On October 21, Novo Nordisk announced positive news on the cardiovascular benefits of its oral glucagon-like peptide-1 receptor (GLP-1R) agonist, Rybelsus, which is currently approved for type 2 diabetes (T2D). According to GlobalData, these results could drive an increase in Rybelsus use, as until now the effects of the drug were not comparable to its injectable alternative.

Novo Nordisk’s oral semaglutide has been on the market under the name Rybelsus since 2019, but the semaglutide injectables, Ozempic and Wegovy, have been the centre of attention since they launched due to their stronger metabolic effects both on T2D and obesity patients. Furthermore, the cardiovascular benefits of Ozempic and Wegovy have been unveiled in the SUSTAIN 6 trial and the SELECT trial. Since then, many prescribers have preferred them to the alternatives for patients with a risk of cardiovascular disease.

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The SOUL trial showed a 14% overall risk reduction in major adverse cardiac events (MACE) in T2D patients with cardiovascular disease with or without chronic kidney disease after Rybelsus use, while Ozempic and Wegovy reduced MACE by 26% and 20%, respectively, in the SUSTAIN 6 and the SELECT trials, when compared to patients receiving placebo.

Thus, the SOUL trial may place Rybelsus at an advantage over other oral GLP-1R agonists that are due to reach the market soon and do not have this kind of data yet. It confirms the overall stronger effects of injectable semaglutide over oral semaglutide, but also decreases this gap in efficacy, proving the cardiovascular benefits of Rybelsus. Reducing cardiovascular disease risk is very important in patient populations such as T2D and obesity patients, and according to key opinion leaders interviewed by GlobalData, such benefits could also be a driver for drug reimbursement in the near future.

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