Still life of Wegovy, an injectable prescription weight loss medication that has helped people with obesity. It should be combined with a weight loss plan and physical activity.

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Novo Nordisk’s Wegovy reduced the risk of serious cardiovascular complications in people with obesity and heart disease in a closely watched study, and showed a particularly large effect on heart attacks. a promising new frontier for the drug.

In the Select study with around 17,500 participants, Wegovy was tested on people with obesity and heart disease but who did not have diabetes. Weekly Wegovy injections reduced the overall risk of heart attack, stroke and death from cardiovascular causes by 20%, according to detailed results of the study presented Saturday at the American Heart Association’s Scientific Sessions and published simultaneously in the New England Journal of Medicine . Novo Nordisk published the key data from the study in August.

The findings could expand Wegovy’s insurance coverage, So far, this represents a major obstacle for the drug and similar GLP-1 agonists, encouraging broader use of the anti-obesity drug.

“This is the first time that drugs approved to treat chronic obesity can be considered life-saving,” said Dr. Robert Kushner, a professor of endocrinology at Northwestern University Feinberg School of Medicine, who was involved in the study.

The new data could also help the Danish pharmaceutical company maintain its lead over Eli Lilly, whose rival weight-loss drug Zepbound was approved in the United States earlier this week. Zepbound has been shown to help people lose more weight, but has not yet been shown to have an impact on cardiovascular outcomes.

“If you look at where the insurance companies have to go, they’re going to be forced to choose the drug that reduces cardiovascular events,” Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart, who was involved in the study.

Test results

Wegovy reduced the risk of a non-fatal heart attack by 28% in the five-year trial. It resulted in a smaller 7% reduction in the incidence of non-fatal strokes, although only a few strokes were observed overall in the study.

In addition, Wegovy showed a reduction in overall cardiovascular events within a few months of participants starting taking the drug, with the difference between the drug and placebo increasing as the study progressed.

About two-thirds of the participants had blood sugar levels that put them in the prediabetes range. Wegovy reduced diabetes progression by 73%, suggesting the drug could be used as an early treatment. Novos Ozempic, which uses the same active ingredient as Wegovy, is approved for diabetes.

The study included both patients whose body mass index met the threshold for overweight or obesity, although most patients were considered obese.

Side effects and limitations

Nearly 17% of people who received Wegovy in the study stopped taking the drug, mostly because of gastrointestinal problems such as vomiting and diarrhea, twice as many as people who stopped taking the placebo. But more people in the control group experienced serious adverse events such as heart disease and medical procedures.

The dropouts may reflect the doctors involved in the study’s less familiarity with Wegovy, said Kushner, who specializes in caring for patients who are overweight or obese. Adjusting the dosage or changing your diet can help deal with unpleasant side effects.

Participants also lost less weight in this study than in previous studies examining Wegovy, although this study did not take lifestyle changes into account and included people with different characteristics.

A limitation of the study was its lack of diversity. Nearly three-quarters of the participants were male and even more were white. Almost 4% of participants were black.

Regardless, doctors expect the results will lead to an increase in the number of people taking Wegovy.

Seeing that a diabetes drug has positive effects on the cardiovascular system and metabolism “opens a new door for treating obese patients with cardiovascular disease,” said Dr. George Dangas, surgical director of the structural heart program at Mount Sinai Health System. However, it could take time and energy to integrate it into clinical practice.

“These are good problems to have,” Dangas said. “We have something good for the patient, which is great.”

—CNBC’s Patrick Manning contributed to this report.

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