GLP-1 Evidence

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Semaglutide: hvat kann royndir vísa

Semaglutide við 2,4 mg um vikuna framdi umleið 15% miðal kroppsvøttataps yvir 68 vikur. Talan er verulig, endurtikin, og ofta mislesin.

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Løtt rundar tabletur stemplaðar við einum identifiserandi kóða, sæð frá ovast
Larry D. Moore · CC BY 4.0 · Wikimedia Commons

Høvuðroyndin

STEP 1 randomiserði vaksnar við yvirvøtt og feittleika og uttan diabetes til vikuliga semaglutide 2,4 mg ella placebo, bæði við lívsstílsviðgerð, í 68 vikur [9]. Miðal vøttabroyting var umleið −14,9% á lyknini móti −2,4% á placebo. Umleið ein triðingur av luttakarunum á lyknini misti 20% ella meira av kroppsvøttinum — ein úrslit, sum áður hevur verið í hendi hjá bariatriskari kirurgi.

Tvær ting eru vert at halda fast við. Fyrst, tað er ein miðal: útbreiðslan er breið, og ein stórur minni partur missir sera lítið. Fyrst, placebo-arma eisini fekk lívsstílsráðgeving, so 2,4% er ikki "at gera einki" — lyknin er mátað yvir ráðgeving, sum sjálv ger nakað.

Talan er minni, um tú hevur diabetes

STEP 2 keyrdi sama uppskrift í vaksnum við type 2 diabetes og fann umleið 9,6% vøttataps við sama doysi [8]. Tann munurin millum umleið 15% og umleið 10% sæst aftur og aftur í flokkinum og er ikki serligur fyri semaglutide. Samfelagsmeta-analyse millum GLP-1 agonistar vísir sama mynstur bæði á vøtt og glykemiskum endapunktum [3].

Semaglutide 2,4 mg um vikuna — miðal vøttabroyting eftir fólki
RannsóknFólkVøtturMiðalvøttan broytingPlacebo
STEP 1 [9]Feitt, uttan diabetes68 vikur≈ −14,9%≈ −2,4%
STEP 2 [8]Feitt + týpu 2 diabetes68 vikur≈ −9,6%≈ −3,4%
STEP 4 [7]Fyrst móti afturhald eftir 20 vikur48 víðari vikurFyrst: víðari tapAfturhald: afturvinning
SELECT [5]Feittleiki + hjartasjúka~4 árHaldin ≈ −10%≈ −1,5%

Hvussu leingi heldur tað fram?

Longri enn 68 vikur royndirnar vístu. Ein meta-analyse av longri tíðardatum fann, at ávirkanin varð hildin væl yvir eitt ár [1], og SELECT hjartasjúkuroyndin — sum var umleið fýra ár og ikki var ætlað sum vøtturoynd — vísti vøttataps platir umleið 10% og so heldur, heldur enn at minka [5]. Platir er verulig; afturhald, sum kritikarar spáðu, er ikki, fyri so leingi sum viðgerð heldur fram.

Haldin vøttataps við framhaldandi viðgerð

Semaglutide móti tirzepatide

Fyri type 2 diabetes, samanbar SURPASS-2 tirzepatide móti semaglutide 1 mg og favoriserði tirzepatide. Fyrir feittleika serliga, kom beinleiðis samanberingin við feittleika doysar seinni og var avgerandi: tirzepatide framdi munandi størri miðal vøttataps enn semaglutide [10], samsvarandi við tær fyrru veruleikabundnu og óbeinleiðis samanberingar [11].

Tað ger ikki sjálvandi, at tirzepatide er rætta valið fyri ein einstakling — tolir, kostnaður, tilfeingi og samfelagsligar sjúkur ávirka tað — men bara á vøttataps eins er raðfestingin ikki í iva. Sí tirzepatide.

Hvar semaglutide hevur eina leiðbeining aftan fyri tað

Burtur frá vøtt, er semaglutide flutt inn í formella leiðbeining fyri metaboliska dysfunksjón-tilknýtt steatotiskar lifrarsjúkur, har felags evropeisku leiðbeiningarnar viðgera sína leiklut [2]. Tað er eisini einasta evnið í flokkinum við eini fullførdari hjartasjúkuroynd í einari ikki-diabetiskari feittligari fólki [5], sum er viðgjørt á hjartasjúkru síðuni.

