Does semaglutide have a place in cardiovascular medicine?

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In recent times tabloid newspapers and medical journals alike have been ablaze with articles about semaglutide (also known as Wegovy and Ozempic), both positive and negative.

Many celebrities have endorsed it as a weight loss drug, but it was first developed as a drug for diabetics, to help control their blood sugar. It works by mimicking a hormone, GLP-1, which is released in the gastrointestinal tract in response to eating, stimulating the body to produce more insulin and thereby reducing blood sugar levels. It has also been found to suppress appetite and slow down the movement of food through the gut, helping people to feel fuller for longer and so help with weight loss.

In addition to the weight loss component of semaglutide, Novo Nordisk, the pharmaceutical company marketing semaglutide, issued a statement a week or so ago to say that it has also been found to reduce the risk of major adverse cardiovascular events such as death, heart attack and stroke by 20% in comparison to patients treated with a placebo. The Executive Vice President for Development at Novo Nordisk said:

People living with obesity have an increased risk of cardiovascular disease but to date, there are no approved weight management medications proven to deliver effective weight management while also reducing the risk of heart attack, stroke or cardiovascular death. Therefore we are very excited about the results from SELECT [the drug trial] showing that semaglutide 2.4 mg reduces the risk of cardiovascular events.

At the moment the surge in prescriptions for semaglutide has led to a supply chain issue which is not likely to be resolved until 2024, so for the time being doctors are being asked not to start patients on this drug. However, the findings from the SELECT trial are compelling – click here to read the full report – and in due course semaglutide will likely have a significant role to play in cardiovascular disease.

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