Sustain 6: A post-hoc analysis of the effect of semaglutide on cardiovascular outcomes over time in subjects with type 2 diabetes

Abstract

Introduction: Semaglutide is a once weekly glucagon-like peptide-1 analogue in development for treatment of type 2 diabetes (T2D). SUSTAIN 6, a 2-year, cardiovascular (CV) outcomes, randomised, placebo-controlled trial, was conducted in 3297 adults with T2D at high CV risk. Semaglutide (0.5 or 1.0 mg) added to standard care led to a significant 26% reduction (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.58-0.95) in risk of the primary outcome (CV death, non-fatal myocardial infarction [MI] or non-fatal stroke) vs placebo, driven by reductions in non-fatal MI (26%; HR 0.74; 95% CI 0.51-1.08) and non-fatal stroke (39%; HR 0.61; 95% CI 0.38-0.99). We explored the effect of semaglutide on the primary outcome over time to help support mechanistic understanding by evaluating if there is evidence of a weakened, strengthened or constant treatment effect during the trial.