Ozempic pill promoted 15% weight loss in study – 06/26/2023 – Equilibrium

The next version of Ozempic and Wegovy — the much-discussed injectable drugs known for their ability to induce weight loss — could come in pill form.

Researchers presented data on two studies on Sunday at the American Diabetes Association Scientific Sessions conference. One of the studies showed that 50 mg of semaglutide —the active compound in the drugs— taken orally every day is approximately as effective as weekly injections of Wegovy in weight loss in overweight or obese people. Wegovy injections contain 2.4 mg of semaglutide.

That study, also published Sunday in The Lancet, followed 667 people over 68 weeks. Among those taking semaglutide, 85% lost at least 5% of their body weight during the study, compared with just 26% of those taking the placebo. Those taking semaglutide lost, on average, about 15% of their body weight — approximately six times as much as the placebo group.

A separate study, also reported on Sunday and published in The Lancet, focused on oral semaglutide for people with type 2 diabetes. More than 1,600 participants were divided into three groups and received daily doses of 14mg, 25mg or 50mg. Those taking the 25 mg and 50 mg doses lost more weight and had greater reductions in blood sugar than those taking the lower dose.

Novo Nordisk, the company that makes the injectable drugs, funded both studies.

“I suspect that many people are not using these treatments because they require an injection,” says Robert Gabbay, chief scientific and medical officer of the American Diabetes Association. “If you could say, ‘Well, actually, you don’t have to,’ that would be a big deal.”

The higher the dose of oral semaglutide, the more side effects seem to be associated with it. In the study of overweight or obese people, 80% of those who took oral semaglutide reported gastrointestinal problems such as vomiting, nausea, constipation or diarrhea. Nearly 13% said they experienced “altered skin sensation” such as tingling.

The authors noted that the majority of study participants were white women, meaning that the results may not apply to the general population of people with obesity.

The second study, in people with diabetes, showed similar side effects: 80% of those who took the 50 mg dose reported adverse effects, with gastrointestinal problems being the most common, which occurred more frequently in people who took higher doses compared with those who took 14 mg.

Among those who received the 50 mg dose, 13% discontinued the drug due to side effects. Injectable semaglutide has similar adverse reactions: in a previous study, 74.2% of participants who received 2.4 mg of injectable semaglutide per week (the same amount as in Wegovy) experienced gastrointestinal disturbances.

Oral semaglutide is nothing new: there is already a tablet form of this compound on the market, marketed under the name Rybelsus. The FDA (American Food and Drug Administration) has approved this drug only for adults with type 2 diabetes, and the pills are given in comparatively smaller daily doses of up to 14 mg.

The pills work similarly to semaglutide injections, regulating insulin, lowering blood sugar and slowing stomach emptying, making people feel fuller for longer periods, said Andrew Kraftson, clinical associate professor at Michigan Medicine. .

According to Gabbay, Rybelsus is less effective than Ozempic and Wegovy.

It is not clear when, or if, higher-dose semaglutide tablets will hit the market. An oral form could allow more people to take these drugs, says Scott Hagan, an assistant professor of medicine at the University of Washington who has studied obesity, because there is less of a barrier to swallowing a pill compared to injecting a drug.

“It’s a welcome addition to treatment options for patients who might benefit from weight management,” he said.

The rise in off-label use of semaglutide among people seeking the cosmetic weight-loss drug could intensify if a high-dose pill becomes available, said A. Janet Tomiyama, a professor of psychology at the University of California at Los Angeles, who studied eating disorders and weight-related stigma, and expressed concern about the impact of these medications on people’s body image.

“Whenever there are weight loss medications, we know it’s a tool that people can use for eating disorder reasons,” she said, citing laxatives and diet pills.

As these drugs become popular, clinicians must focus on whether semaglutide, in any form, can help improve a patient’s health, rather than just reduce body weight, Hagan said.

“I’m concerned about the widespread use of these drugs just to promote weight loss,” he said, “and how that contributes to our overall food culture, our cultural obsession with thinness.”