In PepBank now:147 peptides, 6 blends and 13 other compounds97,577 study results from 17,383 studies8,473 clinical trialsUpdated
Comparing 2 peptides · Data version 308560
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| Peptide | Natural peptide Exenatide (exendin-4) | Synthetic analog Semaglutide | |
|---|---|---|---|
| Identity | |||
| Kind | Natural peptide | Synthetic analog | |
| Area | Weight and metabolic | Weight and metabolic | |
| Evidence | |||
| Amount of evidence | 3,292 | 4,624 | |
| Evidence level | Has results from studies in people | Has results from studies in people | |
| Safety | |||
| Safety results | 449 (415 in people) | 1,224 (1,221 in people) | |
| Status | |||
| Approval | |||
| Sport (WADA) | |||
| Registered trials | 322 · 11 active54 more mention it but do not test it | 663 · 284 active124 more mention it but do not test it | |
Shared outcomes
From the regulatory data of each peptide.
The FDA label for Byetta says: “Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus” No central EU authorisation (EMA).
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.
| Outcome group | Exenatide (exendin-4) | Semaglutide |
|---|---|---|
| Glycemic controlMetabolic and weight | 8967171727 |
PepBank is a research reference. Talk to a doctor before you use any peptide.
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…”
| Body weightMetabolic and weight | 27223438 | 969954105 |
|---|
| Adverse eventsWhole body | 27225121 | 7757723 |
|---|
| Gastrointestinal adverse eventsGastrointestinal | 1351341 | 345345 |
|---|
| Cardiovascular eventsCardiovascular | 41383 | 2672634 |
|---|
| LipidsMetabolic and weight | 11998201 | 1181171 |
|---|
| Kidney functionKidney and urinary | 947321 | 1361351 |
|---|
| Liver fat and liver functionLiver | 4826211 | 17917441 |
|---|
| PharmacokineticsPharmacology | 12978492 | 93894 |
|---|
| Heart functionCardiovascular | 14882606 | 67616 |
|---|
| Blood pressureCardiovascular | 58553 | 9999 |
|---|
| Appetite and food intakeNervous system and cognition | 802258 | 97952 |
|---|
Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.
Semaglutide differs from Glucagon-like peptide 1 (7-37) at 2 positions and carries 1 added group.
What is different
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.
Top 3 of 322 trials, ranked by phase, then posted results and enrollment: 3 completed · 3 with posted results · source ClinicalTrials.gov (opens in a new tab)
AstraZeneca14,752 participants18 Jun 2010 to 24 Apr 2017
Type 2 Diabetes Mellitus
AstraZeneca1,036 participantsSept 2009 to Aug 2012
Type 2 Diabetes Mellitus
AstraZeneca1,029 participantsSept 2006 to Mar 2011
Type 2 Diabetes Mellitus
54 more mention it but do not test it. They only measure it or name it in their text.
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)
Novo Nordisk A/S17,604 participants24 Oct 2018 to 29 Jun 2023
Overweight · Obesity
Novo Nordisk A/S9,651 participants17 Jun 2019 to 23 Aug 2024
Diabetes Mellitus, Type 2
Novo Nordisk A/S3,533 participants17 Jun 2019 to 9 Jan 2024
Diabetes Mellitus, Type 2
124 more mention it but do not test it. They only measure it or name it in their text.
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.
| Outcome | Exenatide (exendin-4) | Semaglutide |
|---|---|---|
| Glycemic controlMetabolic and weightCompared as: value in the arm that got the peptide, in % | −0.9% HbA1c reduction from baseline · Shown as a change. The study reports a hba1c reduction from baseline of this size. Dose studied: 2.0 mg56 weeksn = 8132018 | 1.5 to 1.9% HbA1c change · semaglutide 1.0 mg, non-elderly Dose studied: 0.5 or 1.0 mg once weeklyn = 3,0452018 |
| Inflammation markersImmune and inflammationCompared as: value in the arm that got the peptide, in % | −61% High-sensitivity CRP reduction · Shown as a change. The study reports a high-sensitivity crp reduction of this size. 1 yearn not reported2010 | −43.5% |
| Sex hormones and fertilityReproductive and sexual healthCompared as: value in the arm that got the peptide, in % | 29.2% Spontaneous pregnancy 12 weeksn = 1602022 | 35% natural pregnancy rate |
| LipidsMetabolic and weightCompared as: value in the arm that got the peptide, in mg/dl | −25.5 mg/dL Triglyceride change 3 monthsn = 502012 | −29.2 mg/dL Triglycerides change Dose studied: up to 1.0 mg/week30 weeksn = 154 |
| Body compositionMetabolic and weightCompared as: value in the arm that got the peptide, in % | −4.67% Total fat percentage reduction · Shown as a change. The study reports a total fat percentage reduction of this size. Dose studied: 10 μg twice daily12 weeksn = 1762017 | −40% Visceral fat area change · semaglutide 2.4 mg Dose studied: 2.4 mg once weekly |
| Body weightMetabolic and weightCompared as: difference from placebo, in kg | −3.1 kg Adjusted treatment difference 26 weeksn not reported2024 | |
| Adverse eventsWhole bodyCompared as: value in the arm that got the peptide, in % | 9.5% Adverse events Placebo: 2.3% Dose studied: 2 mg once weekly6 weeksn = 842021 | |
| Gastrointestinal adverse eventsGastrointestinalCompared as: value in the arm that got the peptide, in % | 41% Nausea Placebo: 8% Dose studied: 10 µg twice daily30 weeksn not reported2011 |
−0.9%
HbA1c reduction from baseline · Shown as a change. The study reports a hba1c reduction from baseline of this size.
