Ozempic (semaglutide) - review of pharmacological properties, mechanism of action and clinical applications
DOI:
https://doi.org/10.12775/QS.2024.16.52659Keywords
ozempic, semaglutide, GLP-1, DM2, obesityAbstract
Introduction: Ozempic is a new generation antihyperglycemic drug used to treat type 2 diabetes in adults whose underlying disease is not sufficiently controlled with physical activity and diet, as well as for long-term weight control in people with excess body weight and comorbidities. The aim of this study is to explore and integrate the latest literature on the analysis of the pharmacology, mechanism of action and clinical applications of Ozempic.
Material and Methods of Research: A literature review focused on keywords related to the topic was performed using databases such as PubMed and Google Scholar.
Results: Ozempic effectively lowers blood glucose levels and supports weight loss in patients with type 2 diabetes and obesity. Clinical trials have demonstrated its superiority over other antidiabetic medications, with significant reductions in HbA1c and body weight. Patients receiving Ozempic experienced improved glycemic control and cardiovascular outcomes, with manageable side effects. Ongoing research suggests additional benefits in cardiovascular prevention and obesity management.
Conclusion: Ozempic (semaglutide) is a potent GLP-1 receptor agonist that effectively improves glycemic control and aids in weight reduction for patients with type 2 diabetes and obesity. Its practical administration, patient education, and regular monitoring are essential for optimal outcomes. Ongoing research and technological advancements, including the development of oral forms, promise to expand its applications and improve patient adherence, making Ozempic a versatile and valuable therapeutic option.
References
Smits, M. M., & Van Raalte, D. H. (2021). Safety of semaglutide. Frontiers in Endocrinology, 12. https://doi.org/10.3389/fendo.2021.645563
Mariam, Z., & Niazi, S. K. (2023). Glucagon‐like peptide agonists: A prospective review. Endocrinology, Diabetes & Metabolism, 7(1). https://doi.org/10.1002/edm2.462
Chao, A. M., Tronieri, J. S., Amaro, A., & Wadden, T. A. (2023). Semaglutide for the treatment of obesity. Trends in Cardiovascular Medicine, 33(3), 159–166. https://doi.org/10.1016/j.tcm.2021.12.008
Tan, Hanna Clementine, et al. “Efficacy and Safety of Semaglutide for Weight Loss in Obesity without Diabetes: A Systematic Review and Meta-Analysis.” Journal of the ASEAN Federation of Endocrine Societies, vol. 37, no. 2, 25 Nov. 2022, pp. 65–72, https://doi.org/10.15605/jafes.037.02.14.
Authors, Jahagirdar, D., & Mahood, Q. (2023, October 1). Semaglutide for Type 2 Diabetes (2 mg). NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK598216/
Ozempic | European Medicines Agency. (n.d.). https://www.ema.europa.eu/en/medicines/human/EPAR/ozempic#assessment-history
Reynolds, M. (2023, June 12). What the scientists who pioneered Weight-Loss drugs want you to know. WIRED. https://www.wired.com/story/obesity-drugs-researcher-interview-ozempic-wegovy/
ClinicalTrials.gov. (n.d.). https://clinicaltrials.gov/study/NCT02648204
Singh, G., Krauthamer, M., & Bjalme-Evans, M. (2022). Wegovy (Semaglutide): a new weight loss drug for chronic weight management. Journal of Investigative Medicine, 70(1), 5–13. https://doi.org/10.1136/jim-2021-001952
Mahapatra, M. K., Karuppasamy, M., & Sahoo, B. M. (2022). Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Reviews in Endocrine and Metabolic Disorders, 23(3), 521–539. https://doi.org/10.1007/s11154-021-09699-1
Semaglutyd - medycyna praktyczna. (n.d.). https://www.mp.pl/pacjent/leki/subst.html?id=5893
Reynolds, M. (2023b, June 12). What the scientists who pioneered Weight-Loss drugs want you to know. WIRED. https://www.wired.com/story/obesity-drugs-researcher-interview-ozempic-wegovy/
Ozempic | European Medicines Agency. (n.d.-b). https://www.ema.europa.eu/en/medicines/human/EPAR/ozempic
Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., & Hjerpsted, J. B. (2017). Effects of once‐weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes, Obesity & Metabolism/Diabetes, Obesity and Metabolism, 19(9), 1242–1251. https://doi.org/10.1111/dom.12932