Kemi laboratoriubenkur við glasvøttum og reaktantfløskum á plássi
Cjp24 · CC BY-SA 3.0 · Wikimedia Commons

Vanlig spurningar

Er Wegovy ymiskur frá Ozempic?
Sama molekyl, ymiskur luttøku doysur og ávísing. Feittleikaroyndirnar brúktu 2,4 mg um vikuna; diabetes doysing er lægri. Effektstøddir, sum verða nevndar fyri vøttataps, koma frá hægri doys.
Hví misti eg minni enn 15%?
Fordi 15% er ein miðal. Svar er breitt ymisk millum einstaklingar í hvørjari roynd, og fólk við type 2 diabetes missa umleið ein triðing minni í miðal [8].
Støttir tað at arbeiða eftir nakrar mánaðir?
Nei. Vøttataps fer at minka og platir, typiskt yvir annað árið, men longri tíðardatum vísa, at tap er hildið við framhaldandi viðgerð [1][5].
Kann eg taka tað bara fyri at missa nakrar kilogram og so stoppa?
Tú kanst, men vænta at flestu av tapinum fer aftur. Tað er tann samanhangandi niðurstøða av afturhaldsdatu [6][7] og er umrøtt í fullu á stopping síðuni.
Evidensin fyri hesa síðu Ein stakkur bar, sum vísir samansetingina av 12 útgávunum, sum eru nevndar á hesi síðu eftir rannsóknartypum. 4101meta-analysis (4)randomised trial (10)other (1)
11 útgávur, 2021–2025. Tað er ein blanda við bæði royndum og samansetingum í henni, sum er støðan, har ein áheitan um orsøkir er rímilig. Kelda: egnu tilvísingalistin á hesi síðu, niðanfyri.

Viðmerkingar

Hver einasta tilvísing niðanfyri bendir til upprunaliga peer-reviewed skjalið á PubMed ella gjøgnum DOI. Einki her er ein staðfesting fyri læknaligt ráð.

