For people with overweight or obesity, the weight loss drug Wegovy (semaglutide) can reduce the risk of developing or dying from events like heart attacks and strokes, according to preliminary results from a new study that offers the first major evidence that the medicine has cardiovascular benefits.
For the study, researchers randomly assigned 17,604 adults with overweight or obesity to take either a placebo or a 2.4 milligram (mg) dose of Wegovy. At the start of the study, all the patients had heart disease but none of them had type 2 diabetes.
After five years, participants on Wegovy were 20 percent less likely to have a heart attack or stroke, or die from causes related to cardiovascular disease, the drug’s developer Novo Nordisk said in a statement announcing the study’s preliminary results. The results haven’t yet been published in a medical journal, a process that typically allows independent experts to verify the findings. Novo Nordisk said it plans to present detailed study results at a medical conference later this year.
“This is very exciting news,” says Shauna Levy, MD, an assistant professor of surgery and the medical director of the bariatric and weight loss center at Tulane University School of Medicine in New Orleans, who wasn’t involved in the study. “I am not surprised by this data. We know that Wegovy leads to weight loss and improvements in cholesterol and hypertension, which are all risk factors for cardiovascular disease.”
What Are GLP-1 Agonists?
Wegovy is in a family of medicines known as glucagon-like peptide 1 (GLP-1) agonists. These medicines work by mimicking the action of GLP-1, a hormone in the gut that helps promote feelings of satiety and fullness after people eat. Semaglutide, the active ingredient in Wegovy, is also the active ingredient in two medicines for type 2 diabetes, Ozempic and Rybelsus.
Ozempic is already FDA-approved to help prevent events like heart attacks and strokes in people with type 2 diabetes. A two-year clinical trial found that Ozempic reduced the risk of experiencing or dying of these events by 26 percent. These results were driven by a 39 percent reduction in the risk of nonfatal strokes. The risk reduction for nonfatal heart attacks and deaths was too small to rule out the possibility that it was due to chance.
Two other GLP-1 drugs, dulaglutide (Trulicity) and liraglutide (Victoza) are also FDA-approved to reduce the risk of heart disease in certain people with type 2 diabetes. These drugs can help with the management of several risk factors for cardiovascular disease, including high blood sugar, obesity, inflammation, and high blood pressure, according to the University of Texas Southwestern Medical Center.
What Are the Heart Benefits of Weight Loss Medications?
While the new study results for Wegovy look promising, it’s too soon to draw broad conclusions about the potential for Wegovy to protect the heart, says Steven Nissen, MD, the chair of cardiovascular medicine and the chief academic officer of the Heart, Vascular, and Thoracic Institute at the Cleveland Clinic Lerner School of Medicine at Case Western Reserve University.
“One number cannot necessarily tell the whole story,” says Dr. Nissen, who wasn’t involved in the new study. Nissen is leading a weight loss study of tirzepatide (Mounjaro), a GLP-1 drug that’s FDA-approved for type 2 diabetes.
“It appears to be a very good result,” Nissen says. “But it’s important to keep in mind that drugs that we have tried in the past for obesity have not reduced cardiovascular outcomes.”
Still, the new study results suggest that there can be benefits to weight loss medicines that go well beyond shedding excess pounds.
“When people lose weight they become more active, they have less pain in their joints, and they have more mobility,” Nissen says. “The more active they become, the more weight they lose, and this has cardiovascular benefits.”
Wegovy May Need to Be Taken for Life to Maintain Health Benefits
To sustain the weight loss benefits — and the heart benefits — it’s likely that people will need to stay on Wegovy as a lifelong treatment, as with medications for many other chronic diseases, Levy says. “I think that the cardiovascular benefits would persist for only a short time if patients stopped taking the medications,” Levy says.
This makes it crucial to have more detailed, long-term study findings to confirm the safety and effectiveness of this medicine and other GLP-1 drugs, Nissen says.
Joseph Wu, MD, PhD, the president of the American Heart Association and the director of the Stanford Cardiovascular Institute in California, agrees that the preliminary results are encouraging and that more research is needed.
“It is quite surprising that semaglutide, a GLP-1 receptor agonist, can have such a dramatic result over the five-year trial period,” Dr. Wu says. “If confirmed by additional safety and efficacy studies, then semaglutide — or this class of drugs — may have a dramatic impact on treatment of cardiovascular disease in the overweight population.”