Liraglutide vs semaglutide

Liraglutide and semaglutide are both GLP-1 receptor agonists approved in the US and EU for type 2 diabetes and weight management. Liraglutide (Victoza, Saxenda) is the older drug, semaglutide (Ozempic, Wegovy) also comes as a tablet, and both have many studies in people. This page compares their results.

Best randomized result by outcome

For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.

Best randomized result by outcome for Liraglutide, Semaglutide
Outcome	Liraglutide	Semaglutide
Body weightMetabolic and weightCompared as: difference from placebo, in %	−8.03% mean difference Dose studied: 3.0 mg once daily24 weeksn = 572023	−2.54% Body weight change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026
Glycemic controlMetabolic and weightCompared as: difference from placebo, in percentage points	−0.75 percentage points HbA1c difference Dose studied: 0.75 mg once daily12 weeksn not reported2004	−0.87 percentage points HbA1c change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026
Liver fat and liver functionLiverCompared as: value in the arm that got the peptide, in %	39% Resolution of definite NASH Placebo: 9% Dose studied: 1·8 mg daily48 weeksn = 452016	62.9% Resolution of steatohepatitis Placebo: 34.3% Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg	−5 mm Hg 24-h systolic blood pressure change Dose studied: 1.8 mg/d12 weeksn = 272017	−3.9 mm Hg Systolic blood pressure difference Dose studied: 2.4 mg once weekly48 weeksn = 8032021
Exercise and physical functionCardiovascularCompared as: value in the arm that got the peptide, in m	488 m 6-minute walk distance 16 weeksn = 412024	21.5 m 6-minute walk distance change Placebo: 1.2 m Dose studied: 2.4 mg once weekly52 weeksn = 5292023
Body compositionMetabolic and weightCompared as: value in the arm that got the peptide, in %	−2.87% Mean percent change in thigh muscle fat Placebo: 0.05% Dose studied: 3.0 mg target dose, once daily40 weeksn = 1282024	−40% Visceral fat area change · semaglutide 2.4 mg Dose studied: 2.4 mg once weekly68 weeksn not reported2022
Appetite and food intakeMetabolic and weightCompared as: difference from placebo, in %	−≈ 16% Ad libitum energy intake decrease · Shown as a change. The study reports a ad libitum energy intake decrease of this size. Dose studied: 1.8 mg and 3.0 mgn = 492014	35% Energy intake difference Dose studied: 2.4 mg once weekly (dose-escalated)20 weeksn = 722021
Sex hormones and fertilityReproductive and sexual healthCompared as: value in the arm that got the peptide, in %	69.2% Cumulative pregnancy rate Dose studied: 1.2 mg once daily12 weeksn = 282018	35% natural pregnancy rate Dose studied: 1 mg once weekly16 weeksn = 802025
PharmacokineticsPharmacologyCompared as: value in the arm that got the peptide, in h	12.6 h half-life · NN2211 s.c. Dose studied: 1.25-12.5 microg/kgseven daysn not reported2002	145 to 165 h Half-life · semaglutide 2.4 mg Dose studied: 2.4 mg20 weeksn = 952021
Gastrointestinal motilityGastrointestinalCompared as: value in the arm that got the peptide, in min	70 min Gastric emptying delay median · liraglutide, 5 weeks Placebo, 5 weeks: 4 min Dose studied: 3·0 mg5 weeksn = 402017	171 min Gastric half-emptying time Placebo: 118 min Dose studied: 1.0 mg once weekly12 weeksn = 202023
Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in days	20 days RMST difference n not reported2018	8 days RMST difference · SUSTAIN-6, semaglutide minus placebo n not reported2018
Kidney functionKidney and urinaryCompared as: difference from placebo, in ml/min/1.73 m²/y	0.26 mL/min/1.73 m²/y eGFR slope decline slowed median follow-up 3.8 yearsn not reported2022	0.87 mL/min/1.73 m²/y eGFR slope decline slowed Dose studied: 1.0 mgmedian follow-up 2.1 yearsn not reported2022

