Weight loss jabs could improve the symptoms of heart failure in obese patients, a new study has found, allowing them to exercise for longer as well as lose weight.
US researchers explored the use of semaglutide – which is sold under the brand names Ozempic, Wegovy and Rybelsus – to treat overweight people with a condition called heart failure with preserved ejection fraction (HFpEF).
HFpEF is when the heart pumps normally but is too stiff to fill properly.
Symptoms include shortness of breath, swelling and physical limitations that can lead to a poor quality of life. Few treatment options are currently available.
The trial – the findings of which were presented at the ESC Congress in Amsterdam on Friday – included 529 patients, all of whom had a body mass index of more than 30, as well as heart failure symptoms and psychical limitations.
The median age of the group was 69 and the median BMI was 105.1kg.
One group was given a once-weekly semaglutide 2.4 mg – also known as Wegovy – for one year while 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), which it described as “gold standard”.
They also determined whether patients were able to perform better walking for six minutes.
After 52 weeks, the mean change on the KCCQ-CSS 16.6 points for patients on Wegovy compared to 8.7 points in the placebo group.
Body weight for those on Wegovy also reduced by a mean of 13.3% compared to 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.
Dr Mikhail Kosiborod, of Saint Luke’s Mid America Heart Institute in Kansas City, was principal investigator on the study.
He said Wegovy “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”.
“To our knowledge, this is the first trial of a pharmacologic agent to specifically target obesity as a treatment strategy for HFpEF, and 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.
“We believe that these findings should also change the nature of the conversation about the role of obesity in HFpEF, as the Step-HFpEF results clearly indicate that obesity is not simply a comorbidity in patients with HFpEF but a root cause and a target for therapeutic intervention.”
The study was sponsored by Wegovy maker Novo Nordisk, which published its own findings from a five-year study on the drug earlier this month.
The Select trial included 17,604 adults over the age of 45 from across 41 countries, each with a BMI of 27 and over, established cardiovascular disease, and no history of diabetes.
Researchers found that the risk of heart attack or stroke in patients given a 2.4mg once-weekly dose of Wegovy, alongside standard care for the prevention of heart attacks or stroke, reduced by 20% compared with those given a placebo drug.
