口服司美格鲁肽减重效果不如针剂？真相是→

Core Viewpoint - Novo Nordisk's GLP-1 drug, semaglutide oral tablets for weight loss, has received FDA approval, marking it as the first oral GLP-1 weight loss medication approved globally. However, it is not yet approved for sale in China [3]. Group 1: Product Details - The initial dosage form approved is a 25mg oral tablet [4]. - Prior to FDA approval, all oral semaglutide was used for diabetes treatment, with significant dosage differences compared to weight loss indications. Non-diabetic users reported poor weight loss results [5][6]. - The approved oral semaglutide for weight loss has a starting dose of 1.5mg, increasing to 4mg after one month, then to 9mg in the third month, and a maintenance dose of 25mg thereafter [6]. Group 2: Clinical Efficacy - Clinical data published in NEJM indicates that the 25mg oral semaglutide can lead to an average weight loss of 16.6% over 64 weeks, with over 34.4% of patients achieving a weight loss of 20% or more, comparable to injection forms [7]. Group 3: Usage Guidelines and Limitations - Experts warn against taking multiple tablets at once to increase dosage, as the absorption rate of oral peptides is low (less than 1%), and exceeding the recommended dose can lead to serious side effects [8][9]. - The oral semaglutide must be taken on an empty stomach with strict dietary restrictions, unlike competitors like Orforglipron, which has higher bioavailability and fewer restrictions [10]. Group 4: Future Developments - Novo Nordisk is increasing its research on next-generation oral weight loss therapies, including a new drug, amycretin, which combines GLP-1 and insulin receptor agonists, showing potential for better clinical applications [10]. - There is currently no clinical registration progress for the oral semaglutide weight loss drug in China, and Novo Nordisk has not clarified its commercialization path in the region [10]. Group 5: Lifestyle Interventions - Experts emphasize that weight loss efficacy varies among individuals, and lifestyle interventions are fundamental to any weight loss strategy. Comprehensive and long-term lifestyle changes are recommended alongside any pharmacological treatments [11].