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▎The content team editor of WuXi AppTec.
Overweight or obesity is an important factor leading to type 2 diabetes.
For patients who still have poor blood sugar control through healthy diet, active exercise, and medication, a breakthrough treatment option is expected.
Today, "The Lancet" recently published online an important research breakthrough of semaglutide in patients with type 2 diabetes.
In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients.
The weight loss effect brought by in.
At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
Screenshot source: The Lancet This is also the third time that the STEP series of semaglutide has won the top medical academic journal in one month.
In the STEP-1 trial published in the New England Journal of Medicine (NEJM) and the STEP-3 trial published in the Journal of the American Medical Association (JAMA), the 68-week Somaru was targeted at people without diabetes but overweight and obesity.
Peptide therapy combined with diet and exercise intervention can reduce body weight by 15kg-17kg.
"These results are exciting and are close to the effects we have observed in invasive (metabolic) surgery.
This represents a new era in weight management for patients with type 2 diabetes, and marks a shift in the treatment model for obesity.
" According to one author, Professor Melanie Davies, co-director of the University of Leicester's Diabetes Center.
Image source: 123RF This global multi-center trial was conducted in 149 clinical centers in 12 countries and regions in North America, Europe, South America, the Middle East, South Africa and Asia, and included 1,210 patients with type 2 diabetes.
These patients with type 2 diabetes have an average course of up to 8 years.
Under the current treatment, their blood sugar control is poor (glycated hemoglobin [HbA1c] 7%-10%), and their body mass index (BMI) exceeds the standard (≥27 kg/m2), and their average weight 99.
8 kg, with an average BMI of 35.
7 kg/m2.
Patients were divided into groups of 1:1:1 to receive semaglutide 2.
4 mg (a trial dose for weight management), semaglutide 1.
0 mg (a dose approved for the treatment of type 2 diabetes), or placebo.
Semaglutide is injected subcutaneously once a week for 68 weeks.
The patients also received lifestyle interventions.
They were required to eat 500 calories less than before the test, exercise 150 minutes a week, and receive consultation visits every four weeks.
Patient compliance is good.
In fact, 87% of patients completed the treatment and 96% completed all the trial links.
24 patients received obesity salvage treatment (4 patients in the semaglutide 2.
4 mg group, 7 patients in the semaglutide 1.
0 mg group, and 13 patients in the placebo group), and 1 patient in the placebo group underwent bariatric surgery .
The results at 68 weeks showed that semaglutide 2.
4 mg compared with semaglutide 1.
0 mg or placebo, the average weight loss effect was more significant and statistically significant.
According to the treatment allocation, the weight of patients in the semaglutide 2.
4 mg group, semaglutide 1.
0 mg group and placebo group was reduced by 9.
6%, 7.
0%, and 3.
4%, respectively.
According to the actual treatment, the weight of patients in the semaglutide 2.
4 mg group, semaglutide 1.
0 mg group and placebo group was reduced by 10.
6%, 7.
6% and 3.
1%, respectively.
▲A-The average weight change of each group during the trial period (assigned by treatment group, regardless of whether treatment is stopped or other interventions) and B- during the actual treatment period (receiving trial treatment).
(Picture source: Reference [1]) According to treatment allocation, more than two-thirds of patients in the semaglutide 2.
4 mg group lost ≥5%, which was higher than the other two groups (68.
8% vs 57.
1% vs 28.
5%) The odds of weight loss ≥5% after treatment with semaglutide 2.
4 mg were 1.
62 times that of 1.
0 mg treatment and 4.
88 times that of placebo treatment.
This data reached the primary endpoint of the trial.
Similarly, more than 45%, 25%, and 10% of patients in the 2.
4 mg semaglutide group lost at least 10%, 15%, and 20%, respectively, which was also higher than the other two groups.
▲A-During the trial (distributed by treatment group, regardless of whether treatment is stopped or receiving other interventions) and B-during the actual treatment (receiving trial treatment), the proportion of each group's weight loss by 5%, 10%, 15% and 20%.
(Image source: Reference [1]) Waist circumference (-9.
4 cm vs -6.
7 cm vs -4.
5 cm) and systolic blood pressure (-3.
9 mm Hg vs -2.
9 mm Hg vs -0.
5 mm) of patients in the semaglutide 2.
4 mg group Hg), multiple blood lipid indexes and a series of inflammatory indexes have also improved significantly.