Friedrichsen, M., Breitschaft, A., Tadayon, S., Wizert, A., & Skovgaard, D. (2021). The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity. Diabetes, Obesity & Metabolism/Diabetes, Obesity and Metabolism, 23(3), 754–762. https://doi.org/10.1111/dom.14280
Hjerpsted, J. B., Flint, A., Brooks, A., Axelsen, M. B., Kvist, T., & Blundell, J. (2017). Semaglutide improves postprandial glucose and lipid metabolism, and delays first‐hour gastric emptying in subjects with obesity. Diabetes, Obesity & Metabolism/Diabetes, Obesity and Metabolism, 20(3), 610–619. https://doi.org/10.1111/dom.13120
Tirandi, A., Montecucco, F., Carbone, F., & Liberale, L. (2024). Obesity, cardiovascular and cerebrovascular disease: the role of GLP-1 receptor agonists. Polskie Archiwum Medycyny Wewnętrznej. https://doi.org/10.20452/pamw.16658
Kosiborod, M. N., Abildstrøm, S. Z., Borlaug, B. A., Butler, J., Rasmussen, S., Davies, M., Hovingh, G. K., Kitzman, D. W., Lindegaard, M. L., Møller, D. V., Shah, S. J., Treppendahl, M. B., Verma, S., Abhayaratna, W., Ahmed, F. Z., Chopra, V., Ezekowitz, J., Fu, M., Ito, H., . . . Petrie, M. C. (2023). Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. New England Journal of Medicine/the New England Journal of Medicine, 389(12), 1069–1084. https://doi.org/10.1056/nejmoa2306963
Gallwitz B. GLP-1 Receptor Agonists in Type 2 Diabetes and Beyond - New Insights 2015. Eur Endocrinol. 2015 Apr;11(1):21-25. doi: 10.17925/EE.2015.11.01.21. Epub 2015 Apr 11. PMID: 29632562; PMCID: PMC5819057
Novo Nordisk. (2018). Ozempic: EPAR – Product infromation (Last updated: 11/04/2024). Retrived from https://www.ema.europa.eu/en/documents/product-information/ozempic-epar-product-information_en.pdf
OZEMPIC (semaglutide) injection, for subcutaneous use - FULL PRESCRIBING INFORMATION. Retrived from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209637lbl.pdf Accessed 21 Apr 2021.
Mosenzon O, Blicher TM, Rosenlund S, Eriksson JW, Heller S, Hels OH, Pratley R, Sathyapalan T, Desouza C; PIONEER 5 Investigators. Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial. Lancet Diabetes Endocrinol. 2019 Jul;7(7):515-527. doi: 10.1016/S2213-8587(19)30192-5. Epub 2019 Jun 9. Erratum in: Lancet Diabetes Endocrinol. 2019 Sep;7(9):e21. PMID: 31189517
Sorli C, Harashima S, Tsoukas GM, Unger J, Karsbøl JD, Hansen T, et al. Efficacy and Safety of Once-Weekly Semaglutide Monotherapy Versus Placebo in Patients With Type 2 Diabetes (SUSTAIN 1): A Double-Blind, Randomised, Placebo-Controlled, Parallel-Group, Multinational, Multicentre Phase 3a Trial. Lancet Diabetes Endocrinol (2017) 5:251–60. doi: 10.1016/S2213-8587(17)30013-X
Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021 Jul 7;12:645563. doi: 10.3389/fendo.2021.645563. Erratum in: Front Endocrinol (Lausanne). 2021 Nov 10;12:786732. PMID: 34305810; PMCID: PMC8294388.
Romera I, Cebrián-Cuenca A, Álvarez-Guisasola F, Gomez-Peralta F. Reviriego J. A Review of Practical Issues on the Use of Glucagon-Like Peptide-1 Receptor Agonists for the Management of Type 2 Diabete. Diabetes Ther (2019) 10:5–19. doi: 10.1007/s13300-018-0535-9
Gotfredsen CF, Mølck A-M, Thorup I, Nyborg NCB, Salanti Z, Knudsen LB, et al. The Human GLP-1 Analogs Liraglutide and Semaglutide: Absence of Histopathological Effects on the Pancreas in Nonhuman Primate. Diabetes (2014) 63:2486–97. doi: 10.2337/db13-1087
Gaborit B, Julla J-B, Besbes S, Proust M, Vincentelli C, Alos B, et al. Glucagon-Like Peptide 1 Receptor Agonists, Diabetic Retinopathy and Angiogenesis: The AngioSafe Type 2 Diabetes Study. J Clin Endocrinol Metab (2020) 105:e1549–60. doi: 10.1210/clinem/dgz069
Bjerre Knudsen L, Madsen LW, Andersen S, Almholt K, de Boer AS, Drucker DJ, et al. Glucagon-Like Peptide-1 Receptor Agonists Activate Rodent Thyroid C-Cells Causing Calcitonin Release and C-Cell Proliferation. Endocrinology (2010) 151:1473–86. doi: 10.1210/en.2009-1272
Feier CVI, Vonica RC, Faur AM, Streinu DR, Muntean C. Assessment of Thyroid Carcinogenic Risk and Safety Profile of GLP1-RA Semaglutide (Ozempic) Therapy for Diabetes Mellitus and Obesity: A Systematic Literature Review. Int J Mol Sci. 2024 Apr 15;25(8):4346. doi: 10.3390/ijms25084346. PMID: 38673931; PMCID: PMC11050669.
