Summary

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• Ozempic (semaglutide) is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease.
• This summary is based on the review of 17 systematic reviews/meta-analyses. ^[1-17]
• HbA1c Reduction: Semaglutide (Sem) demonstrated a significant reduction in HbA1c levels, with Sem 0.5 mg and 1.0 mg reducing HbA1c by 0.56% and 0.63%, respectively, compared to other glucose-lowering agents. Tirzepatide (Tir) (5 mg, 10 mg, 15 mg) showed superior HbA1c reduction compared to Sem 1 mg, while Sem 2.0 mg was more effective than Dulaglutide 3.0 mg and 4.5 mg in reducing HbA1c.
• Body Weight Reduction: Semaglutide consistently resulted in significant weight loss, with Sem 0.5 mg and 1.0 mg reducing body weight significantly more than placebo and other glucose-lowering agents. Tirzepatide demonstrated greater weight reduction than Sem 1 mg, and Sem 2.0 mg was more effective than Dulaglutide 3.0 mg and 4.5 mg in reducing body weight.
• Cardiovascular Outcomes: Semaglutide reduced major adverse cardiovascular events (MACE) and stroke incidences compared to placebo and other agents, with consistent cardiovascular outcomes observed across different baseline cardiovascular risk profiles.
• Comparison with Other Drugs: Tirzepatide showed superior efficacy in both HbA1c and weight reduction compared to Semaglutide, while Semaglutide was more effective than Dulaglutide and SGLT-2 inhibitors in these outcomes.
• Semaglutide was associated with a higher incidence of gastrointestinal-related adverse events, including nausea, diarrhea, and vomiting, particularly at higher doses.
• There were increased cases of diabetic retinopathy reported with subcutaneous Semaglutide.
• Semaglutide did not increase the incidence of serious adverse events compared to placebo or other agents.
• Semaglutide was effective in both GLP-1 RA-naïve and GLP-1 RA-experienced patients, and showed similar cardiovascular outcomes regardless of baseline metformin use, with consistent efficacy across varying cardiovascular risk profiles.