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expert reaction to study looking at semaglutide versus placebo in people with obesity-related heart failure

A study published in the Lancet looks at semaglutide and obesity-related heart failure. 


Prof Kazem Rahimi, Professor of Cardiovascular Medicine and Population Health, University of Oxford; and Honorary Consultant Cardiologist, Oxford University Hospitals NHS Trust, said:

“This is an important study which provides evidence for treatment of patients with heart failure with preserved ejection fraction (HFpEF).  Until very recently, we had only one approved drug class (SGLT2-I) for treatment in this patient group.  The present study provides a second treatment option for a subset of HFpEF patients.  Obesity and diabetes are very common in patients with HFpEF.  This study shows that treatment with semagulatide, a weight reduction medicine, leads to substantial improvements in patient symptoms and quality of life.  Heart failure admissions and other clinical events, including adverse events were also less common in those treatment with the drug (vs placebo), although the statistical power was somewhat limited.  While several questions remain to be answered before the adoption of such drugs into practice, the findings thus far are highly promising and provide great hope for this difficult to treat patient group.”


Prof Naveed Sattar, Professor of Cardiometabolic Medicine/Honorary Consultant, University of Glasgow, said:

“These two well-conducted trials when combined suggest we have underestimated the impact of excess weight in the development of heart failure with preserved ejection fraction.  Cardiologists should look at these results with great interest as semaglutide (and potentially other drugs that follow) are likely to be of great importance in the care of their patients living with heart disease and heart failure in the near future.”



‘Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials’ by Javed Butler et al. was published in the Lancet at 19:00 UK time on Sunday 7 April 2024.


DOI: 10.1016/S0140-6736(24)00469-0



Declared interests

Prof Kazem Rahimi: “No conflicts of interest.”

Prof Naveed Sattar: “I have consulted for many companies that own weight loss drugs including Novo Nordisk, Eli Lilly, Boehringer Ingelheim, Pfizer and AstraZeneca.

I have also contributed to many funded trials of low calorie diets in a range of clinical conditions.”

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