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*Treatment use to be within individual product indications/labels.13-15
†STEP 5 was a 104-week randomised, double-blind, placebo-controlled trial in 304 adult patients with obesity (BMI ≥30 kg/m2), or who were overweight (BMI ≥27 kg/m2 to <30 kg/m2) and had at least 1 weight-related comorbidity comparing Wegovy® 2.4 mg and placebo.13,16 Results (trial product estimand): Mean change in body weight at Week 104, baseline 106.0 kg (N=304): -16.7% Wegovy® 2.4 mg (n=152) vs -0.6% placebo (n=152).16
‡STEP 1 was a 68-week double-blind trial in 1961 adult patients with obesity (BMI ≥30 kg/m2), or who were overweight (BMI ≥27 kg/m2 to <30 kg/m2) and had at least 1 weight-related comorbidity comparing Wegovy® 2.4 mg and placebo. Cardiometabolic risk factor improvement vs placebo included: weight -14.9% vs -2.4% (treatment policy estimand), systolic blood pressure -6.2 mmHg vs -1.1 mmHg, waist circumference -13.5 cm vs -4.1 cm (all P<0.001), as well as glycated haemoglobin levels and lipid levels.13,17
§Rybelsus® is indicated for the treatment of adults with insufficiently controlled T2DM to improve glycaemic control as an adjunct to diet and exercise as monotherapy when metformin is considered inappropriate due to intolerance or contraindications, or in combination with other medicinal products for the treatment of diabetes.14
||PIONEER 3 was a 78-week, randomised, double-blind, double-dummy, parallel group trial in 1864 adult patients with T2D comparing Rybelsus® 3, 7 and 14 mg with sitagliptin 100 mg. Results (treatment policy estimand): Mean change in HbA1c at Week 26 (+ MET ± SU), baseline 8.3% (N=1864): -0.6% Rybelsus® 3 mg (n=466), (P=0.008), -1.0% Rybelsus® 7 mg (n=465), (P<0.001) and -1.3% Rybelsus® 14 mg (n=465), (P<0.001) vs -0.8% sitagliptin 100 mg (n=467). Mean change in body weight at Week 26 (+ MET ± SU), baseline 91.2 kg (N=1864): -1.2 kg Rybelsus® 3 mg (n=466), (P=0.02), -2.2 kg Rybelsus® 7 mg (n=465), (P<0.001) and -3.1 kg Rybelsus® 14 mg (n=465), (P<0.001) vs -0.6 kg sitagliptin 100 mg (n=467).18
**PIONEER 4 was a 52-week, double-blind, double-dummy trial in 711 adult patients with T2D comparing Rybelsus® vs liraglutide and placebo. Cardiometabolic risk reduction included HbA1c -1.2% (P<0.05), weight -4.3 kg, systolic blood pressure -3 mmHg, lipid profile (TC reduction, LDL-C reduction, TG reduction) and waist circumference -4.3 cm. Apart from HbA1c, the remaining cardiometabolic risk factor results were significant vs placebo not liraglutide.19
††Ozempic® is indicated for the treatment of adults with insufficiently controlled T2DM as an adjunct to diet and exercise as monotherapy when metformin is considered inappropriate due to intolerance or contraindications, or in addition to other medicinal products for the treatment of diabetes.15
‡‡SUSTAIN 7 was a 40-week, randomised, open-label, active-controlled trial in 1201 adult patients with T2D comparing Ozempic® 0.5 mg with dulaglutide 0.75 mg and Ozempic® 1 mg with dulaglutide 1.5 mg. Results: Mean change in HbA1c at Week 40 (+ MET), baseline 8.2% (N=1201): -1.5% Ozempic® 0.5 mg (n=301) vs -1.1% dulaglutide 0.75 mg (n=299), (P<0.0001); -1.8% Ozempic® 1 mg (n=300) vs -1.4% dulaglutide 1.5 mg (n=299), (P<0.0001). Mean change in body weight at Week 40 (+ MET), baseline 95.2 kg (N=1201): -4.6 kg Ozempic® 0.5 mg (n=301) vs -2.3 kg dulaglutide 0.75 mg (n=299), (P<0.0001); -6.5 kg Ozempic® 1 mg (n=300) vs -3.0 kg dulaglutide 1.5 mg (n=299), (P<0.0001).15,20
§§Results apply to Ozempic® 0.5 mg and 1 mg plus SOC vs placebo plus SOC in adults with T2D who have high CV risk, or established ASCVD.21
The images are models and not real patients.
