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Will oral semaglutide be used to reduce cardiovascular risk in subjects with type 2 diabetes instead of subcutaneous semaglutide?
Expert Opinion on Biological Therapy ( IF 4.6 ) Pub Date : 2020-02-05 , DOI: 10.1080/14712598.2020.1724952
Sheila A Doggrell 1
Affiliation  

Introduction: The 'glutides,' which stimulate the glucagon-like peptide 1 (GLP-1) receptor to stimulate insulin secretion, are used in the treatment of type 2 diabetes. Semaglutide is the first glutide to be developed in an oral form. The PIONEER series of clinical trials (Peptide Innovation for Early Diabetes Treatment) were undertaken to establish a clinical role for oral semaglutide.Areas covered: This evaluation is of PIONEER 6 in a non-inferiority phase 3a trial. In PIONEER 6, the primary outcome was the time from randomization to first occurrence of a major adverse cardiovascular event and this was non-inferior with oral semaglutide, compared to placebo.Expert opinion: In my opinion, there are several reasons why once-daily oral semaglutide may not replace once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes. Most importantly, subcutaneous semaglutide has already been shown to be superior to placebo in reducing cardiovascular risk, whereas the study of this with oral semaglutide will not be completed until 2024. Secondly, it is debatable whether subjects will find the daily protocol for taking oral semaglutide more convenient than that for the weekly subcutaneous formulation.

中文翻译:

口服司马鲁肽可代替皮下司马鲁肽用于降低2型糖尿病患者的心血管风险吗?

简介:刺激胰高血糖素样肽1(GLP-1)受体刺激胰岛素分泌的“谷蛋白”用于治疗2型糖尿病。Semaglutide是第一种以口服形式形成的谷氨酸。开展了PIONEER系列临床试验(用于早期糖尿病治疗的肽创新疗法)以确立口服semaglutide的临床作用。研究范围:该评估是针对PIONEER 6的一项非劣效性3a试验。在PIONEER 6中,主要结果是从随机分组到首次出现严重的不良心血管事件的时间,与安慰剂相比,口服Semaglutide的疗效不逊于专家。我认为,每天一次的原因有很多在治疗2型糖尿病时,口服semaglutide可能无法取代每周一次的皮下semaglutide。
更新日期:2020-04-20
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