Evidence mapPaperPMID 42294355Full record

ArticleThe Lancet regional health. Europe2026

Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study.

Franziska S Ulrich, Morten Frost Nielsen, Nicola Napoli, Andrea M Burden

Abstract read
In one paragraph

Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

4 authors.

Franziska S UlrichInstitute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland.
Morten Frost NielsenDepartment of Endocrinology, Odense University Hospital, Odense, Denmark.
Nicola NapoliUnit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy.
Andrea M BurdenInstitute of Pharmaceutical Sciences, ETH Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The SUSTAIN-7 trial demonstrated greater HbA1c and bodyweight reductions with once-weekly semaglutide versus dulaglutide in type 2 diabetes, but strict eligibility criteria limit external validity. We evaluated the comparative real-world effectiveness and safety of these agents in UK primary care. Methods: Using the IQVIA Medical Research Data (IMRD) incorporating data from THIN, a Cegedim Database, we included adults with type 2 diabetes initiating semaglutide or dulaglutide between 01-Jan-2019 and 01-Dec-2022, followed through 30-Jun-2023. Co-primary outcomes were 1-year changes in HbA1c and bodyweight, estimated using a new-user, active-comparator cohort design with marginal structural models and inverse probability of treatment weighting. Treatment heterogeneity was assessed in the primary per-protocol analysis by SUSTAIN-7 trial-eligibility. Safety events were assessed while-on-treatment. Findings: Among 6616 new users, 4636 (70.1%) remained on-treatment and 1980 (29.9%) discontinued early. Semaglutide new users (n = 1901) achieved greater 1-year reductions than dulaglutide new users (n = 2735) in HbA1c (estimated treatment difference [ETD] -0.22 percentage points [95% CI -0.30, -0.15]) and bodyweight (ETD -1.92 kg [95% CI -2.91, -0.93]). While semaglutide's benefits were preserved across the 87.7% (n = 4064) not meeting SUSTAIN-7 trial-eligibility (HbA1c: ETD -0.23 percentage points [95% CI -0.31, -0.15]; bodyweight: ETD -2.01 kg [95% CI -3.07, -0.95]), reductions in HbA1c and bodyweight were greater among trial-eligible individuals (12.3%; n = 572) for both agents (trial-eligible [semaglutide/dulaglutide] versus non-eligible [semaglutide/dulaglutide] individuals, HbA1c: -1.10/-1.02 versus -0.83/-0.60 percentage points; bodyweight: -5.72/-4.18 versus -5.50/-3.49 kg). Early discontinuers showed attenuated treatment effects and higher gastrointestinal event rates than those remaining on-treatment (23.5-26.1 versus 10.6-13.8 per 100 person-years). Interpretation: New users of semaglutide achieved greater reductions in HbA1c and bodyweight than new users of dulaglutide with comparable safety, with benefits preserved across SUSTAIN-7 trial-eligible and non-eligible individuals, supporting preferential use of semaglutide in UK clinical practice. Funding: Swiss National Science Foundation.

Indexed as

Blood pressureBodyweightCardio-renal-metabolicCausal inferenceCohort studyComparative effectiveness and safetyDulaglutideeGFRElectronic medical recordsEpidemiologyGLP-1 receptor agonistHbA1cPrimary careReal-world evidenceSemaglutideTarget trial emulationTreatment heterogeneityType 2 diabetesUnited Kingdom

Identifiers

PMID42294355
PMCPMC13262276

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.