Impact of semaglutide on cardiovascular events in T2D across varying cardiovascular risk

  • Husain M & al.
  • Diabetes Obes Metab
  • 5 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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.