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While some blockbuster weight-loss drugs have been found to significantly protect the heart, new research shows that the cardiovascular benefits could be extended to a wider patient population — preventing tens of thousands of heart attacks and strokes each year in the United States, according to clinical trial data.
Clinical trial data from drugmaker Novo Nordisk showed that people using Wegovin had a 20% lower risk of heart disease compared to people who received a placebo. In March, the US Food and Drug Administration approved that change Cardiovascular benefits added to Wegovy account.It makes it the first weight-loss drug to be prescribed to people at high risk for the disease to reduce the risk of heart attack, stroke or heart-related death.
Wegovy belongs to a class of drugs called GLP-1 receptor agonists, and its ingredient, semaglutide, is approved to treat type 2 diabetes, like Ozempic.
The Novo Nordisk trial has previously been limited to obese people who have had a previous heart attack or stroke or have symptoms of coronary artery disease, such as blocked arteries in the arms or legs.
brand new From Dandelion Health ResearchThe platform, which uses real-world data and clinical AI to advance personalized care, has found that GLP-1 drugs can also be used as primary prevention, in people with mild or moderate coronary heart disease who do not have heart problems.
With the help of artificial intelligence, researchers analyzed real-world medical records of patients similar to those enrolled in the Novo Nordisk clinical trial but without a history of serious cardiovascular events.
Tracking years of medical history—focusing specifically on electrocardiogram readings, or measurements of the heart's electrical activity—the researchers used an AI model to predict the benefits of GLP-1s in reducing the risk of heart attack or stroke, and then confirmed them. Predictions on actual events.
According to the results of the clinical trial, GLP-1s reduced the risk of heart attack or stroke by 15 percent to 20 percent — but could add up to 44 million more people to the general population.
Based on these results, they estimate that 34,000 fewer heart attacks and strokes could occur each year if potentially eligible patients took GLP-1s in this large population.
“In clinical research, you take moderate-to-severe patients because you need a few patients to prove efficacy. But there's a huge risk that you'll permanently miss the drug's effect on the general population because you don't have the time and money to study them. That's just an inherent flaw of clinical research,” Dandelion Health said. Founder and CEO Elliott Green.
Expanding the scope of the analysis — with the help of AI — will help capture a group of patients that Dandelion Health researchers have deemed “clinically silent.”
Experts say GLP-1 drugs have already changed cardiovascular care, and the ability to use them as a primary prevention method could change the landscape even more.
“I think of these drugs not as weight loss drugs or obesity drugs, but as health boosters. They improve health,” said Dr. Harlan Krumholz, a cardiologist and scientist at Yale University and Yale New Haven Hospital who was not involved in the new analysis.
But for those who are unsure about using the drugs to treat obesity, more evidence of their heart benefits could make all the difference, he said.
“We can moderate the conversation,” Kruholz said. “It's about trying to get them into the low-risk category and help them live longer, healthier lives.”
Dr. Brendan Everett, a cardiologist at Brigham and Women's Hospital and an associate professor at Harvard Medical School, prescribes GLP-1s to some of his patients.
“I'm a preventive cardiologist who wants people to be healthy, and I've seen this disease called obesity and cardiometabolic disease consume America over the last two or three decades,” he said. “If you want to provide good care to your patients, you have to at least think about it [GLP-1s] And you know how to use them. So increasingly, I'm treating obesity for the sake of treating obesity.”
GLP-1s have created an “absolute paradigm shift” in the care of people with cardiovascular disease, he said. As long as the costs and goals of prevention are clearly understood, they may be beneficial for use in people with mild or moderate disease.
An Analysis Published last month in the Journal of Health Affairs, Medicare coverage of these weight-loss drugs could increase Part D costs by $3 billion, even though only 5 percent of eligible patients are prescribed them. But preventing heart attacks and strokes can reduce health care costs in other ways; Research As of last year, heart attacks cost hospitals an average of $19,000.
Randomized controlled clinical trials like Novo Nordisk are the gold standard for evaluating drug safety and efficacy. AI-based findings will need further testing before they can be used for more formal drug approvals, but the new research highlights some of the potential benefits such could provide.
The analysis by Dandelion Health included a more diverse population than the Novo Nordisk trial, including a greater ratio of men to women and three times the proportion of non-white patients.
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The new report also found an immediate sign: the AI model reduced cardiovascular risk in patients less than two years after starting to use GLP-1s; The Novo Nordisk trial took more than three years to complete.
The opportunities to improve cardiovascular health in the US are significant. It is a heart disease leading factor It is the fifth leading cause of death and stroke in the US.
And as GLP-1 drugs grow in popularity, more data could help health care providers better ensure that the current limited supply is reaching those who need it most, experts say.
Dr. Jody Dushay, an endocrinologist at Beth Israel Deacon Medical Center and an assistant professor of medicine at Harvard Medical School, told in March that Wegovy's expanded cardiovascular benefits would improve insurance coverage, especially as generic weight-loss drug options can carry heart risks. “It might as well help,” she added. Prioritize to use [the drugs] “The highest risk is among people who are obese” and those with cardiovascular disease.
's Meg Tirell contributed to this report.