Pivotal clinical trials
Below: every randomized trial relevant to semaglutide weight management, type 2 diabetes, cardiovascular outcomes, and kidney outcomes. PMIDs link to PubMed.
- STEP-1 trial — Pivotal weight-loss in non-diabetic adults. NEJM 2021, n=1,961, PMID 33567185. 14.9% mean weight loss at 2.4 mg / 68 weeks.
- SUSTAIN-6 trial — Cardiovascular safety in type 2 diabetes. NEJM 2016, PMID 27633186. 26% MACE reduction in T2D + high CV risk.
- SELECT trial — CV outcomes in non-diabetic adults with overweight/obesity + CVD. NEJM 2023, PMID 37952131. 20% MACE reduction.
- FLOW trial — Kidney outcomes in T2D + CKD. NEJM 2024, PMID 38785189. 24% reduction in major kidney/CV events.
Mechanism & pharmacology
Semaglutide is a long-acting GLP-1 receptor agonist with ~7-day half-life enabling weekly subcutaneous dosing. Read the mechanism page →
Safety & contraindications
Boxed warning: thyroid C-cell tumors (rodent studies). Contraindicated in MTC, MEN 2, pregnancy, breastfeeding. Full safety page →
Side effect profile
Most common: nausea (44%), diarrhea (30%), vomiting (24%), constipation (24%). Detailed side-effect page →
Dosing
Wegovy titration: 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. Dosing reference →