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RYBELSUS® – Semaglutide as the world’s first and only oral GLP-1 analogue

    • Endocrinology and Diabetology
    • RX
  • 3 minute read

People with type 2 diabetes have too little endogenous GLP-1 (glucagon-like peptide 1) or its effect is reduced. Semaglutide, which mimics natural GLP-1, can compensate for this.1,2 It lowers blood glucose, supports weight loss and reduction of cardiovascular burden.1,2,* RYBELSUS® (Semaglutide) is approved in Switzerland as the world’s first and only oral GLP-1 analog for patients with inadequately controlled T2DM.1

When we eat, our intestines produce a substance called GLP-1. This stimulates the secretion of insulin in the pancreas in a glucose-dependent manner and inhibits that of glucagon. In addition, GLP-1 slows gastric emptying, increases the feeling of satiety and centrally regulates cravings. This prevents the blood sugar from rising too high.

In patients with type 2 diabetes, too little GLP-1 is probably released or its effect is impaired, which increases the blood glucose level and subsequently also the long-term blood glucose value HbA1C. The latter is a risk factor for various secondary diseases.

Semaglutide – a modern and potent GLP-1 analogue

Semaglutide is a modern and potent GLP-1 analogue that mimics natural GLP-1.1,2 The optimized active ingredient is degraded in a delayed manner, which prolongs its duration of action and opens up new application possibilities.4 Semaglutide can do the following:

  • It lowers elevated blood glucose in a glucose-dependent manner, thereby significantly lowering patients’ HbA1C.1,2
  • By regulating the feeling of satiety and hunger, it can lead to weight loss.1,2,*

All of this helps patients with inadequately controlled type 2 diabetes and obesity (BMI ≥ 28) achieve their treatment goals and prevent microvascular and macrovascular sequelae thanks to Semaglutide.1,2,* For these patients, a reduction in their cardiovascular burden is of key importance (prevention of myocardial infarction, stroke, etc.).3

The PIONEER 6 clinical trial of the cardiovascular outcome of oral semaglutide demonstrated a numerically reduced cardiovascular risk (vs. placebo).1,5,*

Semaglutide (RYBELSUS®) as the world’s first and only oral GLP-1 analogue

In diabetes therapy, a departure for new shores is now beginning. Since April 2020, RYBELSUS® has been approved by Swissmedic in Switzerland for patients with T2DM, as the world’s first and only oral GLP-1 analog. The good efficacy of Semaglutide is opened up to an even larger group of patients via the simple administration of RYBELSUS®: This allows a choice between a once-daily RYBELSUS® tablet and the once-weekly subcutaneous Ozempic®.1,2 With RYBELSUS® , 7 out of 10 patients achieve a treatment target of HbA1C ≤7 %, with a sustained effect.1 This and the consistent weight loss under RYBELSUS® is significantly better compared to other modern antidiabetic drugs.1,*,**

The individually tunable patient benefit enables the optimization of compliance and thus effective prevention of secondary diseases.6

* RYBELSUS® and Ozempic® are indicated for the treatment of inadequately controlled type 2 diabetes mellitus in addition to diet and exercise, but are not indicated for weight loss or reduction of cardiovascular events.

** Clinical trials showed significantly better glycemic control (baseline HbA1C during study duration) and weight reduction (change in body weight during study duration) for semaglutide vs. placebo (PIONEER 8)1,7, vs. empagliflozin (PIONEER 2)1,8, vs. sitagliptin (PIONEER 3 and PIONEER 7)1,9,10, and vs. liraglutide (PIONEER 4)1,11.

Abbreviations: CVOT: cardiovascular outcome study; GLP-1: glucagon-like peptide 1; T2DM: type 2 diabetes.

References

1. Rybelsus® Professional Information, www.swissmedicinfo.ch.
2. Ozempic® SmPC, www.swissmedicinfo.ch.
3rd SGED/SSED Working Group. Recommendations of the Swiss Society of Endocrinology and Diabetology (SGED/SSED) for the treatment of type 2 diabetes mellitus (2020). Status: January 23, 2020. Available at: https://www.sgedssed.ch/fileadmin/user_upload/6_Diabetologie/61_Empfehlungen_Facharzt/-2020_Swiss_Recomm_Medis_DE_def.pdf, last accessed 05/2020.
4. Lau et al. Discovery of the once-weekly glucagon-like peptide-1 (GLP-1) analogue semaglutide. J Med Chem. 2015; 58:7370-80.
5 Husain et al. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2019;381(9):841-51.
6. Polonsky et al. Patient perspectives on once-weekly medications for diabetes. Diabetes Obes Metab. 2011;13(2):144-9.
7. Zinman et al. Efficacy, Safety, and Tolerability of Oral Semaglutide Versus Placebo Added to Insulin With or Without Metformin in Patients With Type 2 Diabetes: The PIONEER 8 Trial. Diabetes Care. 2019;42(12):2262-71.
8. Rodbard et al. Oral Semaglutide Versus Empagliflozin in Patients With Type 2 Diabetes Uncontrolled on Metformin: The PIONEER 2 Trial. Diabetes Care. 2019;42(12):2272-81.
9. Rosenstock et al. Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. JAMA. 2019;321(15):1466-80.
10 Pieber et al. Efficacy and safety of oral semaglutide with flexible dose adjustment versus sitagliptin in type 2 diabetes (PIONEER 7): a multicentre, open-label, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2019;7(7):528-39.
11 Pratley et al. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. Lancet. 2019;394(10192):39-50.
 
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