Evidence mapPaperPMID 34277983Full record

ArticleEndocrinology, diabetes & metabolism2021

A population-adjusted indirect comparison of cardiovascular benefits of once-weekly subcutaneous semaglutide and dulaglutide in the treatment of patients with type 2 diabetes, with or without established cardiovascular disease.

Lyndon Marc Evans, Linda Mellbin, Pierre Johansen, Jack Lawson, Abby Paine, Anna Sandberg

Registry-linked trialOpen access · goldFull text read
In one paragraph

Article in Endocrinology, diabetes & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT02692716. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02692716 phase3completed

A Trial Investigating the Cardiovascular Safety of Oral Semaglutide in Subjects With Type 2 Diabetes

Ran2017Enrolled3,183Registered outcomes18Posted comparisons13ConditionsDiabetes, Diabetes Mellitus, Type 2ArmsPlacebo, semaglutide
Open the trial in the graph
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Review
  3. Observational
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Lyndon Marc EvansCardiff and Vale University Cardiff UK.ORCID 0000-0003-0671-0778
Linda MellbinDepartment of Medicine Solna Karolinska Institutet Stockholm Sweden.
Pierre JohansenNovo Nordisk A/S Søborg Denmark.ORCID 0000-0002-6287-7508
Jack LawsonNovo Nordisk A/S Søborg Denmark.
Abby PaineZedediah Consulting on behalf of DRG Abacus (part of Clarivate) Wokingham UK.ORCID 0000-0002-2332-1099
Anna SandbergNovo Nordisk A/S Søborg Denmark.
Novo Nordisk (Denmark) · DKABS Consulting (United States) · USCardiff and Vale University Health Board · GBKarolinska Institutet · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCardiovascular (CV) effects of once-weekly subcutaneous (s.c.) semaglutide 0.5 and 1 mg and dulaglutide 1.5 mg are reported in their respective placebo-controlled cardiovascular outcome trials (CVOTs), SUSTAIN 6 and REWIND. There is no head-to-head CVOT comparing these treatments and heterogeneity between their CVOTs renders conventional indirect comparison inappropriate. Therefore, a matching-adjusted indirect comparison (MAIC) was performed to compare the effects of s.c. semaglutide and dulaglutide on major adverse cardiovascular events (MACE) in patients with and without established cardiovascular disease (CVD).

methodsIndividual patient data from SUSTAIN 6 were matched with aggregate data from REWIND, using a propensity score method to balance baseline effect-modifying patient characteristics. Hazard ratios (HRs) for three-point (3P) MACE (CV death, non-fatal myocardial infarction, non-fatal stroke), anchored via placebo, were then indirectly compared between balanced populations. Sensitivity analyses were performed to test the robustness of the main analysis.

resultsAfter matching, included effect modifiers were balanced. In the main analysis, s.c. semaglutide was associated with a statistically significant 35% reduction in 3P MACE versus placebo (HR, 0.65 [95% confidence interval [CI]; 0.48, 0.87]) and nonsignificantly greater reduction (26%) versus dulaglutide (HR, 0.74 [95% CI; 0.54, 1.01]). Results were supported by all sensitivity analyses.

conclusionsThis study demonstrated a statistically significant lower risk of 3P MACE for s.c. semaglutide versus placebo, in a population with lower prevalence of pre-existing CVD than that in the pre-specified primary analysis in SUSTAIN 6. Reduction in 3P MACE with s.c. semaglutide was greater than with dulaglutide, although not statistically significant.

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Glucagon-Like PeptidesHumansHypoglycemic AgentsImmunoglobulin Fc FragmentsRecombinant Fusion ProteinsSemaglutidedulaglutideGlucagon-Like PeptidesHypoglycemic AgentsImmunoglobulin Fc FragmentsRecombinant Fusion ProteinsSemaglutidecardiovascular risksGLP‐1 receptor agonisttype 2 diabetes

Identifiers

PMID34277983
PMCPMC8279621
OpenAlexW3161793984

What Socratic holds

Textfull text, public
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.