#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#
CS

Anti-obesity drug with exceptional benefit for preventive cardiology: current results of the SELECT trial

Czech version

Authors: Eva Tůmová;  Michal Vrablík
Authors‘ workplace: III. interní klinika, klinika endokrinologie a metabolismu, 1. LF UK a VFN v Praze
Published in: AtheroRev 2023; 8(3): 145-152
Category: Clinical Studies

Overview

In August this year, the main results of the SELECT study, one of the largest surveys in the field of cardiovascular prevention in the obese, were announced. The authors compared subcutaneous administration of 2.4 mg semaglutide once weekly with placebo as “on top” therapy in secondary cardiovascular prevention, with the primary endpoint being 3-point MACE (death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke). A total of 17,604 non-diabetic patients who were overweight (obese) or obese and had a history of cardiovascular disease were followed for 3–5 years and the expected results are now known – there was a reduction in MACE of more than 20% in the treatment arm compared to the placebo arm, making semaglutide the first anti-obesity drug with a proven benefit on the incidence of cardiovascular events and huge potential in preventive cardiology.

Keywords:

cardiovascular disease – MACE – obesity – preobesity – preventive cardiology – SELECT study – semaglutide

Sources
  1. WHO. Fact sheet – CVDs. Dostupné z WWW: <https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)>. [01–2023].
  2. Roth GA, Mensah GA, Johnson CO et al. [GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group]. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study. J Am Coll Cardiol 2020; 76(25): 2982–3021. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2020.11.010>. Erratum in: J Am Coll Cardiol 2021; 77(15): 1958–1959. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2021.02.039>. 
  3. World Obesity Federation. World obesity atlas 2023. Dostupné z WWW: <https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2023>. [08–2023]. 
  4. Khan SS, Ning H, Wilkins JT et al. Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity. JAMA Cardiol 2018; 3(4): 280–287. Dostupné z DOI: <http://dx.doi.org/10.1001/jamacardio.2018.0022>. 
  5. Caleyachetty R, Thomas GN, Toulis KA et al. Metabolically Healthy Obese and Incident Cardiovascular Disease Events Among 3.5 Million Men and Women. J Am Coll Cardiol 2017; 70(12): 1429–1437. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2017.07.763>. 
  6. Lawler PR, Bhatt DL, Godoy LC et al. Targeting cardiovascular inflammation: next steps in clinical translation. Eur Heart J 2021; 42(1): 113–131. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehaa099>. 
  7. Pasanisi F, Contaldo F, de Simone G et al. Benefits of sustained moderate weight loss in obesity. Nutr Metab Cardiovasc Dis 2001; 11(6): 401–416. 
  8. Bianchi VE. Weight loss is a critical factor to reduce inflammation. Clin Nutr ESPEN 2018; 28: 21–35. Dostupné z DOI: <http://dx.doi.org/10.1016/j.clnesp.2018.08.007>. 
  9. Holst JJ, Deacon CF, Vilsboll T et al. Glucagon‑like peptide‑1, glucose homeostasis and diabetes. Trends Mol Med 2008; 14(4): 161–168. Dostupné z DOI: <http://dx.doi.org/10.1016/j.molmed.2008.01.003>.
  10. Haluzík M. Semaglutid. Remedia 2019; 29(1): 25–31.
  11. Sorli C, Harashima SI, Tsoukas GM et al. Efficacy and safety of once‑weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double‑blind, randomised, placebo‑controlled, parallel‑group, multinational, multicentre phase 3a trial. Lancet Diabetes Endocrinol 2017; 5(4): 251−260. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30013-X>.
  12. Ahrén B, Masmiquel L, Kumar H et al. Efficacy and safety of once‑weekly semaglutide versus once‑daily sitagliptin as an add‑on to metformin, thiazolidinediones, or both, in patients with type 2 diabetes (SUSTAIN 2): a 56‑week, double‑blind, phase 3a, randomised trial. Lancet Diabetes Endocrinol 2017; 5(5): 341−354. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30092-X>.
  13. Ahmann AJ, Capehorn M, Charpentier G et al. Efficacy and Safety of Once‑Weekly Semaglutide Versus Exenatide ER in Subjects With Type 2 Diabetes (SUSTAIN 3): A 56‑Week, Open‑Label, Randomized Clinical Trial. Diabetes Care 2018; 41(2): 258−266. Dostupné z DOI: <http://dx.doi.org/10.2337/dc17–0417>.
  14. Pratley RE, Aroda VR, Lingvay I et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open‑label, phase 3b trial. Lancet Diabetes Endocrinol 2018; 6(4): 275−286. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(18)30024-X>.
  15. Aroda VR, Bain SC, Cariou B et al. Efficacy and safety of once‑weekly semaglutide versus once‑daily insulin glargine as add‑on to metformin (with or without sulfonylureas) in insulin‑naive patients with type 2 diabetes (SUSTAIN 4): a randomised, open‑label, parallel‑group, multicentre, multinational, phase 3a trial. Lancet Diabetes Endocrinol 2017; 5(5): 355−366. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(17)30085–2>.