Body weightMetabolic and weightCompared as: difference from placebo, in %
- Liraglutide
  −8.03%
  mean difference
  Dose studied: 3.0 mg once daily24 weeksn = 572023
- Semaglutide
  −2.54%
  Body weight change at 13 weeks
  Dose studied: maximum 14 mg once dailyn = 9,6502026
Glycemic controlMetabolic and weightCompared as: difference from placebo, in percentage points
- Liraglutide
  −0.75 percentage points
  HbA1c difference
  Dose studied: 0.75 mg once daily12 weeksn not reported2004
- Semaglutide
  −0.87 percentage points
  HbA1c change at 13 weeks
  Dose studied: maximum 14 mg once dailyn = 9,6502026
Liver fat and liver functionLiverCompared as: value in the arm that got the peptide, in %
- Liraglutide
  39%
  Resolution of definite NASH
  Placebo: 9%
  Dose studied: 1·8 mg daily48 weeksn = 452016
- Semaglutide
  62.9%
  Resolution of steatohepatitis
  Placebo: 34.3%
  Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025
Blood pressureCardiovascularCompared as: difference from placebo, in mm hg
- Liraglutide
  −5 mm Hg
  24-h systolic blood pressure change
  Dose studied: 1.8 mg/d12 weeksn = 272017
- Semaglutide
  −3.9 mm Hg
  Systolic blood pressure difference
  Dose studied: 2.4 mg once weekly48 weeksn = 8032021
Exercise and physical functionCardiovascularCompared as: value in the arm that got the peptide, in m
- Liraglutide
  488 m
  6-minute walk distance
  16 weeksn = 412024
- Semaglutide
  21.5 m
  6-minute walk distance change
  Placebo: 1.2 m
  Dose studied: 2.4 mg once weekly52 weeksn = 5292023
Body compositionMetabolic and weightCompared as: value in the arm that got the peptide, in %
- Liraglutide
  −2.87%
  Mean percent change in thigh muscle fat
  Placebo: 0.05%
  Dose studied: 3.0 mg target dose, once daily40 weeksn = 1282024
- Semaglutide
  −40%
  Visceral fat area change · semaglutide 2.4 mg
  Dose studied: 2.4 mg once weekly68 weeksn not reported2022
Appetite and food intakeMetabolic and weightCompared as: difference from placebo, in %
- Liraglutide
  −≈ 16%
  Ad libitum energy intake decrease · Shown as a change. The study reports a ad libitum energy intake decrease of this size.
  Dose studied: 1.8 mg and 3.0 mgn = 492014
- Semaglutide
  35%
  Energy intake difference
  Dose studied: 2.4 mg once weekly (dose-escalated)20 weeksn = 722021
Sex hormones and fertilityReproductive and sexual healthCompared as: value in the arm that got the peptide, in %
- Liraglutide
  69.2%
  Cumulative pregnancy rate
  Dose studied: 1.2 mg once daily12 weeksn = 282018
- Semaglutide
  35%
  natural pregnancy rate
  Dose studied: 1 mg once weekly16 weeksn = 802025
PharmacokineticsPharmacologyCompared as: value in the arm that got the peptide, in h
- Liraglutide
  12.6 h
  half-life · NN2211 s.c.
  Dose studied: 1.25-12.5 microg/kgseven daysn not reported2002
- Semaglutide
  145 to 165 h
  Half-life · semaglutide 2.4 mg
  Dose studied: 2.4 mg20 weeksn = 952021
Gastrointestinal motilityGastrointestinalCompared as: value in the arm that got the peptide, in min
- Liraglutide
  70 min
  Gastric emptying delay median · liraglutide, 5 weeks
  Placebo, 5 weeks: 4 min
  Dose studied: 3·0 mg5 weeksn = 402017
- Semaglutide
  171 min
  Gastric half-emptying time
  Placebo: 118 min
  Dose studied: 1.0 mg once weekly12 weeksn = 202023
Cardiovascular eventsCardiovascularCompared as: value in the arm that got the peptide, in days
- Liraglutide
  20 days
  RMST difference
  n not reported2018
- Semaglutide
  8 days
  RMST difference · SUSTAIN-6, semaglutide minus placebo
  n not reported2018
Kidney functionKidney and urinaryCompared as: difference from placebo, in ml/min/1.73 m²/y
- Liraglutide
  0.26 mL/min/1.73 m²/y
  eGFR slope decline slowed
  median follow-up 3.8 yearsn not reported2022
- Semaglutide
  0.87 mL/min/1.73 m²/y
  eGFR slope decline slowed
  Dose studied: 1.0 mgmedian follow-up 2.1 yearsn not reported2022

Comparing 2 peptides · Data version 308560

Only differences

Swipe sideways to see every peptide.

