Weight loss drug’s heart benefits extend to people with heart failure, study finds

The anti-obesity medicine semaglutide might assist to stop coronary heart assaults and different main hostile cardiac occasions amongst obese individuals who have heart problems, whether or not or not in addition they have coronary heart failure, based on a brand new examine led by UCL’s Professor John Deanfield.

The outcomes comply with earlier analysis from the identical worldwide crew discovering that weekly injections of semaglutide have been linked to a 20% discount in main hostile cardiac occasions (MACE) equivalent to coronary heart assaults and strokes for folks with weight problems or who have been obese and had heart problems.

The new examine, printed in The Lancet, discovered comparable cardiovascular advantages for a subgroup of examine members who have been additionally judged to have coronary heart failure (i.e. whose hearts didn’t pump blood across the physique correctly) by a clinician at first of the trial.

The researchers checked out knowledge from 4,286 folks—out of a complete of 17,605 from the landmark Semaglutide and Cardiovascular Outcomes (SELECT) trial who have been randomly assigned both semaglutide or a placebo—who have been adopted up over a median of greater than three years.

They discovered that semaglutide was linked to a 28% discount in main hostile cardiac occasions (12.3% within the placebo group had such occasions in comparison with 9.1% within the semaglutide group), in addition to a 24% discount in cardiovascular disease-related deaths for this subgroup of individuals with pre-existing coronary heart failure, and a 19% discount in deaths of any trigger.

Lead creator Professor John Deanfield (UCL Institute of Cardiovascular Science) mentioned, “Our earlier SELECT evaluation confirmed the advantages of semaglutide for folks with heart problems who had weight problems or have been obese. This new examine finds that, inside this group, folks with coronary heart failure did simply in addition to folks with out by way of the outcomes we measured.

“This is necessary as there have been considerations that semaglutide is likely to be dangerous for folks with a sort of coronary heart failure often called lowered ejection fraction, the place the center pumps much less blood across the physique. Our findings present that the good thing about semaglutide was comparable no matter coronary heart failure kind.”

The examine checked out knowledge from the landmark SELECT trial—the most important and longest scientific trial of the consequences of semaglutide on weight in over 17,000 adults who didn’t have diabetes however who have been obese or had weight problems. The worldwide crew that runs the trial contains Professor Deanfield.

Semaglutide, a GLP-1 receptor agonist, simulates the capabilities of the physique’s pure incretin hormones, which assist to decrease blood sugar ranges after a meal. It was initially prescribed for adults with kind 2 diabetes.

Semaglutide is the energetic ingredient in Wegovy and Ozempic. In July, because of proof from the SELECT trial, the UK medicines regulator accredited Wegovy as a therapy for these with heart problems, which means it may be prescribed privately.

However, the drug just isn’t but really helpful for this use within the NHS. Its advantages might first have to be in comparison with these of one other new drugs, SGLT2 inhibitors, a diabetes drug additionally discovered to have cardiovascular advantages. (Wegovy is already out there on the NHS to assist with weight administration and for folks with kind 2 diabetes.)

The actual mechanism by which semaglutide delivers cardiovascular advantages just isn’t recognized, however might embrace the drug’s optimistic impacts on blood sugar, blood strain, and irritation, in addition to direct results on the center muscle and blood vessels.

The researchers mentioned the discount in all-cause mortality in all coronary heart failure teams “suggests the potential for different, as but unknown, advantages.”

The examine in contrast the affect of semaglutide for folks with two varieties of coronary heart failure: preserved ejection fraction, the place the center pumps blood usually however is simply too stiff to fill correctly, and lowered ejection fraction.

These two coronary heart failure varieties have totally different causes and reply to therapy in another way, with preserved ejection fraction, the most typical kind, not responding so properly to conventional remedies, resulting in appreciable unmet scientific want.

The researchers discovered the scientific advantage of semaglutide was no matter kind of coronary heart failure. It was additionally discovered to be impartial of age, intercourse, baseline BMI, and scientific standing.

Serious hostile occasions have been reported extra incessantly within the placebo group than within the semaglutide group. Treatment was discontinued extra usually within the semaglutide group, primarily pushed by gastrointestinal issues (14.7% vs. 9.0% within the coronary heart failure teams; and 17.2% vs. 7.9% in non-heart failure teams).

These findings, they mentioned, supported using semaglutide, on high of normal care, to cut back the danger of main hostile cardiac occasions in a broad inhabitants of individuals with established atherosclerotic heart problems and obese/weight problems.

The researchers famous additional trials have been wanted to judge the affect of semaglutide on coronary heart failure-related outcomes. As SELECT was not a devoted coronary heart failure trial, the examine outcomes can’t be extrapolated to sufferers with coronary heart failure usually, they mentioned.

In their part on limitations, the authors famous {that a} majority of examine members have been male and a excessive proportion have been white. In future, they mentioned, GLP-1 receptor agonist trials ought to study responses by ethnicity and intercourse.