Semaglutide & heart disease

Introduction

The European Congress on Obesity was held in Venice between May 12th and 15th 2024. One of the conference presentations generated headlines, such as “Weight-loss jab ‘cuts heart disease deaths by 20%’” (Ref 1). The press release behind this headline can be seen here (Ref 2). The press release featured two studies about a drug called semaglutide. One of these has been peer-reviewed and published (Ryan et al); we await the other.

This week we’ll look at three papers about semaglutide. We’ll summarise the STEP-1 trial, which I reviewed in March 2021 (Ref 3). The STEP-1 trial examined the efficacy and safety of semaglutide for weight loss in obese or overweight people with related comorbidities, but not diabetes. It is useful to revisit this trial for the first reports of weight loss and side effects.

We’ll then turn to the subject of this week’s note – semaglutide and heart disease. The SELECT trial examined the impact of semaglutide on cardiovascular events in obese or overweight people without diabetes, but with established cardiovascular disease. The seminal paper from the SELECT trial was published in December 2023 (Lincoff et al) (Ref 4). We will then have the background necessary to review the update on the SELECT trial – the one that has just been published alongside the Venice congress (Ryan et al) (Ref 5). This link is a useful summary of all the semaglutide trials – the STEP trials for weight loss and the SELECT trial for cardiovascular events (Ref 6).