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Moreover, a separate STEP UP sub-analysis presented at ECO shows that most of the weight loss with Wegovy® was coming from body fat, and most of the muscle mass was kept2.
The STEP UP trial in people with obesity tested the higher dose of semaglutide (7.2 mg) against the 2.4 mg dose and placebo over 72 weeks in over 1,400 adults living with obesity without type 2 diabetes3. The results were striking. On average, people taking the 7.2 mg dose lost 21% of their total body weight – the equivalent of around 23 kg for the average person in the trial who weighed 113 kg before starting treatment with semaglutide3. People on the 2.4 mg dose lost about 17.5% within 72 weeks, while those on the placebo lost 2.4%3. The 21% weight loss with semaglutide 7.2 mg was achieved with a safety and tolerability profile consistent with the 2.4 mg semaglutide dose3.
A new analysis has revealed insights into how fast and how much weight loss people who respond differently can expect, and the findings are presented at ECO. ‘Early responders’ were identified as people who lost 15% or more of their body weight within just the first 24 weeks (about 6 months) of treatment1. About 1 in 4 people (27%) taking the 7.2 mg dose of Wegovy® had an early response, compared with about 1 in 5 (21%) on the 2.4 mg dose and 3% on placebo1. The early responder group lost 27.7% of their body weight at week 721.
STEP UP weight-loss results1,3
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| Fallender Kurs |
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| Semaglutide 7.2 mg | Semaglutide 2.4 mg | Placebo | |
| STEP UP primary results | |||
| Average weight loss % across all groups | 20.7% | 17.5% | 2.4% |
| STEP UP sub-analysis | |||
| Average weight loss % in early responders (≥15% loss by week 24) | 27.7% (in 26.9% of participants) | 24.8% (in 20.9% of participants) | - |
| Average weight loss in Responders (excluding early responders) | 15.4% | 13.2% | - |
“Obesity as a chronic disease demands lifelong, holistic treatment. Early weight loss may indicate who is likely to achieve the most weight loss from semaglutide – but it is important to highlight that those without an ‘early’ treatment response still experience a substantial and clinically meaningful weight loss. These new insights from the STEP UP sub-analysis presented at ECO can help healthcare professionals with managing expatiations and setting goals with their patients when initiating obesity medications and potentially support long-term persistence to treatments,” said Dr Dror Dicker, associate clinical professor of Internal Medicine at The Faculty of Medicine and Health Sciences, Tel-Aviv University, Israel.
Improved muscle health
Another secondary analysis from a sub-population (55 participants) in the STEP UP trial studied body scan images (MRI) showing that 84% of the lost weight with semaglutide (2.4 and 7.2 mg) was due to a reduction in fat mass2. The abdominal visceral fat was reduced by over 30% with semaglutide2. Muscle mass was reduced by only 10% compared to baseline with semaglutide, and importantly, this was accompanied by improved muscle health, as assessed by the amount of muscle fat2. Both visceral and muscle fat are highly associated with the risk of cardiometabolic complications4-6. This means the drug was highly effective at specifically targeting fat in different body depots. Importantly, participants taking semaglutide maintained their functional muscle strength, even as they lost significant weight2. Muscle function was measured using a 30-second sit-to-stand test, which showed the same functional muscle strength in both the semaglutide and placebo groups before and after treatment2. Together, these results underscore the healthy improvements seen with semaglutide in body composition and muscle function2.
"The analyses from STEP UP presented at ECO are really promising, further highlighting the potential of the higher dose of Wegovy® to achieve substantial weight loss. Importantly, for individuals focused on losing weight, the goal is often to reduce fat rather than muscle mass. These studies show that weight loss with Wegovy® is predominantly driven by reductions in fat, while muscle function is preserved. This is great news for people living with obesity,” said Emil Kongshøj Larsen, executive vice president and head of International Operations at Novo Nordisk.
The results of the STEP UP sub-analysis of semaglutide’s improvement of body composition have been submitted for publication to a scientific journal.
About Wegovy®7,8
Wegovy® is approved as once-daily Wegovy® pill (semaglutide 25 mg) by the FDA and once-weekly Wegovy® injection (2.4 mg and 7.2 mg) by the FDA, EMA and other regulatory authorities worldwide. The Wegovy® pill is currently pending marketing approval from the EMA and other regulatory authorities.
