Semaglutide (Wegovy) has shown promising results in a weight-loss drug trial, reducing major adverse cardiovascular events (MACE) by 20% compared to a placebo. The trial, called SELECT, involved over 17,000 patients who had either overweight or obesity and established cardiovascular disease (CVD), but not diabetes.
The findings of this trial could pave the way for greater patient access to semaglutide, a glucagon-like peptide-1 (GLP-1) agonist weight-loss agent. Historically, skepticism among US payers has hindered patient access to this drug, as its health benefits and cost-effectiveness were questioned, especially for individuals whose only indication for treatment is overweight or obesity.
According to the top-line results released by Novo Nordisk, the pharmaceutical company behind semaglutide, the group of patients who received weekly 2.4 mg subcutaneous injections of the drug experienced a significant 20% reduction in the combined endpoint of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. Although the specific magnitude of the reductions in each endpoint was not provided, the results suggest that semaglutide treatment has a positive impact on cardiovascular health.
Safety and patient tolerance for the weekly injections were consistent with prior reports on semaglutide. The drug, marketed as Wegovy, received approval from the US Food and Drug Administration in 2021 for weight loss and in 2017 for glucose control in individuals with type 2 diabetes. In SELECT, which began in 2018, over 17,000 adults aged 45 and older were randomly assigned at multiple sites across 41 countries.
Leading experts in the field have expressed excitement about the top-line results, noting the importance of preventing heart attacks and strokes with a drug like semaglutide that also aids in weight loss. However, further data is needed to determine the extent to which weight loss contributes to the observed reduction in cardiovascular events.
The findings from SELECT have the potential to challenge long-standing prejudices against the use of weight-loss agents solely for helping individuals lose weight. Previous options for weight loss were often associated with adverse effects and increased rates of MACE, leading to concerns about the safety and efficacy of anti-obesity drugs. As a result, health insurance coverage for weight-loss treatments has been limited.
Semaglutide belongs to a class of agents that mimic the action of the incretin glucagon-like peptide-1 (GLP-1). The introduction of this class of GLP-1 agonists for weight loss began in 2014 with the approval of liraglutide (Saxenda) by the FDA. This marked a significant step forward in establishing the class as safe and effective for weight loss.
In summary, the SELECT trial has demonstrated the potential of semaglutide (Wegovy) as a weight-loss agent that also reduces the risk of cardiovascular events. The positive findings from this trial could change the way obesity is regarded and treated. However, further research is needed to fully understand the role that weight loss plays in achieving these outcomes.
