Hormonal
Once-weekly semaglutide (2.4 mg) significantly improves heart failure symptoms, physical limitations, and exercise capacity in patients with obesity-related heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes, independent of the magnitude of weight loss.
If you have heart failure with preserved ejection fraction, are obese, and have type 2 diabetes, once-weekly semaglutide (2.4 mg) can significantly reduce your heart failure symptoms and help you lose weight. This treatment works even if your weight loss isn't as dramatic as in people without diabetes, suggesting it helps your heart directly. It is administered as a weekly injection, starting at a low dose to minimize side effects, and titrated up over 16 weeks.
Among patients with obesity-related heart failure with preserved ejection fraction and type 2 diabetes, semaglutide led to larger reductions in heart failure–related symptoms and physical limitations and greater weight loss than placebo at 1 year.
Why this rating
Large, double-blind, randomized, placebo-controlled trial (STEP-HFpEF DM) with 616 participants, published in NEJM.
Source
Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes
Mikhail Kosiborod et al. · New England Journal of Medicine · 2024
DOI 10.1056/nejmoa2313917
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →