Imcivree Vs. Wegovy: Drug Comparison

Imcivree^® (setmelanotide) is a medication used to treat rare genetic conditions that cause severe obesity by activating the melanocortin-4 receptor (MC4R), which helps regulate hunger and energy expenditure. Its FDA-approved indications include the treatment of obesity due to certain genetic conditions, including POMC (pro-opiomelanocortin gene) deficiency, LEPR (leptin receptor gene) deficiency, and Bardet-Biedl syndrome. Imcivree is available as a subcutaneous injection, typically administered daily. Common side effects include injection site reactions, darkening of the skin, and nausea, with more serious risks including depression and suicidal thoughts.

Wegovy^® (semaglutide) is an injectable medication approved for chronic weight management in adults with obesity or overweight with at least one weight-related condition, such as hypertension, type 2 diabetes, or high cholesterol. It works by mimicking the hormone glucagon-like peptide-1 (GLP-1), which regulates appetite and food intake, leading to reduced calorie consumption and significant weight loss. Wegovy is administered once weekly and is intended to be used in conjunction with a reduced-calorie diet and increased physical activity. Common side effects include nausea, diarrhea, vomiting, and constipation. It should be used with caution in patients with a history of pancreatitis and is not recommended for use in pregnant or breastfeeding individuals​.

Melanocortin 4 (MC4) receptor agonist

Glucagon-like peptide-1 (GLP-1) receptor agonist

Imcivree (setmelanotide) is indicated for chronic weight management in adult and pediatric patients 6 years of age and older with monogenic or syndromic obesity due to:

• Pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency as determined by an FDA-approved test demonstrating variants in POMC, PCSK1, or LEPRgenes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS)

• Bardet-Biedl syndrome (BBS)

Wegovy (semaglutide) is indicated in combination with a reduced calorie diet and increased physical activity:

• To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight

• To reduce excess body weight and maintain weight reduction long term in:

  • Adults and pediatric patients aged 12 years and older with obesity

  • Adults with overweight in the presence of at least one weight-related comorbid condition

• Typically taken as an injection once daily

• Comes in a 10 mg/mL solution in a 1 mL multiple-dose vial

• Typically taken as an injection once weekly

• Comes in single-dose pens that deliver 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg per injection

The most common adverse reactions (incidence ≥20%) included:

• Skin hyperpigmentation

• Injection site reactions

• Nausea

• Headache

• Diarrhea

• Abdominal pain

• Vomiting

• Depression

• Spontaneous penile erection

Most common adverse reactions (incidence ≥5%) in adults or pediatric patients aged 12 years and older are:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Headache

• Fatigue

• Indigestion

• Dizziness

• Abdominal distension

• Belching

• Low blood sugar in patients with type 2 diabetes

• Flatulence

• Inflammation of the digestive system

• Gastroesophageal reflux disease (heartburn)

• Inflammation of the nasal cavities and back of the throat

• Prior serious hypersensitivity to setmelanotide or any of the excipients in Imcivree

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Known hypersensitivity to semaglutide or any of the excipients in Wegovy

• Drug interactions: Wegovy delays gastric emptying. May impact absorption of concomitantly administered oral medications

• Disturbance in sexual arousal

• Depression and suicidal ideation

• Hypersensitivity reactions

• Skin pigmentation and darkening of pre-existing nevi

• Pregnancy: Risk of serious adverse reactions due to benzyl alcohol preservative in neonates and low birth weight infants

• Breastfeeding: Not recommended when breastfeeding

• Acute pancreatitis

• Acute gallbladder disease

• Low blood sugar: Concomitant use with insulin or an insulin secretagogue may increase the risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Diabetic retinopathy complications in patients with type 2 diabetes

• Heart rate increase

• Suicidal behavior and ideation

• Pregnancy: May cause fetal harm. When pregnancy is recognized, discontinue Wegovy

• Females and males of reproductive potential: Discontinue Wegovy at least 2 months before a planned pregnancy because of the long half-life of semaglutide

WARNING: RISK OF THYROID C-CELL TUMORS

In rodents, semaglutide causes thyroid C-cell tumors at clinically relevant exposures. It is unknown whether Wegovy causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

Wegovy is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

*This information is from the label for brand name Imcivree^®. See the Full Prescribing Information for more complete information.

*This information is from the label for brand name Wegovy^®. See the Full Prescribing Information for more complete information. Semaglutide, the active ingredient in Wegovy, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient semaglutide.