New analyses of the longest clinical trial of the weight-loss drug Wegovy have shown that it helps people lose weight quickly and sustain that weight loss over four years of use. The trial, called Select, also indicated that Wegovy may provide heart benefits beyond weight loss alone. The study included more than 17,600 people and showed that Wegovy reduced the risk of heart-related events by 20% in individuals with existing cardiovascular risk who were overweight or obese. These findings have raised questions about how drugs in this class, known as GLP-1 receptor agonists, should be used and covered by insurers.
The analysis of participants in the Select trial who took Wegovy showed an average weight loss of over 10%, which was sustained for up to four years. The weight loss continued for about 65 weeks before plateauing. Furthermore, after two years, about 68% of Wegovy users had lost at least 5% of their body weight, while 23% had lost at least 15%, and almost 5% had lost more than 25%. These results indicate that weight loss can vary for each individual and is not consistent across the board.
While more individuals on Wegovy experienced side effects compared to those on a placebo, there were no new safety concerns identified in the analysis. Gastrointestinal disorders like nausea, diarrhea, vomiting, and constipation were the most commonly reported side effects, especially in the initial months as the medication dose was increased. Additionally, gallbladder disorders were more prevalent in those on Wegovy compared to placebo, but there was no significant increase in acute pancreatitis.
The new analysis suggests that the cardiovascular benefits of Wegovy may be independent of weight loss. Individuals who took the medication saw a reduction in the risk of heart-related events, even if they did not lose weight. This indicates that the drug may have other protective effects on the heart beyond weight reduction. Dr. Daniel Drucker, a GLP-1 research pioneer, believes that these benefits may be related to the drug’s ability to reduce inflammation, which could improve heart health in individuals with cardiovascular disease.
The results of the Select trial have raised questions about whether individuals who have had a heart attack or stroke but are not overweight or obese could benefit from taking Wegovy to prevent future cardiovascular events. Additionally, the findings suggest that insurers should consider covering these medications more broadly, given the potential benefits for heart health even without significant weight loss. The cost of drugs like Wegovy can be significant, but the potential benefits in reducing heart attack, strokes, and death should be taken into consideration when determining coverage criteria.
