What is the risk of pancreatitis with Wegovy (semaglutide)?

From the Guidelines

Wegovy (semaglutide) carries a small risk of pancreatitis as a potential side effect, with clinical trials showing that acute pancreatitis occurred in approximately 0.2% of patients taking Wegovy compared to 0.1% in those on placebo, as reported in the most recent study 1.

Key Points to Consider

• The risk of pancreatitis appears to be higher in people with a history of pancreatitis, gallbladder disease, or excessive alcohol consumption.
• The mechanism behind this side effect involves GLP-1 receptor activation, which increases pancreatic enzyme secretion and may potentially lead to inflammation in susceptible individuals.
• Patients taking Wegovy should be aware of pancreatitis symptoms, including severe abdominal pain that may radiate to the back, nausea, vomiting, and fever, and seek immediate medical attention if these symptoms occur.
• Healthcare providers should monitor patients for these symptoms, especially during the initial months of treatment.

Benefits and Risks

• While the risk of pancreatitis exists, it is essential to note that pancreatitis remains an uncommon side effect, and for most patients, the benefits of Wegovy for weight management outweigh this risk, as supported by the study 1.
• The study 1 also highlights the efficacy of semaglutide in reducing weight and improving weight-related comorbidities, which can have a significant impact on morbidity, mortality, and quality of life.

Monitoring and Precautions

• Patients with a history of pancreatitis or gallbladder disease should be closely monitored while taking Wegovy, and the medication should be discontinued if pancreatitis is suspected.
• Healthcare providers should also be aware of the potential consequences of delayed absorption of oral medications and monitor patients for gastrointestinal disorders, such as severe constipation and small bowel obstruction/ileus progression, as reported in the study 1.

From the FDA Drug Label

In glycemic control trials, acute pancreatitis was confirmed by adjudication in 7 OZEMPIC-treated patients (0.3 cases per 100 patient years) versus 3 in comparator-treated patients (0. 2 cases per 100 patient years). One case of chronic pancreatitis was confirmed in an OZEMPIC-treated patient. After initiation of OZEMPIC, observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting) If pancreatitis is suspected, OZEMPIC should be discontinued and appropriate management initiated; if confirmed, OZEMPIC should not be restarted.

The risk of pancreatitis on Wegovy (semaglutide) is present, with a reported incidence of 0.3 cases per 100 patient years in glycemic control trials.

• Patients should be carefully observed for signs and symptoms of pancreatitis after initiation of semaglutide.
• If pancreatitis is suspected, semaglutide should be discontinued and appropriate management initiated.
• The drug label advises against restarting semaglutide if pancreatitis is confirmed 2.

From the Research

Risk of Pancreatitis on Wegovy

• The risk of pancreatitis associated with Wegovy (semaglutide) is a concern, as it is a glucagon-like peptide-1 (GLP-1) receptor agonist, which has been linked to pancreatitis in some cases 3.
• However, a meta-analysis of 21 clinical trials found that semaglutide therapy was not associated with an increased risk of acute pancreatitis compared to placebo 4.
• Another study reported a case of acute pancreatitis likely due to semaglutide, highlighting the need for awareness among patients and clinicians 3.
• It is worth noting that the risk of pancreatitis may be higher in certain individuals, such as those with a history of pancreatic injury or those taking other medications that may increase the risk of pancreatitis.
• Orlistat, a pancreatic lipase inhibitor, has been associated with an increased risk of pancreatitis in some cases, but the evidence for semaglutide is less clear 5, 6.
• Overall, while there is some evidence to suggest a potential link between semaglutide and pancreatitis, the current evidence does not suggest a significant increased risk 4, 7.