Semaglutide Audit: HbA1c and Weight Changes at 6- and 12-Months Post Commencement

Updated results from the ABCD Semaglutide audit show significant weight reductions at 6 months in GLP1RA-naive individuals, with no significant change at 12 months. Similarly, HbA1c reductions were greater at 6 months for GLP1RA-naive individuals compared to switch individuals, showing significant improvements in both groups over time. The audit aims to collect real-world data on the use of semaglutide in diabetes management, with baseline characteristics indicating a total of 797 patients analyzed from UK centers. Methods included paired t-tests using Stata 16 for analysis.

• Semaglutide
• Audit
• HbA1c
• Weight Changes
• Diabetes

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1. HbA1c and weight changes with semaglutide at 6- and 12- months post commencement: Updated results from the ABCD Semaglutide audit BCT Field, TSJ Crabtree, Adamson3, D Barnes, S Sivappriyan, A. Bickerton, A Gallagher, IW Gallen, I Idris, REJ Ryder; on behalf of ABCD Semaglutide audit contributors 1. Faculty of Medical and Health Sciences, University of Surrey, Guildford, UK, 2. University of Nottingham, Derby, UK, 3. St John's Hospital, Livingston, UK, 4. Maidstone & Tunbridge Wells NHS Trust, Kent, UK, 5. Yeovil District Hospital NHS Trust, Yeovil, UK, 6. University Hospitals of Leicester NHS Trust, Leicester, UK, 7. Royal Berkshire Hospitals NHS Trust, Reading, UK, 8. Diabetes & Endocrinology, Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust, UK, Derby, UK, 9. Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK.

2. Disclosures

3. The ABCD audit programmes The Semaglutide audit first audit launched in 2019 Aims: To collect anonymised routine clinical data for patients taking semaglutide in order to provide real-world data on it s use

4. Methods Data from UK centres within the ABCD audit Those with baseline data and relevant follow-up data were included in the analysis: first return - 3-9 months second return - 9-15 months Total of 797 patients included Analysis conducted in Stata 16 using paired t-tests

5. Baseline characteristics n= Age, mean SD Gender, % male Weight (kg), mean SD BMI (kg/m2), mean SD Diabetes duration (years), median (IQR) HbA1c (%), mean SD HbA1c (mmol/mol), mean SD GLP1RA Na ve 596 59.1 10.3 49.6% 106.7 22.6 37.1 7.5 10.6 (5.9-15.0) 9.5 1.7 79.9 18.7 GLP1RA switch 201 59.2 10.7 50.3% 109.1 24.8 37.9 6.8 13 (9.8-18) 8.9 1.6 73.9 17.8 Total 797 59.2 10.6 49.8% 107.3 23.2 37.3 7.3 10.9 (6.4-14.9) 9.3 1.7 78.4 18.7

6. Figure Weight change, nave vs switch In GLP1RA na ve individuals weight reductions were: 2.2kg (95% CI 1.1-3.3, p<0.0001) greater at 6-months No statistical significance was noted between these groups at 12-months (p=0.07) 6-months 12-months 0 -1 -2 -3 n=489 -4 -5 For both groups over time Significant differences between baseline and 6- and 12-months (P<0.001 for both) No further significant difference between 6- and 12- months n=173 n=199 -6 -7 -8 n=94 -9 GLP1RA Switch GLP1RA Naive All results in figures significant to P<0.05. Error bars showing 95% CI

7. Figures 4 HbA1c change, nave vs switch 6-months 12-months 0 In GLP1RA na ve individuals HbA1c reductions were: 6.1mmol/mol (95% CI 3.0-9.1, p<0.001) greater at 6-months 4.9mmol/mol (95%CI 0.3-9.4, p=0.036) greater by 12-months -2 -4 HbA1c, mmol/mol -6 -8 -10 For both groups over time Significant differences between baseline and 6- and 12-months (P<0.001 for both) No further significant difference between 6- and 12- months -12 n=136 n=79 -14 -16 n=138 n=364 -18 GLP1RA Switch GLP1RA Naive All results in figures significant to P<0.05. Error bars showing 95% CI

