Semaglutide, the active ingredient in diabetes drugs that have also become popular as a weight-loss aid, is primarily available in injectable form.This includes the two most widely used drugs, Wegovy and Ozempic. Rybelsus is currently the only oral semaglutide drug on the market.
The study’s results suggest that oral semaglutide may be of most use in the early stages of diabetes. People whose diabetes was recently diagnosed showed significant improvements in levels of HbA1c — a measurement of blood sugar — and their body weight. The study results appear in the Journal of Clinical Medicine.Semaglutide is a GLP-1 agonist that slows the emptying of the stomach, providing a sense of fullness that leads to less eating.
A significant effect of taking semaglutide is weight loss. Excess body weight is a risk factor for both diabetes and cardiovascular disease (CVD).
The researchers also observed positive changes related to cardiovascular risk. These included improved lipid profiles, eGFR — an indicator of kidney function — and blood pressure. Of semaglutide drugs, only Wegovy is officially approved by the Federal Food and Drug Administration (FDA) for weight loss. However, other semaglutide drugs approved for treating diabetes and CVD, such as Ozempic, are frequently used “off-label” for weight loss. Oral semaglutide has been the subject of several studies, with mixed findings. A definitive assessment of its efficacy has yet to be determined.
In the PIONEER-6 trial funded by Novo Nordisk — the manufacturer of Wegovy and Ozempic — oral semaglutide performed better than a placebo, particularly at high weekly doses of 14 milligrams (mg) that produced a 21% reduction in cardiovascular risk. Having semaglutide available as an oral or injectable allows accommodation for patient preferences. This flexibility may be especially important for adolescents where there is a major need for safe pharmacology treatments. The typical dosing for Ozempic, said Ahmed, is weekly doses of 0.25 mg, 0.5 mg, 1 mg, and 2 mg, increased at four-week intervals based on the presence and toleration of gastrointestinal side effects. For Wegovy, it is 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg per week, increased in the same manner.
The participants in the new study were given daily oral prescriptions of 3 mg before being raised to 7 mg. Most of the study cohort remained at a maximum of 7 mg daily for the study period. For about 2% of participants, the daily dose was increased to 14 mg. The researchers reported that even the 14 mg dose was generally well tolerated. At 14 mg per day, the weekly dose adds up to 98 mg per week, far larger than the maximum Wegovy dose of 2.4 mg per week.
