プログラムを見ましたが、今日は初日です。さほど興味深い話はなさそう。ただ海外で、リラグリチド（ビクトーザ）の常量量が1日量で１．２ｍｇだという事は、ちょっと驚きでした。ただし、経口糖尿病薬も、１~３剤、併用しての話なので、血糖コントロールを達成するだけなら、それで、十分なのでしょう。

体重減少は、明らかにセマグルタイドのほうが強いのですが、ポイントは「脱落率」です。 The proportion of subjects with TEAEs leading to premature treatment discontinuation was 11.4% with semaglutide and 6.6% with liraglutide; 7.6% and 3.8% discontinued due to GI AEs.　。つまり、１週間に１回のGLP1製剤のほうが、ビクトーザ１．２ｍｇよりも、約２倍のドロップアウトをだしている、脱落している、気分不快で継続できない、という事も知られています。

私の意見では、１週間に１回、注射しただけで、その１週間の食事摂取量をぐんと抑えることが楽しいでしょうか？　日本人には向かないかも。日本人は日々、違った食事を楽しみたがりますよね。１週間、同じような食生活をしている民族ならそれでもいいかもしれません。いずれにせよ、１週間に１回のGLP1製剤は、気分を不快にし、悪心、嘔吐を強くするようです。

気分不快、悪心を利用するダイエットなら、バイエッタのほうが、遙かに安くできて、安全なダイエット治療薬とも言えるかもしれません。サクセンダ２．４ｍｇ、３．０ｍｇもしかりです。ともかく、セマグルタイドが、抗肥満薬として承認されるかは、微妙ですね。

１７日、欧州糖尿病学会、初日のレポートから。

☆☆☆☆☆☆☆☆

Efficacy and safety of semaglutide 1.0 mg once weekly vs liraglutide 1.2 mg once daily as add-on to 1-3 oral glucose-lowering drugs in subjects with type 2 diabetes (SUSTAIN 10)
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Authors
M.S. Capehorn1, A.-M. Catarig2, J.K. Furberg2, A. Janez3, H.C. Price4, S. Tadayon2, B. Vergès5, M. Marre6;
1Rotherham Institute for Obesity, Clifton Medical Centre, Rotherham, UK, 2Novo Nordisk A/S, Søborg, Denmark, 3Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia, 4West Hampshire Community Diabetes Service, Lyndhurst, UK, 5CHU, Dijon, France, 6Bichat-Claude Bernard Hospital, Paris, France.
Disclosures
M.S. Capehorn: Grants; NovoNordisk, Novartis, BI, Eli Lilly, GSK, Leo, Abbott. Honorarium; NovoNordisk, BI, Eli Lilly, Janssen, MSD. Lecture/other fees; Lighterlife, NovoNordisk, BI, Eli Lilly, Janssen. Stock/Shareholding; Partner of Clifton Medical Centre, Director of RIO Weight Management Ltd.
Abstract
Background and aims: Semaglutide and liraglutide are glucagon-like peptide-1 analogues for the treatment of type 2 diabetes (T2D). SUSTAIN 10 compared the efficacy and safety of the anticipated most frequent semaglutide dose (1.0 mg) vs the most frequently prescribed liraglutide dose in Europe (1.2 mg).
Materials and methods: In this phase 3b, open-label trial, 577 adults with T2D (HbA1c 7.0-11.0%) on 1-3 oral glucose-lowering drugs (metformin, sulphonylurea, sodium-glucose cotransporter-2 inhibitors) were randomised 1:1 to semaglutide 1.0 mg once weekly or liraglutide 1.2 mg once daily, both administered subcutaneously. Primary and confirmatory secondary endpoints were change in HbA1c and body weight, respectively, from baseline to week 30. Supportive secondary efficacy endpoints included other glycaemic and weight parameters. Treatment satisfaction (change from baseline in Diabetes Treatment Satisfaction Questionnaire status version [DTSQs] scores) was also assessed.
Results: Mean HbA1c (baseline 8.2%) decreased by 1.7%-point with semaglutide vs 1.0%-point with liraglutide (estimated treatment difference [ETD] -0.69%-point; 95% CI -0.82 to -0.56; p<0.0001; Table); 80.4% vs 45.9% of subjects achieved HbA1c <7.0% (odds ratio [OR] 5.98; p<0.0001) and 58.5% vs 24.8% achieved HbA1c ≤6.5% (OR 4.84; p<0.0001). Mean body weight (baseline 96.9 kg) decreased by 5.8 kg with semaglutide vs 1.9 kg with liraglutide (ETD -3.83 kg; 95% CI -4.57 to -3.09; p<0.0001); 55.9% vs 17.7% of subjects achieved weight loss ≥5% (OR 5.89; p<0.0001) and 19.1% vs 4.4% achieved weight loss ≥10% (OR 4.99; p<0.0001). HbA1c <7.0% without severe or blood glucose-confirmed symptomatic hypoglycaemia and no weight gain was achieved by 75.6% of subjects on semaglutide and 36.8% on liraglutide (OR 6.07; p<0.0001). The DTSQs summary score improved in both treatment arms (ETD 0.63; p=0.0814). Overall, 70.6% and 66.2% of exposed subjects reported treatment-emergent adverse events (TEAEs) with semaglutide and liraglutide, respectively; 5.9% and 7.7% reported serious TEAEs. No fatal TEAEs were reported. The most frequently reported TEAEs with semaglutide (43.9%) and liraglutide (38.3%) were gastrointestinal (GI) disorders. The proportion of subjects with TEAEs leading to premature treatment discontinuation was 11.4% with semaglutide and 6.6% with liraglutide; 7.6% and 3.8% discontinued due to GI AEs.
Conclusion: Semaglutide 1.0 mg was superior to liraglutide 1.2 mg in reducing HbA1c and body weight. Safety profiles were generally similar, except for a higher proportion of subjects with GI TEAEs with semaglutide.