New data suggests the weight-loss drug Wegovy may significantly reduce the risk of heart disease even before users experience substantial weight loss.
The drug, containing semaglutide, curbs appetite and is available through the NHS for individuals with a high BMI, as well as from private providers.
Manufacturer Novo Nordisk presented “landmark” data indicating Wegovy’s potential to protect against heart disease in its early stages, while also dramatically lowering the risk of heart attacks, strokes, and premature death in high-risk patients.
Analysis of a clinical trial revealed a 37 per cent reduction in the risk of heart attack, stroke, or heart disease-related death within the first three months of treatment for individuals with obesity and cardiovascular disease.
Further analysis showed even more promising results after six months of Wegovy treatment.
The risk of cardiovascular death decreased by 50 per cent, and the need for urgent heart failure treatment was also significantly reduced.
The Select trial, involving 17,604 participants, demonstrated Wegovy’s protective effect against heart disease even before patients achieved clinically significant weight loss (defined as less than 5 per cent).
This suggests the drug’s protection against heart disease is not only related to its effect on driving weight loss, researchers said.
The effect was also found before people had even moved on to the 2.4mg maintenance dose of the drug, which is a GLP-1 receptor agonist.
Professor Donna Ryan, from Pennington Biomedical Research Centre in Louisiana, US, said the effects on reducing the risk of heart attacks and stroke were seen “almost immediately” and before clinicians would expect patients to have lost weight.
She said the study, which she worked on, is “definite proof that we could reduce cardiovascular events in individuals who are at high risk for it”.
She said the drug had an effect “before you would expect weight loss, and it’s before you would even expect to see highest doses of semaglutide.
“So we’re starting to see this almost immediately.”
Prof Ryan added that the “interpretation of this for clinicians should be that we should not wait to start this drug if we want cardiovascular risk reduction in individuals who’ve had a heart attack, had a stroke or who have symptomatic peripheral artery disease – we are getting benefits early. There’s no need to wait. We should treat early.”
She said she expects “patients walk out of the cath (catheter) lab (and) get put on the medication”.
Asked if semaglutide should be given as a preventative medicine to those who have not had a heart attack or stroke, or showing signs of heart disease, she said: “There’s a big gap between suggesting and proving.”
She said using the drug in this way would require a “much bigger, longer, more expensive study”.
She added: “We may get some answers from that, from real world data, but I think it would be such an expensive and huge undertaking to show this preventative aspect, we would have to think about how to fund that.”
Dr Jorge Plutzky, lead study author and director of preventive cardiology at Brigham and Women’s Hospital at Harvard Medical School in the US, said: “Semaglutide 2.4mg is the only GLP-1 to have shown these early, rapid effects on heart disease, with benefits seen in the order of months, not years – underscoring its important role in clinical practice.”
He added: “Our findings reveal an early separation in the treatment effect of semaglutide that occurs even without a significant amount of weight lost and prior to full semaglutide titration.
“More research is needed to understand the mechanisms through which semaglutide produces these early clinical benefits, but they may include the drug’s positive effects on reducing inflammation, blood sugar, blood pressure, direct effects on the heart and blood vessels, early dietary changes, or an interaction among these or other responses.”
The Select trial is a randomised, double-blind trial looking at semaglutide 2.4mg versus placebo for the prevention of heart attacks, strokes and early death in people with established cardiovascular disease who are overweight or have obesity.
All have had a prior heart attack, stroke or peripheral artery disease.
Patients in the trial were already on other drugs such as for cholesterol and blood pressure, suggesting semaglutide had benefits on top of these.
