A new meta-analysis of diabetes medications based on semaglutide – sold under brand names including Ozempic, Wegovy and Rybelsus – has confirmed a significant reduction in cardiovascular risk.
Brazilian scientists at State University of Ponta Grossa reported in the International Journal of Obesity that semaglutide reduced: deaths from causes related to cardiovascular disease by 17 percent; hospitalisations for heart failure by 76 percent; non-fatal myocardial infarction (heart attack) by 24 percent; need for coronary revascularisation by 24 percent; strokes in people with diabetes by 35 percent; and deaths by any cause by 21 percent.
Lead author Andre Saad explained semaglutide ‘stabilises atherosclerotic plaques, preventing the development of acute myocardial infarction’ and ‘improves systemic inflammation caused by obesity’.
But he noted to medicalnewstoday.com: ‘Weight loss is closely related to improved cardiovascular health, especially in patients who have developed heart failure. Therefore a study like ours is not able to separate the effect of weight loss and medication on cardiovascular events.’
However, prominent US cardiologist Dr Jayne Morgan (not involved in the study) commented that ‘the meta-analysis does seem to address this with the random effects model, which can be a powerful tool statistically, allowing capture of the variability in weights across the studies’.
She explained ‘semaglutides act directly on blood vessels by improving blood flow to the heart and lowering blood pressure, on kidneys by reducing the rate of GFR (glomerular filtration rate) decline, on the liver by reducing steatosis and improving cholesterol profile, and also on the central nervous system’. With these direct cardiovascular benefits, the meta- analysis ‘certainly implies’ semaglutide has value for people at risk of cardiovascular disease who do not have diabetes or obesity.
The meta-analysis also investigated frequently reported gastrointestinal adverse effects accompanying semaglutide (including stomach pain, nausea, constipation and/or diarrhoea) across varying dose sizes, for both subcutaneous injection and orally-taken versions. Those receiving the 2.4mg dose reported the highest number of gastrointestinal adverse effects, and patients using subcutaneous semaglutide had a higher general frequency of side effects.
For constipation, researchers found no difference between subcutaneous and oral semaglutide; but a 50mg dose was associated with a higher occurrence of adverse effects apart from constipation compared to 3mg, 7mg, 14mg and 25mg doses.
The meta-analysis also found oral semaglutide was superior to the subcutaneous version at reducing all-cause mortality.
In addition, for those taking subcutaneous semaglutide, nausea increased from 23 percent at 0.5mg to 68 percent when taking 2.4mg, and vomiting increased from 9 percent to 45 percent. Overall, among subcutaneous semaglutide users, between 9-11 percent decided to stop treatment due to adverse effects.
With oral semaglutide, the number discontinuing treatment due to adverse effects rose steadily according to dose from 3mg to 25mg, then began decreasing at 50mg.
