Anti-obesity drug promises to reverse heart failure symptoms

“Clearly, we cannot continue to treat obesity just as something that accidentally happens to occur in these patients. It’s likely a root cause of the complications and should be treated as such,” said Mikhail Kosiborod, lead researcher and a cardiologist at Saint Luke's Health System Kansas City.

Semaglutide’s effect on heart patients 

The researchers tested semaglutide against a placebo (an inert drug with no health benefit) in 529 individuals with a body mass index of more than 30 and had heart failure with preserved ejection fraction (HFpEF).

Ejection fraction is the measure of the volume of blood pumped by the human heart during every heartbeat. Heart failure with preserved ejection fraction (HFpEF) occurs when the heart's main pumping chamber, i.e., the left ventricle, faces higher pressure during filling, even though the amount of blood pumped out is within the normal range.

The high filling pressure results from the stiffness of heart muscles caused by factors like high blood pressure, inflammation, and numerous other conditions. This high pressure further leads to heart failure symptoms like fatigue, swelling in body parts, and shortness of breath.

During the study, the researcher administered a 2.4 mg dose of semaglutide (Wegovy) to one group of patients on a weekly basis. Meanwhile, patients in another group received the same amount of placebo. The trial continued for 52 weeks.

Kosiborod and his team then analyzed the heart failure symptoms in both patients using a 100-point scale, where 100 represented the maximum improvement and one denoted the least improvement in the patient’s condition. 

They found that patients who had semaglutide witnessed a 17-point improvement in HFpEF symptoms as well as underwent a 13 percent loss in their body weight. On the other hand, patients in the placebo group scored just nine points and lost only 2.6 percent of their body weight. 

The researchers also conducted an interesting six-minute walk test during which they noticed that heart failure patients on semaglutide medication walked 66 feet (20 meters) longer than patients on placebo. 

“In patients with heart failure with preserved ejection fraction and obesity, treatment with semaglutide (2.4 mg) led to larger reductions in symptoms and physical limitations, greater improvements in exercise function, and greater weight loss than placebo,” the study authors note.

Semaglutide can open new treatment avenues

Apart from some diuretics and anti-diabetic medicines, currently, there exists no other treatment that promises to alleviate symptoms in heart failure patients. Even the existing drugs only provide temporary relief.

The current study suggests that semaglutide could emerge as a new and effective treatment option for heart failure patients. The drug reduces HFpEF symptoms and also improves overall heart health by decreasing obesity, hypertension, and inflammation.

What’s more exciting is that during the trials, none of the patients experienced any serious side effects. They only encountered some minor gastrointestinal problems, which is normal for the class of drugs to which semaglutide belongs.    

Hopefully, the drug will prove its effectiveness in future trials as well and help millions of heart patients across the globe.

Disclaimer: The trial was funded by Novo Nordisk, the pharma company that manufactures Wegovy (semaglutide injection).

The study was published in the New England Journal of Medicine. 

Study Abstract:

Heart failure with preserved ejection fraction is increasing in prevalence and is associated with a high symptom burden and functional impairment, especially in persons with obesity. No therapies have been approved to target obesity-related heart failure with preserved ejection fraction. We randomly assigned 529 patients who had heart failure with preserved ejection fraction and a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or higher to receive once-weekly semaglutide (2.4 mg) or placebo for 52 weeks. The dual primary end points were the change from baseline in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; scores range from 0 to 100, with higher scores indicating fewer symptoms and physical limitations) and the change in body weight. Confirmatory secondary end points included the change in the 6-minute walk distance; a hierarchical composite end point that included death, heart failure events, and differences in the change in the KCCQ-CSS and 6-minute walk distance; and the change in the C-reactive protein (CRP) level.