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

Among 1864 adults, oral semaglutide (7 mg/d and 14 mg/d), vs sitagliptin, resulted in significantly greater reductions in HbA1c over 26 weeks (differences from baseline, -0.3% and -0.5%, respectively; p<0.001 for both). No significant benefit was noted with 3-mg/d dosage.

A related editorial notes that the introduction of semaglutide, an investigational oral preparation of a glucagon-like peptide-1receptor agonists (GLP-1RAs), could be an important addition to the growing list of pharmacological options for type 2 diabetes. However, potential benefit may be limited by its high cost.

In the US, semaglutide has been filed for regulatory approval for blood sugar control and cardiovascular risk reduction in adults with type 2 diabetes.

In UK, semaglutide is currently only available as an injection for the treatment of adults with insufficiently controlled type 2 diabetes mellitus