Patients who took the diet drug Wegovy for a year had a reduced risk of heart disease in an early hint that Novo Nordisk’s best-selling obesity medicine may also have a positive impact on cardiovascular health.

People followed in a study saw their 10-year risk of cardiovascular disease decline by 18%, said Andres Acosta, an associate professor of medicine at the Mayo Clinic. Researchers used a standardized survey of heart risk to assess about 100 people, mostly White women, who took Wegovy over the course of a year at clinic sites around the US. 

The study took place in the real world rather than a clinical trial, meaning there was no control group, so researchers couldn’t say for sure whether the improvement was due to Wegovy, known generically as semaglutide, or whether other factors could have been at play. But the outcome is a positive sign as doctors await results from a larger, more rigorous trial being run by Novo, Acosta said in an interview. 

The results are “a great sign that the Select trials that are ongoing for cardiovascular overall mortality hopefully will be successful,” Acosta said in an interview, using the name assigned to Novo’s study. “But we need to wait for those studies.” He presented the findings at the European Congress on Obesity in Dublin.

The larger trial follows 17,500 patients with obesity and a history of cardiovascular disease, and its results are due this summer.  

Though the much smaller Mayo Clinic study wasn’t randomized, its authors did observe positive impacts on blood pressure, blood sugar level and liver function and less use of other drugs, said Grace O’Malley, leader of the Obesity Research and Care Group at Ireland’s RCSI University of Medicine and Health Science, who wasn’t involved with the trial. 

Uncontrollable Vomiting

Hearing about “outcomes other than body weight alone” is crucial, O’Malley said, noting the frequency of side effects. “Access to obesity medicines should be protected for those with complications related to obesity and should not be used in an attempt to change body size for aesthetic reasons.”

The Mayo Clinic team also looked at the weight patients shed and at side effects. Weight loss averaged around 13% of body weight among about 300 patients the group followed, mirroring what had been seen in randomized clinical trials. About half experienced side effects, mostly nausea, as well as diarrhea, abdominal pain and constipation.

As many as 5% of the Wegovy patients required hospitalization or a visit to the emergency room due to severe side effects, a larger number than had been seen in clinical trials, according to Acosta. The hospital visits were a result of patients becoming dehydrated due to uncontrollable nausea and vomiting, he said, a sign that doctors will need to monitor patients closely as weight-loss drugs are more widely prescribed.   

The real-world trial mirrored the constrictions on supply that patients with obesity are experiencing. The clinic’s doctors had prescribed the drug to about 1,000 people, but only about 300 were able to start taking it, Acosta said. Patients had difficulty accessing the medicine because of shortages as well as a lack of insurance coverage.

Naomi Kresge, Bloomberg

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