Semaglutide vs Liraglutide — Which Induces More Weight Loss?

In a comparison of injectable GLP-1 receptor agonists, a Phase IIIb STEP 8 study showed that semaglutide (Wegovy) beat liraglutide (Saxenda) when it came to weight loss.

In a randomized trial of 2.4 mg semaglutide, 3.0 mg liraglutide, and a placebo for both, patients who received diet and exercise with semaglutide lost an average baseline weight compared to patients who received liraglutide. Increased by 9.4%, Domenica M. Rubino reported.MD of the Washington Weight Management Research Center in Arlington, Virginia, and JAMA..

During the 68-week study period, adults who were overweight or obese but did not have diabetes with semaglutide showed an average weight loss of 15.8%, compared to 6.4% with liraglutide. This meets the main endpoint of research.

In addition, patients taking semaglutide are more likely to achieve weight loss compared to liraglutide, a confirmatory secondary endpoint (all). P<0.001):

• Weight loss of 10% or more: achieved in 70.9% vs. 25.6% patients, respectively (OR 6.3, 95% CI 3.5-11.2)
• 15% and above: 55.6% vs. 12% of patients (OR 7.9, 95% CI 4.1-15.4)
• 20% or more: 38.5% for 6% of patients (OR 8.2, 95% CI 3.5-19.1)

Moreover, 27.6% of patients taking liraglutide discontinued treatment for some reason, compared to 13.5% taking semaglutide. As expected with GLP-1 receptor agonists, the majority of both treatment groups reported gastrointestinal adverse events.

Both drugs induce weight loss by reducing energy intake, but Rubino’s group pointed out that the reduction in caloric intake appears to be greater with semaglutide-against 16% of liraglutide. About 35%.

“Semaglutide is also associated with reduced food craving, which is less obvious with liraglutide and suggests a different mechanism of energy intake regulation,” they wrote. “Further research is being conducted to investigate whether structural differences affect these mechanisms, for example, by allowing semaglutide to target a wider range of neuronal GLP-1 receptors than liraglutide. Is required.”

This analysis was yet another article in the Semaglutide Therapeutic Efficacy (STEP) clinical program in obese patients, which supported the FDA approval of 2.4 mg semaglutide in June 2021. This drug was indicated for chronic weight management in obese adults (BMI 30+) or obese (BMI 27+) and is used in combination with a low-calorie diet and exercise therapy, hypertension, 2 For adults with at least one weight-related condition such as type diabetes or high cholesterol.

Since its approval, 2.4 mg semaglutide has been very successful in the US market, even when demand exceeds supply. In late December, manufacturer Novo Nordisk announced that it was facing supply challenges, saying in a statement, “We do not expect to meet US demand in the first half of 2022 and are new. It is expected that few patients will be treated. Treatment will begin. “

In December 2014, in addition to lifestyle management, 3.0 mg liraglutide was first approved for adults with a BMI of 30 or 27, or at least one weight-related condition. In December 2020, it weighed more than 132 pounds (60 kg) and was approved for use in obese adolescents aged 12 to 17 years.

Both drugs are also indicated at low doses in patients with type 2 diabetes.

A total of 338 participants were included in this 19-site open-label study, 126 received weekly subcutaneous semaglutide over a 16-week escalation period, and 127 received 1 daily in a 4-week escalation phase. He was given a dose of subcutaneous liraglutide. Those who could not tolerate 2.4 mg of semaglutide were eligible to receive 1.7 mg, and those who could not tolerate 3 mg of liraglutide were able to discontinue treatment and resume titration.