Findings from a Phase 3 trial reveal that weekly injections of the weight-loss drug, Wegovy- or ‘semaglutide’- significantly reduce the risk of COVID-related death and overall mortality in overweight patients with cardiovascular disease. The corresponding study was published in the Journal of the American College of Cardiology.
The Semaglutide Effects on Cardiovascular Outcomes in Patients with Overweight or Obesity (SELECT) trial started before the COVID-19 pandemic. As the most severe periods of the trial coincided with the trial, it offered a valuable opportunity to understand the effects of semaglutide on COVID-19-related complications and death among certain high-risk patients.
The SELECT trial recruited 17, 604 patients of at least 45 years old with a body mass index of over 27. All had established cardiovascular disease but did not have diabetes. They were randomized to receive either a once-weekly subcutaneous dose of semaglutide 2.4 mg or a placebo, and were followed for an average of 3.3 years.
Ultimately, 833 deaths were recorded during the study period; 58% of which were related to cardiovascular disease. The study showed that patients on Wegovy were around 15% less likely to die from cardiovascular disease and 23% less likely to die from other reasons compared to patients who took a placebo.
While semaglutide did not reduce the incidence of COVID-19 among the patients, among those who developed COVID-19, it was related to fewer COVID-19-related serious adverse events, and a lower risk of COVID-related death.
Whether the benefits of semaglutide on non-cardiovascular mortality stem from weight loss or other pathways remains unknown. The researchers also wrote that reductions in cardiovascular death, heart attack, and ischemic stroke with semaglutide observed in the SELECT trial do not seem to have been mediated through weight loss.
They noted, however, that it is plausible that the observed decrease in infectious deaths among those taking semaglutide arose due to weight loss, which reduces inflammation.
“It is rare for a cardio-metabolic drug to modify non-cardiovascular outcomes,” said corresponding author Benjamin M. Scirica, professor of medicine at Harvard Medical School, in a press release.
“The fact that semaglutide reduced non-cardiovascular death, and in particular COVID-19-related deaths, was surprising. It opens up new avenues for exploring how this class of drugs may benefit patients,” he added.
Sources: Neuroscience News, Journal of the American College of Cardiology