8. Discussion Our data suggest that HbA1c reductions associated with semaglutide are observed in the first 6-months and persist at one year Weight lost may continue beyond the initial 6-month period Weight and HbA1c changes may be smaller in those switched from alternative GLP1RA therapies to semaglutide at 6-months For weight (but not HbA1c), these differences no longer exist by 12-months Irrespective of previous GLP1RA use weight and HbA1c reductions are observed and persist at 12-months

9. With thanks to all ABCD nationwide Semaglutide audit contributors! Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham: Magnalita Chatto, Thomas SJ Crabtree, Melissa L Cull, Parijat De, Wenbun Leong, Manjusha Rathi, Robert EJ Ryder Sheffield Teaching Hospital NHS Foundation Trust, Northern General Hospital: Mohummad Shaan Goonoo Shrewsbury and Telford NHS Trust, Royal Shrewsbury Hospital: David Morris University Hospitals Birmingham NHS Foundation Trust, Good Hope Hospital: Barbara Santamarta-Fernandez Hywel Dda University Health Board, Glangwili General Hospital: Lisa Forrest Swansea Bay University Health Board, Neath Port Talbot Hospital: Thinzar Min NHS Lothian, St John's Hospital, Livingston: Karen Adamson, Hazel Reid Northern Health and Social Care Trust, Antrim Area Hospital: Anna Strzelecka Eclipse Users East Sussex and North Essex NHS Foundation Trust: Gerry Rayman Gloucestershire Hospitals NHS Foundation Trust: Alison Evans, Suzanne Phillips Luton & Dunstable Hospital NHS Trust: Shiu-Ching Soo Maidstone and Tunbridge Wells NHS Trust: Dennis Barnes, Siva Sivappriyan Royal Berkshire NHS Foundation Trust, Royal Berkshire Hospital: Ian Gallen Sheffield Teching Hospitals NHS Trust: Jackie Elliott The Norfolk and Norwich NHS Trust: Ketan Dhatariya The Princess Alexandra Hospital NHS Trust: Devesh Sennik The Royal Wolverhampton NHS Trust: Rajeev Raghavan University Hospitals of Leicester NHS Trust: Alison Gallagher West Essex CCG: Anurita Rohilla Yeovil District Hospital NHS Trust: Alex Bickerton Participate: abcd.care/ABCD- nationwide-audits ABCD nationwide Semaglutide audit initial setup, maintenance and nationwide analysis: Ryder, REJ, Gallen I, Crabtree TSJ, Cull ML. Audit maintenance and set-up: Ryder, REJ, Gallen I, Crabtree TSJ, Cull ML. Barts Health NHS Trust, Obesity Clinic, St Bartholomew's Hospital: Anjali Zalin Cambridgeshire and Peterborough NHS Foundation Trust, Healthy Living Centre:: Jonathan Roland East & North Hertfordshire NHS Trust, Lister Hospital: Denise Chilton, Stella George East & North Hertfordshire NHS Trust, The New QE2 Hospital: Samer Alsabbagh Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire Royal Hospital: Yuk-Fun Liu, Suzanne Phillips Guys and St Thomas NHS Foundation Trust, Community, GSTT Intermediate Diabetes Care Team Southwark: Helen Noakes Manchester University NHS Foundation Trust, Manchester Diabetes Centre, Manchester Royal Infirmary: Francesca Dirosa, Nicola Milne NHS Darlington CCG, St. George's Medial Practice: Patrick Holmes NHS Oxfordshire CCG, Cowley Road Medical Practice: Adina Josephs NHS Oxfordshire CCG, Didcot Health Centre Practice: Perdy Vandenberg North East Essex Diabetes Service, Bluebell Surgery: Rianna Delabruyere, Louise Roberts, Janette Streeting, Catherine Walsh Acknowledgment The ABCD nationwide semaglutide audit is an independent audit supported by an unrestricted grant from Novo Nordisk