Journal of Diabetes Investigation (Sep 2024)

Efficacy and tolerability of oral semaglutide in Japanese patients with type 2 diabetes mellitus: Analysis report from diabetes specialist clinics

  • Tetsuaki Inokuchi,
  • Yoshihide Fukumoto,
  • Gendai Lee,
  • Yoshifumi Yokomizo,
  • Kokichi Tanaka,
  • Michiko Chosa,
  • Masaru Doi,
  • Noboru Tamaki,
  • Seiichi Goto,
  • Kojiro Ichikawa,
  • Kazuo Kobayashi

DOI
https://doi.org/10.1111/jdi.14225
Journal volume & issue
Vol. 15, no. 9
pp. 1202 – 1210

Abstract

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ABSTRACT Introduction Glucagon‐like peptide 1 receptor agonists (GLP1Ras) have emerged as pivotal agents in diabetes management and organ protection. However, their use is limited due to the necessity for injectable administration. The advent of the first oral GLP1Ra (oral semaglutide) in Japan since 2021 is expected to expand its usage. The aim of this study is to survey the efficacy and tolerability of oral semaglutide in clinical practice. Materials and Methods We retrospectively analyzed 120 outpatients diagnosed with type 2 diabetes mellitus who had received oral semaglutide for >6 months. Changes in clinical parameters during oral semaglutide treatment from baseline to 12 months were analyzed. The inverse probability weighting method using the propensity score was used to evaluate the differences in clinical parameters at 6 months after treatment, based on the patients’ obesity levels. Results Body weight (BW), glycated hemoglobin A1c (HbA1c), and alanine aminotransferase (ALT) levels at baseline decreased significantly after treatment compared with those at 12 months (P < 0.001, P < 0.001, and P = 0.03, respectively). The patients were divided into two groups using a cutoff baseline body mass index (BMI) of 30.3 kg/m2. Although no significant difference was observed, changes in body weight and HbA1c indicated a potentially greater decrease in the BMI ≧ 30.3 group than that in the BMI < 30.3 group (P = 0.07 and 0.13, respectively). Among 206 registered patients, 25 (12.1%) discontinued oral‐semaglutide treatment owing to adverse effects, including gastrointestinal symptoms. Conclusions Oral semaglutide treatment demonstrates efficacy and tolerability for managing type 2 diabetes mellitus in Japan. Significant improvements in metabolic factors induced by oral semaglutide are anticipated, particularly in obese patients.

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