Hormonal
Semaglutide 2.4 mg administered subcutaneously once weekly reduces major adverse cardiovascular events (MACE) in patients with established cardiovascular disease and overweight or obesity, independent of diabetes status.
If you have established heart disease and are overweight or obese, but do not have diabetes, semaglutide 2.4 mg once weekly is a treatment option being tested to reduce your risk of heart attack, stroke, or cardiovascular death. It is taken as a weekly injection, started at a low dose to minimize stomach side effects, and used alongside standard heart health care. This approach targets obesity as a direct cause of cardiovascular risk, independent of blood sugar levels.
SELECT is a randomized, double-blind, parallel-group trial testing if semaglutide 2.4 mg subcutaneously once weekly is superior to placebo when added to standard of care for preventing major adverse cardiovascular events in patients with established CVD and overweight or obesity but without diabetes.
Why this rating
This is a large-scale, randomized, double-blind, placebo-controlled Phase 3 clinical trial (SELECT) with ~17,500 participants, representing the highest level of clinical evidence.
Source
Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) rationale and design
Donna H. Ryan et al. · American Heart Journal · 2020
DOI 10.1016/j.ahj.2020.07.008
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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