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SUSTAIN trial programme (revision 3)

Old revision·21:36, 2 Aug 2024·ForestPlotFinn

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SUSTAIN trial programme
DrugSemaglutide 0.5 and 1.0 mg weekly
IndicationType 2 diabetes
Notable memberSUSTAIN 6, cardiovascular outcomes
Topic infobox · conventions

The SUSTAIN trial programme is the phase 3 series that established weekly semaglutide for type 2 diabetes. Its trials compared semaglutide against placebo and against active comparators including sitagliptin, exenatide extended-release, insulin glargine and dulaglutide.[1]

Across the programme, semaglutide 1.0 mg reduced glycated haemoglobin by roughly 1.5–1.8 percentage points from baseline, with weight reduction of about 4–6 kg — substantially less than the 2.4 mg obesity dose studied in STEP.[1]

Structure of the programme

[edit]
TrialComparatorPrincipal finding
SUSTAIN 1PlaceboHbA1c −1.5% at 1.0 mg
SUSTAIN 2SitagliptinGreater HbA1c and weight reduction
SUSTAIN 3Exenatide extended-releaseGreater HbA1c and weight reduction
SUSTAIN 4Insulin glargineGreater HbA1c reduction, weight loss vs gain
SUSTAIN 6Placebo, CV outcomesMACE HR 0.74 (0.58–0.95)
SUSTAIN 7DulaglutideGreater HbA1c and weight reduction

Active-comparator trials are more informative than placebo trials for a class with several members, and SUSTAIN 7 is one of relatively few head-to-head comparisons within the GLP-1 class.[1]

References

  1. ^ a b c Sorli C, Harashima SI, Tsoukas GM, et al. "Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in type 2 diabetes (SUSTAIN 1)." The Lancet Diabetes & Endocrinology 5(4):251–260 (2017). PMID 28110911.