& Bhargava, P
The standard dosage and titration schedule for semaglutide for weight loss is as follows: Starting dose: 0.25 mg once a week Titration: Increase the dose by 0.25 mg every 4 weeks until reaching the target maintenance dose of 2.4 mg once a week Maintenance dose: 2.4 mg once a week Semaglutide is most effective when used in conjunction with a reduced-calorie diet and increased physical activity
INTRODUCTION The prevalence of type 2 diabetes (T2D) and prediabetes increased significantly from the 1980s to the 2000s in the Japanese population, with increasing obesity and declining physical activity.1 Achieving glycated haemoglobin (HbA1c) targets is a challenge for many patients with T2D.2 Avoidance of weight gain and hypoglycaemia are important considerations in selecting appropriate treatment and individualizing treatment goals.3, 4 Unlike most other T2D therapies, glucagonlike peptide1 (GLP1) receptor agonists (RAs) can achieve glycaemic control and reduce body weight, with a low risk of hypoglycaemia.5 Semaglutide is a GLP1 analogue in development for the treatment of T2D, with a 94% homology to native GLP1.6 A halflife of ~1 week makes it appropriate for onceweekly administration.6, 7 Sitagliptin, a oncedaily dipeptidyl peptidase4 (DPP4) inhibitor, is a widely used oral antidiabetic drug (OAD), and the most commonly used DPP4 inhibitor in Japan.8 DPP4 inhibitors achieve glycaemic control by inhibiting DPP4dependent inactivation of both GLP1 and gastric inhibitory polypeptide (GIP), thereby enhancing GLP1 and GIP receptor signalling, and thus are distinct from GLP1 RAs, which stably activate GLP1 receptor signalling.9 Semaglutide has been evaluated in the Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN) programme, consisting of six phase III global clinical trials that evaluated the efficacy and safety (including cardiovascular outcomes) of semaglutide vs a range of comparators, including sitagliptin.10, 11, 12, 13, 14, 15 Two additional phase III clinical trials in the SUSTAIN programme investigated the effect of semaglutide in Japanese populations.16, 17 In the present trial we evaluated the safety and efficacy of 30 weeks of treatment with onceweekly semaglutide (0.5 and 1.0 mg) vs oncedaily sitagliptin (100 mg), both as monotherapy, in Japanese adults with T2D who were previously stable on diet/exercise or OAD monotherapy.17 2
These formulations provide more stable absorption profiles and easier dose titration compared to transdermal systems, which must overcome skin variation and patient adherence challenges
-1.jpg&w=1200&q=75)
