Hormonal
Once-weekly subcutaneous semaglutide (0.5 mg or 1.0 mg) significantly reduces the risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes at high cardiovascular risk, demonstrating both noninferiority and superiority over placebo.
If you have type 2 diabetes and are at high risk for heart problems, once-weekly semaglutide injections can significantly lower your risk of heart attack, stroke, or cardiovascular death compared to placebo. The treatment involves a gradual dose increase to minimize side effects like nausea, which are common but usually mild and temporary. The cardiovascular benefits are substantial and well-supported by a large, rigorous clinical trial.
The primary outcome occurred in 108 of 1648 patients (6.6%) in the semaglutide group and in 146 of 1649 patients (8.9%) in the placebo group (hazard ratio, 0.74; 95% confidence interval [CI], 0.58 to 0.95; P<0.001 for noninferiority).
Why this rating
Large-scale, randomized, double-blind, placebo-controlled trial (SUSTAIN-6) with 3297 patients and rigorous adjudication.
Source
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
Steven P. Marso et al. · New England Journal of Medicine · 2016
DOI 10.1056/nejmoa1607141
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
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