Latest news with #DonnaRyan
Medscape
14-05-2025
- Health
- Medscape
Semaglutide May Cut Cardiovascular Risk Before Weight Loss
MÁLAGA, Spain — Semaglutide (Wegovy) is associated with a 41% reduction in the risk for major adverse cardiovascular events (MACEs) within 6 months of initiation — well before patients achieve substantial weight loss or reach the full 2.4 mg weekly dose — according to new data from the SELECT trial. 'The cumulative incidence of MACEs during the first 6 months showed a hazard ratio of 0.59,' said Donna Ryan, MD, professor emerita at Pennington Biomedical Research Center in Baton Rouge, Louisiana. Ryan, a member of the SELECT steering committee, presented the data alongside Jorge Plutzky, MD, director of Preventive Cardiology at Brigham and Women's Hospital and professor of medicine at Harvard Medical School, Boston. The findings were presented at the European Congress on Obesity (ECO) 2025. Early Benefits The early cardiovascular (CV) benefit emerged before participants reached the target dose of semaglutide or experienced meaningful weight reduction. The hazard ratio (HR) of MACEs for patients receiving semaglutide was 0.63 (95% CI, 0.41-0.95) during the first 3 months. 'The HRs for MACEs were below 1 before the weight loss started and before participants reached the top dose,' Ryan said. 'Almost immediately, the risk is less on semaglutide than on placebo.' The first statistically significant reduction in MACEs occurred by day 20 after randomization, with sustained significance evident by day 86. In the first 6 months, 67 MACEs occurred in the semaglutide arm vs 113 in the placebo arm (HR, 0.59; 95% CI, 0.44-0.80). The researchers observed a 53% reduction in CV deaths (14 deaths with semaglutide vs 30 deaths with placebo) and a 43% reduction in nonfatal myocardial infarction. The reduction in nonfatal stroke was not statistically significant (HR, 0.87; 95% CI, 0.47-1.58). Design and Execution These new findings add to results from the main SELECT trial, which previously was reported by Medscape Medical News . That trial found a 20% reduction in MACEs over nearly 40 months in patients with overweight or obesity and established CV disease (CVD; HR, 0.80; 95% CI, 0.72-0.90; P < .001). 'The design and precision of execution give us confidence in the results,' Ryan said. SELECT enrolled 17,604 participants aged 45 years or older with overweight or obesity (body mass index ≥ 27) and established CVD, which was defined as prior myocardial infarction, stroke, or symptomatic peripheral artery disease. Eligible participants did not have type 2 diabetes, although two-thirds of participants had prediabetes. Participants were randomly assigned to once-weekly subcutaneous semaglutide or placebo (titrated to 2.4 mg by week 16) alongside standard-of-care treatments including statins, antihypertensives, and antiplatelet therapy. 'This was not a weight loss study,' Ryan emphasized. 'We thought that the drug itself might have properties beneficial to cardiovascular outcomes apart from weight loss.' CV Benefits First In the first 12 months, semaglutide was associated with a 9% reduction in body weight. However, this degree of weight loss was not yet apparent when the early CV benefit emerged. At week 4, change in body weight was −1.1% for patients on semaglutide compared with placebos (95% CI, −1.2 to −1.1). By week 12, the difference was −3.6% (95% CI, −3.7 to −3.5). To explore whether weight loss explained the early benefit, investigators compared daily hazard ratios for MACEs with average weight change over time. The dissociation between the curves suggested that the early CV benefit may occur independently of weight loss. Potential Mechanisms Asked to comment by Medscape Medical News , Jason Halford, PhD, head of the School of Psychology at the University of Leeds, Leeds, England, and past president of the European Association for the Study of Obesity, London, England, said that the results were surprising. 'This [study] suggests that [the benefits are] not mediated by weight loss and that there must be some other mechanism underpinning it,' Halford said. 'Possibly a reduction in inflammation, because obesity is an inflammatory disease, and it's a component of many other diseases.' These findings may inform early treatment decisions in patients with obesity and CVD, even before significant weight loss has been achieved. Halford suggested that the findings could have implications for CV medicine. 'Of course, they are managing CVD with other therapies, and it would be interesting to compare not one antiobesity drug with another but to see how this impacts existing treatments for CVD. It might be preferable to use one drug to treat two things, for example.' Halford also noted that as new antiobesity drugs and combinations of mechanisms emerge, comparisons should extend beyond weight loss to include CV outcomes. 'These early data shift the narrative. We knew the long-term benefits, but the short-term effect is unexpected.'
