SCHOLAR study: retrospective cohort using the Tianjin, China regional electronic health records database to evaluate real-world once-weekly semaglutide effectiveness in Chinese T2DM patients. Reports HbA1c reduction, proportion achieving HbA1c <7%, weight change, and tolerability in routine clinical practice. Provides China-specific real-world semaglutide effectiveness data—important given demographic, dietary, and genetic differences between Chinese and Western diabetic populations that may influence GLP-1 RA pharmacodynamic response.
Abstract
INTRODUCTION: The aim of this study was to evaluate changes in clinical parameters among adults with type 2 diabetes (T2D) after initiating subcutaneous semaglutide in Chinese clinical practice.
METHODS: SCHOLAR was a retrospective cohort study using data from the Tianjin regional electronic health records database, including adults with T2D who initiated once-weekly semaglutide (full analysis set [FAS]). Endpoints included change in glycated hemoglobin (HbA) and proportion with HbA < 7.0% at month 6 (primary)/12 (secondary); lipids, medication classes, and safety (exploratory endpoints).
RESULTS: Among 26,859 individuals (FAS), mean ± SD age was 57 ± 13 years, and duration of T2D was 4 ± 3 years. Individuals with HbAmeasurements at baseline and month 6 (n = 3055; baseline HbA7.65%) and 12 (n = 2897; baseline HbA7.75%) were included in the HbAanalyses. Mean change (95% CI) in HbAwas - 0.65%-points (- 0.71, - 0.59) at month 6, and - 0.47%-points (- 0.53, - 0.41) at month 12 with semaglutide (both p < 0.0001). The proportion of individuals with HbA < 7.0% was 40.4%, 57.9%, and 49.8% at baseline, month 6, and month 12, respectively. Additionally, for individuals with HbA ≥ 7.0% at baseline (mean HbA8.59%), mean HbAchange (95% CI) at month 6 was - 1.17%-points (- 1.25, - 1.08) (p < 0.0001). Total cholesterol, low-density lipoprotein cholesterol, and triglycerides significantly decreased after 12 months with semaglutide (p < 0.05). Among individuals with continued semaglutide use, mean daily insulin dose, and number of combined oral antidiabetic, antihypertensive, and lipid-lowering medication classes reduced after 6/12 months (all p < 0.05). In the FAS, constipation, diarrhea, and abdominal discomfort were the most frequently reported adverse events (1.73%, 0.91%, and 0.89%, respectively).
CONCLUSIONS: Initiating once-weekly semaglutide was associated with significant improvements versus baseline in glycemic control and lipids in people with T2D from Tianjin, China. Safety of semaglutide was similar to the established safety profile per adverse events assessment.
CLINICAL TRIALS REGISTRATION: NCT06351748.