The anti-diabetes semaglutide, a ‘pharmastar’ molecule which is very popular among VIPs for its anti-obesity effect, makes women lose more weight. The data emerges from a secondary analysis of STEP-HFpEF, a research program that evaluates the action of the drug in people suffering from obesity and heart failure (with or without diabetes), presented in Orlando, Florida during the 2024 Scientific Sessions of American Diabetes Association and published in the ‘Journal of the American College of Cardiology’ (JACC). With semaglutide, female patients lost on average almost 10% of their weight compared to approximately 7% of men: “A significant difference”, underline the authors, highlighting however that the improvement in cardiac symptoms was practically the same in both patients. sexes. This suggests that “the benefits of semaglutide for heart failure may be partly independent of weight loss.”
The STEP-HFpEF program, consisting of two studies (STEP-HFpEF and STEP-HFpEF DM), compared semaglutide with placebo in 1,145 participants – including 570 women – for 52 weeks. The objective of the analysis which appeared in Jacc and was illustrated at the congress by Subodh Verma, St. Michael’s Hospital and the University of Toronto in Canada, was to understand “whether the phenotypic characteristics and the effects of treatment with semaglutide vary according to sex in insufficiency obesity-related heart disease with preserved ejection fraction (HFpEF)”.
“Understanding sex differences in obesity-related HFpEF is of great importance,” explains senior author Mikhail Kosiborod, from the Saint Luke’s Mid-America Heart Institute in Kansas City, Missouri, considering that “obesity and Visceral adiposity are key factors in the development and progression of HFpEF and this may be even more amplified in women, who represent the majority of patients and bear a heavier burden of the symptoms and physical limitations of heart failure.” Verma, lead author, remarks: “It was observed that women with obesity and HFpEF had a higher BMI body mass index and were much more symptomatic. They also had greater systemic inflammation and, compared to previous research, were also younger” .
The analysis showed that semaglutide, compared to placebo, improved heart failure-related symptoms, physical limitations and exercise capacity similarly in men and women – even in key age and BMI subgroups, reducing the inflammation and natriuretic peptides. It also lowered my systolic (the ‘maximum’) blood pressure and waist size. As for weight loss, however, females experienced greater weight loss: on average they lost 9.6%, compared to 7.2% of males. “Although a significant reduction in body weight was found in both sexes, this was statistically significantly greater in women,” the authors point out.
In an accompanying editorial Anuradha Lala (Mount Sinai School of Medicine, head of heart failure research at the NHLBI Cardiothoracic Surgery Network) comments that “further studies are needed to shed light on the mechanism through which semaglutide produces benefits, with continued attention to the differences sex-specific responses to treatment”.
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