Wegovy - a weight-loss drug that can also prevent heart disease

2023-11-29

Researchers are excited by clinical trial results showing a powerful weight-loss drug may well protect against serious heart problems. They believe that this result may change the way and who uses this drug and a new generation of weight loss drugs.

Wegovy - the brand name for the drug semaglutide. Full clinical trial data have not yet been released. Denmark-based Novo Nordisk, the maker of Wegovy, announced results showing a weekly dose of Wegovy reduced the risk of serious cardiovascular events in adults with heart disease and who are overweight or obese. 20%. This is the first time results have shown that semaglutide can prevent serious cardiovascular disease events in people without type 2 diabetes.

The researchers say that if the trial results are confirmed, they could change the practice of preventive cardiology. These results also suggest that a new generation of weight-loss drugs can not only reduce weight but also greatly improve physical health. "This is probably the most important study in our field in the past decade," said Michael Blaha, director of clinical research at the Johns Hopkins Center for the Prevention of Cardiovascular Disease. "It addresses a cardiometabolic problem that is difficult to treat in practice. risk."

"It's hard to imagine other drugs other than statins that would have such a dramatic effect," said Martha Gulati, chief of preventive cardiology at Cedars-Sinai Medical Center in Los Angeles.

Full results from this trial are expected to be released at a conference later this year. The SELECT study currently includes 17,604 participants with cardiovascular disease but without diabetes. Participants received injections of Wegovy or a placebo and were followed for five years. Participants who received Wegovy had a lower risk of heart attack, stroke and death from cardiovascular disease than those who received a placebo.

Semaglutide, sold under the trade names of the weight-loss drug Wegovy and the diabetes drug Ozempic, works by mimicking glucagon-like peptide-1 (GLP-1), a hormone related to appetite regulation.

Researchers suspected that Wegovy could prevent heart disease. Obesity itself is a major risk factor for cardiovascular disease, and weight loss can improve risk factors such as blood pressure and cholesterol levels. But changes in other factors may also have contributed to the reduction in risk. There is evidence that drugs that mimic GLP-1 can improve fatty acid metabolism and reduce inflammation, Gulati said. “That’s what makes these drugs so amazing. They act on the brain, on the pancreas, on the cardiovascular system, on the gastrointestinal tract, and their effects are It does more than just lose weight.”

Additional data may help explain whether this protective effect is primarily related to weight loss or whether it results from other drug-induced changes.

Joseph Wu, president of the American Heart Association and a cardiologist at Stanford University School of Medicine, said that because obesity is associated with hypertension, sleep apnea, and non-alcoholic fatty liver disease, “so through weight loss, these comorbidities may also be improved.” .

Blaha pointed out that because the SELECT trial only analyzed a small number of serious cardiovascular events, it may have underestimated the cardiovascular health benefits of semaglutide and its potential to improve mobility, mood and other traits that can be improved after weight loss.

Will the results of this trial influence doctors to prescribe this drug?

Drugs like Wegovy may be favored by more professionals than just obesity experts, said Beverly Tchang, an endocrinologist at Weill Cornell Medical College. The trial results once again prove that Wegovy is not only a weight-loss drug but also a cardiovascular drug.

Wu agreed, saying, "Doctors may prescribe this drug more to overweight patients with cardiovascular risk factors."

Repurposing the weight-loss drug Wegovy for cardiovascular disease may improve its acceptability as a long-term drug. Tchang predicts, "As a heart disease drug, everyone will take it more seriously."

By the end of the year, Novo Nordisk plans to apply for approval of Wegovy to treat more diseases in the United States and Europe. Professionals believe that the complete trial results may provide enough evidence for the U.S. Food and Drug Administration (FDA) to approve the drug for mitigating cardiovascular risks. "If the label changes, I believe the prescribing rate of this drug will skyrocket," Blaha said.

Cardiologists hope the results of the SELECT trial will improve access to the drug. Some U.S. insurance companies currently only reimburse the drug for diabetics. Gulati said that physicians hope to use this new drug that mimics GLP-1, but are worried that patients will be rejected by insurance companies if they get hope. Expanding coverage will bring about qualitative changes in clinical practice for preventing heart disease.