Confirming the Benefit of Semaglutide in Heart Failure

Pyrrhosoma nymphulaObesity research never rests, it seems. Over the weekend, at the American College of Cardiology annual meeting and in the New England Journal of Medicine, we got a third confirmation of the benefit that semaglutide delivers to patients with obesity and heart failure. Specifically, this is about heart failure with preserved ejection fraction – HFpEF.

On top of this yesterday, Lancet published a pooled analysis of all of the data from studies in HFpEF. The authors of this analysis conclude that it offers the most convincing evidence to date for semaglutide to both improve weight status and the symptoms, physical limitations, and exercise function of people living with both heart failure and obesity.

Now Two Major RCTs

The newest data come from the second major RCT of semaglutide in people with this kind of heart failure and obesity. Unlike the first study, this new study was done in patients who also had type 2 diabetes. The earlier study yielded two major publications last year. One of those focused on the primary outcomes, showing improvement in the symptoms and adverse events of heart failure. The other was a prespecified analysis that showed the benefit to these patients accrues directly from treating obesity.

In short, it is now abundantly clear that treating the disease of obesity helps to improve one of its important symptoms – heart failure.

The Latest Results

No two ways about it, this new study is impressive. Patients with diabetes, obesity, and HFpEF are seriously ill. With the added complication of diabetes, people are generally sicker and already getting more intensive care for heart failure. So this is a tough test of the benefits semaglutide can deliver in obesity and heart failure.

From the University of Glasgow, Professor Naveed Sattar tells us that these studies are likely to improve the care of patients with heart failure and obesity:

“These two well-conducted trials when combined suggest we have underestimated the impact of excess weight in the development of heart failure with preserved ejection fraction. Cardiologists should look at these results with great interest as semaglutide (and potentially other drugs that follow) are likely to be of great importance in the care of their patients living with heart disease and heart failure in the near future.”

FDA will be reviewing the data from these studies for the potential to add new indications for the benefits of semaglutide in obesity.

Click here for the study in NEJM, here for the study in Lancet, here and here for further reporting on it. For perspective on the two earlier publications of semaglutide in HFpEF, click here and here.

Pyrrhosoma nymphula, photograph by Luc Viatour, licensed under CC BY-SA 3.0

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April 8, 2024