Novo Nordisk, the company that manufactures Wegovy and Ozempic, funded both trials.
“I suspect there are a lot of people that are not using these treatments because it requires an injection,” said Dr. Robert Gabbay, the chief scientific and medical officer of the American Diabetes Association. “If you could say, ‘Well, actually, it doesn’t,’ that’s big.”
The higher the dose of oral semaglutide, the more side effects seem to come with it. In the trial of people who were overweight or obese, 80 percent of those who took oral semaglutide reported gastrointestinal issues like vomiting, nausea, constipation or diarrhea. Nearly 13 percent said they experienced “altered skin sensation,” such as tingling. The majority of study participants were white and female, the authors noted, which means the results may not apply to the broader population of people with obesity.
The second trial, in people with diabetes, showed similar side effects: 80 percent of those who took the 50-milligram dose reported adverse effects, most commonly gastrointestinal issues, which occurred more frequently in people who took the higher doses than in those who took 14 milligrams. Thirteen percent of people who received the 50 milligram dose stopped taking the medication because of the side effects. Injectable semaglutide elicits similar side effects; in a previous study, 74.2 percent of participants who received 2.4 milligrams of injectable semaglutide each week (the amount that’s in Wegovy) experienced gastrointestinal disorders.
Another trial presented at the conference and published on Friday in the New England Journal of Medicine looked at a different oral compound, orforglipron, which belongs to the same class of medications as semaglutide. The study was funded by Eli Lilly. Pfizer has also tested its own pill in that drug class.
Oral semaglutide is not new: There’s already a tablet form of the compound on the market, sold under the name Rybelsus. The Food and Drug Administration has only approved that drug for adults with Type 2 diabetes, and the tablets come in comparably smaller daily doses, up to 14 milligrams. The tablets work in a similar way to semaglutide injections, which regulate insulin, lowering blood sugar and slowing the emptying of the stomach, making people feel fuller for longer periods of time, said Dr. Andrew Kraftson, a clinical associate professor at Michigan Medicine.
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