Patients with type 2 diabetes experience greater glycaemic control and weight loss with a GLP-1 receptor agonist than an SGLT-2 inhibitor, a first-of-its-kind study has found.

The findings from the head-to-head comparison could guide clinical decision-making on treatment intensification, the researchers say, and they support use of semaglutide as an alternative to canagliflozin.

Although canagliflozin is not currently marketed in Australia, three other SGLT-2 inhibitors are available as second-line treatment options.

In the multicentre trial conducted across 11 countries, researchers compared the efficacy and safety of the second-line treatments – subcutaneous semaglutide 1mg once-weekly or oral canagliflozin 300mg daily – in 788 patients (mean age 57) with uncontrolled type 2 diabetes on metformin therapy.