Predictors of response to injectable once weekly Semaglutide: Insights from the association of British Clinical Diabetologists Nationwide Audit

Introduction: Trials have observed individual differences in response to glucagon-like peptide-1 receptor agonists (GLP1RA) according to baseline characteristics. The ABCD audit launched in January 2019 to assess the clinical utility, efficacy and safety of injectable Semaglutide in routine practice. The aim of this analysis was to explore which baseline characteristics might predict larger weight or HbA1c reductions in the real-world. Methods: Data were extracted from the secure online tool and individuals with baseline and follow-up data available within a defined six (3–9) month window were included. Variables were assessed as both continuous variables and categorical variables in a multivariate regression model. Missing data were multiply imputed. Results: Six hundred twenty individuals with baseline (mean ± SD) age 58.7 ± 10.7 years, HbA1c 81.6 ± 18.5 mmol/mol (9.5 ± 1.7%), weight 108.2 ± 24.2 kg and BMI 37.6 ± 7.6 kg/m2. Median diabetes duration was 11.2 years (IQR 6.6–16) and 50.5% (313/620) were male. The median follow-up 0.5 years. HbA1c reduced by 14.9 mmol/mol (95% CI 13.5, 16.1, p < 0.001) and weight reduced by 4.2 kg (95% CI 3.6, 4.8; p < 0.001). Individuals with higher HbA1c, who were younger or GLP1RA naive had the largest HbA1c reductions. Higher baseline weight/BMI and being GLP1RA naïve were associated with larger weight reductions. Conclusion: In this real-world study, baseline HbA1c and weight are predictors of the respective outcomes following initiation of Semaglutide. Additionally, individuals who are younger may get more glycaemic benefit from Semaglutide. Individuals switching to Semaglutide from alternative GLP1RAs had smaller additional HbA1c and weight reductions. Our data mirror existing randomised control trial data and may have implications in view of current supply issues. Further evidence over a longer follow-up period is being collected.

Citation

Field et al (2024). Predictors of response to injectable once weekly Semaglutide: Insights from the association of British Clinical Diabetologists Nationwide Audit. Diabetic Medicine. 41 (S1). p.134

DOI

10.1111/dme.15296

URI

https://hdl.handle.net/20.500.14709/1235

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