South Wales Guardian
13-05-2025
- Health
- South Wales Guardian
Wegovy slashes heart disease risk ‘even before people shed weight'
The drug, which contains the active ingredient semaglutide, works by reducing food cravings and is available on the NHS for people with a high BMI, or via private providers. New 'landmark' data, presented by the manufacturer Novo Nordisk, shows Wegovy can protect against heart disease in the earliest stages, while also working to dramatically cut the risk of having a heart attack, stroke or early death in high-risk patients. Analysis of a clinical trial found it reduced the risk of having a heart attack, stroke or heart disease death by 37% in people with obesity and cardiovascular disease within the first three months of treatment. Furthermore, within six months of treatment, Wegovy reduced the risk of cardiovascular death by 50% and cut the risk of needing urgent treatment due to heart failure. Analysis of the Select trial data on 17,604 people found Wegovy protected against heart disease even before people had lost clinically meaningful amounts of weight (considered as less than 5%). This suggests the drug's protection against heart disease is not only related to its effect on driving weight loss, researchers said. The effect was also found before people had even moved on to the 2.4mg maintenance dose of the drug, which is a GLP-1 receptor agonist. Professor Donna Ryan, from Pennington Biomedical Research Centre in Louisiana, US, said the effects on reducing the risk of heart attacks and stroke were seen 'almost immediately' and before clinicians would expect patients to have lost weight. She said the study, which she worked on, is 'definite proof that we could reduce cardiovascular events in individuals who are at high risk for it'. She said the drug had an effect 'before you would expect weight loss, and it's before you would even expect to see highest doses of semaglutide. 'So we're starting to see this almost immediately.' Prof Ryan added that the 'interpretation of this for clinicians should be that we should not wait to start this drug if we want cardiovascular risk reduction in individuals who've had a heart attack, had a stroke or who have symptomatic peripheral artery disease – we are getting benefits early. There's no need to wait. We should treat early.' She said she expects 'patients walk out of the cath (catheter) lab (and) get put on the medication'. Asked if semaglutide should be given as a preventative medicine to those who have not had a heart attack or stroke, or showing signs of heart disease, she said: 'There's a big gap between suggesting and proving.' She said using the drug in this way would require a 'much bigger, longer, more expensive study'. She added: 'We may get some answers from that, from real world data, but I think it would be such an expensive and huge undertaking to show this preventative aspect, we would have to think about how to fund that.' Dr Jorge Plutzky, lead study author and director of preventive cardiology at Brigham and Women's Hospital at Harvard Medical School in the US, said: 'Semaglutide 2.4mg is the only GLP-1 to have shown these early, rapid effects on heart disease, with benefits seen in the order of months, not years – underscoring its important role in clinical practice.' He added: 'Our findings reveal an early separation in the treatment effect of semaglutide that occurs even without a significant amount of weight lost and prior to full semaglutide titration. 'More research is needed to understand the mechanisms through which semaglutide produces these early clinical benefits, but they may include the drug's positive effects on reducing inflammation, blood sugar, blood pressure, direct effects on the heart and blood vessels, early dietary changes, or an interaction among these or other responses.' The Select trial is a randomised, double-blind trial looking at semaglutide 2.4mg versus placebo for the prevention of heart attacks, strokes and early death in people with established cardiovascular disease who are overweight or have obesity. All have had a prior heart attack, stroke or peripheral artery disease. Patients in the trial were already on other drugs such as for cholesterol and blood pressure, suggesting semaglutide had benefits on top of these. – The study was presented at the European Congress on Obesity in Malaga, Spain.
