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Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.

Abstract Background Regulatory guidance specifies the need to establish cardiovascular safety of new diabetes therapies in patients with type 2 diabetes in order to rule out excess cardiovascular risk. The cardiovascular effects of semaglutide, a glucagon-like peptide 1 analogue with an extended half-life of approximately 1 week, in type 2 diabetes are unknown. Methods We randomly assigned 3297 patients with type 2 diabetes who were on a standard-care regimen to receive once-weekly semaglutide (0.5 mg or 1.0 mg) or placebo for 104 weeks. The primary composite outcome was the first occurrence of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. We hypothesized that semaglutide would be noninferior to placebo for the primary outcome. The noninferiority margin was 1.8 for the upper boundary of the 95% confidence interval of the hazard ratio. Results At baseline, 2735 of the patients (83.0%) had established cardiovascular disease, chronic kidney disease, or both. The primary outcome occurred in 108 of 1648 patients (6.6%) in the semaglutide group and in 146 of 1649 patients (8.9%) in the placebo group (hazard ratio, 0.74; 95% confidence interval [CI], 0.58 to 0.95; P<0.001 for noninferiority). Nonfatal myocardial infarction occurred in 2.9% of the patients receiving semaglutide and in 3.9% of those receiving placebo (hazard ratio, 0.74; 95% CI, 0.51 to 1.08; P=0.12); nonfatal stroke occurred in 1.6% and 2.7%, respectively (hazard ratio, 0.61; 95% CI, 0.38 to 0.99; P=0.04). Rates of death from cardiovascular causes were similar in the two groups. Rates of new or worsening nephropathy were lower in the semaglutide group, but rates of retinopathy complications (vitreous hemorrhage, blindness, or conditions requiring treatment with an intravitreal agent or photocoagulation) were significantly higher (hazard ratio, 1.76; 95% CI, 1.11 to 2.78; P=0.02). Fewer serious adverse events occurred in the semaglutide group, although more patients discontinued treatment because of adverse events, mainly gastrointestinal. Conclusions In patients with type 2 diabetes who were at high cardiovascular risk, the rate of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke was significantly lower among patients receiving semaglutide than among those receiving placebo, an outcome that confirmed the noninferiority of semaglutide. (Funded by Novo Nordisk; SUSTAIN-6 ClinicalTrials.gov number, NCT01720446 .).
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the new england journal of medicine
Publication Year Start




