Analiza učinkovitosti peroralnega in injekcijskega semaglutida pri osebah s sladkorno boleznijo tipa 2

Novak, Neža (author), Žiberna, Lovro (mentor), Lunder, Mojca (comentor)

Sladkorna bolezen tipa 2 (SB2) s spremljajočimi kroničnimi zapleti vodi v slabšo kvaliteto življenja in krajšo pričakovano življenjsko dobo. Zato je dobra urejenost glikemije bistvenega pomena, kar omogoča razpoložljivost različnih skupin antidiabetičnih zdravil. Semaglutid je agonist receptorjev glukagonu podobnega peptida 1 (GLP-1) in se uporablja za zdravljenje SB2. V Evropi je na voljo v obliki podkožne injekcije od leta 2018. Od 2020 je na voljo tudi prvi in trenutno edini agonist receptorjev GLP-1, ki je na voljo v peroralni obliki. Analiza uporabe semaglutida v vsakdanji klinični praksi je izrednega pomena za zanesljivo oceno njegove učinkovitosti in varnosti. Izvedli smo retrospektivno raziskavo, v katero smo vključili 104 osebe s SB2, ki so se spremljale v Diabetološki ambulanti Kliničnega oddelka za endokrinologijo, diabetes in presnovne bolezni Univerzitetnega kliničnega centra Ljubljana v obdobju od januarja 2021 do decembra 2023. Vse osebe so imele predpisan semaglutid, bodisi v peroralni ali injekcijski obliki, pri čemer se je odmerek postopoma stopnjeval do najvišjega možnega odmerka. Preučevali smo vpliv peroralnega in injekcijskega semaglutida na glikemične parametre, telesno maso, indeks telesne mase, krvni tlak in srčno frekvenco; primerjali smo podatke pred uvedbo in vsaj 3 mesece po prejemanju najvišjega odmerka semaglutida. Preverjali smo tudi učinkovitost peroralnega in injekcijskega semaglutida z analizo relativnih sprememb parametrov pred in po uvedbi zdravljenja. Zdravljenje z obema oblikama semaglutida je privedlo do statistično značilnega znižanja glikemičnih parametrov, telesne teže, indeksa telesne mase in sistoličnega krvnega tlaka ter zvišanja srčne frekvence. Injekcijski semaglutid je statistično značilno bolj znižal vrednosti HbA1c v primerjavi s peroralno obliko. Pri primerjavi vpliva na ostale parametre nismo ugotovili statistično značilnih razlik med posameznima oblikama semaglutida. Zaključimo lahko, da je učinkovitost peroralnega semaglutida v vsakdanji klinični praksi v veliki meri primerljiva z učinkovitostjo injekcijskega semaglutida.

• Language: Slovenian
• Keywords: sladkorna bolezen tipa 2, agonisti receptorjev glukagonu podobnega peptida 1, GLP-1, semaglutid, farmacevtske oblike
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2025
• PID: 20.500.12556/RUL-167335
• Publication date in RUL: 15.02.2025

Secondary language

• Language: English
• Title: Efficacy analysis of oral and injectable semaglutide in persons with type 2 diabetes

Abstract

Type 2 diabetes mellitus (T2DM) with accompanying chronic complications diminishes the quality of life and shortens life expectancy. Consequently, achieving and maintaining good glycemic control is essential, supported by the availability of diverse groups of antidiabetic drugs. Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is a prominent treatment option for T2DM. It has been available in Europe as a subcutaneous injection since 2018. From 2020 it is also the first and currently only oral GLP-1 receptor agonist. The evaluation of semaglutide's application in routine clinical practice is crucial for reliably assessing its efficacy and safety. In our retrospective study we included 104 individuals with T2DM who were monitored at the Diabetology Outpatient Clinic of the Clinical Department of Endocrinology, Diabetes and Metabolic Diseases at the University Clinical Center Ljubljana from January 2021 to December 2023. All participants were prescribed semaglutide, either in oral or injectable form, with dosages progressively escalated to the maximum dose. We analyzed the effects of oral and injectable semaglutide on glycemic parameters, body weight, body mass index, blood pressure and heart rate prior to treatment initiation and at least 3 months after receiving the maximum dose of semaglutide. We also compared oral and injectable semaglutide with the analysis of relative changes in these parameters before and after the initiation of treatment. Treatment with both forms of semaglutide led to statistically significant reductions in glycemic parameters, body weight, body mass index and systolic blood pressure, and an increase in heart rate. Injectable semaglutide demonstrated a significantly greater reduction in HbA1c levels compared to oral semaglutide. No statistically significant differences were observed between the two forms regarding their impact on other studied parameters. Our findings suggest that the efficacy of oral semaglutide in everyday clinical practice is largely comparable to that of injectable semaglutide.

• Keywords: type 2 diabetes, glucagon-like peptide 1 receptor agonists, GLP-1, semaglutide, pharmaceutical forms