Semaglutide Use Reduces Heart Attack Incidence in Obese Individuals
Some interesting numbers for the effects of weight loss in obese individuals on risk of age-related disease arise from the use of semaglutide in clinical trials. In the study noted here, treated individuals lost 9% of body weight versus 1% for the placebo arm. The outcome of that is at least as good as the use of statins when it comes to effects on cardiovascular disease. The lesson to take away from this is likely that being overweight is more harmful than most people like to think that it is. Existing data is certainly supportive of that conclusion. Excess visceral fat tissue has been shown to lead to a shorter life expectancy, higher lifetime medical costs, greater incidence of all common age-related disease, and the more of it, the worse the outcome.
In a multicenter, double-blind, randomized, placebo-controlled, event-driven superiority trial, we enrolled patients 45 years of age or older who had preexisting cardiovascular disease and a body-mass index (the weight in kilograms divided by the square of the height in meters) of 27 or greater but no history of diabetes. Patients were randomly assigned in a 1:1 ratio to receive once-weekly subcutaneous semaglutide at a dose of 2.4 mg or placebo. The primary cardiovascular end point was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke in a time-to-first-event analysis. Safety was also assessed.
A total of 17,604 patients were enrolled; 8803 were assigned to receive semaglutide and 8801 to receive placebo. The mean duration of exposure to semaglutide or placebo was 34.2 ± 13.7 months, and the mean duration of follow-up was 39.8 ± 9.4 months. A primary cardiovascular end-point event occurred in 569 of the 8803 patients (6.5%) in the semaglutide group and in 701 of the 8801 patients (8.0%) in the placebo group (hazard ratio, 0.80). Adverse events leading to permanent discontinuation of the trial product occurred in 1461 patients (16.6%) in the semaglutide group and 718 patients (8.2%) in the placebo group.