Diabetes, obesity & metabolism

Semaglutide improves heart and metabolism health risks in adults with overweight or obesity

Updated

Abstract

1961 participants in the STEP 1 trial and 803 in STEP 4 showed significant improvements in various cardiometabolic risk factors with semaglutide 2.4 mg.

  • Semaglutide treatment resulted in greater reductions in waist circumference, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, fasting serum insulin, and lipids compared to placebo.
  • Weight loss categories indicated that reductions in systolic blood pressure, non-HDL cholesterol, low-density lipoprotein cholesterol, and fasting plasma glucose were generally more pronounced with semaglutide.
  • Non-significant reductions in atherosclerotic cardiovascular disease risk were observed with semaglutide when compared to placebo.
  • Improvements in waist circumference, systolic blood pressure, fasting plasma glucose, fasting serum insulin, and lipids were maintained during continued semaglutide treatment but deteriorated after switching to placebo.
  • There were net reductions in the use of antihypertensive and lipid-lowering medications with semaglutide compared to placebo in both trials.

Simplified

Key numbers

51.5%
Increase in ACC/AHA BP Target Achievement
Proportion of participants achieving <130/80 mmHg at week 68
−12.4 percentage points
Weight Loss Difference
Estimated treatment difference in weight loss from baseline to week 68 in STEP 1
N/A
Reduction in Antihypertensive Medication Use
Proportion of participants decreasing or stopping antihypertensive medications

Full Text

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Funding

Competing interests

MB is an employee of Novo Nordisk A/S. MD has received research funding from AstraZeneca, Boehringer Ingelheim, Janssen, Novo Nordisk and Sanofi‐Aventis, paid to her institution; has acted as a consultant, advisory board member, and speaker for Boehringer Ingelheim, Eli Lilly, Novo Nordisk and Sanofi‐Aventis; an advisory board member and speaker for AstraZeneca; an advisory board member for Gilead Sciences Ltd and Lexicon; and a speaker for Napp Pharmaceuticals and Takeda Pharmaceuticals International Inc. She is co‐funded by the NIHR Leicester Biomedical Research Centre. JED has received honoraria, speaker, or other fees from Aegerion Pharmaceuticals, Amgen, Bayer, Boehringer Ingelheim, Merck, Novartis, Novo Nordisk, Pfizer, Sanofi‐Aventis and Takeda Pharmaceuticals International Inc.; has acted as a consultant for GENinCode. He has unpaid leadership or fiduciary roles in Our Future Health and Public Health England. WTG has served as a volunteer on advisory boards, without receipt of financial compensation, for Boehringer Ingelheim, Eli Lilly, JAZZ Pharmaceuticals, Novo Nordisk and Pfizer, and served on advisory boards for Alnylam Pharmaceuticals and Fractyl Health, where he received financial compensation for this service. He has participated as site principal investigator for multicentred clinical trials sponsored by his university and funded by Eli Lilly, Epitomee, Novo Nordisk, and Pfizer. UK was an employee of Novo Nordisk A/S during the conduct of the trials. MNK has received research grants from AstraZeneca and Boehringer Ingelheim; has served as a consultant/advisory board member for Alnylam, Amgen, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Eli Lilly, Esperion Therapeutics, Janssen, Lexicon, Merck (Diabetes and Cardiovascular), Novo Nordisk, Pharmacosmos, Sanofi and Vifor Pharma; has received honoraria from AstraZeneca, Boehringer Ingelheim and Novo Nordisk. RK has received grants and speaker fees from, and served as an advisory board member for, Novo Nordisk; and has received honoraria from CME Outfitters, Medscape, Pri‐Med, Rockpointe and Vindico Medical Education. DMR has received research grants, consultancy fees, travel fees and honoraria from, acted as an advisory board member, speaker, and principal investigator for Novo Nordisk; has received research grants from, and is a principal investigator and advisor for Boehringer Ingelheim; has received research funds from Epitomee Medical; and has received honoraria from the Endocrine Society, Medscape and the PeerView Institute. SV has received research grants and/or contracts, honoraria, and consulting fees from, and acted as an advisory board member for AstraZeneca, Boehringer Ingelheim, Eli Lilly and Novo Nordisk; has received research grants and/or contracts and honoraria from, and acted as an advisory board member for Amarin, Bayer, HLS Therapeutics, Janssen and Novartis; has received research grants and/or contracts from, and acted as an advisory board member for Amgen; has received research grants and/or contracts and honoraria from PhaseBio, Pfizer and Sanofi; has received research grants and/or contracts from Bristol‐Myers Squibb and Otsuka; has received honoraria from the Canadian Medical & Surgical Knowledge Translation Research Group, EOCI Pharmacomm Ltd, Sun Pharmaceuticals and Toronto Knowledge Translation Working Group. He is also the President of the Canadian Medical and Surgical Knowledge Translation Research Group and holds the Tier 1 Canada Research Chair in Cardiovascular Surgery. NZ is an employee and shareholder of Novo Nordisk A/S.
PubMed

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