A new clinical trial in Italy investigates the efficacy of oral semaglutide compared to injectable versions of the drug, such as Wegovy and Ozempic, in treating diabetes and promoting weight loss. The study found that oral semaglutide was most effective in patients in the early stages of diabetes, with less significant benefits for others. Despite higher doses of oral semaglutide, less of it gets into the bloodstream compared to injectables, potentially reducing its effectiveness. Semaglutide works by mimicking the glucagon-like peptide-1 hormone, stimulating insulin release and slowing stomach emptying to create a sense of fullness. This ultimately leads to weight loss, which is a risk factor for diabetes and cardiovascular disease. Improved glycemic control, metabolic changes, and positive cardiovascular risk factors were observed in patients taking oral semaglutide.
Although only Wegovy is FDA-approved for weight loss, other semaglutide drugs like Ozempic are used off-label for the same purpose. Oral semaglutide has shown promising results in previous studies, but a definitive assessment of its efficacy is still pending. The PIONEER-6 trial found that high weekly doses of oral semaglutide reduced cardiovascular risk by 21%. A recent study concluded that oral semaglutide may be best used as an add-on to injectable forms. Further studies, such as the ongoing SOUL study, are needed to determine its benefits on cardiovascular events. The availability of both oral and injectable options allows for patient preferences and may be particularly beneficial for adolescents who require safe diabetes treatments.
Regarding dosing, typical weekly doses of Ozempic and Wegovy range from 0.25 mg to 2.4 mg, depending on tolerability. In the Italian study, participants were given daily oral doses of 3 mg, which were later increased to 7 mg. Some patients received a maximum daily dose of 14 mg, which was generally well tolerated. Despite the high doses, the bioavailability of oral semaglutide is lower than that of injectables, resulting in lower and more variable levels in the blood. Higher tolerability was also observed in another study testing oral semaglutide at 50 mg daily.
Overall, while injectable semaglutide remains more effective than the oral version, oral delivery makes the medication more accessible. It allows physicians to choose the best route of administration based on individual patient needs and preferences. The study’s findings highlight the potential benefits of oral semaglutide in early-stage diabetes management and weight loss, with ongoing research needed to fully assess its efficacy and impact on cardiovascular outcomes.
