In the latest results from the STEP UP phase 3b trial, semaglutide 7.2 mg, a higher dose of the widely used GLP-1 agonist, demonstrated a 20.7% reduction in body weight at 72 weeks for adults with obesity. This result is notably higher compared to the 17.5% weight loss observed with the standard 2.4 mg dose of semaglutide (Wegovy) and a minimal 2.4% weight loss with a placebo.
The trial, which enrolled 1,407 adults with a body mass index (BMI) of 30 kg/m² or higher, aimed to test the efficacy and safety of semaglutide 7.2 mg, administered once a week, against the 2.4 mg dose and a placebo. Participants also received lifestyle interventions to aid weight loss. A significant finding from the study was that 33.2% of participants receiving semaglutide 7.2 mg achieved a weight loss of 25% or more, compared to 16.7% in the 2.4 mg group.
The safety profile of semaglutide 7.2 mg was consistent with other GLP-1 receptor agonists, with mild to moderate gastrointestinal side effects being the most commonly reported. This trial further supports the use of semaglutide for obesity management, building on its established benefits in cardiovascular risk reduction as observed in the SELECT trial.
However, experts such as Dr. Steven B. Heymsfield from Pennington Biomedical Research Center caution that while the higher dose of semaglutide yields greater weight loss, it may also come with an increased risk of side effects. He highlighted that, while promising, the 7.2 mg dose is still under scrutiny to determine if the additional weight loss justifies any potential risks compared to lower doses or alternative treatments like tirzepatide.
The STEP UP trial’s findings suggest that semaglutide 7.2 mg could be a game-changer for weight management in adults with obesity, but further studies and detailed safety data will be crucial in determining its place in treatment options. Results from the ongoing STEP UP T2D trial, which also involves adults with obesity and type 2 diabetes, are expected soon and could provide further insight into the broader application of semaglutide.
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