Wegovy may be valuable new option for heart failure patients

Weight-loss drug Wegovy (semaglutide) and its diabetes-focused cousin, Ozempic, have already upended the treatment of both obesity and diabetes, with sales of both drugs skyrocketing.

Now, injected Wegovy could prove a boon for many patients battling heart failure, a new study suggests. The trial results were presented Friday in Amsterdam at the annual meeting of the European Society of Cardiology (ESC).

Treatment with the drug "produced large improvements in symptoms, physical limitations and exercise function" compare to placebo, explained study lead author Dr. Mikhail Kosiborod, of Saint Luke's Mid America Heart Institute in Kansas City.

In the trial, obese heart failure patients who took Wegovy for a year also showed "greater weight loss and fewer serious adverse events as compared with placebo," Kosiborod added in an ESC news release.

The findings were published simultaneously in the New England Journal of Medicine (NEJM).

The new trial focused on a subset of patients with what's known as "heart failure with preserved ejection fraction," comprising about half of all people with heart failure.

Ejection fraction measures the heart's ability to pump oxygen-rich blood out to the body. Having a low ejection fraction means pumping ability is dangerously impaired. But heart failure patients can have a preserved ejection fraction, meaning they retain pumping ability that's in a healthy range.

Heart failure is still an often lethal ailment, however, with patients experiencing shortness of breath, swelling and fatigue on moving that can lower quality of life.

Since obesity and heart failure often go together, Kosiborod's group wanted to see if Wegovy might help patients with both conditions.

The new trial was funded by Wegovy's maker, Novo Nordisk. It included 529 patients recruited from North America and globally. All had heart failure with preserved ejection fraction, a BMI of 30 or above (the threshold for obesity), and declines in function as measured by two standard tests. Just over half of the participants were women, and patients averaged 69 years of age.

People received injections of either Wegovy (semaglutide 2.4 milligrams) or a placebo once a week, and their progress was tracked for one year.

Weight loss was one big difference between the two groups: People taking Wegovy saw an average 13.3% drop in their weight after a year, compared to a 2.6% decline in those taking the placebo, the researchers reported.

Heart failure symptoms improved for Wegovy recipients, too. Based on a standard 100-point scoring system called the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score—where 100 points is "excellent health status" and 0 to 25 points is "very poor"—patients taking Wegovy saw an average 16.6-point improvement in their scores, compared to 8.7 points for those on placebo.

People taking Wegovy also showed marked improvements in completing what's known as the Six-Minute Walk Test, compared to those on placebo, the researchers noted.

In addition, "serious adverse events"—such as ER visits or hospitalizations—were also markedly less frequent among the Wegovy group than those on placebo, the team noted.

How is Wegovy helping these patients? Weight loss is one key factor, reducing the underlying "metabolic disease" that contributes to heart failure, noted Dr. Yigal Pinto in an editorial published in the NEJM.

Pinto, a professor of cardiology at Amsterdam University Medical Centers in the Netherlands, noted that the trial was "relatively small," however. He said much better data is needed before reaching a clear understanding of exactly how Wegovy is helping the heart.

Still, Pinto called the new findings "encouraging," adding that they "potentially add a much-needed extra option for these patients."

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