Four-Year Study Shows Semaglutide's Heart Benefits Beyond Weight Loss
Key Takeaways
- Semaglutide provides cardiovascular benefits beyond just weight loss.
- The SELECT trial indicates a 20% reduction in major cardiovascular events with semaglutide treatment.
- Mechanisms other than weight loss, such as improved blood pressure and reduced inflammation, may contribute to these benefits.
Did You Know?
Introduction: New Insights on Semaglutide
Four-year data from the SELECT clinical trial reveal remarkable findings about the drug semaglutide, marketed as Wegovy, and its cardiovascular benefits. Conducted among patients with preexisting cardiovascular disease (CVD), overweight or obesity, but no diabetes, the study uncovers significant improvements in patients' health beyond weight loss.
Presented at the 2024 European Congress on Obesity, the research also appears in the journal Nature Medicine. The findings highlight semaglutide’s role in lowering the risk of major adverse cardiovascular events (MACEs).
Weight Loss Outcomes
The SELECT trial included 17,604 patients from 41 countries who were given either semaglutide or a placebo for an average of 40 months. Participants injected semaglutide subcutaneously at a gradually increasing dose, reaching 2.4 mg per day by week 16.
Over the course of four years, patients on semaglutide showed a mean weight loss of 10.2% and a reduction of 7.7 cm in waist circumference. This weight loss and its sustained nature were found to be clinically meaningful.
Interestingly, women tended to lose more weight than men during the study. Those with higher BMI lost more weight compared to those starting with lower BMI values.
Cardiovascular Benefits
John Deanfield, MD, from University College London, focused on the cardiovascular benefits of semaglutide during the SELECT trial. His secondary analysis showed that the cardiovascular advantages of the drug appeared to be independent of weight loss or body fat percentage.
The study demonstrated a 20% reduction in the risk of major adverse cardiovascular events, including heart attacks, strokes, and deaths from cardiovascular causes. This shows semaglutide’s potential for treating CVD beyond its weight-loss effects.
Mechanisms Beyond Weight Loss
Deanfield suggested that other mechanisms such as improved blood sugar control, lower blood pressure, reduced inflammation, and direct effects on heart muscles and blood vessels might contribute to semaglutide’s cardiovascular benefits.
This broadens the potential applications of semaglutide in treating other diseases like kidney and neurological disorders, leveraging its initial development for type 2 diabetes and glycemic control.
Long-Term Implications
Donna Ryan, MD, highlighted the significance of the long-term effects of semaglutide seen in such a diverse study population, including older patients and those who had suffered previous cardiovascular events like strokes.
The study included patients who were not just typical subjects of weight management trials but also those with more severe health challenges, further proving semaglutide’s efficacy and broader applicability.
Adverse Events and Safety
Fewer adverse events were reported in patients treated with semaglutide compared to those on placebo. This reduction in cardiovascular incidents contributed significantly to its safety profile.
These findings emphasize that the benefits were consistent across different baseline BMI levels, further supporting the drug’s use in varied populations.
Future Perspectives
Naveed Sattar, PhD, from the University of Glasgow, and Professor Sir Martin Landray, MD, added that while semaglutide's direct cardiovascular effects are promising, weight loss remains a critical factor for overall health benefits, including managing heart failure and improving quality of life.
The study suggests that semaglutide, if affordable and widely available, could serve as a valuable tool in reducing cardiovascular risks for a broad range of patients with existing CVD, similar to how statins are used today.
Conclusion: A Paradigm Shift
The SELECT trial’s findings mark a significant step forward in understanding the dual benefits of semaglutide for weight loss and cardiovascular health. Clinicians can now consider it a multi-faceted treatment option for patients struggling with CVD and obesity.
As researchers continue to explore its full potential, semaglutide might become a cornerstone in the fight against cardiovascular diseases and related health conditions.