*The characters and their descriptions are for representation purposes only and do not reflect real patients.
Kadowaki T, Maegawa H, Watada H, et al. Interconnection between cardiovascular, renal and metabolic disorders: A narrative review with a focus on Japan. Diabetes Obes Metab. 2022;24(12):2283–2296. doi:10.1111/dom.14829.
Lastra G, Manrique C, Sowers JR. Obesity, cardiometabolic syndrome, and chronic kidney disease: the weight of the evidence. Adv Chronic Kidney Dis. 2006;13(4):365–373. doi:10.1053/j.ackd.2006.07.011.
Piché ME, Tchernof A, Despré JP. Obesity phenotypes, diabetes, and cardiovascular diseases. Circulation Research. 2020;126:1477–1500. doi:10.1161/ CIRCRESAHA.120.316101.
Iglay K, Hannachi H, Howie PJ, et al. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin. 2016;32(7):1243–1252. doi:10.1185/03007995.2016.1168291.
Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323. doi:10.1093/eurheartj/ehz486.
Low Wang CC, Hess CN, Hiatt WR, et al. Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes – mechanisms, management, and clinical considerations. Circulation. 2016;133(24):2459–2502. doi:10.1161/CIRCULATIONAHA.116.022194.
Kitzman DW, Shah SJ. The HFpEF obesity phenotype: the elephant in the room. J Am Coll Cardiol. 2016;68(2):200–203. doi:10.1016/j.jacc.2016.05.019.
García-Carro C, Vergara A, Bermejo S, et al. A nephrologist perspective on obesity: from kidney injury to clinical management. Front Med (Lausanne). 2021;8:655871. doi:10.3389/fmed.2021.655871.
Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753–2786. doi:10.2337/dci22-0034.
Lind M, Imberg H, Coleman RL, et al. Historical HbA1c values explain type 2 diabetes legacy effect: UKPDS 88. Diabetes Care. 2021;44(10):2231–2237. doi:10.2337/dc20-2439.
Burke GL, Bertoni AG, Shea S, et al. The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis. Arch Intern Med. 2008;168(9):928–935. doi:10.1001/archinte.168.9.928.
Mendis S, Puska P, Norrving B. Global Atlas on cardiovascular disease prevention and control. World Health Organization, Geneva 2011.
Wegovy® [summary of product characteristics]. Bagsværd, Denmark: Novo Nordisk A/S; April 2024.
Rybelsus® [summary of product characteristics]. Bagsværd, Denmark: Novo Nordisk A/S; March 2024.
Ozempic® [summary of product characteristics]. Bagsværd, Denmark: Novo Nordisk A/S; March 2024.
Garvey WT, Batterham RL, Bhatta M, et al. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial. Nat Med. 2022;28(10):2083–2091 and supplementary appendix. doi:10.1038/s41591-022-02026-4.
Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. doi:10.1056/ NEJMoa2032183.
Rosenstock J, Allison D, Birkenfeld AL, et al. Effect of additional oral semaglutide vs sitagliptin on glycated hemoglobin in adults with type 2 diabetes uncontrolled with metformin alone or with sulfonylurea: the PIONEER 3 randomized clinical trial. JAMA. 2019;321(15):1466–1480. doi:10.1001/jama.2019.2942.
Pratley R, Amod A, Hoff ST, et al. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. Lancet. 2019;394(10192):39–50 and supplementary appendix. doi:10.1016/S0140-6736(19)31271-1.
Pratley RE, Aroda VR, Lingvay I, et al. SUSTAIN 7 Investigators. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018;6(4):275–286. doi:10.1016/S2213-8587(18)30024-X.
Marso SP, Bain SC, Consoli A, et al. SUSTAIN-6 Investigators. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375(19):1834–1844. doi:10.1056/NEJMoa1607141.