Still life of Wegovy an injectable prescription weight loss drug that has helped people with obesity. It should be used with a weight loss program and physical activity.
Michael Siluk | UCG | Getty Images
Novo Nordisk’s Wegovy reduced the risk of serious cardiovascular complications in people with obesity and heart disease in a carefully monitored trial, demonstrating a particularly large effect on heart attacks, a promising new frontier for medicine.
The Select study of about 17,500 people looked at Wegovy in people with obesity and heart disease but who did not have diabetes. Weekly Wegovy injections reduced the overall risk of heart attack, stroke and cardiovascular death by 20 percent, according to detailed results from the trial presented Saturday at the American Heart Association Scientific Sessions and published simultaneously in the New England Journal of Medicine. Novo Nordisk disclosed key data from the study in August.
The findings could extend Wegovy’s insurance coverage, a major hurdle so far for the drug and similar GLP-1 agonists and encourages wider use of the anti-obesity drug.
“This is the first time that a drug approved for the management of chronic obesity can be considered lifesaving,” said Dr. Robert Kushner, professor of medicine in endocrinology at Northwestern University Feinberg School of Medicine who participated in the study.
The new data could also help the Danish drugmaker maintain its lead over Eli Lilly, whose rival weight-loss drug Zepbound was approved in the US earlier this week. Zepbound has been shown to help people lose more weight, but has yet to show an effect on cardiovascular outcomes.
“If you look at where insurance companies are going to be forced to go, they’re going to be forced to go with the drug that reduces cardiovascular events,” said Dr. Howard Weintraub, clinical director of the Center for Cardiovascular Disease Prevention at NYU Langone Heart who participated in the study.
Wegovy reduced the risk of non-fatal heart attack by 28% in the five-year trial. It produced a smaller 7% reduction in the occurrence of non-fatal stroke, although few strokes were seen in the trial overall.
In addition, Wegovy began to show a reduction in total cardiovascular events within months of participants starting the drug, with the difference between the drug and placebo widening as the study continued. The researchers noticed this effect even before people lost significant weight, an “exciting” finding that suggests both weight loss and the drug itself could play a role in heart health, said Dr. Anya Jastrebov, director of of the Yale Obesity Research Center.
“I think it’s all additive, and I don’t think we can dissect one from the other,” Jastreboff, who was not involved in the study, told a news conference.
About two-thirds of the participants had blood sugar levels that put them in the prediabetes range. Wegovy reduced progression to diabetes by 73%, suggesting the drug could be used as an early treatment. Novo’s Ozempic, which uses the same active ingredient as Wegovy, is approved for diabetes.
The study included both patients whose body mass index met the cutoff for overweight or obesity, although most patients were considered obese.
Almost 17% of people taking Wegovy in the trial stopped taking the drug, mainly because of gastrointestinal problems such as vomiting and diarrhoea, twice the rate of people who stopped taking the placebo. However, more people in the control group experienced serious side effects, such as heart problems and medical procedures.
The interruptions may reflect less familiarity with Wegovy among the doctors who participated in the study, said Kushner, who specializes in caring for patients who are overweight or obese. Adjusting the dosage or adjusting the diet can help people cope with unpleasant side effects.
Participants also lost less weight in this study than previous ones looking at Wegovy, although this study did not incorporate lifestyle changes and enrolled people with different characteristics.
A limitation of the study was the lack of diversity. Nearly three-quarters of the participants were male, and even more were white. Just 4% of participants were black.
Regardless, doctors expect the results to increase the number of people taking Wegovy.
Seeing a diabetes drug produce positive cardiovascular and metabolic effects “opens a new door for treating obese patients with cardiovascular disease,” said Dr. George Dangas, director of cardiovascular innovation for Mount Sinai Hospital. But it may take time and energy to incorporate it into clinical practice.
“These are good problems to have,” Dangas said. “We have something good for the patient, that’s great.”
— CNBC’s Patrick Manning contributed to this report.
CORRECTION: This article has been updated to correct the title of Dr. George Dangas, director of cardiovascular innovation for Mount Sinai Hospital.