How Ozempic could save millions of lives (and not because of weight loss)

Could semaglutide drugs be the new statins?

Ozempic could dramatically reduce the risk of heart attacks and stroke, a new study indicates.

The weight loss jab has become a blockbuster pharmaceutical hit, with people, including the diabetics it was originally designed for, struggling to get their hands on it.

But new research indicates it could have even more wide ranging effects, with patients taking it once a week seeing a 20% lower risk of major cardiac events, no matter how much weight they lost.

Published in Nature Medicine yesterday, the five-year study looked at obese patients with heart problems who did not have diabetes (as it had already been proven to reduce the risk of cardiac problems in obese people who did have diabetes).

It comprised 17,604 adults over the age of 45 from 41 countries, and measured the amount of time before they developed heart failure or major cardiac events.

Half received semaglutide – sold under the brand names Wegovy, Ozempic and Rybelsus– and the other half a placebo.

Unsurprisingly, patients lost a lot more weight if they were taking Ozempic compared to the control group (62% of patients had lost more than 5% of their bodyweight after 20 weeks, compared with only 10% not taking it).

But the risk reduction of heart attacks, stroke or heart failure was similar no matter how much weight patients taking semaglutide lost – and the risk even reduced if they gained weight.

A 2.4mg once-weekly dose of Wegovy, alongside standard care for the prevention of heart attacks or stroke, lowered the risk by 20% compared with those given a placebo, the study showed.

Out of the 8,803 patients prescribed semaglutide, 569 had a major cardiac event compared to 701 out of 8,801 not taking it.

Semaglutide’s weight loss effects were discovered incidentally after it was given to diabetics to help regulate blood sugar.

The mechanism by which it appears to reduce heart attack risk could be related to the impacts on blood sugar, or could be via a different pathway.

Professor John Deanfield, of University College London (UCL), used data from the Select trial, which was conducted by semaglutide manufacturer Novo Nordisk.

He said the findings ‘have important clinical implications’.

‘Around half of the patients that I see in my cardiovascular practice have levels of weight equivalent to those in the Select trial and are likely to derive benefit from taking semaglutide on top of their usual level of guideline-directed care,’ he added.

‘Our findings show that the magnitude of this treatment effect with semaglutide is independent of the amount of weight lost, suggesting that the drug has other actions which lower cardiovascular risk beyond reducing unhealthy body fat.

‘These alternative mechanisms may include positive impacts on blood sugar, blood pressure or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these.’

However, while semaglutide has been proved to have dramatic benefits, it is not without side effects.

The number of people in the study who had to drop out leading to discontinuation of the trial was higher in the semaglutide group (1,461 patients) compared to 718 patients in the control group, notably for gallbladder issues and stomach problems.

‘Nausea, vomiting, and diarrhea are not uncommon during treatment,’ the study noted.

Authors also said a limitation of the study was that they had not looked at whether it could stop heart disease developing entirely, as the patients all had preexisting cardiac problems.