Cardiovascular outcomes and safety of semaglutide in non-overweight populations with type 2 diabetes: a comparison with dipeptidyl peptidase 4 inhibitors
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.54 95% CI 0.45–0.65Authors' conclusion
In patients with T2D and BMI <25 kg/m2, semaglutide was associated with a lower 3-year risk of all-cause mortality than DPP-4 inhibitors.
Study context
- Population
- Patients with T2DM and body mass index (BMI) <25 kg/m², TriNetX electronic medical records, 2018–20204,194 per group after matching
- Participants
- 340,721 patients
- Exposure
- Semaglutide vs DPP-4 inhibitors
- Semaglutiden = 4,194
- DPP-4 inhibitorn = 4,194reference
- Outcome
- Cumulative incidence of all-cause mortality
- Follow-up
- 3 years
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
All-cause mortality
Hazard ratio
0.54
95% CI 0.45–0.65
P < 0.001
By group
Semaglutidevs DPP-4 inhibitor
HR 0.54 (95% CI 0.45–0.65); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Semaglutide | HR (95% CI) | P value | |
|---|---|---|---|---|
| Acute MI · 3 yearsSemaglutidevs DPP-4 inhibitorsPropensity score matching | 0.87 (0.72–1.06) | P = 0.173 | ||
| Stroke · 3 yearsSemaglutidevs DPP-4 inhibitorsPropensity score matching | 8.4% | 1.11 (0.94–1.32) | P = 0.220 | |
| 0.512Hazard ratio (log scale) |
- Stroke: DPP-4 inhibitors 7.7%
Safety
Nausea and vomiting, diarrhoea, hypoglycaemia
- Not significantly different between the groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Cardiovascular outcomes and safety of semaglutide in non-overweight populations with type 2 diabetes: a comparison with dipeptidyl peptidase 4 inhibitors. Eur Heart J Qual Care Clin Outcomes. Published 17 July 2025. doi:10.
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