  16. Marso SP, Bain SC, Consoli A et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375(19): 1834−1844. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1607141>.
  17. Husain M, Birkenfeld AL, Donsmark M et al. [PIONEER 6 Investigators]. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2019; 381(9): 841–851. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1901118>. 
  18. Wilding JPH, Batterham RL, Calanna S et al. [STEP 1 Study Group]. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med 2021; 384(11): 989–1002. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2032183>. 
  19. Davies M, Færch L, Jeppesen OK et al. [STEP 2 Study Group]. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet 2021; 397(10278): 971–984. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(21)00213–0>.
  20. Powell-Wiley TM, Poirier P, Burke LE et al. [American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council]. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2021; 143(21): e984-e1010. Dostupné z DOI: <http://dx.doi.org/10.1161/CIR.0000000000000973]>.
  21. Ryan DH, Lingvay I, Colhoun HM et al. Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) rationale and design. Am Heart J 2020; 229: 61–69. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ahj.2020.07.008>. 
  22. Lingvay I, Brown-Frandsen K, Colhoun HM et al. [SELECT Study Group]. Semaglutide for cardiovascular event reduction in people with overweight or obesity: SELECT study baseline characteristics. Obesity (Silver Spring) 2023; 31(1): 111–122. Dostupné z DOI: <http://dx.doi.org/10.1002/oby.23621>. 
  23. Novo Nordisk A/S. Company announcement, 8 August 2023. Dostupné z WWW: <https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=166301>. [08–08–2023].
  24. Sharma AM. M, M, M & M: a mnemonic for assessing obesity. Obes Rev 2010; 11(11): 808–809. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1467–789X.2010.00766.x>.
  25. Guh DP, Zhang W, Bansback N et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health 2009; 9: 88. Dostupné z DOI: <http://dx.doi.org/10.1186/1471–2458–9-88>.
  26. Luppino FS, de Wit LM, Bouvy PF et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67(3): 220–229. Dostupné z DOI: <http://dx.doi.org/10.1001/archgenpsychiatry.2010.2>.
  27. Simon GE, Von Korff M, Saunders K et al. Arch Gen Psychiatry 2006; 63(7): 824–830. Dostupné z DOI: <http://dx.doi.org/10.1001/archpsyc.63.7.824>.
  28. Church TS, Kuk JL, Ross R et al. Association of cardiorespiratory fitness, body mass index, and waist circumference to nonalcoholic fatty liver disease. Gastroenterology 2006; 130(7): 2023–2030. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2006.03.019>.
  29. Li C, Ford ES, Zhao G et al. Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005–2006. Prev Med 2010; 51(1): 18–23. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ypmed.2010.03.016>.
  30. Hosler AS. Prevalence of self-reported prediabetes among adults participating in a community-based health awareness program, New York State. Prev Chronic Dis 2009; 6(2): A48. PMID: 19288991.
  31. Lammert F, Gurusamy K, Ko CW et al. Gallstones. Nat Rev Dis Primers 2016; 2: 16024. Dostupné z DOI: <http://dx.doi.org/10.1038/nrdp.2016.24>.
  32. Powell-Wiley TM, Poirier P, Burke LE et al. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2021; 143(21): e984-e1010. Dostupné z DOI: <http://dx.doi.org/10.1161/CIR.0000000000000973>.
  33. Larsson SC, Spyrou N, Mantzoros CS. Body fatness associations with cancer: evidence from recent epidemiological studies and future directions. Metabolism 2022; 137: 155326. Dostupné z DOI: <http://dx.doi.org/10.1016/j.metabol.2022.155326>.
  34. Magkos F, Fraterrigo G, Yoshino J et al. Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity. Cell Metab 2016; 23(4): 591–601. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cmet.2016.02.005>.
Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adults
2023 Update on European Atherosclerosis Society Consensus Statement on Homozygous Familial Hypercholesterolaemia: new treatments and clinical guidance
VICTORY project: impact of complex pharmacotherapy on compensation of patients with type 2 diabetes mellitus
Use of a fixed combination of ramipril with rosuvastatin in the management of lipitension: an observational study
Measuring lipoprotein(a) concentrations: what and how do we measure and where do we go from here?
New treatment possibilities of homozygous familial hypercholesterolemia
Additional Cardiovascular Risk in Patients Living with HIV Associated with Antiretroviral Therapy
Šobrův den 2023: lipidová doba postmoderní
Rešerše zajímavých článků ze zahraniční literatury
Article was published in

Athero Review

Issue 3
2023 Issue 3
Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#