Semaglutide

Semaglutide has been shown to significantly reduce weight, especially in patients with diabetes.

This is a comparative study of cardiovascular benefits (SELECT) and long-term outcomes in diabetes (SUSTAIN-6) of glucagon-like peptide-1 (GLP-1) receptor agonists. Researchers randomly assigned 17,604 patients with atherosclerotic cardiovascular disease (82% of whom had coronary artery disease) and a body mass index (BMI) of 27 or higher, but without a history of diabetes, to receive either semaglutide at a dose of 2.4 mg once weekly or placebo.

After approximately 40 months of follow-up, semaglutide reduced the combined risk of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke by 20%. As expected, discontinuation due to gastrointestinal events was more common in the semaglutide group than in the placebo group (10.0% vs. 2.0%), but serious adverse events were less frequent in the semaglutide group.

71% of participants in the trial were obese. However, the effect of semaglutide was not dependent on baseline BMI. On average, semaglutide treatment resulted in a significant weight loss of 9.4%. In SUSTAIN-6, semaglutide reduced the risk of cardiovascular events in diabetic patients by 26%, although weight loss was only 4% to 5% at lower doses. In the SELECT trial, semaglutide improved lipid profiles, inflammatory markers, and blood pressure.