New research presented this year at the European Congress on Obesity in Dublin, Ireland, shows that patients treated with the obesity drug semaglutide have a reduced cardiovascular risk score after one year of use. The study is led by Dr. Andres Acosta and Dr. Wissam Ghusn, Precision Medicine Program for Obesity at Mayo Clinic, Rochester, MN, USA and their colleagues.
Obesity is a major risk factor for the development of abnormal blood fat levels, type 2 diabetes mellitus (T2D), high blood pressure and obstructive sleep apnea. These comorbidities are associated with an increased risk of cardiovascular disease (CVD), which is the leading cause of death worldwide. Therefore, there is a strong need to prevent CVD by targeting excess adiposity in overweight or obese patients.
Semaglutide is a recently approved anti-obesity drug whose cardiovascular impact in patients with and without T2D is not well established. In this new research, the authors analyzed the actual effect of semaglutide use on CVD risk in overweight or obese patients.
They carried out a multicenter retrospective study of 93 patients with a body mass index (BMI) of 27 kg/m2 or older, age between 40 and 79 and no history of CVD. They collected baseline demographic, clinical, and blood lipid data to calculate the 10-year risk of atherosclerotic cardiovascular disease (10-year ASCVD) at baseline (i.e. before starting semaglutide) and 1 year after starting semaglutide.
The score used is the 10-year ASCVD risk estimator created by the American College of Cardiology. The primary endpoint included the calculation of the difference in ASCVD score between baseline and after 1 year of starting semaglutide. Secondary outcomes included metabolic parameters and medication use.
Of the 93 participants, 69% were women and the average age was 55 years old. Almost all (91%) were white. The average BMI was 39.8 kg/m2borderline between class II and class III obesity.
There was a significant decrease in the risk of ASCVD at 10 years from baseline to 1 year: 7.64% versus 6.26%, a decrease of 1.38%. The following parameters decreased significantly: blood pressure by 9.3/4.9 mmHg (for systolic and diastolic), total cholesterol by 9.5 mg/dL; LDL of 6.6 mg/dL, triglycerides of 20.0 mg/dL, fasting blood sugar of 23.0 mg/dL and HbA1c (a measure of blood sugar control) of 0.72%. There was no significant change in the use of blood pressure medications, statins, or aspirin from baseline to last follow-up. The total percent body weight loss associated with semaglutide use at 12 months was 10.9% (out of 41 patients for whom weight data was available at 12 months).
The authors conclude:The use of semaglutide in overweight or obese patients is associated with a reduced risk of CVD at 10 years. Although modest after only one year of use, this decrease may translate into a reduced risk of cardiovascular morbidity and mortality over time with continued weight loss. Further studies, with larger sample sizes and longer follow-up periods, are needed to assess the cardiovascular outcomes of semaglutide..”
The authors plan to conduct longer-term studies to see if the effect of semaglutide on cardiovascular risk extends/changes over time.
European Association for the Study of Obesity