Novo Nordisk announces new oral treatment for type 2 diabetes

Novo Nordisk announces first oral tablet to treat type 2 diabetes

Novo Nordisk has announced that Rybelsus® (semaglutide tablets), the world’s first and only oral GLP1-RA treatment for type 2 diabetes (T2D), is now available in the UK. After 15 years of research and innovation and investment from Novo Nordisk of approximately £1.8 million in clinical R&D, this new GLP-1 RA treatment can help people with T2D achieve their target blood sugar, with the additional benefit of weight loss, with a convenient once-daily tablet.

Until now, GLP-1 RA treatments were only available as injections, which is a barrier to adherence for patients and is also a barrier to prescribing for GPs. As a pill, Rybelsus® can make it easier and quicker for patients to be initiated on a GLP-1 RA in primary care, without the burden of teaching injection technique. It could even be prescribed remotely, helping to reduce the risk of COVID-19 transmission from face-to-face appointments.

In clinical trials, people with T2D treated with Rybelsus® 14 mg achieved significantly greater HbA1c (blood sugar) reduction compared to commonly used treatments in the UK, with the additional benefit of consistent weight loss.

In the PIONEER clinical development programme, oral semaglutide 14mg demonstrated significantly greater HbA1c reduction at one year*, with the additional benefit of consistent weight reduction, versus treatments used in the UK: sitagliptin, empagliflozin and liraglutide.1,2,3,4 In addition, up to 7 out of 10 patients achieved target blood sugar (HbA1c) of <53 mmol/mol (7%) with oral semaglutide.1 These data reveal the benefits of this effective new treatment option, as despite the number of treatments currently available, 40% of adults with T2D in the UK fail to achieve target blood sugar of ≤7%.1 This puts them at increased risk of diabetes-related complications.1

The link between diabetes and worse COVID-19 outcomes has elevated the importance of managing key drivers of uncontrolled T2D including blood sugar and weight, both of which may have been negatively impacted during lockdown.2,3

Rybelsus® (semaglutide tablets), an analogue of the naturally occurring hormone glucagon-like peptide-1 (GLP-1), is the first and only GLP-1 RA in a pill.1 For 15 years, Novo Nordisk has been researching a way to deliver GLP-1 RA treatment in a pill, without the protein being broken down by stomach acid. Novo Nordisk has formulated semaglutide (previously only available as a once-weekly subcutaneous injection) with an absorption enhancer (SNAC), which allows it to be taken orally and absorbed from the stomach.4 In the EU and UK, Rybelsus® is indicated for the treatment of adults with insufficiently controlled T2D, to improve glycaemic control as an adjunct to diet and exercise 1

As monotherapy when metformin is considered inappropriate due to intolerance or contraindications. In combination with other medicinal products for the treatment of diabetes

It is administered once daily and is approved for use in two maintenance dosages, 7 mg and 14 mg. The starting dose is 3 mg daily for 4 weeks.

References

1 de Pablos-Velasco P, Parhofer K, Bradley C et al. Current Level of Glycaemic Control and Its Associated Factors in Patients With Type 2 Diabetes Across Europe: Data From the PANORAMA Study. Clin Endocrinol. 2014 ;80(1):47-56
2 Valabhji J et al. Type 1 and Type 2 Diabetes and COVID-19 related mortality in England: a whole population study [COVID-19 and Diabetes Paper 1]. NHS England. Available at: https://www.england.nhs.uk/publication/type-1-and-type2-diabetes-and-covid-19-related-mortality-in-england/ Lass accessed: June 2020
3 Hartmann-Boyce J, et al. Diabetes and COVID-19: Risks, Management, and Learnings From Other National Disasters. Diabetes Care 2020;43:1695–1703 | https://doi.org/10.2337/dc20-1192
4 Buckley et al. Transcellular stomach absoption of a derivatized glucagon-like peptide-1 receptor agonist. Science Translational Medicine. 10, eaar7047 (2018)