Semaglutide vs Teriparatide

Weeks to months

Months (titrated over 16-20 weeks)

Months to years

Especially during dose escalation

Over ~18-24 months of daily use

Over ~18-24 months

Detectable by ~3 months

Hours after each dose

Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1).

N Engl J Med (2021) · Rct · n=1961

Double-blind RCT in 1,961 adults with obesity/overweight WITHOUT diabetes, randomized 2:1 to subcutaneous semaglutide 2.4 mg/week or placebo plus lifestyle for 68 weeks

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT).

N Engl J Med (2023) · Rct · n=17604

Large cardiovascular-outcomes RCT: 17,604 patients with preexisting cardiovascular disease and overweight/obesity but WITHOUT diabetes

Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6).

N Engl J Med (2016) · Rct · n=3297

Pre-approval cardiovascular-safety RCT in 3,297 patients with type 2 diabetes at high cardiovascular risk, semaglutide (0.5/1.0 mg/week) vs placebo for 104 weeks

Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis.

N Engl J Med (2001) · Rct · n=1637

Pivotal Fracture Prevention Trial: 1637 postmenopausal women with prior vertebral fractures randomized to PTH(1-34) 20 or 40 microg/day or placebo, median 21 months

Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial.

Lancet (2018) · Rct · n=1360

Head-to-head double-blind, double-dummy RCT of teriparatide 20 microg/day vs risedronate 35 mg/week in 1360 women with severe osteoporosis over 24 months

Teriparatide or alendronate in glucocorticoid-induced osteoporosis.

N Engl J Med (2007) · Rct · n=428

18-month randomized, double-blind, controlled head-to-head trial in 428 patients with glucocorticoid-induced osteoporosis