Semaglutide Linked to Lower Seizure and Alcohol-Related Hospitalization Risks; Brazil Approves Five New GLP-1 Drugs

New research and regulatory actions are expanding the role of GLP-1 receptor agonists: a large population-based study found semaglutide associated with a lower risk of adult-onset seizures, a BMJ Open study linked newer GLP-1 medications to reduced alcohol-related hospitalizations, and Brazil's health regulator Anvisa approved five new injectable semaglutide drugs for diabetes and obesity.

In the seizure study, researchers used electronic medical record data from the All of Us program of the National Institutes of Health, selecting 69,228 patients with type 2 diabetes from about 390,000 people. Among 18,243 adults newly prescribed semaglutide, other glucose-lowering drugs, or SGLT2 inhibitors, the semaglutide group had about a 56% lower risk of adult-onset seizures than the group receiving other glucose-lowering drugs (hazard ratio 0.44), and about a 52% lower risk compared with SGLT2 inhibitors (hazard ratio 0.48). The four-year cumulative risk differences were 1.78 and 1.46 percentage points, respectively. Converting to number needed to treat, treating 70 patients with semaglutide instead of other glucose-lowering drugs, or 131 patients instead of SGLT2 inhibitors, could prevent one additional case of adult-onset seizure. Mediation analysis showed changes in glycated hemoglobin accounted for only 2.4% to 6.5% of the effect and changes in BMI accounted for 0% to 0.7%, and the preventive effect was not clearly observed with other GLP-1 class drugs. The findings were published in a recent issue of Neurology.

Another study, published online in BMJ Open, compared alcohol-related hospitalizations in 40,703 adults with alcohol-use disorder and type 2 diabetes or obesity who started a newer GLP-1 receptor agonist (semaglutide or tirzepatide) or a comparator drug between 1 January 2018 and 31 December 2024. Participants taking GLP-1 receptor agonists had a lower risk of alcohol-related admission to hospital during all four trials. Use of GLP-1 receptor agonists was associated with a 26% lower risk of alcohol-related hospital admission than other diabetes medicines and a 32% lower risk than other obesity medicines. Compared with taking drugs for alcohol-use disorder, including acamprosate, disulfiram and naltrexone, use of GLP-1 receptor agonists by adults with type 2 diabetes was associated with a 63% lower risk of alcohol-related hospitalization, and for adults with obesity a 65% lower risk. The authors concluded that initiation of newer GLP-1 receptor agonists among patients with alcohol-use disorder was associated with a lower observed risk of alcohol-related hospitalization, with similar associations across populations with type 2 diabetes and obesity.

In Brazil, health regulator Anvisa approved five new injectable GLP-1 drugs for diabetes and obesity treatment, following expedited regulatory reviews after the expiration of Ozempic's patent in the country in March. The newly authorized medications – Owozy, Seemasun, Zempneo, Semavy, and Orsema – all use synthetically obtained semaglutide as their active ingredient. Authorized based on clinical comparisons to Ozempic, the injectables are cleared alongside diet and exercise for adult patients who cannot tolerate metformin. The approvals follow an accelerated initiative by Anvisa to clear registration backlogs for semaglutide and liraglutide treatments; the regulator has completed reviews for 11 of 24 candidate therapies, resulting in six total approvals after clinical trials, document reviews, and factory inspections. The first synthetic semaglutide pen was greenlighted by Anvisa in May, with the registering of EMS's drug Ozivy.

Among current FDA-approved weight loss injections, tirzepatide and semaglutide are considered the most effective for eligible adults. Tirzepatide is a weekly GIP and GLP-1 medication that produced some of the largest average reductions in body weight in clinical trials, with average weight reductions reaching approximately 20% or more at higher studied maintenance doses. Semaglutide is a weekly GLP-1 medication; its trials demonstrated substantial average weight reduction, commonly around 15% in key adult obesity studies. Liraglutide, a daily GLP-1 injection, generally produces less average weight loss. FDA-approved weight-management brands include Zepbound for tirzepatide, Wegovy for semaglutide, and Saxenda for liraglutide.

A commentary by researchers at the American Gastroenterological Association, published in the Gastroenterology Journal in June 2026, updates the POWER framework first released in 2017 for guiding obesity treatment. The authors note that GLP-1 receptor agonists have become mainstream treatment options, less invasive procedures such as endoscopic sleeve gastroplasty have improved, and bariatric surgery has expanded. They point out that BMI alone does not capture the full picture of health risk, citing the concept of 'clinical obesity,' and connect obesity to diabetes, kidney and liver disorders, and cardiovascular disease. The update emphasizes that no single treatment works best on its own, and that combining approaches — for example, pairing an endoscopic procedure with a GLP-1 medication — produced significantly more weight loss than the procedure alone. The commentary also makes a case for gastroenterologists and hepatologists playing a role in obesity treatment.