How Does Orforglipron Compare with an SGLT-2 Inhibitor for Diabetes?

In patients with type 2 diabetes, glucagon-like peptide-1 (GLP-1)–receptor agonists or sodium–glucose cotransporter-2 (SGLT-2) inhibitors often are prescribed as the next step after metformin. In such patients, how do the glucose-lowering effects of these two drug classes compare?

To address this question, researchers identified ≈1000 patients with type 2 diabetes, glycosylated hemoglobin (HbA_1c) between 7% and 10.5% (mean, 8.1%) during metformin monotherapy, and body-mass index ≥23 kg/m² (mean, 33 kg/m²). They were randomized to receive orforglipron (Foundayo; a recently approved oral GLP-1 agonist) or the SGLT-2 inhibitor dapagliflozin. The study was sponsored by orforglipron’s manufacturer.