Comparison of Liraglutide, Semaglutide
Peptide	Synthetic analog Liraglutide	Synthetic analog Semaglutide
Identity
Kind	Synthetic analog	Synthetic analog
Area	Weight and metabolic	Weight and metabolic
Evidence
Amount of evidence	4,766	4,624
Evidence level	Has results from studies in people	Has results from studies in people
Safety
Safety results	805 (793 in people)	1,224 (1,221 in people)
Status
Approval
Sport (WADA)
Registered trials	469 · 30 active49 more mention it but do not test it	663 · 284 active124 more mention it but do not test it

Shared outcomes

Body weight1803
Glycemic control1785
Adverse events1279
Gastrointestinal adverse events530
Cardiovascular events400
Liver fat and liver function315
Heart function281
Lipids261
Kidney function240
Blood pressure219
Appetite and food intake209
Pharmacokinetics189

Approval and sport status

From the regulatory data of each peptide.

Liraglutide
The EMA label for Victoza says: “Adults, adolescents and children 10 years and older with insufficiently controlled type 2 diabetes, as an adjunct to diet and exercise”
Semaglutide
The FDA label for Ozempic says: “Adjunct to diet and exercise for glycemic control in adults with type 2 diabetes; reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease; reduce the risk of sustained eGFR decline…”

Amount of evidence by outcome

Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.

Study results per shared outcome group and evidence class
Outcome group	Liraglutide	Semaglutide
Body weightMusculoskeletal	83481717	969954105
Glycemic controlNervous system and cognition	1,1171067491	66866512
Adverse eventsWhole body	50449311	7757723
Gastrointestinal adverse eventsGastrointestinal	185185	345345
Cardiovascular eventsCardiovascular	13313111	2672634
Liver fat and liver functionMetabolic and weight	1361279	17917441
Heart functionCardiovascular	214198142	67616
LipidsMetabolic and weight	14313733	1181171
Kidney functionWhole body	1049932	1361351
Blood pressureCardiovascular	1201182	9999
Appetite and food intakeNervous system and cognition	1129517	97952
PharmacokineticsPharmacology	969231	93894

Sequence alignment

Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.

Against Glucagon-like peptide 1 (7-37)Liraglutide, Semaglutide

Liraglutide differs from Glucagon-like peptide 1 (7-37) at 1 position and carries 1 added group.

Top row: Glucagon-like peptide 1 (7-37) (parent, numbered from 7)
Bottom row: Liraglutide

HAEGTFTSDV

SSYLEGQAA

EFIAWLVGR

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 26: Lys carries an added group: lipidation.
2Position 34: Lys is replaced by Arg.

Semaglutide differs from Glucagon-like peptide 1 (7-37) at 2 positions and carries 1 added group.

Top row: Glucagon-like peptide 1 (7-37) (parent, numbered from 7)
Bottom row: Semaglutide

HEGTFTSDV

SSYLEGQAA

EFIAWLVGR

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 8: Ala is replaced by Aib, an amino acid that is not one of the standard 20.
2Position 26: Lys carries an added group: lipidation.
3Position 34: Lys is replaced by Arg.

Trials side by side

Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.

Liraglutide469 registered trials

Top 3 of 469 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT01179048

Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results

Novo Nordisk A/S9,341 participants31 Aug 2010 to 17 Dec 2015

Diabetes · Diabetes Mellitus, Type 2

Trial page ClinicalTrials.gov

CompletedPhase 3Results postedNCT01794143

A Comparative Effectiveness Study of Major Glycemia-lowering Medications for Treatment of Type 2 Diabetes

GRADE Study Group7,850 participantsMay 2013 to 30 Apr 2021

Type 2 Diabetes · Comparative Effectiveness of Glycemia-lowering Medications

Trial page ClinicalTrials.gov

CompletedPhase 3Results postedNCT01272219

Effect of Liraglutide on Body Weight in Non-diabetic Obese Subjects or Overweight Subjects With Co-morbidities: SCALE™ - Obesity and Pre-diabetes

Novo Nordisk A/S3,731 participants1 Jun 2011 to 2 Mar 2015

Metabolism and Nutrition Disorder · Obesity

Trial page ClinicalTrials.gov

49 more mention it but do not test it. They only measure it or name it in their text.

Semaglutide663 registered trials

Top 3 of 663 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT03574597