Semaglutide

Also: Ozempic, Wegovy, Rybelsus

Summary

Semaglutide is a synthetic analogue of GLP-1, a hormone released by the gut after eating. Unlike most peptides on this site, it is an approved prescription medicine in all three launch countries, and its trial programme is among the largest in modern medicine.

What it targets

Semaglutide acts on GLP-1 receptors, which are involved in insulin release and appetite signalling. The STEP-1 trial tested once-weekly semaglutide in adults with overweight or obesity. The SELECT trial then asked whether it reduces cardiovascular risk in people who are overweight or obese without diabetes: 17,604 patients aged 45 or over with existing cardiovascular disease were randomised to semaglutide or placebo, with a primary endpoint combining cardiovascular death, non-fatal heart attack and non-fatal stroke. Two further phase 3 trials tested it in combination with cagrilintide, in adults with obesity and in adults with obesity and type 2 diabetes, reporting mean body-weight reductions of about 20 and 14 percent respectively over 68 weeks against about 3 percent with placebo.

body weight in overweight and obesity (phase 3)cardiovascular events in people with cardiovascular disease and obesity (17,604 people)body weight and glycaemic control in combination with cagrilintide (two phase 3 trials)type 2 diabetes (approved indication)

Clinical Research

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. (2023). New England Journal of Medicine. human 17,604 patients aged 45 or over with existing cardiovascular disease and a BMI of 27 or more, without diabetes; multicentre, double-blind, placebo-controlled
Once-weekly semaglutide in adults with overweight or obesity
Wilding JPH, Batterham RL, Calanna S, et al. (STEP 1 Study Group) (2021). New England Journal of Medicine. human adults with overweight or obesity, phase III, n=1961
Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity
Garvey WT, Blüher M, Osorto Contreras CK, et al. (REDEFINE 1 Study Group) (2025). New England Journal of Medicine. human adults with overweight or obesity, without diabetes, phase 3a, n=3417
Cagrilintide–Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes
Davies MJ, Bajaj HS, Broholm C, et al. (REDEFINE 2 Study Group) (2025). New England Journal of Medicine. human adults with overweight or obesity and type 2 diabetes, phase 3a, n=1206

All research on Semaglutide →