Is It Time for Oral Semaglutide to Replace Injectables?

Об этом видео: Is It Time for Oral Semaglutide to Replace Injectables?

The treatment landscape for obesity is rapidly evolving, and new evidence suggests that the era of oral semaglutide may be arriving sooner than expected.
A recent OASIS 4 study tested oral semaglutide at a dose of 25 mg in people with obesity or overweight (without diabetes). After 64 weeks of therapy, participants achieved an average weight loss of 16.6%, with more than one third (34.4%) losing at least 20% of their body weight.
Injectable semaglutide 2.4 mg (“Wegovy”), studied in the STEP trials, has until now been the benchmark. In STEP 1 and STEP 5, patients achieved average losses of 14.9% at 68 weeks and 15.2% at 104 weeks, with similar proportions reaching ≥20% reduction in body weight.
In other words, oral semaglutide — at least at the higher studied dose — performs on par with, and in some measures slightly better than, the injectable form.
Both oral and injectable semaglutide deliver robust weight loss in patients with obesity.
Functional and cardiovascular benefits appear similar across both formulations.
Adverse events were consistent, with gastrointestinal side effects most common and usually mild to moderate.
For patients, the possibility of an effective oral therapy could eliminate one of the major barriers to GLP-1–based treatment: the need for self-injection. For physicians, it may broaden the appeal of prescribing semaglutide to patients hesitant about injections.
While the results are promising, oral semaglutide at 25 mg is not yet widely available, and its long-term safety, adherence, and real-world performance remain to be fully established. Injectable semaglutide remains a proven, guideline-supported therapy. Transitioning to oral formulations should be considered only when clinically appropriate, with careful monitoring.
The OASIS 4 trial demonstrates that high-dose oral semaglutide achieves weight loss nearly equivalent to injectable semaglutide, with overlapping safety and clinical benefit. This may mark the beginning of a new era where patients and physicians can choose between equally effective oral and injectable options.