Dose studied: 2.0 mg56 weeksn = 8132018
1.5 to 1.9%
HbA1c change · semaglutide 1.0 mg, non-elderly
Dose studied: 0.5 or 1.0 mg once weeklyn = 3,0452018
The other peptides have no randomized result on the same measure, so these results cannot be set side by side.
| Outcome | Exenatide (exendin-4) | Semaglutide |
|---|---|---|
| Cardiovascular eventsCardiovascularCompared as: difference from placebo, in p | 0.06 P P value for superiority Dose studied: 2 mg once weeklyn = 14,7522017 |
CRP change
Placebo: −7.3%
Dose studied: 2.4 mg once weekly52 weeksn = 5292023
−9.1 kg
Total body weight change
Dose studied: 2.4 mg/wk24 weeksn = 1012026
86.2% Adverse events · semaglutide 0.5 mg Dose studied: 0.5 mg56 weeksn = 6012018 |
42% Nausea · semaglutide 0.4 mg Placebo: 11% Dose studied: 0.4 mg once daily72 weeksn not reported2021 |
−61%
High-sensitivity CRP reduction · Shown as a change. The study reports a high-sensitivity crp reduction of this size.
1 yearn not reported2010
−43.5%
CRP change
Placebo: −7.3%
Dose studied: 2.4 mg once weekly52 weeksn = 5292023
29.2%
Spontaneous pregnancy
12 weeksn = 1602022
35%
natural pregnancy rate
Dose studied: 1 mg once weekly16 weeksn = 802025
−25.5 mg/dL
Triglyceride change
3 monthsn = 502012
−29.2 mg/dL
Triglycerides change
Dose studied: up to 1.0 mg/week30 weeksn = 1542025
−4.67%
Total fat percentage reduction · Shown as a change. The study reports a total fat percentage reduction of this size.
Dose studied: 10 μg twice daily12 weeksn = 1762017
−40%
Visceral fat area change · semaglutide 2.4 mg
Dose studied: 2.4 mg once weekly68 weeksn not reported2022
−3.1 kg
Adjusted treatment difference
26 weeksn not reported2024
−9.1 kg
Total body weight change
Dose studied: 2.4 mg/wk24 weeksn = 1012026
9.5%
Adverse events
Placebo: 2.3%
Dose studied: 2 mg once weekly6 weeksn = 842021
86.2%
Adverse events · semaglutide 0.5 mg
Dose studied: 0.5 mg56 weeksn = 6012018
41%
Nausea
Placebo: 8%
Dose studied: 10 µg twice daily30 weeksn not reported2011
42%
Nausea · semaglutide 0.4 mg
Placebo: 11%
Dose studied: 0.4 mg once daily72 weeksn not reported2021
No comparable result 78 randomized-trial results measure it in another way or another unit. |
| Blood pressureCardiovascularCompared as: difference from placebo, in mm hg | No comparable result 29 randomized-trial results measure it in another way or another unit. | −3.84 mm Hg SBP change at 13 weeks Dose studied: maximum 14 mg once dailyn = 9,6502026 |
|---|
| Cardiometabolic risk factorsMetabolic and weightCompared as: value in the arm that got the peptide, in % | No comparable result 2 randomized-trial results measure it in another way or another unit. | −61.1% Relative risk score change Placebo: −12.9% Dose studied: 2.4 mg68 weeksn = 1,5832023 |
|---|
| Liver fat and liver functionLiverCompared as: difference from placebo, in percentage points | No comparable result 18 randomized-trial results measure it in another way or another unit. | 28.7 percentage points Estimated difference Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025 |
|---|
0.06 P
P value for superiority
Dose studied: 2 mg once weeklyn = 14,7522017
No comparable result
78 randomized-trial results measure it in another way or another unit.
No comparable result
29 randomized-trial results measure it in another way or another unit.
−3.84 mm Hg
SBP change at 13 weeks
Dose studied: maximum 14 mg once dailyn = 9,6502026
No comparable result
2 randomized-trial results measure it in another way or another unit.
−61.1%
Relative risk score change
Placebo: −12.9%
Dose studied: 2.4 mg68 weeksn = 1,5832023
No comparable result
18 randomized-trial results measure it in another way or another unit.
28.7 percentage points
Estimated difference
Dose studied: 2.4 mg once weekly72 weeks (interim analysis; planned 240 weeks)n = 8002025