Large Trial Finds Wegovy Weight Loss Medication Reduces Heart Attack Risk

In a recently concluded American Heart Association meeting, A. Michael Lincoff, a cardiologist from the Cleveland Clinic, presented remarkable findings from a clinical trial for the weight loss drug, semaglutide. This sparked enthusiastic applause from all the attending physicians.

Semaglutide, also known as Wegovy, can reportedly reduce the risk of significant cardiovascular complications by 20 percent. Lincoff also disclosed that the drug could lower the risk of death from any cause among participants of the study, which lasted an average of about 40 months.

This study further solidifies semaglutide's role as a useful drug, which is currently prescribed to manage diabetes and obesity. This new study indicates that the drug can also benefit overweight or obese patients with cardiovascular diseases that do not have diabetes. This finding is significant, as it could amplify the number of potential beneficiaries of semaglutide.

Tiffany Powell-Wiley, a cardiologist and epidemiologist at the National Heart, Lung and Blood Institute in Bethesda, Md, believes that semaglutide could represent a serious turning point for over six million Americans afflicted by cardiovascular diseases who are obese or overweight but don’t have diabetes. However, she stressed that this drug alone is not the ultimate solution to obesity, and it might not be effective on a diverse demographic. She also mentions that societal, environmental and social factors that contribute to obesity remain unaddressed by semaglutide. 

Semaglutide is part of a broader family of drugs that are being used successfully in treating obesity. The US Food and Drug Administration has approved another relative of semaglutide named tirzepatide, better known as Zepbound.

Since its introduction into the market as a treatment for diabetes under the brand name Ozempic in 2017, Semaglutide's range of applications has continually expanded. Last year, the FDA approved it for reducing the cardiovascular risk in patients with diabetes and heart disease. In 2021, it was approved as a treatment for obesity under the brand name Wegovy. 

Lincoff’s trial of semaglutide involved over 17,000 patients, half of whom were given semaglutide every week for approximately three years; the remainder were given a placebo. Only 6.5% of the semaglutide group were found to have had a nonfatal stroke or heart attack, or died because of cardiovascular issues at the end of the trial, a notable decline compared to 8% of the placebo. Amit Khera, a cardiologist from UT Southwestern Medical Center, hailed this as a "massive result" and said the findings are a very significant advancement in the treatment for patients with cardiovascular diseases.

The fact that such a risk decrease was seen early in the trial, even before the patients lost considerable weight, suggests that the drug may inherently benefit heart health.

However, the study does have some limitations. It was discovered that patients were slightly more likely to withdraw from the trial if they were on semaglutide, likely due to the drug's gastrointestinal side effects, which include nausea, diarrhea, and vomiting. However, the incidence of severe issues, like cancer or infection, was slightly lower among the semaglutide group.

Though semaglutide offered clear cardiovascular benefits for patients, one mysterious aspect of the data snagged researchers’ attention. The drug’s protective effects became apparent early in the trial — well before participants had shed lots of pounds.

That’s a big deal because it suggests semaglutide may be boosting heart health directly, perhaps in addition to the typical benefits that accompany weight loss, says Caroline Apovian, an obesity medicine specialist at Harvard Medical School and Brigham and Women’s Hospital in Boston. She was not involved in the study but is on Novo Nordisk’s scientific advisory board. Lincoff said his team is “working feverishly” on analyzing the SELECT data to better understand semaglutide’s actions.

Those data include demographic and medical information on thousands of trial participants. But the trial does have one “huge limitation,” says Powell-Wiley: 84 percent of the study’s participants were white and 72 percent were men. 

Expanding the diversity of people represented in clinical trials like these is crucial, she said. It’s a point she brought up in a panel discussion after Lincoff’s talk, and one that — like the trial’s results — garnered widespread applause. In the United States, African-American, Hispanic and Indigenous people are most impacted by obesity, Powell-Wiley says, and the new trial doesn’t tell us much about how semaglutide works in those groups.