Semaglutide

Semaglutide is a synthetic GLP-1 RA that belongs to a class of antidiabetic agents called incretin mimetics. Incretins are endogenous compounds, including GLP-1, that improve glycemic control once released into the circulation via the gut. Semaglutide subcutaneous injection (Ozempic) and oral tablets (Rybelsus) are used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM). Semaglutide subcutaneous injection (Ozempic) is also used to reduce the risk of non-fatal cardiovascular (CV) events and CV mortality in T2DM patients with CV disease. Semaglutide oral tablets demonstrated CV safety by meeting the primary endpoint of non-inferiority for the composite MACE endpoint; the proportion of patients who experienced at least one MACE was 3.8% with semaglutide oral tablets and 4.8% with placebo. However, semaglutide oral tablets are not approved for the reduction of CV events.As with other agents in this class, semaglutide has a boxed warning regarding rodent thyroid C-cell tumor findings and the uncertain relevance to humans.First-line T2DM therapy depends on comorbidities, patient-centered treatment factors, and management needs and generally includes metformin and comprehensive lifestyle modification.