A closer look at how weight loss drug semaglutide improves the cardiovascular health of obese patients without diabetes
Weekly treatments of semaglutide can reduce the risk of cardiovascular death, heart attack or stroke among obese patients without diabetes, according to new data presented at the American Heart Association’s Scientific Sessions 2023 conference and simultaneously published in The New England Journal of Medicine.[1]
Subcutaneous treatments of semaglutide, a GLP-1 receptor agonist originally developed to treat diabetes, are being sold and marketed by Novo Nordisk under the brand name Wegovy. (Novo Nordisk also sells Ozempic, a slightly different form of semaglutide.)
Prior research had already confirmed semaglutide/Wegovy can help overweight and obese patients lose weight. However, this represents the first time it has been proven that a medication for weight loss can also significantly reduce a patient’s major adverse cardiovascular event (MACE) risk.
Novo Nordisk first shared initial results from the SELECT trial back in August, promising that the full study would come later in the year. The company has now followed through with that promise by sharing the full results at AHA 2023 and in NEJM.
“This landmark study builds on more than 20 years of research in obesity, a serious chronic disease associated with severe co-morbidities and outcomes,” Martin Langue, executive vice president and head of development at Novo Nordisk, said in a statement. “The results from SELECT will be instrumental in changing the way we perceive and treat obesity.”
Exploring data on the cardiovascular impact of weekly semaglutide treatments from the SELECT trial
SELECT enrolled more than 17,000 patients with pre-existing cardiovascular disease who were overweight or obese, but did not present with diabetes. While one-half of the study’s participants were treated with semaglutide, the other half was treated with a placebo. Treatment went on for a mean duration of 34.2 months. The mean duration of follow-up, meanwhile, was nearly 40 months.
Overall, MACEs—deaths from cardiovascular causes, nonfatal myocardial infarctions or nonfatal strokes—were seen in 6.5% of patients treated with semaglutide and 8% of patients treated with a placebo. Cardiovascular death, meanwhile, was seen in 2.5% of semaglutide patients and 3% of placebo patients, not enough of a difference to be viewed as significant.
Semaglutide was also associated with a significant reduction in the risk of heart failure hospitalization or all-cause mortality. In addition, though this specific study was not designed to focus on weight loss, it was linked helping patients lose an average of 9.4% of their total body weight.
Another key takeaway was that serious adverse events of any kind were reported in 33.4% of semaglutide patients and 36.4% of placebo patients.
Reviewing their findings, the study’s authors made sure they also focused on its limitations. For example, only patients with preexisting cardiovascular disease were included, a detail that means the medication may not necessarily be as helpful for all obese/overweight patients. Another key limitation was that the study’s patient population was not diverse enough to be viewed as a “globally representative population.”
‘Semaglutide has ushered in a new era’
Donna Ryan, MD, professor emeritus for the Pennington Biomedical Research Center at Louisiana State University, served as co-chair of the SELECT trial’s steering committee. She said in a statement that semaglutide provides a new way for physicians to “address the resulting effects of obesity and diabetes."
“Semaglutide has ushered in a new era of medications for weight loss and the results of the SELECT study are showing that its benefits extend beyond that of treating obesity,” she said.
Novo Nordisk is working to gain an updated indication from the U.S. Food and Drug Administration for Wegovy based on these positive results. An answer from the agency is expected in 2024.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.