Efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes: A subgroup analysis by baseline variables in the PIONEER 9 and PIONEER 10 trials

Aims/Introduction To assess the impact of baseline characteristics on the efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes. Materials and Methods In the Peptide InnOvatioN for Early diabEtes tReatment (PIONEER) 9 and 10 trials, Japanese patients were randomized to once-daily oral semaglutide (3, 7, or 14 mg) or a comparator (placebo or once-daily subcutaneous liraglutide 0.9 mg in PIONEER 9; once-weekly subcutaneous dulaglutide 0.75 mg in PIONEER 10) for 52 weeks, with 5 weeks of follow up. An exploratory analysis grouped patients in each trial according to baseline glycated hemoglobin (HbA(1c); <= 8.0, >8.0-<= 9.0, or >9.0%), body mass index (<25, >= 25-<30, or >= 30 kg/m(2)) and, for PIONEER 10 only, by background medication (sulfonylurea, glinide, thiazolidinedione, alpha-glucosidase inhibitor, sodium-glucose cotransporter 2 inhibitor). Efficacy (changes from baseline to week 26 in HbA(1c) and bodyweight) and safety were assessed. Results Seven hundred and one patients were included (PIONEER 9: N = 243; PIONEER 10: N = 458). In both trials, HbA(1c) reductions increased as baseline HbA(1c) increased; there were no other apparent patterns between the variables investigated and HbA(1c) or bodyweight changes. There was one statistically significant subgroup interaction between baseline HbA(1c) and estimated treatment differences in bodyweight change for oral semaglutide 14 mg versus placebo in PIONEER 9 (P = 0.0286). Baseline HbA(1c), baseline body mass index and background medication did not appear to affect the proportions of patients reporting adverse events. Conclusions Oral semaglutide is effective across a range of baseline subgroups of Japanese patients with type 2 diabetes, with no unexpected safety findings.