Semaglutide at ADA2024: Old News or Gaining Momentum?

Dynamism of a DancerIt’s over. The 84th Scientific Sessions of the American Diabetes Association came to an end yesterday and for anyone interested in obesity, it has given us a lot to absorb. After four days with a steady stream of new information about drugs like the GLP-1 agonists that regulate appetite and adiposity, we are left wondering. Where does all this news leave the drug that started all this excitement? Is semaglutide fast becoming old news or is it gaining momentum?

Old News

The old news dimension is easy to spot. We saw a flood of data on newer options for obesity treatment. Perhaps the biggest news was the SURMOUNT-OSA study of tirzepatide presented on Friday. We’ve already explained that this a first and a huge milestone in showing how treating the disease of obesity prevents so many other diseases. It adds to the recent news that tirzepatide – as well as survodutide – appear to be effective for reducing fibrosis and other symptoms of MASH.

On top of news about those two agents came news about CagriSema, retatrutide, pemvidutide, petrelintide, and HRS9531. This is just a sample of more than a hundred new agents in development. So yes, thinking that semaglutide will not be at the top of the heap for much longer is perfectly reasonable.

Only Now Hitting Its Stride

But we have good reasons to feel that semaglutide is only now hitting its stride. Yesterday we got further detail on the FLOW trial of semaglutide in patients with diabetes and kidney failure. The more we see of that data, the more impressive it becomes. A whole symposium reviewed these data and Nature Medicine published a new analysis digging into the question of whether semaglutide adds anything when a patient is already taking another drug for preventing problems with chronic kidney disease – an SGLT-2 inhibitor.

In short, it does. “Semaglutide benefits on major cardiovascular events and all-cause death were similar regardless of SGLT2i use,” said the authors. Other data suggest a benefit in patients with obesity, kidney, and heart disease who don’t have diabetes.

Thus, we can say with confidence that semaglutide is indeed maturing, but it is hardly past its prime. Impressive data on the benefits of it just keep coming. As the authors of the FLOW study tell us, “it saves kidneys, hearts, and lives.” Along the lines of saving hearts, researchers also presented an analysis of cardiovascular outcomes in the SELECT trial broken down HbA1c status. All of these were patients without diabetes. This analysis concluded that the cardiovascular benefits were independent of their baseline HbA1c status, and any change in that status.

That’s not bad for an aging competitor in an increasingly competitive marketplace.

Click here for the new paper on the FLOW study data, here for the new SELECT study, and here for more on the news on obesity medicines presented at the ADA Scientific Sessions.

Dynamism of a Dancer, painting by Gino Severini / WikiArt

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June 25, 2024