Oral Semaglutide: A Review of the First Oral Glucagon-Like Peptide-1 Receptor Agonist.

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Bucheit J, Pamulapati LG, Carter NM, Malloy K, Dixon D, Sisson E

Oral Semaglutide: A Review of the First Oral Glucagon-Like Peptide-1 Receptor Agonist.

Diabetes Technol Ther. 2019 Aug 22. doi: 10.1089/dia.2019.0185.

PubMed ID
31436480 [ View in PubMed
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Abstract

Glucagon-like peptide 1 receptor agonists (GLP-1 RA) are highly effective at lowering HbA1c and facilitating weight loss. Four agents in the GLP-1 RA class, albiglutide, liraglutide, dulaglutide, and semaglutide, also have cardioprotective effects. However, subcutaneous administration of these agents remains a major reason for their underutilization. A new co-formulation of semaglutide with sodium N-[8-(2-hydroxybenzoyl amino]caprylate (SNAC) is the first oral GLP-1 RA reviewed by the U.S. Food and Drug Administration (FDA). The SNAC technology prevents destruction of semaglutide in the stomach and facilitates transcellular absorption through the gastric membrane enabling semaglutide to reach systemic circulation intact. The oral formulation of semaglutide was studied in the PIONEER trials, demonstrating similar efficacy to the currently available GLP-1 RAs in regards to HbA1c lowering and weight loss. Although PIONEER 6 trial suggests positive effects on cardiovascular mortality with oral semaglutide, these benefits may not fully be appreciated until the completion of the SOUL trial.

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