Evidence Grade A — Regulatory approved. 5387 published studies. 509 registered clinical trials.
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Liraglutide is a once-daily injectable GLP-1 medication sold as Victoza for type 2 diabetes and as Saxenda for weight management. It was one of the first GLP-1 treatments to prove that this drug class can reduce heart attacks and strokes in people with diabetes — a landmark finding from the LEADER trial. While newer GLP-1 medications now deliver significantly more weight loss, liraglutide has over a decade of real-world safety data.
Liraglutide is also known by these brand and alternate names:
5,387 published studies: 3267 human, 797 animal, 349 in-vitro, 1518 reviews
Liraglutide is marketed as Victoza for type 2 diabetes (approved 2010) and Saxenda for weight management (approved 2014). The LEADER trial, involving over 9,300 patients followed for nearly four years, established that liraglutide reduced the risk of major cardiovascular events by 13% — a landmark finding that helped establish GLP-1 treatments as a class with heart benefits. Saxenda is also approved for adolescents aged 12 and older.
While historically significant, liraglutide has been substantially surpassed by newer agents. In a direct comparison, semaglutide achieved 15.8% weight loss compared to liraglutide's 6.4%. Liraglutide remains relevant as a lower-intensity option and as a benchmark against which newer treatments are measured. It has over a decade of real-world safety data, making it one of the best-understood medications in this class.
Like semaglutide, liraglutide works by mimicking GLP-1, the natural hormone that helps control blood sugar and appetite after eating. It stimulates insulin release when blood sugar is elevated, suppresses the hormone that raises blood sugar, slows stomach emptying, and reduces appetite through the brain. The key difference from newer treatments like semaglutide is that liraglutide's molecular design gives it a shorter duration of action, requiring daily rather than weekly injections.
The LEADER trial, following over 9,300 patients for nearly four years, established that liraglutide reduces major cardiovascular events by 13%. This was a pivotal moment that helped redefine GLP-1 treatments as more than just blood sugar medications. Saxenda's approval for weight management and subsequently for adolescents aged 12 and older expanded the drug's reach beyond diabetes. However, liraglutide has been significantly surpassed in efficacy. In a direct comparison trial, semaglutide produced 15.8% weight loss versus liraglutide's 6.4%. Tirzepatide has shown even larger effects. The daily injection requirement also compares unfavourably to semaglutide's weekly dosing. Liraglutide carries the class-wide thyroid tumour boxed warning (based on animal studies) and risks including pancreatitis and gallbladder disease. It remains relevant as a lower-intensity option, as a benchmark for clinical research, and for its uniquely extensive long-term safety data.
PeptideTrace tracks 509 registered clinical trials for Liraglutide sourced from ClinicalTrials.gov.
Metabolic Surgery for Atrial Fibrillation Elimination
TP04HN106 in the Treatment of Patients With Amyotrophic Lateral Sclerosis
RWS of of Liraglutide Alone and in Combination With Orlistat for Weight Loss in Overweight/Obese Patients.
A Study to Estimate Early Clinical Efficacy Signals of GLP-1 Agonist Administration in Conjunction With Levonorgestrel Intrauterine Device in Obese Patients With Endometrioid Intraepithelial Neoplasia
The Evira Study: Additional Support During Obesity Treatment
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Liraglutide is an acylated human GLP-1 analogue with 97% homology to native GLP-1. It differs by a Lys34 substitution (replacing Arg34) and a C16 palmitic acid chain attached at Lys26 via a glutamic acid spacer. Its molecular weight is 3,751 Da, and the acylation provides a half-life of approximately 13 hours, enabling once-daily subcutaneous dosing.
Liraglutide activates the GLP-1 receptor via the same Gs/cAMP/PKA pathway as native GLP-1, producing glucose-dependent insulin secretion, glucagon suppression, delayed gastric emptying, and central appetite suppression. The C16 palmitic acid chain promotes self-association at the injection site and non-covalent albumin binding in the circulation, slowing absorption and renal clearance. Unlike semaglutide's C18 diacid chain, the shorter C16 chain results in lower albumin binding affinity, contributing to liraglutide's shorter half-life and need for daily dosing.
Liraglutide is marketed as Victoza (type 2 diabetes, approved January 25, 2010) and Saxenda (chronic weight management, approved December 23, 2014). In the SCALE Obesity and Prediabetes trial (N=3,731), liraglutide 3.0 mg achieved 8.0% mean weight loss versus 2.6% with placebo over 56 weeks, with 63.2% of patients losing ≥5% body weight versus 27.1%. The LEADER trial (N=9,340; median follow-up 3.8 years) demonstrated cardiovascular superiority with a 13% reduction in 3-point MACE (HR 0.87; 95% CI 0.78–0.97; P=0.01) and a secondary renal composite benefit (HR 0.78). In a head-to-head comparison (STEP 8), semaglutide 2.4 mg was substantially more effective for weight loss (15.8% vs 6.4%).
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Danuglipron's original twice-daily formulation achieved 8–13% weight loss in Phase IIb but with treatment discontinuation rates exceeding 50%, with nausea affecting up to 73% of patients. Pfizer discontinued the twice-daily formulation and is developing a once-daily modified-release version. Danuglipron is not a peptide. Its development trajectory illustrates that even effective weight loss compounds can fail commercially if tolerability is inadequate. The reformulation effort aims to reduce peak drug concentrations that likely drive the gastrointestinal side effects.
Setmelanotide is marketed as Imcivree (Rhythm Pharmaceuticals; approved November 2020 for POMC, PCSK1, or LEPR deficiency; June 2022 for Bardet-Biedl syndrome; December 2024 expanded to patients aged 2 years and older). Genetic testing confirming an eligible mutation is required before treatment. In patients with POMC or PCSK1 deficiency, approximately 80% achieved at least 10% weight loss in clinical trials. In Bardet-Biedl syndrome, 32.3% achieved the same threshold. The most common side effects are injection-site reactions and skin darkening (due to the melanocortin pathway's connection to pigmentation). Setmelanotide exemplifies precision medicine — it is highly effective in the specific genetic populations it targets but is not indicated for common obesity.
CT-388 is in Phase II/III development (not yet approved). Phase II results (469 patients, 48 weeks) showed 22.5% placebo-adjusted weight loss at the highest dose, with low discontinuation rates due to adverse events (5.9%). Phase III trials are underway. The combination of high efficacy and low discontinuation rates in Phase II is notable — many obesity drugs achieve high weight loss but suffer from tolerability-driven dropouts. Roche's $2.7 billion acquisition of the developer signals significant confidence in the programme.
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