Study shows Wegovy (semaglitude) associated with lower symptoms of heart failure in those who do not have diabetes

September 4, 2023

This post authored by my colleague Patricia Toro, MD MPH

The New England Journal of Medicine (NEJM) published research last week that examined the impact of semaglutide (Wegovy) on patients who had heart failure but were not diabetic. They randomly assigned 529 patients to either receive a semaglutide injection weekly or a placebo for a year.

At the end of the year, they tested the patients’ change in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS), a patient-reported survey of symptoms and physical limitations of heart failure. Patient scores improved 16.6 points with semaglutide and 8.7 points with a placebo. The authors also looked at the change in the 6-minute walk distance from baseline to 1 year, which improved 21.5 meters for the semaglutide group and 1.2 meters with the placebo group.

Lastly, (and no surprise!), the weight loss was greater in the semaglutide group (-13.3%) versus the placebo (-2.6%).

There are several limitations to this study. First, the population studied was overwhelmingly white (95%) and older (median age was 69 years overall). So, these results may not be applicable to the population in employer-sponsored health insurance plans. Second, this study did not enroll enough people to evaluate any changes in hospitalizations or some other key outcomes – it was only structured to look at the outcome measurements they shared. Third, the study only looked at patients over one year – the results may look different if followed over a longer period of time. Lastly, the authors did not look at diabetic metrics or outcomes – they have another study where they are looking at that.

Implications for employers:

-        This study provides new data showing the benefit of semaglutide and possibly other GLP-1 anti-obesity medications for heart failure

-        There will be more studies in other conditions to assess the impact of GLP-1s.

-        Employers should be considering their broader obesity and cardiovascular strategy, which may include the GLP-1 medications

Illustration by Dall-E

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Tomorrow: The value of “negative” studies