Clinical Reference

Clinical reference

STEP Trial Results
STEP-1 through STEP-4 trials established semaglutide's weight-management efficacy. Pivotal STEP-1 (NEJM 2021, PMID 33567185): 14.9 SUSTAIN Trial Results
SUSTAIN-6 (NEJM 2016, PMID 27633186) cardiovascular safety in T2D + high CV risk: 26% MACE reduction. Led to Ozempic's FDA approva SELECT Trial Results
SELECT (NEJM 2023, PMID 37952131): 20% MACE reduction in non-diabetic adults with overweight/obesity + established CVD. Led to Weg FLOW Trial Results
FLOW (NEJM 2024, PMID 38785189): 24% reduction in major kidney/CV events in T2D + CKD over median 3.4 years. Mechanism of Action
Semaglutide selectively activates the GLP-1 receptor: glucose-dependent insulin secretion, glucagon suppression, slowed gastric em Contraindications & Boxed Warning
Semaglutide is contraindicated in MTC, MEN 2, pregnancy, breastfeeding. Boxed warning: thyroid C-cell tumors (rodent studies, huma Side Effects
Most common: nausea (44%), diarrhea (30%), vomiting (24%), constipation (24%). Mostly mild-moderate and titration-dependent. Serio Dosing & Pharmacology
Wegovy: 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg weekly. Ozempic: 0.25 → 0.5 → 1.0 → 2.0 mg weekly. Rybelsus: 3 → 7 → 14 mg daily oral. Drug Interactions
Key interactions: oral medications (delayed gastric emptying), insulin and sulfonylureas (hypoglycemia risk), oral contraceptives