Wegovy, a weight loss drug from Novo Nordisk, reduces the likelihood of severe cardiovascular events.

• Wegovy, a drug developed by Novo Nordisk, reduced the likelihood of severe cardiovascular issues in individuals with obesity and heart disease.
• The full results of Novo's Select trial were presented by researchers at the American Heart Association Scientific Sessions and published in the New England Journal of Medicine on Saturday.
• The research could increase the application of Wegovy and preserve Novo's advantage over Eli Lilly, whose weight-loss medication Zepbound was authorized in the U.S. recently.

In a closely watched trial, Wegovy demonstrated a particularly large effect on heart attacks, cutting the risk of serious cardiovascular complications in people with obesity and heart disease, opening up a promising new frontier for the drug.

The Select study, which involved approximately 17,500 individuals with obesity and heart disease but not diabetes, found that weekly injections of Wegovy reduced the overall risk of heart attack, stroke, and death from cardiovascular causes by 20%. The results were presented at the American Heart Association Scientific Sessions and published in the New England Journal of Medicine. Novo Nordisk released the topline data from the study in August.

The results could increase insurance coverage for Wegovy, a significant obstacle to the drug and other GLP-1 agonists, and encourage wider use of the anti-obesity medication.

Dr. Robert Kushner, a professor of medicine in endocrinology at the Northwestern University Feinberg School of Medicine, stated that the medication approved for chronic obesity management is considered life-saving for the first time.

The new data could aid the Danish pharmaceutical company in preserving its advantage over Eli Lilly, whose weight-loss medication Zepbound was recently approved in the U.S. Although Zepbound has been proven to aid in weight loss, it has not yet demonstrated any impact on cardiovascular outcomes.

According to Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart, insurance companies will be obligated to go with the drug that reduces cardiovascular events as per their future obligations.

Trial results

In the five-year trial, Wegovy reduced the risk of non-fatal heart attack by 28%, but only produced a smaller 7% reduction in the occurrence of non-fatal stroke, despite few strokes being seen in the trial overall.

The study found that Wegovy reduced overall cardiovascular events within months of participants starting the drug, with the difference between the drug and placebo increasing as the study progressed. Researchers observed this effect even before significant weight loss, suggesting that both weight loss and the drug itself may contribute to heart health, said Dr. Ania Jastreboff, director of the Yale Obesity Research Center.

Jastreboff, who was not part of the study, stated at a press conference that he believes it's all additive and we cannot differentiate between them.

Two-thirds of participants had blood sugar levels that put them at risk for prediabetes. Wegovy reduced the likelihood of developing diabetes by 73%, indicating its potential as an early treatment option. Ozempic, a drug from Novo that contains the same active ingredient as Wegovy, has been approved for use in diabetes.

Both patients in the study had a body-mass index above the threshold for overweight or obesity, with the majority being classified as obese.

Side effects and limitations

In the trial, 17% of Wegovy recipients stopped taking the drug due to gastrointestinal problems, while the placebo group had a lower rate of discontinuation. However, the control group experienced more serious adverse events, including cardiac disorders and medical procedures.

The unfamiliarity of Wegovy among doctors in the study may have contributed to the discontinuations, according to Kushner, who specializes in treating overweight and obese patients. Adjusting the dosage or modifying the diet can help alleviate unwanted side effects.

Although this study did not include lifestyle changes and enrolled participants with different characteristics, they lost less weight than those in previous Wegovy studies.

The study had a limitation in terms of diversity, as it lacked representation from different genders and races. Specifically, 75% of participants were male, 90% were white, and only 4% were Black.

Doctors anticipate that the results will boost the number of individuals who use Wegovy.

Dr. George Dangas, director of cardiovascular innovation for Mount Sinai Hospital, stated that the discovery of a diabetes drug producing positive cardiovascular and metabolic effects "opens a new door to treat obese patients with cardiovascular disease." However, it may take time and effort to incorporate it into clinical practice.

It's great that we have something good for the patient," Dangas said, "and those are good problems to have.

— CNBC’s Patrick Manning contributed to this report.

The title of Dr. George Dangas, director of cardiovascular innovation for Mount Sinai Hospital, has been corrected in this article.