Ildiko Lingvay, MD: Predictors of Gastrointestinal Events with Semaglutide

Despite SGLT2 inhibitors taking centerstage at meetings in recent years, the HbA1c lowering and weight loss associated with GLP-1 receptor agonists still leave them the preferred class for some diabetics.

Still, clinicians prescribing these agents need to be aware of the increased risk for adverse gastrointestinal events associated with use of GLP-1 receptor agonists. To further aid clinicians treating diabetics, a recent study from the American Diabetes Association’s (ADA) 80th Scientific Sessions is providing clinicians a comprehensive overview of predictors for these events with once-weekly semaglutide from 12 trials, including SUSTAIN 1-10.

Using data from the 10 SUSTAIN trials and 2 Japanese studies examining use of semaglutide, investigators were able to analyze potential risk predictors associated with gastrointestinal adverse events in patients receiving once-weekly 1mg semaglutide. From these studies, investigators hoped to assess the impact of age, region, ethnicity, diabetes duration, gender, renal function, smoking status, HbA1c, body weight, alanine aminotransferase, and bilirubin on the incidence of gastrointestinal events compared against non-GLP1 receptor agonists included in these studies. 

Of note, exenatide extended release, dulaglutide, and liraglutide were not included as comparators in the analyses.

Results of the analysis indicated frailty and female gender were associated with a marginally greater risk when compared against non-frailty and male gender, regardless of treatment. Investigators also highlighted lower baseline body weight was associated with lower risk than higher body weight—these results were confirmed by formal statistical analysis.

Investigators highlighted the results of the study also suggested use of semaglutide was associated with reduced HbA1c and weight loss, regardless of the presence of adverse gastrointestinal events.

To learn more about this analysis, HCPLive invited study author Ildiko Lingvay, MD, MPH, professor of medicine at University of Texas Southwestern and medical director of the Office of Clinical Trials Management at UT Southwestern Medical Center, to take part in a special edition ADA 2020 House Call.

This study, “Identifying Risk Predictors for Gastrointestinal Adverse Events with Once-Weekly Semaglutide,” was presented at ADA 2020.