Endocrine Abstracts

Introduction: During most of the autumn of 2022, the standard maintenance presentation of parenteral semaglutide (1.0 mg for weekly dosage) was temporarily unavailable. Many of the patients using this dose were switched to the standard maintenance dose of oral semaglutide (14 mg daily). The leaflet included with the product specifies that the 14 mg daily oral dose is equivalent to the 0.5 mg parenteral weekly dose, but this is most likely an interpolation, as there are no reported head-to-head comparisons of the comercially available doses of oral and parenteral semaglutide in the literature.

Methods: We obtained data retrospectively from patients with obesity and type 2 diabetes who had switched from 1.0 mg parenteral semaglutide to 14 mg oral, forced by the unavailability of the parenteral presentation. Body weight, BMI, SBP, HbA1c, triglycerides and reported side effects were obtained from the clinical records. The patients answered anonymally a simple web-based questionnaire with two questions: -Their satisfaction with the switch from parenteral to oral semaglutide was: [very high/high/fair/low/very low/no answer]. -Would they switch back to parenteral semaglutide when available [yes/no/no answer]. All patients included gave their informed consent.

Results: 48 patients who had been at least 3 months with parenteral semaglutide 1.0 mg weekly and switched to oral semaglutide 14 mg daily were recruited, with available data in the last month before the switch and new data 2-4 months after the switch. 26 (54%) were female, mean±sd age was 57±13 years, and diabetes duration vas 8.4±6.2 years. There was a non-significant reduction in BMI (-0.3±0.2 kg/m²), in HbA1c (-0.41±0.25%), in SBP (-4±2 mmHg) and a non-significant increase in triglycerides (+16±12 mg/dl). 7 (15%) of the patients reported new or worsened minor gastrointestinal side effects but there were no withdrawals. Reported satisfaction with the switch was 16/18/15/4/0/1 [very high/high/fair/low/very low/no answer]. The intention to switch back was 18/29/1 [yes/no/no answer].

Conclusions: In this group of patients with obesity and type 2 diabetes we did not find inferior results with oral semaglutide 14 mg daily vs. parenteral semaglutide 1 mg weekly. A solid majority of the patients (70%) reported high or very high satisfaction with the switch, and 62% had no intention of switching back. The reported side effects of the switch were infrequent and minor. We conclude that the acceptability of switching parenteral to oral semaglutide was high in our patients, with no apparent inferiority in clinical results.