Wegovy and Heart Disease: Study Shows New Benefits

A new study sheds light on the link between the weight-loss drug Wegovy and heart disease: in patients with a certain form of heart failure, the drug may improve symptoms and exercise capacity.

Heart disease is a term that encompasses a wide range of heart conditions, including heart failure that affects approximately 6.2 million American adults. About half have heart failure with preserved ejection fraction (HFpEF), a condition in which the heart pumps normally but is too stiff to fill properly.

Most patients with HFpEF are overweight or obese. Growing evidence suggests that excess weight may play a significant role in the development and progression of the condition.

Patients with obesity-related HFpEF experience debilitating symptoms, such as shortness of breath and exercise intolerance, as well as physical limitations, which combined lower the quality of life. Thus far, there are no approved therapies specifically targeting HFpEF caused by obesity.

New research presented in a Hot Line session at ESC Congress 2023 looked at the link between Wegovy and heart disease. In particular, whether semaglutide, the active ingredient of a weight loss drug Wegovy, can significantly improve symptoms and physical limitations in patients with HFpEF and obesity.

The STEP-HFpEF trial included 529 patients with HFpEF with body mass index (BMI) 30 and over who experienced heart failure symptoms and functional limitations. The average age of the participants was 69 years, and the median BMI was 37.0 at the beginning of the study.

The severity of symptoms and physical limitations were evaluated using the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS), a score from 0 to 100, with 0 denoting the worst and 100 the best possible health status.

The participants were randomly assigned to a once-weekly subcutaneous semaglutide 2.4 mg or a placebo for 52 weeks.

The participants who took semaglutide saw a 16.6 points change on average in their KCCQ-CSS score compared to 8.7 points in a placebo group. Moreover, semaglutide reduced the body weight by 13.3% compared to a 2.6% reduction in the placebo group.

Participants on semaglutide also performed much better at a six-minute walk distance (6MWD) test, which measures functional exercise capacity. The average change in the distance HFpEF patients cpuld walk was 21.5 meters (70 feet) for semaglutide compared to 1.2 meters (3.9 feet) for placebo.

Serious adverse events were reported in 13.3% and 26.7% of participants with semaglutide and placebo, respectively.

"In patients with HFpEF and obesity, treatment with semaglutide 2.4 mg produced large improvements in symptoms, physical limitations and exercise function, reduced inflammation, and resulted in greater weight loss and fewer serious adverse events as compared with placebo," said the Principal investigator Dr. Mikhail Kosiborod of Saint Luke's Mid America Heart Institute, Kansas City, in a statement.

The U.S. Food and Drug Administration (FDA) approved Wegovy for weight management in adults with obesity or overweight with at least one weight-related condition, such as type 2 diabetes or high blood cholesterol.

Wegovy belongs to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1RAs) that act by mimicking the hormone GLP-1, which is released after eating. The class of drugs also includes medications for type 2 diabetes, such as Ozempic and Rybelsus, that are increasingly used off-label for weight loss.

Research suggests that the benefits of GLP-1RAs are not limited to managing type 2 diabetes and weight loss.

According to a recent study on Wegovy and heart disease, the drug may reduce the risk of heart attack, stroke, or death from heart disease by 20%. The study was conducted by Wegovy's manufacturer, Novo Nordisk, and the data is yet to be peer-reviewed. Researchers are also examining the possible GLP-1RAs benefits for treating alcohol use disorder and preventing dementia.

While effective, GLP-1RAs like Ozempic and Wegovy are associated with adverse side effects, including stomach paralysis and vomiting. Regulators in the European Union (E.U.) and the United Kingdom (U.K) launched probes into Ozempic and Saxenda, a weight loss drug, as patients reported the drugs causing suicidal or self-harming thoughts.