Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial
McCrimmon RJ,Catarig AM,Frias JP,Lausvig NL,le Roux CW,Thielke D,Lingvay I
Intra-abdominal or visceral obesity is associated with insulin resistance and an increased risk for cardiovascular disease. This study aimed to compare the effects of semaglutide 1.0 mg and canagliflozin 300 mg on body composition in a subset of participants from the SUSTAIN 8 Phase IIIB, randomised double-blind trial who underwent whole-body dual-energy x-ray absorptiometry (DXA) scanning. Adults (age >=18 years) with type 2 diabetes, HbA1c 53-91 mmol/mol (7.0-10.5%), on a stable daily dose of metformin (>=1500 mg or maximum tolerated dose) and with an eGFR >=60 ml/min/1.73m2 were randomised 1:1 to semaglutide 1.0 mg once weekly and canagliflozin placebo once daily, or canagliflozin 300 mg once daily and semaglutide placebo once weekly. Body composition was assessed using whole-body DXA scans. Change from baseline to week 52 in total fat mass (kg) was the confirmatory efficacy endpoint. A subset of 178 participants (semaglutide, n = 88; canagliflozin, n = 90) underwent DXA scanning at screening and were randomised into the substudy. Of these, 114 (semaglutide, n = 53; canagliflozin, n = 61) participants had observed end-of-treatment data included in the confirmatory efficacy analysis. Numerical improvements in body composition (including fat mass, lean mass and visceral fat mass) were observed after 52 weeks with both treatments. Total fat mass (baseline 33.2 kg) was reduced by 3.4 kg and 2.6 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: -0.79 [95% CI -2.10, 0.51]). Total lean mass (baseline 51.3 kg) was also reduced by 2.3 kg and 1.5 kg with semaglutide and canagliflozin, respectively (estimated treatment difference: -0.78 [-1.61, 0.04]), though the proportion of lean mass (baseline 59.4%) increased by 1.2- and 1.1-percentage points, respectively. Changes in visceral fat mass and overall changes in body composition (fat to lean mass ratio) were comparable between treatment groups. In individuals with uncontrolled type 2 diabetes on stable-dose metformin therapy, the changes in body composition with semaglutide and canagliflozin were not significantly different; there was no placebo arm, so the specific impact of either treatment on body composition is speculative.
PMID 31897524 31897524 DOI 10.1007/s00125-019-05065-8 10.1007/s00125-019-05065-8 McCrimmon et al. 2020, McCrimmon 2020
Cite this article
McCrimmon, R. J., Catarig, A. M., Frias, J. P., Lausvig, N. L., le Roux, C. W., Thielke, D., & Lingvay, I. (2020). Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial. Diabetologia. https://doi.org/10.1007/s00125-019-05065-8
McCrimmon RJ, Catarig AM, Frias JP, Lausvig NL, le Roux CW, Thielke D, Lingvay I. Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial. Diabetologia. 2020. doi:10.1007/s00125-019-05065-8
McCrimmon, R. J., et al. "Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: a substudy of the SUSTAIN 8 randomised controlled clinical trial." Diabetologia, 2020.
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