In a significant development presented at the 2024 European Congress on Obesity (ECO) in Venice, Italy, Novo Nordisk showcased two landmark studies. These pivotal research projects are part of the largest and longest – running clinical trials on the impact of semaglutide on body weight, involving over 17,000 non – diabetic adults who are obese or overweight.
Semaglutide’s Cardiovascular Benefits in SELECT Trial
The Semaglutide and Cardiovascular Outcomes (SELECT) clinical trial demonstrated remarkable results. In a group of 17,604 non – diabetic adults who were overweight or obese and had a history of cardiovascular disease, semaglutide showed a 20% reduction in major adverse cardiovascular events.
From October 2018 to June 2023, 17,604 adult patients with obesity or overweight (with a body mass index, BMI, of 27 kg/m² or higher) from 804 sites in 41 countries were recruited for the SELECT study. They were randomly assigned to receive either semaglutide (2.4mg) or a placebo. All participants had previously experienced a heart attack, stroke, and/or had peripheral artery disease, but did not have type 1 or type 2 diabetes at the start of the study.
Long – Term Weight Loss Effects
The research team evaluated the impact of semaglutide on body weight, composition, fat distribution (waist circumference, waist – to – height ratio), safety, and tolerance based on baseline BMI. The results were striking: in non – diabetic obese or overweight patients treated with semaglutide, weight loss persisted for over 65 weeks and lasted up to four years.
Specifically, at 208 weeks, the semaglutide treatment group experienced a 10.2% reduction in body weight, a 7.7 – centimeter decrease in waist circumference, and a 6.9% reduction in the waist – to – height ratio. In contrast, the placebo group had only a 1.5% weight loss, a 1.3 – centimeter decrease in waist circumference, and a 1.0% reduction in the waist – to – height ratio.
In terms of safety, semaglutide was associated with fewer serious adverse events. Across all BMI categories, the incidence of serious adverse events in the semaglutide treatment group was lower than that in the placebo group. Importantly, semaglutide did not increase the incidence of pancreatitis. However, it was associated with an increased rate of discontinuing the trial drug, and this rate increased as the BMI category decreased.
Overall, compared to the placebo, semaglutide led to clinically significant weight loss and improvements in anthropometric measures in non – diabetic obese or overweight patients at 208 weeks, with the weight loss sustained for more than four years. Significantly, both men and women of all ethnicities, ages, and body types across all regions were able to achieve sustained, clinically significant weight loss. Relatively, women had a better weight – loss effect than men, and Asian participants had a less pronounced weight – loss effect compared to other ethnic groups.
The research team stated that this long – term analysis of semaglutide confirmed that clinically significant weight loss could be maintained for up to four years in a geographically and ethnically diverse group of non – diabetic obese or overweight adults. The degree of weight loss in such a large and diverse population suggests that semaglutide could potentially impact the public health burden of various obesity – related diseases. Although the clinical trial focused on cardiovascular events, many other chronic conditions, including several types of cancer, osteoarthritis, anxiety, and depression, could also benefit from effective weight management.
Cardiovascular Benefits Unrelated to Weight Loss
The second study analyzed the relationship between baseline weight measurements, weight changes during the study, and cardiovascular outcomes. These outcomes included the time to the first occurrence of major adverse cardiovascular events (MACE) and heart failure indicators.
The findings indicated that semaglutide provided cardiovascular benefits regardless of the patients’ initial weight and the amount of weight lost. This suggests that even relatively mildly obese patients or those who only lost a small amount of weight could experience improved cardiovascular outcomes.
The research team noted that these findings have important clinical implications. In cardiovascular clinical practice, approximately half of the patients have a body weight similar to those in this trial and may benefit from semaglutide treatment. The results also suggest that the strength of semaglutide’s therapeutic effect is independent of the degree of weight loss. This indicates that the drug has additional mechanisms to reduce cardiovascular risk beyond reducing unhealthy body fat. These alternative mechanisms may include positive effects on blood sugar, blood pressure, or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these factors.
These research results were simultaneously published in the top international medical journal Nature Medicine on May 13, 2024. The title of the paper is “Long – term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial”.
Related topics:
New Genetic Study Uncovers 4 Autism Symptoms Subtypes
PTSD Treatment Innovator: Redefining Trauma Care Science
Germany Leads EU in Depression Treatment via Psilocybin Access
