Weight-loss drug can reverse heart failure symptoms, study finds

Semaglutide injections trigger ‘very large improvements’ in patients with hearts too stiff to fill properly.

Andrew Gregory  Amsterdam 25 Aug 2023 05.55 EDT

Weight-loss jabs can reverse the symptoms of heart failure, according to a global trial that experts say could revolutionise treatment.

Heart failure is one of the world’s fastest growing health threats. About 65 million people have the condition, with cases soaring in recent years. However, few treatment options are available.

In a study that is the first of its kind, US researchers discovered that semaglutide – sold under the brand names Ozempic, Wegovy and Rybelsus – triggers “very large improvements” across a wide range of symptoms.

“We are talking about marked improvements in symptoms such as shortness of breath, fatigue, inability to have physical exertion, swelling,” said the lead author, Dr Mikhail Kosiborod, a cardiologist and vice-president for research at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri. “These types of improvements can be very impactful for patients living with heart failure.”

“It is one of the most promising developments in this field,” he added.

The findings were revealed on the first day of the annual meeting of the European Society of Cardiology, the world’s largest heart conference. Experts not involved with the study hailed the breakthrough, saying it could have a “transformational impact” on the lives of many patients.

In the randomised, double-blind, placebo-controlled trial – the gold standard of medical studies – researchers used semaglutide to treat patients suffering from heart failure with preserved ejection fraction (HFpEF). This is when the heart pumps normally but is too stiff to fill properly.

As many as half of patients with heart failure worldwide have HFpEF, and most of those are overweight or obese.

The trial included 529 patients from 13 countries in Europe, North America, South America and Asia. All had a body mass index of more than 30, as well as heart failure symptoms and physical limitations. The median age of the group was 69 and the median weight was 105.1kg (231.7lb).

One group was given 2.4mg of semaglutide once a week for a year. The other was given a placebo. Researchers assessed changes in body weight, as well as changes to heart failure-related symptoms using the clinical summary score (CSS) of the Kansas City Cardiomyopathy Questionnaire (KCCQ).

They also looked at whether patients were able to perform better walking for six minutes. After 52 weeks, the mean change on the KCCQ-CSS was 16.6 points for patients on the weight-loss jabs compared with 8.7 points in the placebo group.

Body weight for those on the drugs also reduced by a mean of 13.3% compared with 2.6%.

The mean change to walking distance in six minutes was 21.5 metres for those on Wegovy and 1.2 metres in the placebo group.

Kosiborod said he was “very excited” by the trial results.

“These findings are impressive and impactful. The benefits we observed with semaglutide versus placebo on these very important outcomes for patients with this type of heart failure – their symptoms and physical function – are the largest that we have ever seen with any pharmacologic intervention in this patient population.”

The medication “produced large improvements in symptoms, physical limitations and exercise function, reduced inflammation, and resulted in greater weight loss and fewer serious adverse events as compared with placebo”.

“The magnitude of the benefits we observed is the largest seen with any agent in HFpEF,” he added.

“This will likely have a significant impact on clinical practice, especially since there is a dearth of efficacious therapies in this vulnerable patient group.”

Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and a consultant cardiologist, welcomed the findings. “Only a few years ago, drugs that could help people to achieve life-changing weight loss felt like a far-off dream,” she said. “But now they are here.

“This study demonstrates that semaglutide is not only safe for people with this type of heart failure but it also has important benefits for their quality of life.

“For some people, living with heart failure can make everyday activities difficult or even impossible. The kind of improvements seen in this study, such as being able to walk further, could have a transformational impact on someone’s life.”

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