Switching from injectable semaglutide or tirzepatide to oral semaglutide led to significant weight loss at 3 months.Individuals with overweight or obesity lost a significant amount of weight 3 months after switching from an injectable formulation of semaglutide or tirzepatide to oral semaglutide, findings from the real-world OCTANE trial have shown. The switch was also associated with high treatment adherence and satisfaction.
“Patients experienced statistically significant reductions in weight and BMI 3 months post-switch,” said Dr Louis Aronne from the Comprehensive Weight Control Center, Weill Cornell Medicine, New York, New York, US, during his presentation at EASD 2026.
Three months after switching, the mean change in body weight was –4 kg (95 percent confidence interval [CI], –4.6 to –3.4; p<0.001), representing a 4.1 percent reduction. [EASD 2026, abstract LBA 59]
“In an exploratory assessment, the average pre-switch weight loss was approximately 3.9 percent, but further validation is needed before it can be completely characterized,” Aronne said. “However, a total of approximately 8 percent weight loss was achieved from the very beginning of treatment with the injectables up to the time of this analysis.”
Approximately 41 percent of participants achieved a weight loss of ≥5 percent. The mean change in BMI was –1.4 kg/m² (95 percent CI, –1.6 to –1.2; p<0.001).
The proportion of participants with obesity (BMI ≥30 kg/m²) decreased from 87.1 percent at baseline (54.6, 16, and 16.5 percent for obesity class I, II, and III, respectively) to 65.5 percent at 3 months (39.7, 14.9, and 10.8 percent, respectively).
Of note, only 12.9 percent of participants were overweight (27–29.9 kg/m2) at baseline. By month 3, this increased to 28.9 percent, and 5.7 percent were under the overweight category of 25–26.9 kg/m2.
At 3 months, approximately 90 percent of participants reported that they took their medication daily and 75 percent reported satisfaction with their treatment.
Approximately 82 percent of participants reported ≥1 meaningful improvement. Sixty-nine percent of participants reported that their clothes fit better, 51.5 percent noted that they were eating healthier, and over one-quarter reported having more energy during the day and being more physically active.
The most common index oral semaglutide dose was 1.5 mg (46.9 percent), followed by 25 mg (35.6 percent) and 9 mg (10.3 percent). “Most patients escalated their dose, with 57.2 percent achieving the 25-mg dose during the 3-month follow-up,” Aronne said. Approximately 26 percent were on the 9-mg dose, while 16.5 percent were receiving the 4-mg dose.
Oral Tx alternative
This retrospective analysis leveraged de-identified data from the large Ro telehealth platform in the US. The final study sample comprised 194 nondiabetic individuals with overweight or obesity who switched from injectable semaglutide or tirzepatide to oral semaglutide on the platform. The patients were on injectables for a mean 5.2 months.
At baseline, the mean weight was 100.5 kg, the mean BMI was 34.5 kg/m2, and 56.2 percent of the participants were women. Half of the participants switched from semaglutide injection, while the other half switched from tirzepatide.
Approximately one-third (30.9 percent) of participants who were initially on semaglutide injection had a last prescribed dose of ≥1.7 mg, while 58.8 percent of those who switched from tirzepatide injection had a last prescribed dose of ≥5 mg.
“These early real-world findings from a telehealth setting support oral semaglutide as an alternative treatment option for weight management among patients experienced with injectable incretin-based therapies,” Aronne concluded.