Study Estimates More than 90 Million US Adults Could Benefit from Semaglutide 2.4 mg

Nathan Wong, PhD
Credit: UC Irvine

Results of a new study from investigators at the University of California, Irvine (UC Irvine) suggest more than 90 million US adults could benefit from the weight-lowering effects of semaglutide 2.4 mg (Wegovy).¹

Coming on the heels of Novo Nordisk announcing topline results from the SELECT trial, results of the current study, which leverages eligibility criteria and risk factor changes from the STEP 1 trial, suggests use of semaglutide 2.4 mg could prevent 1.5 million cardiovascular disease events over a 10-year period.^1,2

“We now have a weight control therapy that also significantly reduces cardiovascular events beyond the diabetes population where it was originally studied,” said Nathan D. Wong, PhD, director of the Heart Disease Prevention Program at UC Irvine.³ “It should be considered for patients who are obese or overweight with other risk factors where cardiovascular disease is their leading cause of disability and death."

The revelations of the weight-lowering effects of GLP-1 receptor agonists have revolutionized the way clinicians approach treatment of obesity, with the June 2021 approval of semaglutide for chronic weight management leading this change. Led by Wong, together with Hridhay Karthikeyan and Wenjun Fan, both of UC Irvine, the current study was launched to explore US eligibility for semaglutide 2.4 mg based on the weight management indication and the impact on obesity and cardiovascular events on a population level. With this in mind, investigators designed their study with the intent of applying STEP 1 trial eligibility criteria to a representative sample of US adults, which was obtained from US National Health and Nutrition Examination Survey (NHANES) survey cycles occurring from 2015-2018.¹

Following the identification of the eligible patient population, investigators also hoped to use 10-year changes in cardiovascular risk using BMI-based Cox regression models through application of risk factor changes observed in STEP 1 to the current study population. Among 19,225 participants who participated in NHANES from 2015-2018, a total of 3999 were considered eligible for STEP 1 and included in the investigators’ analytic sample. This is representative of 93.0 million patients nationwide.¹

Applying treatment effects from the STEP 1 trial, investigators concluded 69.1% of the estimated 93-million-person patient population could achieve a weight reduction of 10% or greater and 50.5% could achieve a weight reduction of 15% or greater. Investigators pointed out this would correspond to a 46.1% reduction in nationwide obesity prevalence.¹

When assessing cardiovascular risk reduction among those without a history of cardiovascular disease, results indicated the 10-year estimated risk was 10.15% prior to the application of treatment effects and 8.35% after the subsequent application of effects, which reflects a 1.81% absolute risk reduction and a 17.8% relative risk reduction. Investigators underlined this would correspond to 1.5 million prevented cardiovascular disease events over a 10-year period.¹

Of note, the 17.8% projected reduction in relative cardiovascular risk used in the trial is less than the 20% risk reduction achieved in the SELECT trial, according to topline results announced by Novo Nordisk on August 8, 2023.²

“Our study suggests over 90 million US adults with overweight or obesity would be potentially eligible for semaglutide treatment for chronic weight management,” wrote investigators.¹ “Such treatment could reduce by nearly half the size of the population with obesity, as well as prevent up to 1.5 million [cardiovascular disease] events if treated for 10 years. This could have a significant impact on reducing healthcare costs associated with obesity and [cardiovascular disease].”

References:

1. Wong ND, Karthikeyan H, Fan W. US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events [published online ahead of print, 2023 Aug 14]. Cardiovasc Drugs Ther. 2023;10.1007/s10557-023-07488-3. doi:10.1007/s10557-023-07488-3
2. Campbell P. Select trial shows semaglutide 2.4 mg could reduce cardiovascular risk. HCP Live. August 8, 2023. Accessed August 21, 2023. https://www.hcplive.com/view/select-trial-shows-semaglutide-2-4-mg-could-reduce-cardiovascular-risk.
3. Popular weight loss medication may benefit 93 million U.S. adults, UC Irvine study found. UCI News. August 16, 2023. Accessed August 21, 2023. https://news.uci.edu/2023/08/16/popular-weight-loss-medication-may-benefit-93-million-u-s-adults-uc-irvine-study-found/.