Taking oral semaglutide may reduce heart-related hospitalizations and deaths among those with a history of heart failure and type 2 diabetes, a new analysis suggests.
Data from a trial funded by Novo Nordisk – which produces the glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide for weight loss (under the brand name Wegovy) and diabetes (Ozempic) – was reanalyzed by an international team of researchers.
The double-blind study involved 9,650 participants across 33 countries recruited between 2019 and 2021 and followed for almost 4 years on average.
By the end of the study period, participants with a history of heart failure had 22 percent fewer adverse cardiovascular events while taking a daily pill of semaglutide than those in a placebo group. No heart health benefits were detected in people without pre-existing heart conditions.
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"These data support the potential benefit of oral semaglutide in reducing heart failure events in people with type 2 diabetes and heart conditions," Oregon Health & Science University diabetologist Rodica Pop-Busui and colleagues write in their paper.
"Limitations include those intrinsic to a secondary analysis, such as the small number of participants in some of the subgroups," the team cautions.
Still, their findings are backed by previous research, which has also suggested semaglutide can reduce cardiovascular events, including strokes and heart attacks, among certain patients by almost 20 percent over about 3 years. What's more, those benefits seem to appear regardless of weight loss.
However, animal studies warn that these benefits may come with more serious risks, in addition to common side effects like nausea and vomiting.
In 2024, a study in mice revealed that semaglutide can have a shrinking effect on a type of muscle specific to mammalian hearts. Other studies have also found significant skeletal muscle loss, along with the desired fat loss and anti-diabetic effects of this molecule.
As with any medication, the use of semaglutide should be closely monitored for undesirable side effects, especially given we're still learning about its longer-term impacts.
Type 2 diabetes impacts roughly half a billion people globally, and heart failure is one of its most common complications. For people with these risk factors, semaglutide's benefits may outweigh its risks with appropriate medical guidance. However, other options, like bariatric surgery still perform better for blood sugar control than the use of this drug.
And, as we do not yet understand the mechanism behind semaglutide's impact on cardiovascular disease, researchers have called for caution when it comes to widespread prescription of this medication for purposes beyond weight loss and diabetes management.
This research was published in JAMA.