The oral drug semaglutide has shown an amazing ability to reduce hospital admissions and deaths related to heart disease in patients with heart failure and type 2 diabetes.
An international team of researchers conducted a new analysis of data from a clinical trial funded by Novo Nordisk, the manufacturer of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist used to treat obesity (under the trade name "Wegovi") and diabetes ("Ozempic").
The study included 9,650 participants from 33 countries, who were recruited between 2019 and 2021 and followed for approximately four years.
The researchers found that participants with a history of heart failure experienced a 22% reduction in adverse cardiovascular events when taking semaglutide daily compared to the placebo group. In contrast, no clear cardiovascular benefits were observed in individuals without pre-existing heart conditions.
Dr. Rodica Pop-Bousoy, a diabetes specialist at Oregon Health & Science University, wrote: "These data support the potential benefit of oral semaglutide in reducing heart failure events in people with type 2 diabetes and heart disease."
The team cautioned that "limitations of the study include those inherent in secondary analysis, such as the small number of participants in some subgroups."
These results are supported by previous studies that indicated that semaglutide may reduce other cardiovascular events, including strokes and heart attacks, in some patients by nearly 20% over a period of about three years, and these benefits do not appear to be solely related to weight loss.
However, animal studies have pointed to potential risks, including effects on the heart muscle and loss of skeletal muscle mass, along with common side effects such as nausea and vomiting. In a study on mice, semaglutide was found to cause shrinkage of a specific type of muscle found in mammalian hearts.
The researchers point out the need to closely monitor the use of the drug to detect any side effects early, especially since its long-term effects are still not fully understood.
Type 2 diabetes affects approximately half a billion people worldwide, and heart failure is one of its most common complications. For these patients, the benefits of semaglutide may outweigh its risks when used under medical supervision, although other options such as bariatric surgery may achieve better blood sugar control.
Because the precise mechanism of action of semaglutide on the cardiovascular system is not yet understood, researchers have called for caution when prescribing this drug for purposes beyond weight loss and diabetes treatment.
This study was published in the journal JAMA.
