平均减重14.3%，还降糖降压降脂！JAMA子刊：口服司美格鲁肽为东亚人群带来临床获益

Core Viewpoint - The article discusses the efficacy of oral semaglutide in weight loss and metabolic disease management, particularly in East Asian populations, highlighting the promising results from the OASIS 2 study [4][10]. Group 1: Study Overview - The OASIS 2 study is a multicenter, double-blind, placebo-controlled Phase III trial conducted in Japan and South Korea, involving 201 adults with an average age of 49 years, where 25.4% had type 2 diabetes [5]. - Participants were required to have a BMI of ≥27 with at least two comorbidities or a BMI of ≥35 with at least one comorbidity, with the study focusing on the specific risks faced by East Asian populations [5]. Group 2: Weight Loss Results - The study found that the semaglutide group experienced an average weight loss of 14.3%, compared to only 1.3% in the placebo group, resulting in a significant difference of 13.07 percentage points (P<0.001) [6]. - The proportions of participants achieving various weight loss thresholds were notable: 84.3% lost ≥5%, 65.4% lost ≥10%, 47.2% lost ≥15%, and 32.3% lost ≥20% [6]. Group 3: Metabolic Improvements - In addition to weight loss, the semaglutide group showed significant metabolic improvements, including an average waist circumference reduction of 10.7 cm, HbA1c decrease of 0.78%, and blood pressure reduction of 9.4/4.9 mmHg [7]. - Other improvements included better lipid profiles and a 32.2% reduction in visceral fat area among patients who underwent CT scans [7]. Group 4: Benefits for Diabetic Patients - Among patients with type 2 diabetes, the average weight loss was 10.7% compared to 1.5% in the placebo group, with a difference of 9.25 percentage points [8]. - By week 68, approximately 75% of diabetic patients showed improvement, with 45.5% reverting to prediabetes and 30.3% achieving normal blood sugar levels, while only 6.3% in the placebo group showed similar improvement [9]. Group 5: Safety Profile - The safety profile of semaglutide was consistent with known GLP-1 receptor agonists, with the most common adverse effects being gastrointestinal symptoms, reported in 63.4% of the semaglutide group versus 34.8% in the placebo group [9]. - The discontinuation rate due to adverse effects was 4.5% in the semaglutide group, indicating a manageable safety profile [9]. Group 6: Clinical Implications - The OASIS 2 study provides clear evidence that daily oral semaglutide at 50 mg can lead to significant and clinically meaningful weight loss, along with improvements in blood sugar, blood pressure, lipid levels, and inflammation markers [10]. - This research offers new hope for managing obesity and metabolic diseases in East Asian populations and supports the global promotion of oral GLP-1 receptor agonists [10].