RYBELSUS® (semaglutide)

RYBELSUS^® is the only glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a pill, which can deliver HbA_1C reduction with the added benefit of weight loss, helping your patients reduce the risk of long-term complication associated with type 2 diabetes.^1-4

greater HbA1C reduction versus empagliflozin at week 26

Up to 5kg weight loss across key phase 3 trials1-4,a

Demonstrated CV safety and no dose adjustment5,c

^a Across PIONEER 1-5 studies, consistent estimated mean weight reductions were achieved with RYBELSUS^® 14 mg.^1-4

^b Results are from a 52 weeks, randomized, open-label, active-controlled trial in 822 adult patients with type 2 diabetes. Data represent estimated means for trial product estimand.

^c Patients with renal impairment, hepatic impairment, and patients aged ≥65 years.¹

^bResults are from a 52 weeks, randomized, open-label, active-controlled trial in 822 adult patients with type 2 diabetes. Data represent estimated means for trial product estimand.

^* Based on the results of a randomized, double-blind, placebo-controlled, Phase 1 study that investigated the effects of oral semaglutide on energy intake, appetite variables, food preference, control of eating, and body weight in 15 people with type 2 diabetes. Study participants were treated with diet and exercise and/or stable dose of metformin for more than 30 days.¹⁹

All results were statistically significantly greater compared with placebo or active comparator. Sita – sitagliptin.

^a Across PIONEER 1-5 studies, consistent estimated mean weight reductions were achieved with RYBELSUS^® 14 mg.^1-4

Take part in how Novo Nordisk developed the world’s first GLP-1 RA in tablet form

By Dr Lyndon Marc Evans

By Dr Tan Ru San

By Dr Roger Tan

By Dr Lyndon Marc Evans

By Dr Bo Ahrén

By Dr Luis Noronha

By Dr Lyndon Marc Evans

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Rosenstock J, Allison D, Birkenfeld AL, et al. Effect of additional oral semaglutide vs sitagliptin on glycated hemoglobin in adults with type 2 diabetes uncontrolled with metformin alone or with sulfonylurea: the PIONEER 3 randomized clinical trial. JAMA. 2019;321(15):1466-1480.

Rodbard HW, Rosenstock J, Canani LH, et al. Oral semaglutide versus empagliflozin in patients with type 2 diabetes uncontrolled on metformin: the PIONEER 2 trial. Diabetes Care. 2019;42(12):2272-2281.

Aroda VR, Rosenstock J, Terauchi Y, Altuntas Y, Lalic NM, Morales Villegas EC, Jeppesen OK, Christiansen E, Hertz CL, Haluzík M; PIONEER 1 Investigators. PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes. Diabetes Care. 2019 Sep;42(9):1724-1732.

Pratley R, Amod A, Hoff ST, et al. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. Lancet. 2019;394(10192):39-50.

RYBELSUS^® Singapore Prescribing Information; January 2023.

Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanisms of incretin hormone action. Cell Metab. 2013 Jun 4;17(6):819-837.

Chai W, Zhang X, Barrett EJ, Liu Z. Glucagon-like peptide 1 recruits muscle microvasculature and improves insulin's metabolic action in the presence of insulin resistance. Diabetes. 2014 Aug;63(8):2788-99.

Drucker DJ. The biology of incretin hormones. Cell Metab. 2006 Mar;3(3):153-65.

Armstrong MJ, Hull D, Guo K, Barton D, Hazlehurst JM, Gathercole LL, Nasiri M, Yu J, Gough SC, Newsome PN, Tomlinson JW. Glucagon-like peptide 1 decreases lipotoxicity in non-alcoholic steatohepatitis. J Hepatol. 2016 Feb;64(2):399-408.

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Marso SP, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016;375:311–22.

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Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Mol Metab. 2021 Apr;46:101102.

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Yang X, Feng P, Zhang X, Li D, Wang R, Ji C, Li G, Hölscher C. The diabetes drug semaglutide reduces infarct size, inflammation, and apoptosis, and normalizes neurogenesis in a rat model of stroke. Neuropharmacology. 2019 Nov 1;158:107748.

13.

Haddock B, Kristensen KB, Tayyab M, Larsson HBW, Lindberg U, Vestergaard M, Francis S, Jensen BL, Andersen UB, Asmar A. GLP-1 Promotes Cortical and Medullary Perfusion in the Human Kidney and Maintains Renal Oxygenation During NaCl Loading. J Am Heart Assoc. 2023 Feb 7;12(3):e027712.

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Lind M, Imberg H, Coleman RL, Nerman O, Holman RR. Historical HbA1c Values May Explain the Type 2 Diabetes Legacy Effect: UKPDS 88. Diabetes Care. 2021 Jul 7;44(10):2231–7.

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Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000 Aug 12;321(7258):405-12.

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Correa MF, Li Y, Kum HC, Lawley MA. Assessing the Effect of Clinical Inertia on Diabetes Outcomes: a Modeling Approach. J Gen Intern Med. 2019 Mar;34(3):372-378.

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Paul, S.K., Klein, K., Thorsted, B.L. et al. Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes. Cardiovasc Diabetol 14, 100 (2015).

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Wilding JPH. The importance of weight management in type 2 diabetes mellitus. Int J Clin Pract. 2014;68(6):682-691.

19.

Gibbons C, Blundell J, Tetens Hoff S, Dahl K, Bauer R, Baekdal T. Effects of oral semaglutide on energy intake, food preference, appetite, control of eating and body weight in subjects with type 2 diabetes. Diabetes Obes Metab. 2021 Feb;23(2):581-588.

20.

Bain SC, Mosenzon O, Arechavaleta R, et al. Cardiovascular safety of oral semaglutide in patients with type 2 diabetes: Rationale, design and patient baseline characteristics for the PIONEER 6 trial. Diabetes Obes Metab. 2019;21(3):499-508.

21.

Husain M, Birkenfeld AL, Donsmark M, et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2019;381(9):841-851.

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