 2012-004827-19 (SUSTAIN 2), 2012-004826-92 (SUSTAIN 3), 2013-004392-12 (SUSTAIN 4), 2013-004502-26 (SUSTAIN 5) and 2014-005375-91 (SUSTAIN 7)