What are the implications of US FDA approval for the injectable weight-loss drug Semaglutide (Wegovy) in preventing heart attacks and strokes? This signifies an extension of Wegovy’s usage to non-diabetic individuals who are significantly overweight as a primary prevention measure against cardiovascular disease.
This decision comes after trials demonstrated that weight loss induced by Semaglutide was therapeutically beneficial for obese patients, resulting in a 20% reduction in their cardiac mortality and morbidity. Moreover, the trials indicated a 15% decrease in the risk of cardiovascular death and a 19% decrease in overall mortality compared to individuals who received a placebo.
What makes the trial and subsequent approval significant?
From a clinical perspective, obesity stands as a significant risk factor for heart disease. Although no magic pill can solely achieve weight loss, it serves as an initial catalyst for individuals committed to achieving their weight loss objectives. Following the shedding of initial stubborn pounds, maintaining weight loss necessitates strict adherence to lifestyle modifications, including a calorie-controlled diet and increased physical activity. Previous weight loss medications did not demonstrate concurrent benefits for heart health. However, since Wegovy has shown statistically significant benefits in this regard, it can serve as a primary anti-obesity therapy rather than merely a cosmetic solution.
In my view, cardiovascular disease, especially when linked with obesity, ranks as a leading cause of mortality. Thus, any treatment that addresses this risk represents a lifesaving intervention.
What is the mechanism by which Semaglutide safeguards cardiovascular health?
During the trial, Semaglutide did not impact total cholesterol, LDL cholesterol, or blood pressure. However, patients experienced an average weight loss of approximately 10%, which subsequently decreased these risks. Further investigation is required to establish a direct link between the drug and its effects on heart health.
Semaglutide is classified as a glucagon-like peptide 1 (GLP-1) receptor agonist. It functions by mimicking the actions of the incretin hormone GLP-1, which is naturally released by the gut following meals. This process stimulates insulin production, reduces glucagon production, and slows gastric emptying. These combined effects help to regulate blood sugar levels, subsequently alleviating strain on the cardiovascular system. Additionally, Semaglutide increases feelings of satiety, reducing hunger cravings and the inclination to overeat, thereby influencing calorie intake and weight.
By promoting weight loss and aiding in weight management, Semaglutide helps regulate additional risk factors associated with cardiovascular disease, including blood pressure, cholesterol levels, and inflammation. Inflammation has been identified as a factor that can narrow blood vessels in the heart, initiate plaque buildup, and cause arterial walls to weaken, potentially leading to ruptures and the formation of blood clots, ultimately increasing the risk of heart attacks and strokes.
What implications does this have for you?
Indians may have to wait for wider availability of injectable Semaglutide, as ongoing clinical trials are still in progress. However, we anticipate these medications to become accessible within the country in the next couple of years. Currently, individuals can obtain these injectables from pharmacies offering imported brands at a significantly high cost, or through individuals returning from abroad. While we have Liraglutide available, which has demonstrated positive effects on cardiac and renal safety outcomes in clinical trials for patients with Type 2 diabetes mellitus, obtaining Semaglutide may require consulting a doctor and obtaining a prescription. It’s crucial to undergo a medical assessment of your health condition before starting any treatment regimen, as it’s not advisable to initiate a medication solely based on others’ experiences.
Moreover, weight loss achieved with Semaglutide persists only as long as one continues to take the medication. Weight loss requires a comprehensive approach, and it’s essential to maintain rigor and discipline in lifestyle habits rather than solely relying on a miraculous drug.