COMMENTARY

Oral Semaglutide the 'Most Efficacious' Oral Diabetes Drug

Martin Haluzik, MD, PhD, DSc

Disclosures

September 23, 2019

This transcript has been edited for clarity.

Hello. My name is Martin Haluzik, and I would like to share some new information regarding the clinical program for the first orally administered peptide for the treatment of type 2 diabetes, oral semaglutide.

Semaglutide is a glucagon-like peptide 1 agonist that has a very close homology to human GLP-1. It is widely available as a once-weekly injectable for the treatment of type 2 diabetes. Oral semaglutide is a novel coformulation of semaglutide with an absorption enhancer called SNAC, which is a molecule that enables the absorption of semaglutide from the stomach.

Oral semaglutide has been extensively tested within the clinical program called PIONEER[1] throughout the entire landscape of type 2 diabetes, starting from patients with a very short duration of disease to those who have had a long duration of type 2 diabetes treated with insulin.

Oral semaglutide has shown very good efficacy and safety throughout this program.[2] In fact, it was the most efficacious oral antidiabetic medication ever used. It was superior to SGLT2 inhibitors, DPP-4 inhibitors, and the injectable GLP-1 receptor agonist, liraglutide, as far as the reduction of glycated hemoglobin is concerned.

Here at the European Association for the Study of Diabetes (EASD) meeting, some new data have been presented on the influence of the duration of diabetes on the efficacy and safety of oral semaglutide.[3] It has been shown that both efficacy and safety are independent of diabetes duration. It has also been shown that the efficacy and safety of oral semaglutide are independent of the baseline HbA1c.

Oral semaglutide is currently under review by both major regulatory drug agencies, the US Food and Drug Administration, and the European Medicines Agency. Let's hope that it will get approval soon, because this very powerful glucose-lowering drug can significantly help us improve not only glucose control in our patients but also compliance. Because it is administered orally, it certainly carries significant advantages over injectables such as liraglutide and others.

Thank you very much for your attention.

Editor's note: On September 20, 2019, Medscape reported that the US Food and Drug Administration has approved oral semaglutide, 7 mg and 14 mg, for the treatment of type 2 diabetes in adults to improve glycemic control along with diet and exercise.

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