The SA Journal Diabetes & Vascular Disease Volume 18 No 2 (November 2021)

VOLUME 18 NUMBER 2 • November 2021 25 SA JOURNAL OF DIABETES & VASCULAR DISEASE Diabetes news Novo Nordisk launches once-weekly Ozempic ® for the treatment of type 2 diabetes in South Africa Diabetes News O zempic ® (once-weekly semaglutide), Novo Nordisk’s latest innovation in diabetes management, provides superior and clinically meaningful reductions in blood glucose and body weight, in addition to proven cardiovascular benefits in people living with type 2 diabetes. 1-5 Novo Nordisk recently announced that Ozempic ® (once-weekly semaglutide), a treatment for type 2 diabetes, is now available in South Africa. Alongside diet and exercise, Ozempic ® is a once weekly glucagon-like peptide 1 (GLP-1) indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise, as monotherapy when metformin is considered inappropriate due to intolerance or contraindications to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease. 6 ‘I see many type 2 diabetes patients in my clinic weekly, many of them are not controlled. The reasons range from underestimating the severity of their condition, to patients remaining on their initial diabetes medication for too long, which leads to complications. These complications can be life threatening and permanent.’ said Dr Bayat, endocrinologist. Approval of Ozempic ® in South Africa is based on results from the SUSTAIN clinical programme, a global clinical development programme comprising 10 phase 3 trials, including more than 10 000 adults with type 2 diabetes. Results from the trials consistently demonstrated superior reductions in blood sugar and body weight versus all comparators. 1-4,7-9 Up to 80% of people treated with Ozempic ® achieved the American Diabetes Association (ADA) treatment target of HbA 1c levels below 7.0%. 1-4,7-9 In a two-year cardiovascular outcomes trial, once-weekly Ozempic ® reduced cardiovascular risk by 26% versus placebo, when added to standard of care in subjects with high cardiovascular risk. 5 ‘We are proud that Ozempic ® is now available to treat type 2 diabetes in South Africa as it reiterates Novo Nordisk’s commitment to bring life-saving treatment to patients’ said Mr Venkat Kalyan, vice president and general manager of Novo Nordisk South Africa. ‘Ozempic ® is the only once-weekly anti-diabetes treatment that unifies superior efficacy and cardiovascular benefits; and we believe the clinical profile of Ozempic ® may help in meeting the real and serious needs of those living with this condition. When type 2 diabetes is well managed, the risk of life-limiting and potentially fatal complications can be reduced.’ Kalyan concluded. About Ozempic ® Ozempic ® (once-weekly semaglutide) is a new analogue of human glucagon-like peptide 1 (GLP-1) that has been developed for the treatment of type 2 diabetes. Ozempic ® stimulates insulin and supresses glucagon secretion in a glucose-dependent manner, while decreasing appetite and food intake. 10-13 It also reduces cardiovascular risk by modifying the progression of atherosclerosis (the build up of fatty deposits in the arteries), as well as by reducing blood pressure, lipid levels and weight. 5,14,15 Across the SUSTAIN clinical trial programme, Ozempic ® was shown to be safe and well tolerated. 1-5,7,8 The most frequently reported adverse reactions were gastrointestinal disorders, including nausea,diarrhoea and vomiting. 1-5,7,8 In general, these reactions were mild or moderate in severity and transient in nature. 1-5,7,8 For information about Ozempic ® , including important safety information, please contact Novo Nordisk’s medical department. References 1. AhrénB,Masmiquel L, Kumar H, et al. Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as an add-on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): A 56-week, double-blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol 2017; 5 : 341–354. 2. Ahmann AJ, Capehorn M, Charpentier G, et al. Efficacy and safety of once-weekly semaglutide versus exenatide ER in subjects with type 2 diabetes (SUSTAIN 3): A 56-week, open-label, randomized clinical trial. Diabetes Care 2018; 41 : 258–266. 3. Aroda VR, Bain SC, Cariou B, et al. Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): A randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial. Lancet Diabetes Endocrinol 2017; 5 : 355–366. 4. Pratley RE, Aroda VR, Lingvay I, et al. Semaglutide once weekly versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open- label, phase 3b trial. Lancet Diabetes Endocrinol 2018. 5. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375 : 1834–1844. 6. Ozempic ® South Africa PI. 7. Sorli C, Harashima SI, Tsoukas GM, et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, parallel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol 2017; 5 : 251–260. 8. Rodbard HW, Lingvay I, Reed J, et al. Semaglutide added to basal insulin in type 2 diabetes (SUSTAIN 5): a randomised, controlled trial. J Clin Endocrinol Metab 2018. ePub ahead of print. DOI: 10.1210/jc.2018-00070. 2018. 9. Capehorn M, Janez A, Price H, et al. Efficacy and safety of semaglutide 1.0 mg once weekly vs liraglutide 1.2 mg once daily as add‐on to 1-3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Abstract presented at the Diabetes UK Conference 2019, Liverpool. 10. Korsatko A, Brunner M, Sach-Friedl S, et al. Effect of once-weekly semaglutide on the counter-regulatory response to hypoglycaemia in subjects with type 2 diabetes. Abstract 764. 52nd Annual Meeting of the European Association for the Study of Diabetes (EASD), Munich, Germany; 12-16 September 2016. 11. Kapitza C, Dahl K, Jacobsen JB, et al. Effects of semaglutide on beta-cell function and glycaemic control in participants with type 2 diabetes: a randomised, double- blind, placebo-controlled trial. Diabetologia 2017; 60 : 1390–1399. 12. Blundell J, Finlayson G, Axelsen M, et al. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes Obes Metab 2017; 19 : 1242–1251. 13. Hjerpsted JB, Flint A, Brooks A, et al. Semaglutide improves postprandial glucose and lipid metabolism, and delays first-hour gastric emptying in subjects with obesity. Diabetes Obes Metab 2018; 20 : 610–619. 14. Drucker DJ. The cardiovascular biology of glucagon-like peptide-1. Cell Metab 2016; 24 (1): 15–30. 15. Rakipovski G, Rolin B, Kirk R, et al. Long acting GLP-1 receptor agonists, semaglutide and liraglutide protect against development of atherosclerosis in animal models independent of body weight lowering effects. Presented at the 77th Scientific Sessions of the American Diabetes Association, 9-13 June 2017, San Diego, USA: Oral 244- OR.