Endocrine Abstracts

Introduction: Oral semaglutide (Rybelsus; Novo Nordisk) is the first glucagon-like peptide-1 receptor agonist (GLP-1 RA) developed for oral administration for the treatment of type 2 diabetes (T2D), and it has been approved by the US Food and Drug Administration and the European Medicines Agency. The efficacy and safety of oral semaglutide were assessed in the (PIONEER) program.

Aim: The purpose of this study was to investigate the initial patterns of routine clinical use of oral semaglutide, as well as the clinical features and glycemic control, and weight of patients.

Method: a retrospective, observational cohort study utilizing retrieved electronic medical records involved database search of 28 patients for the demographic parameters at the index date, as well as baseline co-morbidities, antidiabetic drugs, and HbA1c. Baseline and after 1-month, weight and FBS levels were determined for patients with relevant data. For inclusion, adult patients (aged<18 years) required a diagnosis of T2D and at least one prescription for oral semaglutide. Patients with type 1 diabetes or gestational diabetes were excluded. The results were analyzed using MS Excel.

Result: Although the medical instructions recommend raising the dose to 7 mg after 30 days, 64.3 percent of patients obtained a prescription solely for the initial 3 mg dose. The mean body mass index was 36.2 kg/m² n, and the mean HbA1c level was 9.1%. The mean change in FBS from baseline to about one month after initiating oral semaglutide was 6.3%, with more significant reductions in those with higher baseline FBS. The average weight loss was 2.3 kg, significantly more significant in patients with a higher baseline BMI.

Discussion: Our data demonstrates early trends in the use of oral semaglutide in routine clinical practice. Oral semaglutide initiators have a high prevalence of obesity and other co-morbidities, a varied treatment history, and improved glycemic control following therapy initiation. The relatively high number of patients allocated 3 mg as their maximum dose shows that, in patients who tolerate oral semaglutide well, dose escalation to 7 and 14 mg, as indicated, may result in even more significant glycemic control improvements. These findings emphasize the critical nature of bridging existing treatment and knowledge gaps in order to maximize the potential of oral GLP-1 RA therapy. Further examination of real-world data will give more information on the translation, uptake, and impact of such breakthroughs in standard treatment.