Wegovy® is indicated to reduce excess body weight and maintain weight reduction long term in adults with obesity or overweight and in the presence of at least one weight-related comorbid condition, and approved by the FDA to reduce the risk of major adverse cardiovascular events, such as death, heart attack or stroke in adults with known heart disease and either obesity or overweight. Furthermore, Wegovy® injection is indicated to reduce excess body weight and maintain long-term weight reduction in paediatric patients aged 12 years and older. It is approved by the FDA for the treatment of MASH in adults with moderate to advanced liver scarring (fibrosis), but not in those with cirrhosis of the liver.
About the STEP UP trials3,9
Novo Nordisk has completed two trials, STEP UP and STEP UP T2D, investigating the efficacy and safety of semaglutide 7.2 mg in people with obesity with or without type 2 diabetes. The 72-week STEP UP trial was a randomised, double-blinded, parallel-group, placebo-controlled, superiority trial designed to evaluate the efficacy and safety of semaglutide 7.2 mg compared to semaglutide 2.4 mg and placebo as an adjunct to lifestyle intervention. The trial included 1,407 adults with a BMI ≥30 kg/m2 without diabetes. The primary objective was to demonstrate the superiority of semaglutide 7.2 mg against placebo on weight loss. Key confirmatory secondary endpoints included the number of participants achieving 10%, 15%, 20% and 25% weight loss, respectively. The 72-week STEP UP T2D trial investigated semaglutide 7.2 mg in 512 adults with obesity and type 2 diabetes, with the primary objective to demonstrate superiority of semaglutide 7.2 mg against placebo on weight loss.
About Novo Nordisk
Novo Nordisk is a leading global healthcare company founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat serious chronic diseases built upon our heritage in diabetes. We do so by pioneering scientific breakthroughs, expanding access to our medicines and working to prevent and ultimately cure disease. Novo Nordisk employs about 67,900 people in 80 countries and markets its products in around 170 countries. For more information, visit novonordisk.com, Facebook, Instagram, X, LinkedIn and YouTube.
Contacts for further information
| Novo Nordisk Media: | |
| Ambre James-Brown +45 3079 9289 globalmedia@novonordisk.com | Liz Skrbkova (US) +1 609 917 0632 usmediarelations@novonordisk.com |
| Novo Nordisk Investors: | |
| Michael Novod +45 3075 6050 nvno@novonordisk.com | Jacob Martin Wiborg Rode +45 3075 5956 jrde@novonordisk.com |
| Sina Meyer +45 3079 6656 azey@novonordisk.com | Max Ung +45 3077 6414 mxun@novonordisk.com |
| Christoffer Sho Togo Tullin +45 3079 1471 cftu@novonordisk.com | Alex Bruce +45 3444 2613 axeu@novonordisk.com |
| Mads Berner Bruun +45 3075 2936 mbbz@novonordisk.com | Frederik Taylor Pitter (US) +1 609 613 0568 fptr@novonordisk.com |
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References
1. Dicker D, Horn DB, Jacobsen CSF, et al. Responders to Semaglutide 7.2 mg: A Post Hoc Analysis of the STEP UP Trial in Adults with Obesity. Guided poster presentation at the European Congress on Obesity (ECO) 2026; 12–15 May 2026; Istanbul, Türkiye.
2. Hjelmesæth J,Bhat S, Garvey W, et al. Effect of Semaglutide on Body Composition and Proximal Muscle Strength: The STEP UP Trial. Guided poster presentation at the European Congress on Obesity (ECO) 2026; 12–15 May 2026; Istanbul, Türkiye.
3. Wharton S, Freitas P, Hjelmesæth J, et al. Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial. Lancet Diabetes Endo. 2025;13:949-963.
4. Souza A, Troschel AS, Marquardt JP, et al. Skeletal muscle adiposity, coronary microvascular dysfunction, and adverse cardiovascular outcomes. Eur Heart J. 2025;46:1112-1123.
5. Neeland IJ, Ross R, Despres JP, et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol. 2019;7:715-725.
6. Khawaja T, Nied M, Wilgor A, et al. Impact of Visceral and Hepatic Fat on Cardiometabolic Health. Curr Cardiol Rep. 2024;26:1297-1307.
7. Wegovy® (semaglutide): US Prescribing Information. [online]. Available at: https://www.novo-pi.com/wegovy.pdf. Last accessed: May 2026.
8. Wegovy® (semaglutide): Summary of Product Characteristics. [online]. Available at: https://www.ema.europa.eu/en/documents/product-information/wegovy-epar-product-information_en.pdf Last accessed: May 2026.
9. Lingvay I, Bergenheim SJ, Buse JB, et al. Once-weekly semaglutide 7.2 mg in adults with obesity and type 2 diabetes (STEP UP T2D): a randomised, controlled, phase 3b trial. Lancet Diabetes Endocrinol. 2025;13:935-948.
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