Real-world weight loss with injectable semaglutide vs dulaglutide for diabetes.

OBJECTIVE: To compare the real-world effects of weekly injectable semaglutide (Ozempic) vs dulaglutide (Trulicity) on weight loss in an urban, predominantly African American patient sample with type 2 diabetes (T2D). STUDY DESIGN: This retrospective cohort study included adult patients with T2D at an academic internal medicine clinic who were initiated on semaglutide or dulaglutide. METHODS: The primary outcome was the percentage change in actual body weight (ABW) from baseline at 52 weeks. Secondary outcomes included mean weight loss in kg, weight loss of at least 5% and at least 10% at 52 weeks, percentage change in hemoglobin A1c (HbA1c) at 52 weeks, and HbA1c levels of less than 7% and less than 8% at 52 weeks. RESULTS: The percentage change in ABW from baseline at 52 weeks was greater with semaglutide (n = 60) than with dulaglutide (n = 60) (-6.51% vs -1.14%; P = .001). The absolute change in ABW at 52 weeks was greater with semaglutide than with dulaglutide (-15.98 kg vs -4.93 kg; P = .001). More patients using semaglutide achieved weight loss of at least 5% and at least 10% at 52 weeks than those using dulaglutide (≥ 5%: 51.7% vs 25.0%; P = .003; ≥ 10%: 31.7% vs 8.3%; P = .001). A higher percentage of patients using semaglutide than those using dulaglutide achieved an HbA1c less than 7% and less than 8% at 52 weeks (< 7%: 53.3% vs 38.3%; P = .100; < 8%: 78.3% vs 68.3%; P = .220). The absolute change in HbA1c was greater with semaglutide than dulaglutide (-2.15% vs -1.36%; P = .033). CONCLUSIONS: Treatment with semaglutide resulted in a greater reduction in body weight and HbA1c than with dulaglutide in a real-world study of patients with T2D.