The weight-loss drug semaglutide - commonly sold under the brand names Ozempic and Wegovy - reduced cardiovascular events such as stroke and heart attack in adults with preexisting disease independent of weight loss.
It also helped people keep their weight down for at least four years.
That is according to two new analyses of a large trial presented at the European Congress on Obesity in Venice on Monday.
Semaglutide is the main active ingredient in the popular weight-loss jabs Ozempic and Wegovy. It mimics the GLP-1 hormone which can signal that your body is full.
The analyses looked at the SELECT trial, which included more than 17,600 adults from 41 countries between October 2018 and March 2021 with pre-existing cardiovascular disease and who were overweight or obese.
It was funded by Novo Nordisk, the Danish pharmaceutical company behind the drug.
Patients from “a geographically and racially diverse population” took semaglutide or a placebo once weekly for a mean of 3.3 years during the trial.
The trial found a 20 per cent reduction in “major adverse cardiovascular events,” such as stroke, heart attack, and cardiovascular death. That finding was published in the New England Journal of Medicine in 2023.
Researchers say those cardiovascular benefits were also independent of weight loss, which suggests “alternative mechanisms of improved cardiovascular outcome,” according to a new analysis of the trial.
John Deanfield, a professor at University College London, told a press conference at the obesity congress that all the patients with a body mass index (BMI) over 27 had cardiovascular benefits “regardless of their starting [weight] levels”.
“Quite clearly, something else is going on that benefits the cardiovascular system,” Deanfield said.
Deanfield added that the drug provided “incremental benefit” on top of therapy patients were already taking such as statins.
“I think it’s a really important discovery,” Deanfield said, adding that this class of drugs could, like statins, “equally transform many chronic diseases”.
New analysis focuses on weight loss
The other new analysis of the trial published in Nature Medicine this week and presented at the congress showed that patients taking semaglutide “lost significantly more weight than those receiving placebo”.
The drug produced “clinically meaningful weight loss” and reduced waist size for at least four years in adults who were overweight or obese but did not have diabetes.
Donna Ryan, lead author of the analysis from the Pennington Biomedical Research Centre in the US, told a press conference that the study showed “patients on semaglutide have a much greater chance of no longer having obesity after treatment with this medication”.
Two years on, nearly 68 per cent of patients taking the drug had five per cent or more weight loss and 44 per cent had 10 per cent or more weight loss.
That was compared to 21 per cent of those taking the placebo having five per cent or more weight loss and nearly seven per cent having 10 per cent or more weight loss.
Ryan added that there were “fewer serious adverse events in semaglutide-treated patients than placebo primarily driven by a reduction in cardiovascular events and a reduction in infections”.
The authors said there were some limitations to the trial such as that people with excess body fat but a normal body mass index (BMI) were not included.
The study authors said that their analysis supports the broad use of the once-weekly drug to prevent stroke or heart attack in overweight and obese individuals with preexisting cardiovascular disease.
“Could this treatment be useful in primary prevention – reducing the risk of not just cardiovascular events but many other diseases in people who are overweight or obese but who have not (yet) had cardiovascular disease?” asks Martin Landray, CEO of the not-for-profit organisation Protas, who was not involved in the analyses.
“Answering that question will require suitably large, inclusive, and long-term trials. The answers could change the way we treat obesity in much the same way that our approach to hypertension and cholesterol has evolved over the last few decades,” Landray said in a statement.
Weight problems and obesity are increasing in EU states, with an estimated 52.7 per cent of the adult EU population being overweight in 2019, according to the bloc’s statistical office, Eurostat.
Obesity is considered a serious public health problem as it increases the risk of chronic diseases such as cardiovascular disease and diabetes.