Gallwitz B, Giorgino F. Clinical Perspectives on the Use of Subcutaneous and Oral Formulations of Semaglutide. Front Endocrinol (Lausanne). 2021 Jun 29;12:645507. doi: 10.3389/fendo.2021.645507. PMID: 34267725; PMCID: PMC8276717.
Lingvay I, Catarig AM, Frias JP, Kumar H, Lausvig NL, le Roux CW, Thielke D, Viljoen A, McCrimmon RJ. Efficacy and safety of once-weekly semaglutide versus daily canagliflozin as add-on to metformin in patients with type 2 diabetes (SUSTAIN 8): a double-blind, phase 3b, randomised controlled trial. Lancet Diabetes Endocrinol. 2019 Nov;7(11):834-844. doi: 10.1016/S2213-8587(19)30311-0. Epub 2019 Sep 17. PMID: 31540867.
Lau J, Bloch P, Schäffer L, et al. Discovery of the Once-Weekly Glucagon-Like Peptide-1 (GLP-1) Analogue Semaglutide. Journal of Medicinal Chemistry. 2015 Sep;58(18):7370-7380. DOI: 10.1021/acs.jmedchem.5b00726. PMID: 26308095.
Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016 Nov 10;375(19):1834-1844. doi: 10.1056/NEJMoa1607141. Epub 2016 Sep 15. PMID: 27633186.
Mann JFE, Ørsted DD, Brown-Frandsen K, Marso SP, Poulter NR, Rasmussen S, Tornøe K, Zinman B, Buse JB; LEADER Steering Committee and Investigators. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med. 2017 Aug 31;377(9):839-848. doi: 10.1056/NEJMoa1616011. PMID: 28854085.
Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, Maryniuk MD, Siminerio L, Vivian E. Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Clin Diabetes. 2016 Apr;34(2):70-80. doi: 10.2337/diaclin.34.2.70. PMID: 27092016; PMCID: PMC4833481.
Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, Silverman MG, Zelniker TA, Kuder JF, Murphy SA, Bhatt DL, Leiter LA, McGuire DK, Wilding JPH, Ruff CT, Gause-Nilsson IAM, Fredriksson M, Johansson PA, Langkilde AM, Sabatine MS; DECLARE–TIMI 58 Investigators. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019 Jan 24;380(4):347-357. doi: 10.1056/NEJMoa1812389. Epub 2018 Nov 10. PMID: 30415602.
Davies M, Pieber TR, Hartoft-Nielsen ML, Hansen OKH, Jabbour S, Rosenstock J. Effect of Oral Semaglutide Compared With Placebo and Subcutaneous Semaglutide on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA. 2017 Oct 17;318(15):1460-1470. doi: 10.1001/jama.2017.14752. PMID: 29049653; PMCID: PMC5817971.
Rosenstock J, Allison D, Birkenfeld AL, Blicher TM, Deenadayalan S, Jacobsen JB, Serusclat P, Violante R, Watada H, Davies M; PIONEER 3 Investigators. Effect of Additional Oral Semaglutide vs Sitagliptin on Glycated Hemoglobin in Adults With Type 2 Diabetes Uncontrolled With Metformin Alone or With Sulfonylurea: The PIONEER 3 Randomized Clinical Trial. JAMA. 2019 Apr 16;321(15):1466-1480. doi: 10.1001/jama.2019.2942. PMID: 30903796; PMCID: PMC6484814.
American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S158-S178. doi: 10.2337/dc24-S009. Erratum in: Diabetes Care. 2024 May 02;: PMID: 38078590; PMCID: PMC10725810.
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Copyright (c) 2024 Anna Maria Koman, Sabina Przygodzka, Katarzyna Gadżała, Izabela Janik, Marzena Pliszka, Karolina Alicja Palacz, Klaudia Brygida Kułak, Izabela Sztybór, Martyna Kuśmierska, Katarzyna Chamera-Cyrek
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