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Oral semaglutide can accomplish levels of glycemic ascendancy and weight accident agnate to those of subcutaneous semaglutide, according to a appearance 2, placebo-controlled balloon appear in the Oct. 17 copy of JAMA.
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In a parallel-group, dosage-finding 26-week trial, 632 patients with blazon 2 diabetes and poor glycemic ascendancy were randomized to either 2.5 mg, 5 mg, 10 mg, 20 mg, or 40 mg of once-daily articulate semaglutide escalated over 4 weeks (standard escalation); 40 mg escalated over 8 weeks; 40 mg escalated over 2 weeks; once-weekly subcutaneous semaglutide (1 mg) for 26 weeks, or articulate placebo.
The abstraction begin that all patients who had accustomed articulate or subcutaneous semaglutide showed decidedly bargain beggarly claret A1c levels compared with placebo. Almost all patients advised with semaglutide – both articulate and subcutaneous – showed a abridgement in HbA1c levels while alone 74% of patients in the placebo accumulation did (JAMA 2017 Oct 17;318[15]:1460-70. doi: 10.1001/jama.2017.14752).
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The estimated analysis aberration compared with placebo at anniversary 26 ranged from –0.4% for the 2.5-mg accumulation to –1.6% for the 40-mg-over-4-weeks group, and –1.6% for the subcutaneous group.
Dr. Melanie Davies
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Researchers additionally saw a dose-dependent abatement in beggarly anatomy weight from baseline to 26 weeks, alignment from –0.9 kg in the 2.5-mg accumulation to –5.7 kg in the 40-mg accepted accretion group, compared with –1.2 kg in the placebo group. The aberration amid analysis and placebo was cogent alone for doses at or aloft 10 mg.
The best accepted adverse contest appear were balmy to abstinent gastrointestinal problems, mostly associated with articulate and subcutaneous semaglutide, which are a accepted ancillary aftereffect of GLP-1 receptor agonists. There was additionally a college amount of abortive cessation of analysis due to gastrointestinal furnishings in the semaglutide-treated patients.
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However, the all-embracing amount of hypoglycemic episodes was low, and was agnate in both semaglutide groups and the placebo group.
There were three cases of astute pancreatitis in patients advised with semaglutide, and the analysis was additionally associated with a cogent access in affection rate, compared with placebo.
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“A best abstraction continuance may accept approved the best HbA1c akin and weight reductions in the groups administered the college doses of the medication,” wrote Melanie Davies, MD, assistant of diabetes anesthetic at the University of Leicester, England, and her coauthors. “Future trials should appraise the ability of articulate semaglutide in patients with a aerial baseline HbA1c akin to analyze its abeyant in patients who are beneath able-bodied controlled, and in aggregate with added glucose-lowering agents.”
Semaglutide architect Novo Nordisk provided beat support. Three authors declared lath associates and consultancy fees from the company, as able-bodied as institutional grants, address fees, and added allotment from added biologic companies. Two authors declared shares in Novo Nordisk. One columnist declared a apparent apropos to semaglutide, and two authors declared allotment from biologic companies including Novo Nordisk.
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