Semaglutide
ALSO KNOWN AS · Ozempic · Wegovy · Rybelsus
A once-weekly GLP-1 receptor agonist and the most widely prescribed drug in the class. Approved for type 2 diabetes, chronic weight management and cardiovascular risk reduction.
Mechanism
Semaglutide is a 94%-homologous analogue of human GLP-1 with two amino-acid substitutions and a C18 fatty di-acid chain attached via a spacer at position 26. The substitution at position 8 blocks DPP-4 cleavage; the fatty acid drives reversible albumin binding, producing a half-life of roughly one week.
Clinical evidence
In STEP 1, adults without diabetes on 2.4 mg weekly lost a mean of 14.9% of body weight at 68 weeks versus 2.4% on placebo. In SELECT, semaglutide 2.4 mg reduced major adverse cardiovascular events by 20% in people with established cardiovascular disease and overweight or obesity.
Gastrointestinal effects — nausea, vomiting, diarrhoea, constipation — are the dominant adverse events and are the main reason for the slow four-week dose escalation schedule.
PRIMARY SOURCES
- 01STEP 1 trial— New England Journal of Medicine
- 02SELECT cardiovascular outcomes— New England Journal of Medicine
Educational reference only. Trial figures are protocol-condition means, not individual predictions. Investigational compounds are not approved medicines and have no legitimate consumer supply route.