Daily Dose: Semaglutide Cuts CV Risk by 20% in Adults with Obesity, CVD and Without DM

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study presented at the American Heart Association (AHA) Scientific Sessions meeting in Philadelphia, PA, that examined whether the addition of semaglutide to standard care would be superior to placebo in reducing the risk of major adverse cardiovascular events among adults with overweight or obesity and pre-existing cardiovascular disease (CVD) who did not have diabetes.

The study

Authors of the SELECT trial enrolled 17 604 patients aged ≥45 years with pre-existing CVD and a body mass index of ≥27 kg/m² but no history of diabetes. Participants were randomly assigned in a 1:1 ratio to receive once-weekly subcutaneous semaglutide 2.4 mg (n=8803) or placebo (n=8801).

The primary end point was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke.

Findings

Treatment with semaglutide 2.4 mg for a mean duration of 33 months reduced the risk of a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke by 20%.

The side effect picture from the trial was mixed. The researchers tallied a lower incidence of serious side effects among the people randomized to treatment with semaglutide than among those randomized to placebo (33.4% vs 36.4%). However, side effects that led to patients discontinuing with their treatment were 2-times more common in the semaglutide group than in the placebo group (16.6% vs 8.2%), and gastrointestinal disorders (nausea, diarrhea), well-documented drawback of semaglutide, were the most common reason.

Authors' comment

“I think most of us believe that some of this is weight loss, but I think that oversimplifies a very complex molecule, a complex receptor on multiple tissues, and I don’t think it is as simple as that.”

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