semaglutide (Ozempic, Rybelsus, Wegovy)

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Indications

* > 1/2 of all adults in the U.S. are eligible for semaglutide[54]

* semaglutide improves HgbA1c more than canagliflozin 1.5 vs 1.0%[8]

* may increase likelihood of NASH (stage F2 or F3 fibrosis) resolution, but does not inmprove fibrosis stage[10]

Contraindications

Dosage

  • 0.25 mg SC once weekly for 4 weeks, then increase to 0.5 mg once weekly
  • if glycemic control is not achieved after at least 4 weeks on 0.5-mg dose, the dose may be increased to 1 mg once weekly
  • investigational 2.4-mg dose weekly induces weight reduction of 10% of body weight in patients with type-2 diabetes[13]

Adverse effects

* not such association was found with liraglutide[44]

Mechanism of action

Clinical trials

  • 6 months, almost all participants achieved 5% weight loss, 1/2 lost >10%, & a 1/4 lost >15% of their body weight[16]
  • STEP 1 & STEP 4 trials:[14][48]
    • 1 year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg & lifestyle intervention, participants regained 2/3 of their prior weight loss, with similar changes in cardiometabolic measures[48]

Notes

More general terms

References

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