Takeaway
- Semaglutide reduced the risk for major adverse cardiovascular events (MACEs) in patients with type 2 diabetes (T2D), and across clinically relevant subgroups, namely those with and without established cardiovascular disease (CVD) and/or chronic kidney disease (CKD), and with and without prior myocardial infarction (MI) or stroke.
- Semaglutide did not show any significant effects on MACEs in patients with T2D and without previous heart failure (HF).
Why this matters
- Findings suggest that semaglutide offered CV benefits in patients with T2D (history of CVD) and in lower CV risk subgroups, despite its different routes of administration.
Study design
- Post-hoc analysis of combined SUSTAIN 6 and PIONEER 6 trials included 6480 patients with T2D who were randomly assigned to receive either semaglutide (n=3239) or placebo (n=3241).
- Main outcome: MACEs (CV mortality, non-fatal MI and non-fatal stroke) and its individual components.
- Funding: Novo Nordisk.
Key results
- Semaglutide vs placebo group had significantly lower risk for MACEs (HR, 0.76; 95% CI, 0.62-0.92), which was mainly driven by the effect on non-fatal stroke (HR, 0.65; 95% CI, 0.43-0.97).
- No significant difference was observed in the risk for hospitalisation for HF between semaglutide and placebo group (HR, 1.03; 95% CI, 0.75-1.40).
- Semaglutide reduced the risk for MACEs in patients with CVD and/or CKD (HR, 0.75; 95% CI, 0.61-0.93; Pinteraction=.944) and prior MI or stroke (HR, 0.83; 95% CI, 0.64-1.07; Pinteraction=.292), except those with prior HF (HR, 1.06; 95% CI, 0.72-1.57; Pinteraction=.046).
- In the combined SUSTAIN 6 and PIONEER 6 glycaemic efficacy trials, the risk for MACEs was lower in semaglutide vs placebo group (HR, 0.85; 95% CI, 0.55-1.33).
Limitations
- Post-hoc analysis.
References
References