OASIS-4 Journal Club
Journal club review of the OASIS-4 trial evaluating oral semaglutide 25 mg for weight loss, including efficacy, safety outcomes, and clinical impact.
The New England Journal of Medicine published the OASIS-4 trial in September 2025. This post is a journal club breaking down the OASIS-4 trial and what change it may bring to our clinical practice.
Background/Overview
Title: Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity
Citation: Wharton S, Lingvay I, Bogdanski P, et al. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. N Engl J Med. 2025;393(11):1077-1087. doi:10.1056/NEJMoa2500969
Objective: To determine the efficacy and safety of oral semaglutide 25 mg for weight loss in overweight or obese patients without diabetes.
Background: Obesity can reduce life expectancy and increase the risk of comorbidity development. With obesity rates continuing to rise, additional therapies are warranted. Semaglutide has been approved as a subcutaneous injection for type 2 diabetes and as an adjunct therapy for weight loss (in addition to lifestyle modifications) in certain populations. Oral semaglutide has been approved for type 2 diabetes and showed positive results for weight loss in the OASIS-3 trial at a dose of 50 mg once daily. A lower dose of 25 mg once daily by mouth of semaglutide may also provide similar benefits while minimizing drug exposure and potential adverse effects.
Primary Efficacy Measure: (1) Percent change in body weight (2) Reduction in body weight ≥5%