Semaglutide is a GLP-1 receptor agonist that is primarily prescribed for the treatment of type 2 diabetes. However, people who are overweight or obese are also often candidates for treatment with the drug - even though they may not have diabetes. Semaglutide, also known under the trade name Ozempic, is often praised as the weight loss medication par excellence and quite a few entertainment personalities resort to injections to lose a lot of weight, quickly. However, it should not be forgotten that the drug primarily offers benefits for high-risk populations: for example, overweight people with pre-existing cardiovascular disease. A recent study (DOI: 10.1056/NEJMoa2307563) focussed on precisely this population.
It is undisputed that the drug leads to weight loss. It is also undisputed that the use of the drug in diabetics is associated with improved cardiovascular outcomes. But can these also be achieved in non-diabetics? This is what the research team investigated in this study.
To this end, they analysed data from over 17,000 people who were overweight or obese and suffered from cardiovascular disease. The participants were randomised 1:1 and administered either 2.4 mg semaglutide or a placebo, subcutaneously, every week. The mean duration of use was approximately 34 months and the mean follow-up was 39 months. The endpoint was defined as death due to cardiovascular events, non-fatal myocardial infarction, or non-fatal stroke.
The study results indicated that in the semaglutide group, 6.5 per cent of participants reached the endpoint, compared to 8 per cent in the placebo arm. The difference was statistically significant.
In terms of general tolerability, however, the placebo performed better: 8.2 per cent of participants in this group discontinued the study. This figure was more than twice as high for semaglutide, at 16.6 per cent.
The data suggest that semaglutide could also lead to improved cardiovascular outcomes in people who do not have diabetes and are taking the drug because they are overweight or obese. This also appears to apply to those who already suffer from cardiovascular disease before starting treatment.