▲The improvement of waist circumference (A) and systolic blood pressure (B) in the three groups (picture source: reference [1]) The blood sugar control of the two semaglutide treatment groups was significantly better.
The HbA1c of the 2.
4 mg semaglutide group, the 1.
0 mg semaglutide group and the placebo group were reduced by 1.
6%, 1.
5%, and 0.
4%, and fasting blood glucose was reduced by 2.
1%, 1.
8%, and 0.
1%, respectively.
28.
6%, 25.
1%, and 7.
1% of the patients in the three groups reported that they took a reduction in the amount of hypoglycemic drugs (dose reduction, dressing change, or withdrawal).
▲The improvement of blood glucose control in the three groups, including HbA1c fasting blood glucose (picture source: reference [1]) Compared with placebo, semaglutide 2.
4 mg also brought greater improvement in physical function scores. In terms of safety, 87.
6% of patients in the semaglutide 2.
4 mg group reported adverse events, and the proportions of the semaglutide 1.
0 mg group and the placebo group were 81.
8% and 76.
9%.
The most common gastrointestinal events, such as nausea, vomiting, diarrhea and constipation, are mostly short-lived, mild to moderate, and recoverable.
Most patients do not stop the drug.
Based on these data, the research team pointed out that for adult patients with overweight or obesity and type 2 diabetes, on the basis of lifestyle intervention, semaglutide 2.
4 mg once a week can bring clinically significant weight loss.
Congratulations on the gratifying results of another STEP trial, and I also look forward to the results of this research to help more diabetic patients achieve the goals of weight management and metabolic health control as soon as possible.
A survey of readers’ interest in new medical perspectives with awards At the beginning of the new year, in order to better understand the medical and health academic information you care about, we invite you to spend 1 minute to fill out the questionnaire.
Participate in the survey for a chance to win prizes.
The questionnaire is anonymous, and the content of the questionnaire does not involve sensitive personal information.
The results of the survey will not be disclosed to the outside world.
They are only used for internal evaluation and serve as an important reference for the content push of this year.
Overweight or obesity is an important factor leading to type 2 diabetes.
For patients who still have poor blood sugar control through healthy diet, active exercise, and medication, a breakthrough treatment option is expected.
Today, "The Lancet" recently published online an important research breakthrough of semaglutide in patients with type 2 diabetes.
In the STEP-2 trial, medication once a week can help overweight or obese type 2 diabetic patients lose an average of nearly 10 kg in weight, and more than a quarter of the patients lose more than 15%, which is much higher than the existing drugs in diabetic patients.
The weight loss effect brought by in.
At the same time, this also significantly improves overall health conditions including blood sugar, blood pressure, and blood lipids.
Screenshot source: The Lancet This is also the third time that the STEP series of semaglutide has won the top medical academic journal in one month.
In the STEP-1 trial published in the New England Journal of Medicine (NEJM) and the STEP-3 trial published in the Journal of the American Medical Association (JAMA), the 68-week Somaru was targeted at people without diabetes but overweight and obesity.
Peptide therapy combined with diet and exercise intervention can reduce body weight by 15kg-17kg.
"These results are exciting and are close to the effects we have observed in invasive (metabolic) surgery.
This represents a new era in weight management for patients with type 2 diabetes, and marks a shift in the treatment model for obesity.
" According to one author, Professor Melanie Davies, co-director of the University of Leicester's Diabetes Center.
Image source: 123RF This global multi-center trial was conducted in 149 clinical centers in 12 countries and regions in North America, Europe, South America, the Middle East, South Africa and Asia, and included 1,210 patients with type 2 diabetes.
These patients with type 2 diabetes have an average course of up to 8 years.
Under the current treatment, their blood sugar control is poor (glycated hemoglobin [HbA1c] 7%-10%), and their body mass index (BMI) exceeds the standard (≥27 kg/m2), and their average weight 99.
8 kg, with an average BMI of 35.
7 kg/m2.
Patients were divided into groups of 1:1:1 to receive semaglutide 2.
4 mg (a trial dose for weight management), semaglutide 1.
0 mg (a dose approved for the treatment of type 2 diabetes), or placebo.
Semaglutide is injected subcutaneously once a week for 68 weeks.
The patients also received lifestyle interventions.
They were required to eat 500 calories less than before the test, exercise 150 minutes a week, and receive consultation visits every four weeks.
