In 366 patients from the Middle East, liraglutide and semaglutide produced comparable weight loss, but semaglutide was significantly better at reducing HbA1c levels.
No significant weight loss difference (P=0.867)Liraglutide and semaglutide produced comparable weight reduction in 366 real-world patients, though semaglutide was superior for HbA1c control
What the researchers found
Among 366 patients (122 liraglutide, 244 semaglutide) with similar baseline characteristics (mean age ~51, mean weight ~94.6-94.7 kg):
- **Weight loss**: No significant difference between liraglutide and semaglutide (P = 0.867)
- **HbA1c reduction**: Semaglutide was significantly superior — median reduction of -0.5% vs. -0.2% for liraglutide (P = 0.003)
- **Lipids**: Both drugs significantly lowered LDL cholesterol and triglycerides
- **Multivariable analysis**: Confirmed no significant difference in weight loss between drugs (B -0.577, 95% CI -1.87 to 0.7; P = 0.38)
- Baseline weight, diabetes status, and SGLT2 inhibitor use were identified as significant factors affecting weight outcomes
Why it matters
With multiple GLP-1 drugs now available, clinicians and patients need real-world data to guide treatment choices. While randomized trials have studied these drugs individually, head-to-head comparisons in real clinical practice are scarce. This study provides practical evidence from a Middle Eastern population — a region with high rates of obesity and diabetes — showing that the weight loss difference between these two drugs may be less dramatic than marketing suggests.
How the study worked
This was a retrospective observational cohort study conducted at a quaternary care hospital in the Middle East Gulf region from June 2018 to July 2022. Adults who received either liraglutide or semaglutide during the study period were identified from medical records. Weight loss was the primary outcome, with HbA1c and lipid changes as secondary outcomes. Multivariable linear regression was used to control for confounding factors.
What this study cannot tell us
This is a retrospective observational study, not a randomized controlled trial, so it cannot establish causation and may be affected by selection bias and unmeasured confounders. The liraglutide group had a longer median follow-up (10 vs. 7.5 months), which could affect comparisons. The abstract does not report the absolute weight loss in kilograms for either group. Dosing details and adherence rates are not specified. The study comes from a single center in the Gulf region, which may limit generalizability.
How to read the evidence
This is a single-center retrospective observational cohort study. While it provides useful real-world data, the non-randomized design, potential for selection bias, and unequal follow-up periods limit the strength of conclusions. It is lower-level evidence than randomized controlled trials.
When this study was published
Published in 2025, this study covers patients treated from 2018-2022 and provides contemporary real-world data on two of the most widely prescribed GLP-1 drugs.
The bigger picture
Most existing comparisons between GLP-1 drugs come from network meta-analyses or indirect comparisons of separate clinical trials. Real-world head-to-head data like this study provides is valuable because it reflects actual clinical conditions — patient selection, dosing patterns, adherence, and concurrent medications. The finding that weight loss is comparable while glycemic control favors semaglutide adds nuance to prescribing decisions.
Questions still open
- Would the weight loss difference between liraglutide and semaglutide become significant with longer follow-up and standardized doses?
- How do these real-world results compare to randomized trial data like the STEP and SCALE programs?
- Does the superior glycemic effect of semaglutide translate to better long-term cardiovascular outcomes compared to liraglutide?
Common questions
If both drugs cause similar weight loss, why would someone choose semaglutide over liraglutide?
Does this study mean the weight loss differences seen in clinical trials aren't real?
Read the original research
Comparing the Efficacy of Liraglutide and Semaglutide on Weight Loss: Experience from the Middle East Gulf Region and Literature Review.
Hospital pharmacy, 00185787251340645
Citation
El Nekidy, Wasim S; Hasan, Haneen; Abidi, Emna; Al Sayegh, Layth; Dajani, Ruba Z; El-Kaissi, Samer; Hegazin, Safa B; Mallat, Jihad. (2025). Comparing the Efficacy of Liraglutide and Semaglutide on Weight Loss: Experience from the Middle East Gulf Region and Literature Review.. Hospital pharmacy, 00185787251340645. https://doi.org/10.1177/00185787251340645