Oral semaglutide, according to the FDA label, needs to be taken in the morning on an empty stomach, 30 minutes before eating, drinking, or using any other oral medication – you are allowed only 4 ounces of plain water. If you eat too soon, the pill is less effective, but if you wait longer than 30 minutes its absorption may be enhanced.
Other companies are working on obesity pills that don’t have such dietary restrictions, and would in theory also appeal to patients who don’t want to inject themselves weekly.
Dr. Filip Knop, professor of endocrinology at Gentofte Hospital, University of Copenhagen and Novo’s study presenter, said his experience is that 20 per cent to 25 per cent of patients would rather have a daily pill instead of a weekly semaglutide injection.
At the ADA meeting on Friday, results from an Eli Lilly mid-stage trial showed that the highest dose of its experimental pill orforglipron helped people who were obese or overweight lose 14.7 per cent of their body weight after 36 weeks, and their weight loss had not yet appeared to plateau.
Pfizer on Monday said it had discontinued development of its experimental once-daily obesity pill, lotiglipron, after liver safety issues were seen in clinical studies. The company also has a twice-daily weight loss drug candidate.
Novo Nordisk said most patients in its obesity trial reported gastrointestinal side effects from oral semaglutide, including mostly mild-to-moderate nausea, constipation, diarrhoea and vomiting.
Around 13 per cent of patients experienced “altered skin sensation,” which was mostly resolved after several weeks, Dr. Knop said.
Results from a separate late-stage trial presented at the ADA meeting showed once-daily oral semglutide, at a dose of up to 50mg, helped patients with type 2 diabetes reduce their blood sugar levels by as much as 2 percentage points.
Details of both Novo trials were also published in the peer-reviewed Lancet medical journal.
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