- A daily pill version of Wegovy worked just as well as the weekly shot in clinical trials.
- If approved by the FDA, the pills could be a nice option for people with obesity and needle phobias.
A new pill version of semaglutide for weight loss could soon be coming to a pharmacy near you.
Late-phase trial results of a study of over 660 people in nine countries were published June 25 in medical journal The Lancet.
The trial tested out a high-dose oral form of semaglutide, and found the pill achieved stunningly similar results compared to the injectable version of the drug for weight loss, which is called Wegovy. Wegovy has been approved to treat obesity since 2021; it's the same drug as diabetes medication Ozempic, just at a higher dose.
Patients on this pill lost, on average, 15.1% of their bodyweight, whereas patients in an earlier trial of injectable semaglutide for weight loss lost, on average, 14.9%.
"No really big differences," were seen in terms of side effects or safety either, lead study author Dr. Filip Knop, an endocrinologist at the University of Copenhagen, said during a press conference announcing the results.
While lower-dose semaglutide pills already exist for type 2 diabetes treatment, sold under the brand name Rybelsus, this data could be the final evidence the Food and Drug Administration needs to approve a pill form of semaglutide for use as a weight loss therapy in the US.
Experts said that a semaglutide weight loss pill, if approved, could be a nice option for people who are afraid of needles. But international diabetes and obesity experts who gathered at the American Diabetes Association conference in San Diego from June 23 to 26, including Knop, agreed that this isn't going to be a magic pill.
The pill requires a special morning routine
The injectable, liquid form of semaglutide is directly shot into the belly with a very small needle dispatched at the click of a pen, once a week. It doesn't matter if you take it with or without food.
"They are so thin that you basically don't feel them penetrate your skin," Knop said of the injectable pens for Ozempic and Wegovy. "It's very, very easy. People, they take it each Sunday, then they don't need to think about it. They can go on a trip."
But because oral semaglutide is swallowed, not injected, it requires a special daily routine. Patients must have an empty stomach when they take it, which means most people pop their pill first thing in the morning, along with half a glass of water. Then, they have to wait at least 30 minutes before drinking any beverages, including coffee, or having breakfast.
This is to ensure "that you actually absorb as much as possible of the active compound from the tablet," Knop said.
In this 15-month trial, 12 of the 334 participants taking the drug quit early because the daily pill routine was a hassle.
A pill form of the drug could also be easier to abuse
Some worry that having a poppable pill on the market for weight loss could lead to more abuse of the drug, and easy access for people with eating disorders.
"My job is not to run a slimming club," said Dr. Carel Le Roux, a diabetes and obesity researcher from University College Dublin, who was at the conference presenting other weight loss drug results, stressing that these new drugs should be used to control the disease of obesity and shouldn't be perceived as diet pills.
Knop, similarly, acknowledged "there is a risk for off-label use" with the pills, including among people with disordered eating.
"There is a big responsibility on the doctors' shoulders when you prescribe these medications," he said. "You need to be responsible in your conduct and only prescribe these medications to relevant patients."