Semaglutide Reduces Cardio Risk in Obesity Without Diabetes

This transcript has been edited for clarity.

Data from another cardiovascular outcomes trial were just released at the American Heart Association meetings and simultaneously published in The New England Journal of Medicine.

This study looked at semaglutide in people with obesity without diabetes, but with known cardiovascular disease. This was a randomized controlled trial looking at semaglutide vs placebo in these individuals who had an average BMI of 33 and a cardiovascular event, so they either had a prior myocardial infarction, a prior stroke, or had peripheral vascular disease.

This was a huge trial. It included 17,604 people, lasting for an average of 34 months. In this study, they showed a significant 20% reduction in the cardiovascular endpoint, which was defined as death from a cardiovascular cause, a nonfatal myocardial infarction, or a nonfatal stroke. This was very significant and consistent with the cardiovascular outcomes data we have with semaglutide in people with type 2 diabetes.

What is different and interesting to me is that many of these people actually had prediabetes. The average A1c in this trial was 5.78%, with about two thirds of the people having prediabetes. The patients who were treated with semaglutide had a reduction in the progression of prediabetes to diabetes, and a reduction in the progression of normal glycemia to prediabetes.

Here, we see both a reduction in cardiovascular events in patients who have obesity and cardiovascular disease, as well as a slowing of progression of prediabetes to diabetes. This confirms what we really already knew, which is that semaglutide reduces the risk for cardiovascular events in people with type 2 diabetes.

Now, we have data that it also reduces cardiovascular risk in people who have obesity, but not type 2 diabetes, but have had a prior cardiovascular event. We also have nice data on its impact on the rates of progression of prediabetes.

Additionally, there was no increase in the risk for pancreatitis in these individuals treated with semaglutide compared with placebo. There was no increase in the risk for depression, but there was an increase in risk for gallbladder-related complications.

This has been Dr Anne Peters for Medscape.

Anne L. Peters, MD, is a professor of medicine at the University of Southern California (USC) Keck School of Medicine and director of the USC clinical diabetes programs. She has published more than 200 articles, reviews, and abstracts, and three books, on diabetes, and has been an investigator for more than 40 research studies. She has spoken internationally at over 400 programs and serves on many committees of several professional organizations.

Cite this: Anne L. Peters. Semaglutide Reduces Cardiovascular Risk in Obesity Without Diabetes - Medscape - Dec 05, 2023.

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