North Wales Chronicle
13-05-2025
- Health
- North Wales Chronicle
Wegovy slashes heart disease risk ‘even before people shed weight'
The drug, which contains the active ingredient semaglutide, works by reducing food cravings and is available on the NHS for people with a high BMI, or via private providers. New 'landmark' data, presented by the manufacturer Novo Nordisk, shows Wegovy can protect against heart disease in the earliest stages, while also working to dramatically cut the risk of having a heart attack, stroke or early death in high-risk patients. Analysis of a clinical trial found it reduced the risk of having a heart attack, stroke or heart disease death by 37% in people with obesity and cardiovascular disease within the first three months of treatment. Furthermore, within six months of treatment, Wegovy reduced the risk of cardiovascular death by 50% and cut the risk of needing urgent treatment due to heart failure. Analysis of the Select trial data on 17,604 people found Wegovy protected against heart disease even before people had lost clinically meaningful amounts of weight (considered as less than 5%). This suggests the drug's protection against heart disease is not only related to its effect on driving weight loss, researchers said. The effect was also found before people had even moved on to the 2.4mg maintenance dose of the drug, which is a GLP-1 receptor agonist. Professor Donna Ryan, from Pennington Biomedical Research Centre in Louisiana, US, said the effects on reducing the risk of heart attacks and stroke were seen 'almost immediately' and before clinicians would expect patients to have lost weight. She said the study, which she worked on, is 'definite proof that we could reduce cardiovascular events in individuals who are at high risk for it'. She said the drug had an effect 'before you would expect weight loss, and it's before you would even expect to see highest doses of semaglutide. 'So we're starting to see this almost immediately.' Prof Ryan added that the 'interpretation of this for clinicians should be that we should not wait to start this drug if we want cardiovascular risk reduction in individuals who've had a heart attack, had a stroke or who have symptomatic peripheral artery disease – we are getting benefits early. There's no need to wait. We should treat early.' She said she expects 'patients walk out of the cath (catheter) lab (and) get put on the medication'. Asked if semaglutide should be given as a preventative medicine to those who have not had a heart attack or stroke, or showing signs of heart disease, she said: 'There's a big gap between suggesting and proving.' She said using the drug in this way would require a 'much bigger, longer, more expensive study'. She added: 'We may get some answers from that, from real world data, but I think it would be such an expensive and huge undertaking to show this preventative aspect, we would have to think about how to fund that.' Dr Jorge Plutzky, lead study author and director of preventive cardiology at Brigham and Women's Hospital at Harvard Medical School in the US, said: 'Semaglutide 2.4mg is the only GLP-1 to have shown these early, rapid effects on heart disease, with benefits seen in the order of months, not years – underscoring its important role in clinical practice.' He added: 'Our findings reveal an early separation in the treatment effect of semaglutide that occurs even without a significant amount of weight lost and prior to full semaglutide titration. 'More research is needed to understand the mechanisms through which semaglutide produces these early clinical benefits, but they may include the drug's positive effects on reducing inflammation, blood sugar, blood pressure, direct effects on the heart and blood vessels, early dietary changes, or an interaction among these or other responses.' The Select trial is a randomised, double-blind trial looking at semaglutide 2.4mg versus placebo for the prevention of heart attacks, strokes and early death in people with established cardiovascular disease who are overweight or have obesity. All have had a prior heart attack, stroke or peripheral artery disease. Patients in the trial were already on other drugs such as for cholesterol and blood pressure, suggesting semaglutide had benefits on top of these. – The study was presented at the European Congress on Obesity in Malaga, Spain.
Powys County Times
12-05-2025
- Health
- Powys County Times
Wegovy slashes heart disease risk ‘even before people shed weight'
The weight-loss drug Wegovy slashes the risk of heart disease even before people shed pounds, data suggests. The drug, which contains the active ingredient semaglutide, works by reducing food cravings and is available on the NHS for people with a high BMI, or via private providers. New 'landmark' data, presented by the manufacturer Novo Nordisk, shows Wegovy can protect against heart disease in the earliest stages, while also working to dramatically cut the risk of having a heart attack, stroke or early death in high-risk patients. Analysis of a clinical trial found it reduced the risk of having a heart attack, stroke or heart disease death by 37% in people with obesity and cardiovascular disease within the first three months of treatment. Furthermore, within six months of treatment, Wegovy reduced the risk of cardiovascular death by 50% and cut the risk of needing urgent treatment due to heart failure. Analysis of the Select trial data on 17,604 people found Wegovy protected against heart disease even before people had lost clinically meaningful amounts of weight (considered as less than 5%). This suggests the drug's protection against heart disease is not only related to its effect on driving weight loss, researchers said. The effect was also found before people had even moved on to the 2.4mg maintenance dose of the drug, which is a GLP-1 receptor agonist. Professor Donna Ryan, from Pennington Biomedical Research Centre in Louisiana, US, said the effects on reducing the risk of heart attacks and stroke were seen 'almost immediately' and before clinicians would expect patients to have lost weight. She said the study, which she worked on, is 'definite proof that we could reduce cardiovascular events in individuals who are at high risk for it'. She said the drug had an effect 'before you would expect weight loss, and it's before you would even expect to see highest doses of semaglutide. 'So we're starting to see this almost immediately.' Prof Ryan added that the 'interpretation of this for clinicians should be that we should not wait to start this drug if we want cardiovascular risk reduction in individuals who've had a heart attack, had a stroke or who have symptomatic peripheral artery disease – we are getting benefits early. There's no need to wait. We should treat early.' She said she expects 'patients walk out of the cath (catheter) lab (and) get put on the medication'. Asked if semaglutide should be given as a preventative medicine to those who have not had a heart attack or stroke, or showing signs of heart disease, she said: 'There's a big gap between suggesting and proving.' She said using the drug in this way would require a 'much bigger, longer, more expensive study'. She added: 'We may get some answers from that, from real world data, but I think it would be such an expensive and huge undertaking to show this preventative aspect, we would have to think about how to fund that.' Dr Jorge Plutzky, lead study author and director of preventive cardiology at Brigham and Women's Hospital at Harvard Medical School in the US, said: 'Semaglutide 2.4mg is the only GLP-1 to have shown these early, rapid effects on heart disease, with benefits seen in the order of months, not years – underscoring its important role in clinical practice.' He added: 'Our findings reveal an early separation in the treatment effect of semaglutide that occurs even without a significant amount of weight lost and prior to full semaglutide titration. 'More research is needed to understand the mechanisms through which semaglutide produces these early clinical benefits, but they may include the drug's positive effects on reducing inflammation, blood sugar, blood pressure, direct effects on the heart and blood vessels, early dietary changes, or an interaction among these or other responses.' The Select trial is a randomised, double-blind trial looking at semaglutide 2.4mg versus placebo for the prevention of heart attacks, strokes and early death in people with established cardiovascular disease who are overweight or have obesity. All have had a prior heart attack, stroke or peripheral artery disease. Patients in the trial were already on other drugs such as for cholesterol and blood pressure, suggesting semaglutide had benefits on top of these.
