Comparison of the clinical efficacy of Semaglutide between DPP4-inhibitor-naive and DPP4-inhibitor-experienced patients in a real world setting in Spain

Miguel Sierra Poyatos Roberto; Jair Cardenas Salas Jersy; Luca Bogdana Luiza; María Sanchez Gomez Nancy; Modroño Mostoles Naiara; Sánchez Lechuga Begoña; Vega Eva Cruces; Jesus Silva Rodriguez Maria; De La Paz Gómez Montes María; Meneses González Diego; Alvarez Teresa Montoya; de los Angeles Velez Romero María; Santos Alicia Estrella; Juaristi Maite Ortega; De Los Angeles Gonzalo Redondo Maria; Martinez Clotilde Vazquez

doi:10.1530/endoabs.73.AEP809

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Endocrine Abstracts (2021) 73 AEP809 | DOI: 10.1530/endoabs.73.AEP809

ECE2021 Audio Eposter Presentations Late Breaking (114 abstracts)

Comparison of the clinical efficacy of Semaglutide between DPP4-inhibitor-naive and DPP4-inhibitor-experienced patients in a real world setting in Spain

Roberto Miguel Sierra Poyatos^{1, 2}, Jersy Jair Cardenas Salas^{1, 3}, Bogdana Luiza Luca¹, Nancy María Sanchez Gomez¹, Naiara Modroño Mostoles³, Begoña Sánchez Lechuga¹, Eva Cruces Vega³, Maria Jesus Silva Rodriguez^{1, 3}, María De La Paz Gómez Montes³, Diego Meneses González¹, Teresa Montoya Alvarez³, María de los Angeles Velez Romero¹, Alicia Estrella Santos¹, Maite Ortega Juaristi¹, Maria De Los Angeles Gonzalo Redondo¹ & Clotilde Vazquez Martinez^{1, 2, 3, 4}

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Author affiliations

¹Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain; ²General Hospital Villalba, Collado Villalba, Spain; ³Hospital Universitario Infanta Elena, Valdemoro, Spain; ⁴Hospital Universitario Rey Juan Carlos, Móstoles, Spain

Introduction

Glucose and weight control effectiveness in patients with Type 2 diabetes (T2D) in treatment with DPP4 inhibitors (DPP4i) that switch to semaglutide is scarce. We aim to assess it in a real-world setting of DPP4i-experienced patients and compare it to DPP4i-naive patients.

Methods

Patients with T2D that were prescribed Once-Weekly semaglutide in 4 hospitals in Madrid-Spain were identified. Patients with another new glucose-lowering-agent prescription and GLP1-experienced patients were excluded. A total of 250 patients were included. The Changes at 6 months of follow up (Paired T-test, Exact McNemar), and comparison between groups (T-test and Chi²) were analysed. A multiple linear regression model to assess HbA1c change in both DPP4i groups (naive vs experienced) adjusted by age, T2D duration, BMI, baseline-HbA1c, insulin use, SGLT2-inhibitors use and semaglutide dose was perfomed.

Results

Baseline weight and BMI was higher in DPP4i-naive group and HbA1c was higher in DPP4i-experienced group. A higher proportion of patients in the DPP4i-naive group had a baseline-HbA1c <7% compared to DPP4i-experienced. There were no other baseline differences (Table 1). At 6 months of follow up boths groups achieved significant reductions in HbA1C, Glucose, weight, BMI and fat mass, but there were no differences between groups. The proportions of patientes that achieved a HbA1c <7% was higher in the DPP4i-naive group (Table-2). Only patients in the DPP4i-naive group achieved a signifficant reduction in insuline dose. After adjusment, the HbA1c reduction in the DPP4i-experienced group was 0.36% lower than in DPP4-naive (IC95%: 0.14% to 0.59%).

**Table 1** Baseline Characteristics
	DPP4i-Naïve n = 153	DPP4i-experienced n = 97
Age(years)	60.1±11.0	62.0±9.5
Male	55.6%	52.6%
T2D duration (years)	9.2±7.4	11.13±7.6
Weight (kg)^ω	100.4±18.4	94.2±13.7
BMI (kg/m²) ^ω	37.0±6.0	34.8±4.1
Metformin treatment	88.2%	82.5%
SGLT2-inhibitors treatment	40.0%	32.0%
Insulin treatment	35.3%	41.2%
HbA1c (%) ^ω	7.6±1.4	8.0±1.3
eGFR(ml/min/1.73 m²)	85.7±20.1	80.2±24.3
HbA1c <7% ^ω	43.1%	22.7%

**Table 2** 6-month Clinical Outcome
	DPP4i-Naive n = 153	DPP4i-experienced n = 97
Glucose(mg/dl)	-29.0 (-37.4 to –20.7)*	–26.1 (–35.4 to –16.9)*
HbA1c (%)	–1.15 (–1.35 to –0.94)*	–0.98 (–1.24 to –0.74)*
Weight (kg)	–5.3 (–6.1 to –4.4)*	–4.0 (–5.1 to –3.0)*
BMI (kg/m²)	–1.9 (–2.3 to –1.6)*	–1.5 (–1.9 to –1.1)*
Fat mass(kg)	–1.54 (–2.84 to –0.24)* n = 54	–1.96 (–3.66 to –0.27)* n = 28
Lean mass(kg)	–0.97 (–2.06 to 0.10) n = 49	+0.25(–1.31 to 1–83) n = 27
HbA1c <7% ^ω	74.5%*	57.7%*
Insuline dose(IU) ^ω	–11.3 (–18.1 to–4.5)*	–0.9(–5.8 to 4.0)
*P<0.05 (6 months vs baseline). ωP <0.05 (DPP4i-Naive vs DPP4i-experienced).