Effectiveness for adding or switching from other incretin‐related drugs to oral semaglutide in type 2 diabetes

ABSTRACT Aims/Introduction This study aimed to evaluate and compare the effectiveness of oral semaglutide after adding to or switching from incretin‐related drugs by assessing the changes in HbA1c and body weight (BW) in participants with type 2 diabetes in clinical settings. Materials and Methods A total of 368 participants were divided into groups according to antidiabetic medications before oral semaglutide treatment; incretin‐related drug‐naïve (naïve), switching from dipeptidyl peptide‐4 inhibitors (DPP‐4i) or glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) groups. Adjusted mean changes in HbA1c and BW at 6 months after oral semaglutide administration were compared among the three groups. Similar analyses were performed in the GLP‐1 RAs group between GLP‐1RAs before switching. Results Mean change of HbA1c in DPP‐4i and GLP‐1 RA groups was −0.67% (95% confidence interval [CI]: −0.79 to −0.54) and −0.13% (95% CI: −0.40 to 0.15), respectively, which were significantly smaller than incretin‐related drug‐naïve group; −0.85% (95% CI: −1.08 to −0.62). Mean change in BW between the naïve and DPP‐4i groups had no differences; however, these changes were lower in the GLP‐1 RA group than in the naïve group. Mean change in HbA1c between pretreatment with GLP‐1 RAs had no differences; however, the mean change in BW in the dulaglutide group was significantly higher than that in the injectable semaglutide group. Conclusion Oral semaglutide reduced HbA1c levels and BW after adding or switching from other incretin‐related drugs in Japanese participants with type 2 diabetes.