Leader Live
12-05-2025
- Health
- Leader Live
Wegovy slashes heart disease risk ‘even before people shed weight'
The drug, which contains the active ingredient semaglutide, works by reducing food cravings and is available on the NHS for people with a high BMI, or via private providers. New 'landmark' data, presented by the manufacturer Novo Nordisk, shows Wegovy can protect against heart disease in the earliest stages, while also working to dramatically cut the risk of having a heart attack, stroke or early death in high-risk patients. Analysis of a clinical trial found it reduced the risk of having a heart attack, stroke or heart disease death by 37% in people with obesity and cardiovascular disease within the first three months of treatment. Furthermore, within six months of treatment, Wegovy reduced the risk of cardiovascular death by 50% and cut the risk of needing urgent treatment due to heart failure. Analysis of the Select trial data on 17,604 people found Wegovy protected against heart disease even before people had lost clinically meaningful amounts of weight (considered as less than 5%). This suggests the drug's protection against heart disease is not only related to its effect on driving weight loss, researchers said. The effect was also found before people had even moved on to the 2.4mg maintenance dose of the drug, which is a GLP-1 receptor agonist. Professor Donna Ryan, from Pennington Biomedical Research Centre in Louisiana, US, said the effects on reducing the risk of heart attacks and stroke were seen 'almost immediately' and before clinicians would expect patients to have lost weight. She said the study, which she worked on, is 'definite proof that we could reduce cardiovascular events in individuals who are at high risk for it'. She said the drug had an effect 'before you would expect weight loss, and it's before you would even expect to see highest doses of semaglutide. 'So we're starting to see this almost immediately.' Prof Ryan added that the 'interpretation of this for clinicians should be that we should not wait to start this drug if we want cardiovascular risk reduction in individuals who've had a heart attack, had a stroke or who have symptomatic peripheral artery disease – we are getting benefits early. There's no need to wait. We should treat early.' She said she expects 'patients walk out of the cath (catheter) lab (and) get put on the medication'. Asked if semaglutide should be given as a preventative medicine to those who have not had a heart attack or stroke, or showing signs of heart disease, she said: 'There's a big gap between suggesting and proving.' She said using the drug in this way would require a 'much bigger, longer, more expensive study'. She added: 'We may get some answers from that, from real world data, but I think it would be such an expensive and huge undertaking to show this preventative aspect, we would have to think about how to fund that.' Dr Jorge Plutzky, lead study author and director of preventive cardiology at Brigham and Women's Hospital at Harvard Medical School in the US, said: 'Semaglutide 2.4mg is the only GLP-1 to have shown these early, rapid effects on heart disease, with benefits seen in the order of months, not years – underscoring its important role in clinical practice.' He added: 'Our findings reveal an early separation in the treatment effect of semaglutide that occurs even without a significant amount of weight lost and prior to full semaglutide titration. 'More research is needed to understand the mechanisms through which semaglutide produces these early clinical benefits, but they may include the drug's positive effects on reducing inflammation, blood sugar, blood pressure, direct effects on the heart and blood vessels, early dietary changes, or an interaction among these or other responses.' The Select trial is a randomised, double-blind trial looking at semaglutide 2.4mg versus placebo for the prevention of heart attacks, strokes and early death in people with established cardiovascular disease who are overweight or have obesity. All have had a prior heart attack, stroke or peripheral artery disease. Patients in the trial were already on other drugs such as for cholesterol and blood pressure, suggesting semaglutide had benefits on top of these. – The study was presented at the European Congress on Obesity in Malaga, Spain.
