Liraglutide

Deep dive

Liraglutide: complete reference

Liraglutide is a long-acting human GLP-1 analog developed by Novo Nordisk, with 97% sequence homology to native GLP-1. Structural modifications include a single amino-acid substitution (arginine at position 34) and attachment of a C16 fatty acid via a glutamic-acid spacer — enabling non-covalent albumin binding that extends half-life to approximately 13 hours, supporting once-daily subcutaneous injection. Liraglutide was FDA-approved in 2010 as Victoza for type 2 diabetes and in 2014 as Saxenda (at the higher 3.0 mg dose) for chronic weight management. Cardiovascular benefit was established in the LEADER trial (13% MACE reduction in T2D patients with established CVD). With the advent of weekly-dosed semaglutide and tirzepatide, liraglutide use has declined substantially — Novo Nordisk discontinued Victoza for the US market in April 2024 while continuing Saxenda. Saxenda remains relevant primarily for adolescents (FDA-approved for ages 12+) and patients who individually tolerate liraglutide better than newer agents.

In practice

Liraglutide was the second GLP-1 ever approved (after exenatide). Its daily dosing requirement was its main drawback — Wegovy (weekly semaglutide) largely replaced it for new patients.

Clinical context

Saxenda is one of two GLP-1s FDA-approved for adolescents (the other is Wegovy). For most adult patients, weekly options have replaced it.