In rodents, semaglutide causes dose-dependent and treatment duration–dependent thyroid C-cell tumors at clinically relevant exposures. Whether it causes thyroid C-cell tumors, including medullary thyroid carcinoma, in humans is unclear, as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined. It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma and in patients with multiple endocrine neoplasia syndrome type 2. Patients should be advised of the potential risk for medullary thyroid carcinoma with semaglutide and the possible symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness).
Semaglutide is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial BMI of ≥ 30 kg/m2 (obesity) or ≥ 27 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, dyslipidemia). For weight management, it should be initiated at a low dose and gradually escalated to a maintenance dose of 2.4 mg/wk subcutaneously to minimize adverse reactions. Oral semaglutide is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of uncertain relevance of rodent C-cell tumor findings to humans.
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Cite this: Romesh Khardori. Fast Five Quiz: Weight Loss - Medscape - Oct 25, 2021.
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