N Engl J Med

ACC 2024: Semaglutide’s impact on HFpEF outcomes in patients with obesity and T2DM

April 8, 2024

Among patients with obesity-related HFpEF and type 2 diabetes, use of semaglutide resulted in larger reductions in HF–related symptoms and physical limitations and greater weight loss, compared with placebo at 1 year.

For the STEP-HFpEF trial, investigators randomly assigned 616 patients who had HFpEF, BMI ≥30, and type 2 diabetes to receive once-weekly semaglutide (2.4 mg) or placebo for 52 weeks. Primary end points were change from baseline in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; range 0 to 100, with higher scores indicating fewer symptoms and physical limitations) and change in body weight. Secondary end points: change in 6-minute walk distance; a hierarchical composite end point that included death, HF events, and differences in change in KCCQ-CSS and 6-minute walk distance; and change in C-reactive protein (CRP) level.

Mean change in KCCQ-CSS was 13.7 points in the semaglutide group and 6.4 points in the placebo group, and the mean percentage change in body weight was −9.8% with semaglutide and −3.4% with placebo. Results for the confirmatory secondary end points favored semaglutide over placebo. The rate of serious adverse events was 17.7% in the semaglutide group vs. 28.8% in the placebo group.

Source:

Kosiborod MN, et al. (2024, April 6). N Engl J Med. Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes. https://www.nejm.org/doi/full/10.1056/NEJMoa2313917