Evaluating semaglutide at a higher dose in adults with overweight or obesity and type 2 diabetes.

This study compared the effect of two doses of semaglutide (Ozempic), 2.4 mg and 1.0 mg to a placebo, given once weekly subcutaneously (sc; injected under the skin) to adults with overweight or obesity and type 2 diabetes (T2D). The authors concluded that patients treated with 2.4 mg of semaglutide once weekly showed a higher decrease in body weight compared to placebo.

Overweight or obesity is often seen in patients with T2D. The ability of patients to lose weight can be affected by some T2D medications since they are associated with weight gain. Weight loss management is important for these patients as it improves blood glucose control and reverses disease progression.

Semaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, at a dose of 1.0 mg, has had the greatest impact on weight loss in patients with T2D. Currently, there is a need to investigate its potential for weight management at a higher dose.

This study included 1210 patients with T2D and overweight or obesity. 403 patients were given 1.0 mg of sc semaglutide once weekly, while 404 patients received 2.4 mg of sc semaglutide once weekly. The other 403 patients were given a placebo. Treatments were received for 68 weeks with diet counseling and physical activity, followed by 7 weeks without treatment.

After 68 weeks, patients in the semaglutide 2.4 mg had lost an average of 9.6% of their initial body weight. This was compared to 7% of those in the semaglutide 1.0 mg group and 3.4% in the placebo group.

Significantly more patients in the semaglutide 2.4 mg group had lost at least 5% of their initial body weight (68.8%) compared to placebo (28.5%).

Patients in the semaglutide 2.4 mg group had improvements in waist circumference, blood fat levels, and blood pressure compared to the placebo group. More patients treated with semaglutide both doses had improvements in blood glucose control and reductions in blood glucose-lowering medications compared to placebo.

Overall, 87.6% of patients treated with semaglutide 2.4 mg, 81.8% with semaglutide 1.0 mg, and 76.9% with placebo reported side effects. 63.5% of patients on 2.4 mg of semaglutide reported gastrointestinal effects compared to 57.5% of those on 1.0 mg or 34.3% with placebo.

The study showed a higher reduction in body weight and better blood glucose control with subcutaneous semaglutide 2.4 mg once a week compared with placebo in patients with T2D and overweight and obesity.

The study did not include patients who were on insulin treatment. This study was funded by Novo Nordisk, the manufacturer of semaglutide.