A multicenter, prospective, real-world study of oral semaglutide in adults with type 2 diabetes in Japanese clinical practice (PIONEER REAL Japan): Subgroup analyses

Aims: HbA[1C] and body weight were assessed across selected subgroups of adults with type 2 diabetes receiving oral semaglutide in clinical practice. Methods: In this non-interventional study, changes in HbA[1C] and body weight to end of study (EoS) and safety were assessed by subgroup: baseline age, body mass index (BMI), type 2 diabetes duration, participants switching from dipeptidyl peptidase-4 inhibitors, and semaglutide dose at EoS. Results: All subgroups experienced reductions in HbA[1C] and body weight. Younger participants had greater reductions in HbA[1C] than older participants (−0.9, −0.7, −0.7, and −0.5 percentage points for participants aged <55, ≥55–<65, ≥65–<75, and ≥75 years, respectively [P = 0.0467]). Shorter type 2 diabetes duration and lower EoS semaglutide dose were associated with greater HbA[1C] reductions (−0.8, −0.7, and −0.6 percentage points with ≤5, >5–≤10, and >10 years' duration, respectively [P < 0.0001]; −1.2, −0.7, and −0.4 percentage points with 3, 7, and 14 mg, respectively [P < 0.0001]). Changes in HbA[1C] were not significantly different across other subgroups. Lower EoS semaglutide dose was associated with greater body weight reductions (−3.8, −2.9, and −2.8 kg with 3, 7, and 14 mg, respectively [P < 0.0001]); body weight reductions were not significantly different across other subgroups. Adverse events were similar between subgroups, except that older subgroups experienced more events. Conclusions: HbA[1C] and body weight decreased across all subgroups, providing insights into oral semaglutide use in clinical practice for individuals with different characteristics in the real-world setting.