Clinical trial data has demonstrated that the anti-obesity drug semaglutide, marketed for obesity and diabetes, could offer substantial protection against heart disease. The results could reshape treatment for obesity and preventive cardiology, indicating that this breakthrough drug holds potential beyond diabetes care and weight reduction.
SELECT Results Suggest a Game-Changer
The study, known as SELECT, was conducted by semaglutide manufacturer, Novo Nordisk, which is headquartered in Bagsværd, Denmark. The trial enrolled 17,604 people aged 45 years and older with cardiovascular disease and no history of diabetes. Researchers tracked major adverse cardiovascular events (MACEs) among the participants over a period of up to five years. The preliminary results, reported by the manufacturer, showed that a weekly 2.4 mg dose of semaglutide was linked to a 20 percent decrease in the risk of MACEs, when compared to a placebo, among adults with heart disease who were either overweight or obese. “SELECT is a landmark trial and has demonstrated that semaglutide 2.4 mg has the potential to change how obesity is regarded and treated,” reported Martin Holst Lange, Novo Nordisk’s executive vice president for development, in the results announcement.
By showing that semaglutide protects against serious episodes of cardiovascular disease in people who do not have type 2 diabetes, the study opens the door to changes in the management of heart disease risk. If the study’s full findings confirm the outcome, researchers say the implications could be significant. “This is probably the most important study in my field in the last ten years,” said Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore, Maryland. “It gets to that cardiometabolic risk that’s been difficult to treat in practice.”
A Mechanism of Action That Reaches Beyond Obesity
Semaglutide simulates the hormone glucagon-like peptide 1 (GLP-1), which plays a role in appetite regulation. Researchers expected to see lower heart disease risk among patients taking the drug, as weight loss can contribute to lower blood pressure and cholesterol levels, for example. However, there’s a possibility that drugs like semaglutide could improve the metabolism of fatty acids and reduce inflammation, among other potential benefits that extend beyond weight loss. “This is what’s so fascinating about these drugs. They work on the brain, the pancreas, the cardiovascular system, the gastrointestinal tract … There’s more to them than simply weight loss,” said Martha Gulati, director of preventive cardiology at Cedars-Sinai Medical Center in Los Angeles, California. Further research is needed to clarify the mechanisms behind the protective effects.
Potential Benefits and Prescribing Implications
Because obesity increases the risk for conditions including hypertension, sleep apnea, and nonalcoholic fatty liver disease, and can reduce mobility and impact mood, weight loss afforded by medications like semaglutide could lead to a wide range of benefits. Given this potential, researchers predict that the SELECT trial results could alter physicians’ prescribing practices. That is, semaglutide could transition from being primarily associated with weight loss to an accepted cardiovascular medication. This shift in perception might convince a wider range of healthcare providers, not just obesity specialists, to prescribe the drug.
Broadening Accessibility and Coverage
When the complete results of the SELECT trial are released, specialists hope that the drug will become more accessible. Novo Nordisk intends to seek approval for expanded indications for semaglutide’s use by the end of the year, both in the US and in Europe. This change in labeling could lead to broader prescription rates, particularly if the drug becomes more widely covered by insurance companies. Broader insurance coverage “will be a game-changer for the clinical practice of preventive cardiology,” Gulati suggested.
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