Author:
Soubry E.,Mathieu C.,Vandistel G.,Mertens A.
Abstract
Oral semaglutide: a new and first oral GLP-1 receptor agonist
Oral semaglutide is a glucagon-like peptide-1 receptor agonist (GLP1-RA) developed for oral administration. It is a coformulation of semaglutide with the absorption enhancer SNAC (sodium N-(8-[2-hydroxybenzoyl]amino)caprylate), which facilitates the absorption of semaglutide across the gastric epithelium. In the PIONEER clinical trial programme, oral semaglutide has been proven effective in lowering HbA1c and also in weight reduction compared to a placebo and several active comparators. Cardiovascular safety was shown to be noninferior to a placebo in patients with a high cardiovascular risk. The tolerability profile was comparable to subcutaneous forms of GLP1-RA. In contrast to subcutaneous GLP1-RA, the cardiovascular outcome of oral semaglutide has still to be proved in the SOUL trial.
Oral semaglutide is available in 3 doses (3, 7 and 14 mg) and in Belgium it is reimbursed as add-on therapy for patients with diabetes mellitus type 2 (DM2) with HbA1c > 7,5% and obesity (BMI > 30 kg/m²), after at least 3 months of treatment with 1 or more antidiabetic drugs, including metformin.