The drug semaglutide can produce significant weight loss in overweight or obese adults who do not have diabetes, reducing cardiovascular events independent of weight loss. These are the indications that come from two studies that were presented at the European Congress on Obesity (Eco), underway in Lido di Venezia, based on the most extensive research carried out on this drug, ‘Select’ (Semaglutide and cardiovascular outcomes), initiated in 2018 and enrolled 17,604 people in 41 countries. The first study, conducted by Donna Ryan of the Pennington Biomedical Research Center, New Orleans, USA, and published in Nature Medicine, examines the long-term effects of semaglutide on weight. The second, conducted by John Deanfield of University College London, investigates the cardiovascular benefits by also evaluating the correlation with the amount of weight lost. Semaglutide is a Glp-1 drug prescribed for adults with type 2 diabetes, but also indicated for weight loss in people with obesity or overweight who have at least one other health problem.
In 2023, the Select study – on which the new data is based – highlighted that adults with overweight or obesity but not diabetes who took semaglutide for more than 3 years had a 20% lower risk of heart attack, stroke or death from of cardiovascular disease and lost an average of 9.4% body weight. The results of the new analyzes showed that treatment with semaglutide brought cardiovascular benefits, regardless of initial weight and the amount of weight lost. This suggests – explain the authors – that even patients with relatively mild levels of obesity, or those who lose only a modest amount of weight, may have improved cardiovascular outcomes.
These findings have important clinical implications,” says Deanfield. “About half of the patients I see for cardiovascular problems have weight levels equivalent to those in the ‘Select’ study and will likely benefit from taking semaglutide in addition to the treatments indicated by the lines guide”.
“Our results – he adds – show that the magnitude of the effect of semaglutide treatment is independent of the amount of weight lost, suggesting that the drug has other actions that reduce cardiovascular risk. These mechanisms may include a positive impact on blood sugar, blood pressure, or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these.” Despite the promising results, the authors caution that ‘Select’ is not a primary prevention study, so the data cannot be applied to all adults with overweight and obesity for the prevention of adverse cardiovascular events.
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