open access publication

Article, Early Access, 2024

Real-World Use of Oral Semaglutide in Adults with Type 2 Diabetes: The PIONEER REAL Switzerland Multicentre, Prospective, Observational Study

DIABETES THERAPY, ISSN 1869-6953, 1869-6953, 10.1007/s13300-023-01525-y


Kick, Anastas [1] M'Rabet-Bensalah, Khadija [2] Acquistapace, Flavio [3] Amadid, Hanan [4] Ambuhl, Robert A. [5] Braae, Uffe Christian 0000-0002-2743-4584 [4] Item, Flurin [2] Schultes, Bernd 0000-0002-5301-1163 [6] Zueger, Thomas 0000-0001-6190-7405 [7] Rudofsky, Gottfried (Corresponding author) [7] [8]


  1. [1] Primary Care Grp Practice Sanacare, Lugano, Switzerland
  2. [NORA names: Switzerland; Europe, Non-EU; OECD];
  3. [2] Novo Nordisk Pharm AG, Zurich, Switzerland
  4. [NORA names: Switzerland; Europe, Non-EU; OECD];
  5. [3] SCA Primary Care Cardiol Practice, Lugano, Switzerland
  6. [NORA names: Switzerland; Europe, Non-EU; OECD];
  7. [4] Novo Nordisk AS, Soborg, Denmark
  8. [NORA names: Novo Nordisk; Private Research; Denmark; Europe, EU; Nordic; OECD];
  9. [5] Primary Care Practice Schongrund, Rotkreuz, Switzerland
  10. [NORA names: Switzerland; Europe, Non-EU; OECD];


Introduction: Real-world data provide insight into how medications perform in clinical practice. The PIONEER REAL Switzerland study aimed to understand clinical outcomes with oral semaglutide in adults with type 2 diabetes (T2D).Methods: PIONEER REAL Switzerland was a 34-44-week, multicentre, prospective, non-interventional, single-arm study of adults with T2D naive to injectable glucose-lowering medication who were initiated on oral semaglutide in routine clinical practice. The primary endpoint was change in glycated haemoglobin (HbA1c) from baseline (BL) to end of study (EOS); secondary endpoints included change in body weight (BW) from BL to EOS and the proportion of participants achieving HbA1c < 7.0% and the composite endpoints HbA1c reduction >= 1%-points with BW reduction >= 3% or >= 5% at EOS. Safety was assessed in participants who received >= 1 dose of oral semaglutide.Results: Of the 185 participants (female/male, n = 67/118) initiating oral semaglutide, 168 (90.8%) completed the study and 143 (77.3%) remained on treatment with oral semaglutide at EOS. At BL, participants had a mean age of 62 years, diabetes duration of 6.4 years, HbA1c of 7.7%, BW of 95.6 kg and body mass index of 33.2 kg/m(2); 56.2% of participants were receiving glucose-lowering medications. Significant reductions were observed for HbA1c (estimated change - 0.91%; 95% confidence interval [CI] - 1.10, - 0.71; p < 0.0001) and BW (estimated change - 4.85%; 95% CI - 5.70, - 4.00; p < 0.0001). In total, 139 adverse events (AEs) were reported in 65 (35.1%) participants; most were mild or moderate. The most frequent AEs were gastrointestinal disorders (27.0%); 31 AEs in 20 (10.8%) participants led to discontinuation of oral semaglutide. Six serious AEs were reported; all were considered unlikely to be related to oral semaglutide.Conclusion: People living with T2D treated with oral semaglutide in Switzerland achieved clinically significant reductions in HbA1c and BW, with no new safety signals.Clinical Trial NCT04537624.A graphical abstract is available for this article.Clinical Trial NCT04537624.A graphical abstract is available for this article.


GLP-1 receptor agonist, Glucose-lowering medication, Glycaemic control, Incretin therapy, Real-world evidence, Semaglutide, Type 2 diabetes

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