Another Piece of the Heart Failure Puzzle for Semaglutide

Novo Nordisk is creeping up on an indication for semaglutide in people with obesity and heart failure. Today in Lancet, we have another piece of the puzzle to suggest this drug might help. In a prespecified analysis from the SELECT study, researchers found that semaglutide reduced heart attacks, strokes, deaths, and problems with heart failure in a broad range of patients with obesity and heart failure in the SELECT study. They concluded:

“A large population of patients with atherosclerotic cardiovascular disease who have overweight or obesity and heart failure could benefit from semaglutide.

Cautiously Positive

This is a secondary, prespecified analysis from the massively successful SELECT study. They looked closely at the 4,286 persons in the study who had heart failure of any kind. That number included people with preserved ejection fractions, with reduced ejection fractions, or with unclassified heart failure. The people with heart failure accounted for roughly a quarter of the 17,604 patients in the larger study of patients with all sorts of heart disease.

Looking at the strengths and weaknesses of this latest study in heart failure, cardiologist Muthiah Vaduganathan expresses caution:

“These data provide general reassurance that GLP-1 receptor agonists prescribed for alternative indications should not necessarily be withheld in a patient with heart failure, especially in those who are asymptomatic or minimally symptomatic. However, this SELECT analysis does not inform whether GLP-1 receptor agonists should represent a new therapeutic pillar of care in the primary treatment of heart failure.”

In other words, these are encouraging data, but not the final word on the utility of semaglutide for people with both heart failure and obesity. For that, we will look to the full data package Novo Nordisk submits to FDA early next year. It’s a work in progress.

Click here for the study and here for Vaduganathan’s commentary. For further reporting on it, click here and here.

Human Heart from Autopsy, photograph by Jebulon / Wikimedia Commons

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August 24, 2024