Semaglutide heart benefits may go beyond weight loss
New data suggests that the benefits of Novo Nordisk’s GLP-1 agonist semaglutide in preventing cardiovascular diseases may not simply be a result of weight loss.
The analysis comes from long-term follow-up of patients with obese but non-diabetic patients in the SELECT trial, which supported the FDA approval of Novo Nordisk’s Wegovy formulation of semaglutide earlier this year to reduce the risk of serious cardiovascular conditions in people who are overweight or obese. It has not yet been cleared for that use in Europe.
While the heart health benefits of GLP-1 agonists have been linked to the amount of weight loss they can achieve, the new data suggests something else may be going on – and that could support wider use of the drugs to prevent cardiovascular disease.
In SELECT, semaglutide showed a 20% reduction in major adverse cardiovascular events (MACE) – including cardiovascular death, non-fatal heart attack, or non-fatal stroke – with the benefits seen regardless of patients’ baseline age, sex, race, ethnicity, and body mass index (BMI).
The new study, published in Nature Medicine and led by researchers at University College London (UCL), found that the significant weight loss achieved with the drug was sustained for up to four years.
Furthermore, it also showed that the cardiovascular benefits seen with semaglutide seemed to be present regardless of how much weight people taking the drug lost, even if they lost no weight at all. That suggests other factors – possibly reductions in blood sugar levels or inflammation and direct effects on the cardiovascular system – may also be having a benefit.
Lead author Prof John Deanfield – who was recently named the UK’s first Government Champion for Personalised Prevention – has said the data raises the possibility that widespread use of semaglutide and other drugs in the class could be used at scale to reduce cardiovascular risk.
That would not be so different to the way statins are now used in people with high cholesterol and blood pressure-lowering medications are used in people with hypertension.
“There are many people living with overweight or with obesity, who have struggled to improve their weight, and these drugs, for that reason alone, produce an important clinical opportunity,” he told the BBC’s Today programme this morning.
“But these are drugs that will also improve their background medical problems. That really is quite exciting, and we have to understand their place … now in future research.”
According to Dr Simon Cork, senior lecturer in physiology at Anglia Ruskin University, the new study is important as it has a bearing on the decisions by some health systems, including the UK NHS, to limit the duration of semaglutide therapy to two years.
“We know that weight regain is very common in patients who stop taking semaglutide after this time, but we didn’t (until now) have any safety data or proof that weight would remain off,” he said.
“Importantly, one of the decisions by the UK health service to limit to two years was because of questionable long-term cost-effectiveness,” he added. “That this data demonstrates improved cardiovascular and metabolic parameters continuing to four years may go some way to negating that argument.”
Image by Total Shape from Pixabay