  1. Effect of glucagon-like peptide-1 receptor agonists and co-agonists on body composition: Systematic review and network meta-analysis Karakasis P, Patoulias D, Fragakis N, et al. · Metabolism: clinical and experimental · 2025 · Meta-analysis DOIPubMed 39719170
  2. Subcutaneously administered tirzepatide vs semaglutide for adults with type 2 diabetes: a systematic review and network meta-analysis of randomised controlled trials Karagiannis T, Malandris K, Avgerinos I, et al. · Diabetologia · 2024 · Meta-analysis DOIPubMed 38613667Full text
  3. Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients Without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Moiz A, Levett JY, Filion KB, et al. · The American journal of cardiology · 2024 · Meta-analysis DOIPubMed 38679221
  4. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD) Journal of hepatology · 2024 · Clinical guideline DOIPubMed 38851997
  5. A systematic review of the effect of semaglutide on lean mass: insights from clinical trials Bikou A, Dermiki-Gkana F, Penteris M, et al. · Expert opinion on pharmacotherapy · 2024 · Systematic review DOIPubMed 38629387
  6. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis Yao H, Zhang A, Li D, et al. · BMJ (Clinical research ed.) · 2024 · Meta-analysis DOIPubMed 38286487Full text
  7. Assessment of Thyroid Carcinogenic Risk and Safety Profile of GLP1-RA Semaglutide (Ozempic) Therapy for Diabetes Mellitus and Obesity: A Systematic Literature Review Feier CVI, Vonica RC, Faur AM, et al. · International journal of molecular sciences · 2024 · Systematic review DOIPubMed 38673931Full text
  8. Once-weekly  semaglutide  for obesity  or overweight: A systematic review and meta-analysis He K, Guo Q, Zhang H, et al. · Diabetes, obesity & metabolism · 2022 · Meta-analysis DOIPubMed 34866313
  9. Efficacy and Safety of Semaglutide for Weight Loss in Obesity Without Diabetes: A Systematic Review and Meta-Analysis Tan HC, Dampil OA, Marquez MM · Journal of the ASEAN Federation of Endocrine Societies · 2022 · Meta-analysis DOIPubMed 36578889Full text
  10. Once-weekly semaglutide 7·2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial Wharton S, Freitas P, Hjelmesæth J, et al. · The lancet. Diabetes & endocrinology · 2025 · Randomised controlled trial DOIPubMed 40961952
  11. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity Wharton S, Lingvay I, Bogdanski P, et al. · The New England journal of medicine · 2025 · Randomised controlled trial DOIPubMed 40934115
  12. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity Garvey WT, Blüher M, Osorto Contreras CK, et al. · The New England journal of medicine · 2025 · Randomised controlled trial DOIPubMed 40544433
  13. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes Davies MJ, Bajaj HS, Broholm C, et al. · The New England journal of medicine · 2025 · Randomised controlled trial DOIPubMed 40544432
  14. evoke and evoke+: design of two large-scale, double-blind, placebo-controlled, phase 3 studies evaluating efficacy, safety, and tolerability of semaglutide in early-stage symptomatic Alzheimer's disease Cummings JL, Atri A, Feldman HH, et al. · Alzheimer's research & therapy · 2025 · Randomised controlled trial DOIPubMed 39780249Full text
  15. Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials Butler J, Shah SJ, Petrie MC, et al. · Lancet (London, England) · 2024 · Randomised controlled trial DOIPubMed 38599221Full text
  16. Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial Deanfield J, Verma S, Scirica BM, et al. · Lancet (London, England) · 2024 · Randomised controlled trial DOIPubMed 39181597
  17. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial Ryan DH, Lingvay I, Deanfield J, et al. · Nature medicine · 2024 · Randomised controlled trial DOIPubMed 38740993Full text
  18. Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial Colhoun HM, Lingvay I, Brown PM, et al. · Nature medicine · 2024 · Randomised controlled trial DOIPubMed 38796653Full text
  19. Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis Bliddal H, Bays H, Czernichow S, et al. · The New England journal of medicine · 2024 · Randomised controlled trial DOIPubMed 39476339
  20. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. · The New England journal of medicine · 2023 · Randomised controlled trial DOIPubMed 37952131
  21. Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): a randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial Kadowaki T, Isendahl J, Khalid U, et al. · The lancet. Diabetes & endocrinology · 2022 · Randomised controlled trial DOIPubMed 35131037
  22. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial Garvey WT, Batterham RL, Bhatta M, et al. · Nature medicine · 2022 · Randomised controlled trial DOIPubMed 36216945Full text
  23. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension Wilding JPH, Batterham RL, Davies M, et al. · Diabetes, obesity & metabolism · 2022 · Randomised controlled trial DOIPubMed 35441470Full text
  24. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial Wadden TA, Bailey TS, Billings LK, et al. · JAMA · 2021 · Randomised controlled trial DOIPubMed 33625476Full text
  25. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial Rubino D, Abrahamsson N, Davies M, et al. · JAMA · 2021 · Randomised controlled trial DOIPubMed 33755728Full text
  26. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial Davies M, Færch L, Jeppesen OK, et al. · Lancet (London, England) · 2021 · Randomised controlled trial DOIPubMed 33667417
  27. Once-Weekly Semaglutide in Adults with Overweight or Obesity Wilding JPH, Batterham RL, Calanna S, et al. · The New England journal of medicine · 2021 · Randomised controlled trial DOIPubMed 33567185
  28. The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity Friedrichsen M, Breitschaft A, Tadayon S, et al. · Diabetes, obesity & metabolism · 2021 · Randomised controlled trial DOIPubMed 33269530Full text
  29. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial Pratley RE, Aroda VR, Lingvay I, et al. · The lancet. Diabetes & endocrinology · 2018 · Randomised controlled trial DOIPubMed 29397376
  30. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity Blundell J, Finlayson G, Axelsen M, et al. · Diabetes, obesity & metabolism · 2017 · Randomised controlled trial DOIPubMed 28266779Full text
  31. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity Aronne LJ, Horn DB, le Roux CW, et al. · The New England journal of medicine · 2025 · Clinical trial DOIPubMed 40353578
  32. Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity Rodriguez PJ, Goodwin Cartwright BM, Gratzl S, et al. · JAMA internal medicine · 2024 · Journal article DOIPubMed 38976257Full text

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