Abstract
Introduction: For older patients with type 2 diabetes, treatments that minimize the risk of hypoglycemia and provide benefits in terms of comorbidities, while optimizing glycemic control, are particularly important. Semaglutide, a glucagon-like peptide-1 receptor agonist available as a once-weekly (OW) subcutaneous and once-daily oral formulation, reduces HbA 1c and body weight with a low risk of hypoglycemia. In addition, major adverse cardiovascular events (MACE) were reduced in SUSTAIN 6 (OW semaglutide; significant) and PIONEER 6 (oral semaglutide; not significant) vs placebo. The aim of this post hoc analysis was to evaluate cardiovascular (CV), metabolic and safety outcomes with semaglutide according to age. Methods: Subgroup analyses for semaglutide vs placebo by age as quartiles (≤60 years; >60 years to ≤65; >65 years to ≤70 years; >70 years) were performed for pooled SUSTAIN 6 and PIONEER 6 data in relation to: CV (3-point and individual MACE components), metabolic (change in HbA 1c , body weight) and safety (severe hypoglycemia, serious adverse events [SAEs]) outcomes. Results: In patients treated with semaglutide (n=3,239) vs placebo (n=3,241), the reduction in MACE and individual components of MACE was consistent across age subgroups (p interaction >0.05 for all; Table ). Minor heterogeneity for change in HbA 1c from baseline was observed with semaglutide vs placebo across the four age subgroups (p interaction =0.01). Weight reduction with semaglutide vs placebo did not differ across age subgroups. Semaglutide (vs placebo) did not result in an increase in severe hypoglycemia or SAEs in any of the age subgroups ( Table ). Conclusions: This post hoc combined analysis of SUSTAIN 6 and PIONEER 6 indicates that the CV and metabolic benefits and the safety profile of semaglutide (vs placebo) align with the drug class and were consistent across age subgroups.
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