In a clinical trial, the diabetes, and weight loss drug semaglutide, sold as Wegovy, significantly reduced symptoms and improved quality of life in people with obesity and the most common form of heart failure, potentially expanding the drug’s use beyond diabetes and weight loss and providing a new treatment option where few are available.
The Novo Nordisk-funded study of 529 patients discovered that a 2.4-milligram weekly dose of semaglutide, sold as Wegovy for weight loss, resulted in a 17-point improvement on a 100-point scale used to assess symptoms of a condition known as heart failure with preserved ejection fraction. In comparison, subjects who received a placebo improved by 9 points. The findings were published in the New England Journal of Medicine on Friday.
That difference means that Wegovy helped people with heart failure have less shortness of breath, fatigue, difficulty exerting themselves, and swelling, as well as better exercise function and quality of life, according to Dr. Mikhail Kosiborod, cardiologist and vice president for research at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, who led the trial.
“This is the largest treatment benefit we’ve ever seen for that endpoint in this patient population with any drug,” Kosiborod told CNN ahead of the European Society of Cardiology meeting in Amsterdam, where the results are being presented.
80% of heart patients in the US are overweight
Novo Nordisk said in a statement about the trial results that there are 64 million patients worldwide who suffer from heart failure. It is a condition in which the heart is unable to pump enough blood to meet the needs of the body.
Preserved ejection is when the heart can pump normally but is too stiff to fill correctly. According to Kosiborod and his colleagues, this form of heart failure accounts for more than half of all instances in the United States and is becoming increasingly common.
He stated that in the United States, 80% of patients with this type of heart failure are obese or overweight. Another goal of the study was weight loss, which the drug also accomplished: during the course of the year-long experiment, those on semaglutide lost roughly 13% of their body weight, compared to 2.6% for those on placebo.
Until recently, the main therapy options for people with this type of heart failure were diuretics, sometimes known as water pills, according to Kosiborod. They increase urination to reduce the amount of fluid in the body and can temporarily alleviate symptoms, but they are “woefully insufficient,” he explained.
Another family of medications known as SGLT2 inhibitors, which are also used to treat Type 2 diabetes, has been demonstrated to reduce the chance of hospitalization for heart failure, but “it’s not enough for most people,” according to Kosiborod. The symptom improvements “are relatively modest.”
Wegovy trial: The six-minute walk test was used in the study to assess exercise function
The six-minute walk test was used in the semaglutide study to assess exercise function. It was discovered that, towards the end of the trial, the drug had helped individuals walk 20 meters farther than those who received a placebo.
Although there were fewer significant safety events in the treatment group than in the placebo group, more patients discontinued using , largely due to gastrointestinal difficulties, which are usual side effects with this class of medicines known as GLP-1 receptor agonists.
The trial’s lack of diversity: 96% of the participants were White
The trial’s lack of diversity was one of its limitations: 96% of the participants were White. “We as a clinical trial community know that we need to do better in terms of patients that are Black, Hispanic, and from other backgrounds that are underrepresented in clinical trials,” Kosiborod said.
He highlighted that another semaglutide heart failure trial with diabetic individuals should have findings shortly and that merging the data could provide a fuller picture of how the medicine works for people of varied racial and ethnic origins.
The latest findings add to previous evidence that Wegovy may be taken for reasons other than weight loss. Novo Nordisk revealed in early August that Wegovy reduced the risk of heart attack, stroke, or heart-related death in adults with cardiovascular disease and obesity by 20%, which is projected to increase the use of the treatment even more. Already, the corporation is unable to meet demand and has been forced to limit access to some lower starter doses of the medication so it can meet supply needs for established patients.
Pharmaceutical advances in weight loss treatment
After decades of treatments with poor efficacy and hazardous side effects, Wegovy and its sibling drug for Type 2 diabetes, Ozempic, as well as a comparable therapy from Eli Lilly called Mounjaro, have been altering the way doctors approach weight loss with pharmaceuticals.
They’re also changing how researchers think about obesity, and the findings on heart failure contribute to that trend, according to Kosiborod.
“Clearly, we cannot continue to treat obesity just as something that accidentally happens to occur in these patients,” he said. “It’s likely a root cause of the complications and should be treated as such.”
He did, however, warn that the medicine may be beneficial in ways other than weight reduction, such as lowering inflammation and congestion.
As a physician caring for patients, Kosiborod found the results “extremely gratifying, because what I now can tell them is that we have pretty definitive evidence that if we prescribe this medication, you will feel better and be able to do more, and it’s going to have a significant impact on your quality of life.”
