Adverse Events Associated with Ozempic (Semaglutide) in Real-World Settings: A Comprehensive Review

Ozempic (semaglutide) has emerged as a promising therapeutic option for individuals with type 2 diabetes mellitus (T2DM), offering significant benefits in glycemic control and weight management. While clinical trials have established its efficacy and safety profile, real-world evidence (RWE) provides valuable insights into the occurrence of adverse events associated with Ozempic use in routine clinical practice. This article aims to comprehensively review the adverse events reported with Ozempic in real-world settings and their clinical implications.

Gastrointestinal Symptoms:

Real-world evidence indicates that gastrointestinal adverse events are among the most commonly reported side effects associated with Ozempic therapy. These symptoms may include nausea, vomiting, diarrhea, and abdominal discomfort. While these adverse events are generally mild to moderate in severity and tend to diminish over time, they can impact patient adherence and quality of life, necessitating proactive management strategies.

Hypoglycemia:

Although Ozempic is associated with a low risk of hypoglycemia when used as monotherapy, real-world data suggest that the risk may increase when combined with other glucose-lowering agents such as sulfonylureas or insulin. Hypoglycemic events, while infrequent, should be carefully monitored, particularly in patients with heightened susceptibility or those receiving concomitant therapies that potentiate hypoglycemia.

Injection Site Reactions:

Injection site reactions, including erythema, pruritus, and swelling, have been reported in real-world studies of Ozempic. While these reactions are typically mild and transient, they may contribute to discomfort and affect patient satisfaction with therapy. Educating patients on proper injection techniques and rotating injection sites can help mitigate these adverse events.

Pancreatitis and Pancreatic Cancer:

Although rare, cases of pancreatitis and pancreatic cancer have been reported with the use of GLP-1 receptor agonists, including Ozempic, in real-world settings. While the causal relationship between Ozempic and these adverse events remains unclear, healthcare providers should remain vigilant for signs and symptoms suggestive of pancreatitis, such as persistent abdominal pain, and promptly evaluate and manage any suspected cases.

Acute Kidney Injury:

Real-world evidence suggests a potential association between GLP-1 receptor agonists, including Ozempic, and acute kidney injury (AKI). While the mechanism underlying this association is not fully understood, clinicians should exercise caution when prescribing Ozempic to patients with pre-existing renal impairment or other risk factors for AKI, and monitor renal function regularly during treatment.

Conclusion:

Real-world evidence provides valuable insights into the occurrence and management of adverse events associated with Ozempic use in clinical practice. While Ozempic offers significant benefits in glycemic control and weight management, healthcare providers should remain vigilant for potential adverse events, particularly gastrointestinal symptoms, hypoglycemia, injection site reactions, and rare but serious complications such as pancreatitis and acute kidney injury. Individualized patient assessment and close monitoring are essential to optimize the safety and tolerability of Ozempic therapy in patients with T2DM.