How Wegovy helps the heart

Patients taking Novo Nordisk’s Wegovy obesity treatment maintained an average of 10% weight loss after four years, potentially boosting the drugmaker’s case to insurers and governments to cover the cost of the effective but expensive drug.

The Danish drugmaker presented the new long-term data on Tuesday at the European Congress on Obesity in Venice, Italy, in a new analysis from a large study for which substantial results had been published last year.

“This is the longest study we’ve conducted so far of semaglutide for weight loss,” Martin Holst Lange, Novo’s head of development, said in an interview, referring to the active ingredient in Wegovy and the company’s diabetes drug Ozempic.

“We see that once the majority of the weight loss is accrued, you don’t go back and start to increase in weight if you stay on the drug,” he added.

The data could go some way to convince insurers and governments to reimburse Wegovy, which ranges from $200 to almost $2,000 a month in the 10 countries it has been launched in so far.

Wegovy was the first to market from a newer generation of medicines known as GLP-1 agonists, originally developed for diabetes, that provide a new way to address record obesity rates. Eli Lilly launched its rival drug Zepbound in the United States in December. Neither company has been able to produce enough to meet unprecedented demand.

Dr. Simon Cork, Senior Lecturer in Physiology from Anglia Ruskin University, said Britain’s public health service’s decision to limit coverage of the medicine to two years was “because of questionable long-term effectiveness”.

The new data showing benefits continuing to four years may go some way to negating that argument, he said.

How Wegovy benefits the heart

The 17,604-patient trial tested Wegovy not for weight loss but for its heart protective benefits for overweight and obese patients who had pre-existing heart disease but not diabetes. Participants were not required to track diet and exercise because it was not an obesity study.

Around 17% of trial participants stopped using Wegovy due to side effects, the most common of which was nausea, Novo said in another analysis in the trial published by the drugmaker on Tuesday.

Patients in the trial, called Select, lost an average of nearly 10% of their total body weight after 65 weeks on Wegovy. That percentage weight-loss was roughly sustained year-on-year until the end of about four years, where weight loss stood at 10.2%, the company said.

A third new analysis on Select published by Novo on Tuesday showed that the heart protective benefits of Wegovy to patients in the trial occurred regardless of their weight before starting on the drug and regardless of how much weight they lose on it.

“We now also understand that while we know that body weight loss is important, it’s not the only thing driving the cardiovascular benefit of semaglutide treatment”, Lange told Reuters in the interview.

The Select study, released in August, showed that Wegovy reduced the risk of a major cardiovascular event such as a stroke by 20% in overweight or obese people with a history of heart disease.

Novo says researchers are still working to understand the mechanisms of the cardiovascular protection that semaglutide provides.

Wegovy and Zepbound are being tested to assess their benefits in a variety of other medical uses such as lowering heart attack risk and for sleep apnea and kidney disease.

The weight loss in the heart trial was less than the average of 15% weight loss in earlier Wegovy obesity studies before the drug was launched in the United States in June 2021.

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