Patient compliance is good.
In fact, 87% of patients completed the treatment and 96% completed all the trial links.
24 patients received obesity salvage treatment (4 patients in the semaglutide 2.
4 mg group, 7 patients in the semaglutide 1.
0 mg group, and 13 patients in the placebo group), and 1 patient in the placebo group underwent bariatric surgery .
The results at 68 weeks showed that semaglutide 2.
4 mg compared with semaglutide 1.
0 mg or placebo, the average weight loss effect was more significant and statistically significant.
According to the treatment allocation, the weight of patients in the semaglutide 2.
4 mg group, semaglutide 1.
0 mg group and placebo group was reduced by 9.
6%, 7.
0%, and 3.
4%, respectively.
According to the actual treatment, the weight of patients in the semaglutide 2.
4 mg group, semaglutide 1.
0 mg group and placebo group was reduced by 10.
6%, 7.
6% and 3.
1%, respectively.
▲A-The average weight change of each group during the trial period (assigned by treatment group, regardless of whether treatment is stopped or other interventions) and B- during the actual treatment period (receiving trial treatment).
(Picture source: Reference [1]) According to treatment allocation, more than two-thirds of patients in the semaglutide 2.
4 mg group lost ≥5%, which was higher than the other two groups (68.
8% vs 57.
1% vs 28.
5%) The odds of weight loss ≥5% after treatment with semaglutide 2.
4 mg were 1.
62 times that of 1.
0 mg treatment and 4.
88 times that of placebo treatment.
This data reached the primary endpoint of the trial.
Similarly, more than 45%, 25%, and 10% of patients in the 2.
4 mg semaglutide group lost at least 10%, 15%, and 20%, respectively, which was also higher than the other two groups.
▲A-During the trial (distributed by treatment group, regardless of whether treatment is stopped or receiving other interventions) and B-during the actual treatment (receiving trial treatment), the proportion of each group's weight loss by 5%, 10%, 15% and 20%.
(Image source: Reference [1]) Waist circumference (-9.
4 cm vs -6.
7 cm vs -4.
5 cm) and systolic blood pressure (-3.
9 mm Hg vs -2.
9 mm Hg vs -0.
5 mm) of patients in the semaglutide 2.
4 mg group Hg), multiple blood lipid indexes and a series of inflammatory indexes have also improved significantly.
▲The improvement of waist circumference (A) and systolic blood pressure (B) in the three groups (picture source: reference [1]) The blood sugar control of the two semaglutide treatment groups was significantly better.
The HbA1c of the 2.
4 mg semaglutide group, the 1.
0 mg semaglutide group and the placebo group were reduced by 1.
6%, 1.
5%, and 0.
4%, and fasting blood glucose was reduced by 2.
1%, 1.
8%, and 0.
1%, respectively.
28.
6%, 25.
1%, and 7.
1% of the patients in the three groups reported that they took a reduction in the amount of hypoglycemic drugs (dose reduction, dressing change, or withdrawal).
▲The improvement of blood glucose control in the three groups, including HbA1c fasting blood glucose (picture source: reference [1]) Compared with placebo, semaglutide 2.
4 mg also brought greater improvement in physical function scores. In terms of safety, 87.
6% of patients in the semaglutide 2.
4 mg group reported adverse events, and the proportions of the semaglutide 1.
0 mg group and the placebo group were 81.
8% and 76.
9%.
The most common gastrointestinal events, such as nausea, vomiting, diarrhea and constipation, are mostly short-lived, mild to moderate, and recoverable.
Most patients do not stop the drug.
Based on these data, the research team pointed out that for adult patients with overweight or obesity and type 2 diabetes, on the basis of lifestyle intervention, semaglutide 2.
4 mg once a week can bring clinically significant weight loss.
Congratulations on the gratifying results of another STEP trial, and I also look forward to the results of this research to help more diabetic patients achieve the goals of weight management and metabolic health control as soon as possible.
A survey of readers’ interest in new medical perspectives with awards At the beginning of the new year, in order to better understand the medical and health academic information you care about, we invite you to spend 1 minute to fill out the questionnaire.
Participate in the survey for a chance to win prizes.
The questionnaire is anonymous, and the content of the questionnaire does not involve sensitive personal information.
The results of the survey will not be disclosed to the outside world.
They are only used for internal evaluation and serve as an important reference for the content push of this year.
