Efficacy and Safety of Once-Weekly Semaglutide 2.0 mg vs 1.0 mg by Baseline HbA1c and BMI: SUSTAIN FORTE Subgroup Analyses

Abstract

Once-weekly subcutaneous semaglutide 2.0 mg showed superior efficacy with similar safety vs 1.0 mg in 961 participants with type 2 diabetes (HbA1c 8.0-10.0%) after 40 weeks in SUSTAIN FORTE. We assessed the effect of semaglutide 2.0 mg vs 1.0 mg on HbA1c and body weight (BW) in prespecified baseline (BL) HbA1c (<9.0%, ≥9.0%) and BMI (<35, ≥35 kg/m2) subgroups. Mean BL HbA1c was 8.9% and BMI 34.6 kg/m2. For HbA1c and BW, estimated treatment differences favored semaglutide 2.0 mg vs 1.0 mg across all BL HbA1c and BMI subgroups. Treatment-by-subgroup interactions were nonsignificant (HbA1c, p=0.55 and p=0.41; BW, p=0.40 and p=0.13; Figures A-D). Greater mean HbA1c reductions were observed for both doses in the higher vs lower BL HbA1c subgroup (Figure A). Conversely, greater mean BW reductions were observed for both doses in the lower vs higher BL HbA1c subgroup (Figure C). Similar mean HbA1c reductions were observed across BL BMI subgroups (Figure B), while greater mean BW reductions were observed for both doses in the higher vs lower BL BMI subgroup (Figure D). Overall, the incidence of adverse events was similar for both doses and across BL HbA1c and BMI subgroups with no new safety concerns identified. In line with the results in the overall population, semaglutide 2.0 mg provided consistently greater reductions in HbA1c and BW vs 1.0 mg across BL HbA1c and BMI subgroups.