Oral semaglutide vs empagliflozin in patients with type 2 diabetes uncontrolled on metformin: The PIONEER 2 trial
Diabetes Care Sep 25, 2019
Rodbard HW, Rosenstock J, Canani LH, et al. - Researchers conducted this PIONEER 2 trial to compare the effectiveness and safety of GLP-1 analog, oral semaglutide, and SGLT-2 inhibitor, empagliflozin, in patients with T2D uncontrolled on metformin. In a 52-week trial, participants were randomized to once-daily open-label treatment with oral semaglutide 14 mg (n = 412) or empagliflozin 25 mg (n = 410). The trial was completed by 400 patients in the oral semaglutide group and 387 in the empagliflozin group. In patients with T2D uncontrolled on metformin, oral semaglutide was superior to empagliflozin in decreasing HbA1c but not body weight at 26 weeks. At week 52, there was a significant reduction in HbA1c and body weight (trial product estimate) compared with empagliflozin. Within the established safety profile of GLP-1 receptor agonists, oral semaglutide was well tolerated. Gastrointestinal adverse events with oral semaglutide were more common.
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