PMID- 27633186
OWN - NLM
STAT- MEDLINE
DA  - 20160916
DCOM- 20161219
LR  - 20170302
IS  - 1533-4406 (Electronic)
IS  - 0028-4793 (Linking)
VI  - 375
IP  - 19
DP  - 2016 Nov 10
TI  - Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes.
PG  - 1834-1844
AB  - Background Regulatory guidance specifies the need to establish cardiovascular
      safety of new diabetes therapies in patients with type 2 diabetes in order to
      rule out excess cardiovascular risk. The cardiovascular effects of semaglutide, a
      glucagon-like peptide 1 analogue with an extended half-life of approximately 1
      week, in type 2 diabetes are unknown. Methods We randomly assigned 3297 patients 
      with type 2 diabetes who were on a standard-care regimen to receive once-weekly
      semaglutide (0.5 mg or 1.0 mg) or placebo for 104 weeks. The primary composite
      outcome was the first occurrence of cardiovascular death, nonfatal myocardial
      infarction, or nonfatal stroke. We hypothesized that semaglutide would be
      noninferior to placebo for the primary outcome. The noninferiority margin was 1.8
      for the upper boundary of the 95% confidence interval of the hazard ratio.
      Results At baseline, 2735 of the patients (83.0%) had established cardiovascular 
      disease, chronic kidney disease, or both. The primary outcome occurred in 108 of 
      1648 patients (6.6%) in the semaglutide group and in 146 of 1649 patients (8.9%) 
      in the placebo group (hazard ratio, 0.74; 95% confidence interval [CI], 0.58 to
      0.95; P&lt;0.001 for noninferiority). Nonfatal myocardial infarction occurred in
      2.9% of the patients receiving semaglutide and in 3.9% of those receiving placebo
      (hazard ratio, 0.74; 95% CI, 0.51 to 1.08; P=0.12); nonfatal stroke occurred in
      1.6% and 2.7%, respectively (hazard ratio, 0.61; 95% CI, 0.38 to 0.99; P=0.04).
      Rates of death from cardiovascular causes were similar in the two groups. Rates
      of new or worsening nephropathy were lower in the semaglutide group, but rates of
      retinopathy complications (vitreous hemorrhage, blindness, or conditions
      requiring treatment with an intravitreal agent or photocoagulation) were
      significantly higher (hazard ratio, 1.76; 95% CI, 1.11 to 2.78; P=0.02). Fewer
      serious adverse events occurred in the semaglutide group, although more patients 
      discontinued treatment because of adverse events, mainly gastrointestinal.
      Conclusions In patients with type 2 diabetes who were at high cardiovascular
      risk, the rate of cardiovascular death, nonfatal myocardial infarction, or
      nonfatal stroke was significantly lower among patients receiving semaglutide than
      among those receiving placebo, an outcome that confirmed the noninferiority of
      semaglutide. (Funded by Novo Nordisk; SUSTAIN-6 ClinicalTrials.gov number,
      NCT01720446 .).
FAU - Marso, Steven P
AU  - Marso SP
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Bain, Stephen C
AU  - Bain SC
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Consoli, Agostino
AU  - Consoli A
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Eliaschewitz, Freddy G
AU  - Eliaschewitz FG
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Jodar, Esteban
AU  - Jodar E
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Leiter, Lawrence A
AU  - Leiter LA
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Lingvay, Ildiko
AU  - Lingvay I
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Rosenstock, Julio
AU  - Rosenstock J
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Seufert, Jochen
AU  - Seufert J
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Warren, Mark L
AU  - Warren ML
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Woo, Vincent
AU  - Woo V
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Hansen, Oluf
AU  - Hansen O
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Holst, Anders G
AU  - Holst AG
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Pettersson, Jonas
AU  - Pettersson J
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
FAU - Vilsboll, Tina
AU  - Vilsboll T
AD  - From the Research Medical Center, Kansas City, MO (S.P.M.); School of Medicine,
      Swansea University, Swansea, United Kingdom (S.C.B.); Department of Medicine and 
      Aging Science and Center of Excellence on Aging and Translational Medicine, G.
      d'Annunzio University, Chieti-Pescara, Italy (A.C.); CPClin Research
      Center/Hospital Israelita Albert Einstein, Sao Paulo (F.G.E.); Hospital
      Universitario Quiron Salud Madrid, Facultad de Ciencias de la Salud, Universidad 
      Europea de Madrid, Madrid (E.J.); Li Ka Shing Knowledge Institute and Keenan
      Research Centre for Biomedical Science, St. Michael's Hospital, University of
      Toronto, Toronto (L.A.L.), and the University of Manitoba, Winnipeg (V.W.) - both
      in Canada; University of Texas Southwestern Medical Center (I.L.) and Dallas
      Diabetes Research Center at Medical City (J.R.) - both in Dallas; University of
      Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg,
      Germany (J.S.); Physicians East, Greenville, NC (M.L.W.); and Novo Nordisk,
      Soborg (O.H., A.G.H., J.P.), and the Center for Diabetes Research, Gentofte
      Hospital, University of Copenhagen, Hellerup (T.V.) - both in Denmark.
CN  - SUSTAIN-6 Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01720446
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20160915
PL  - United States
TA  - N Engl J Med
JT  - The New England journal of medicine
JID - 0255562
RN  - 0 (Hemoglobin A, Glycosylated)
RN  - 53AXN4NNHX (semaglutide)
RN  - 62340-29-8 (Glucagon-Like Peptides)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
SB  - AIM
SB  - IM
CIN - N Engl J Med. ;376(9):890. PMID: 28252261
CIN - N Engl J Med. ;376(9):890-1. PMID: 28252263
CIN - N Engl J Med. 2017 Mar 2;376(9):891. PMID: 28249136
MH  - Aged
MH  - Cardiovascular Diseases/mortality/*prevention &amp; control
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Diabetic Nephropathies/epidemiology/prevention &amp; control
MH  - Diabetic Retinopathy/epidemiology
MH  - Female
MH  - Gastrointestinal Diseases/chemically induced
MH  - Glucagon-Like Peptide 1/*analogs &amp; derivatives
MH  - Glucagon-Like Peptides/adverse effects/*therapeutic use
MH  - Hemoglobin A, Glycosylated/analysis
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
EDAT- 2016/09/17 06:00
MHDA- 2016/12/20 06:00
CRDT- 2016/09/17 06:00
AID - 10.1056/NEJMoa1607141 [doi]
PST - ppublish
SO  - N Engl J Med. 2016 Nov 10;375(19):1834-1844. Epub 2016 Sep 15.

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