Semaglutide for Cardiovascular Health in Obesity

In today’s world, obesity has reached alarming levels, with cardiovascular diseases (CVD) emerging as a formidable threat to public health. But what if we told you that medication might hold the key to slimming down that risk? Enter semaglutide, a glucagon-like peptide-1 receptor agonist, which has been causing quite a stir in the medical world.

Traditionally known for its effectiveness in managing diabetes, semaglutide has recently made headlines for its potential role in curbing CVD in individuals who are overweight or obese but do not have diabetes. The SELECT trial, an international randomized controlled trial (RCT), has shed light on this intriguing possibility.

In this groundbreaking study, adults aged 45 or above with prior cardiovascular disease and BMI of 27 or higher, but no diabetes history, were recruited by researchers. The participants were randomly assigned either a weekly subcutaneous injection of Semaglutide at a 2.4mg dose or a placebo. The primary goal? To assess the impact on cardiovascular health, specifically by measuring a composite endpoint that included cardiovascular-related death, nonfatal myocardial infarction (heart attack), and nonfatal stroke in a time-to-first-event analysis. Of course, safety was also a top priority.

The results were nothing short of remarkable. Of the 17,604 patients enrolled in the trial, 8803 received semaglutide, while 8801 received a placebo. Over an average follow-up period of 39.8 months, the semaglutide group experienced a 20% reduction in the primary cardiovascular endpoint compared to the placebo group, with 6.5% of patients in the semaglutide group and 8.0% in the placebo group experiencing such events. 

Out of the 1461 patients who were administered with semaglutide, a higher number of patients experienced side effects that led to discontinuation of the trial product. In comparison, to 718 patients in the placebo group had to discontinue the medication.

What does all of this mean? Well, it suggests that semaglutide, typically used for diabetes and weight management, could potentially be a game-changer in the fight against CVD in individuals grappling with obesity. While the medication has its side effects, the prospect of significantly lowering cardiovascular risk in this high-risk population is undeniably exciting.

So, as we navigate the obesity epidemic, keep an eye out for semaglutide—it might just be the key to unlocking better cardiovascular health for many who need it most.

Translation of the linked study

Breaking this down into simpler terms:

Study Population: A total of 17,604 patients were part of this study. They were divided into two groups:

8,803 patients received a Semaglutide.
8,801 patients received a placebo, which is basically a treatment that looks like the medication but has no active ingredient.

Duration of Treatment and Follow-up:

On average, patients took semaglutide or the placebo for about 34.2 months, but this varied a bit among patients (some more, some less, with a variation of 13.7 months).

The average time the patients were observed or followed up in the study was about 39.8 months, with a similar variation of 9.4 months.

Main Results – Cardiovascular Events:

The main thing they were looking at was how many patients experienced major heart-related problems (like heart attacks, strokes, etc.).

In the semaglutide group, 569 out of 8,803 patients (or 6.5%) had such events.

In the placebo group, 701 out of 8,801 patients (or 8.0%) had these events.

They used something called a hazard ratio to compare these rates, which was 0.80. This means that the risk of having these events was 20% lower in the semaglutide group compared to the placebo group. The 95% confidence interval (0.72 to 0.90) suggests they are pretty confident about this finding.

The “P<0.001” part means that the results were statistically significant – the likelihood that this result is due to chance is less than 1 in 1,000.

Adverse Events Leading to Discontinuation:

They also looked at how many patients stopped taking their assigned treatment due to adverse events or side effects.

In the semaglutide group, this happened to 1,461 patients (16.6%).
In the placebo group, it happened to 718 patients (8.2%).
Again, the “P<0.001” indicates that this difference is very unlikely to be due to chance.

The study shows that semaglutide seems to reduce the risk of major heart-related problems compared to a placebo, but more people stopped taking it due to side effects.

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