Semaglutide treatment considerably enhances health results for patients with heart failure with preserved ejection portion (HFpEF), showing decreased reliance on loop diuretics, and enhancements in symptoms and physical limitations.Weight Loss Drug Linked With Reduced Need for Diuretics in Heart Failure PatientsSemaglutide lowers the requirement for loop diuretic usage and dosage, and has favorable results on signs, physical limitations, and body weight in clients with heart failure with preserved ejection fraction (HFpEF) regardless of diuretic use, according to late-breaking research provided today (May 13) at Heart Failure 2024, a scientific congress of the European Society of Cardiology (ESC). Patients were stratified by baseline diuretic use (none, non-loop diuretic just, loop diuretic). The adjusted mean distinction vs. placebo varied from -8.8% (95% CI -10.3, -6.3) to -6.9% (95% CI -9.1, -4.7) from no diuretics to the highest loop diuretic dosage classification; p interaction=0.39. There were fewer serious unfavorable occasions with semaglutide vs. placebo across diuretic subgroups.Conclusion by Dr. Kavita SharmaStudy author Dr. Kavita Sharma of Johns Hopkins University School of Medicine, Baltimore, US, stated: “Semaglutide improved symptoms, physical restrictions and led to greater weight loss across diuretic use classifications in clients with HFpEF. In addition, there was proof of a significant decrease in average loop diuretic dose, a lower likelihood of diuretic treatment escalation, and a greater likelihood of diuretic treatment de-escalation with semaglutide versus placebo– specifications that suggest disease-modifying impacts of semaglutide, and are associated with much better long-term medical results in this client population.
Semaglutide treatment considerably enhances health outcomes for patients with heart failure with preserved ejection fraction (HFpEF), revealing reduced dependency on loop diuretics, and enhancements in symptoms and physical limitations.Weight Loss Drug Linked With Reduced Need for Diuretics in Heart Failure PatientsSemaglutide reduces the need for loop diuretic usage and dose, and has favorable impacts on symptoms, physical constraints, and body weight in patients with heart failure with preserved ejection portion (HFpEF) no matter diuretic use, according to late-breaking research provided today (May 13) at Heart Failure 2024, a scientific congress of the European Society of Cardiology (ESC). [1] HFpEF is a condition in which the heart pumps generally but is too stiff to fill correctly, rendering the heart unable to support the bodys need for oxygen-rich blood. The condition is becoming more typical as populations age and levels of weight problems and sedentary way of lives increase. [2] Signs of HFpEF can consist of shortness of breath– frequently with exertion– fatigue, and inflamed ankles.Trials Show Significant BenefitsThe STEP-HFpEF and STEP-HFpEF DM trials evaluated once-weekly semaglutide treatment vs. placebo in clients with obesity-related HFpEF, without and with diabetes, respectively. [3,4] Both research studies revealed a considerable enhancement with semaglutide for cardiac arrest symptoms, physical limitations, weight-loss, and six-minute walk range compared to placebo. This pre-specified analysis of pooled data from the 2 trials examined whether the effects of semaglutide vs. placebo varied according to baseline diuretic usage. In addition, the effects of semaglutide vs. placebo on modifications in diuretic treatment use and dosage during the trials were evaluated.Detailed Trial ResultsIn both trials, clients had obesity-related HFpEF with left ventricular ejection fraction ≥ 45%, body mass index ≥ 30 kg/m [2], Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) << 90, proof of elevated left ventricular filling pressures, structural heart abnormalities plus raised natriuretic peptides, or current heart failure hospitalization plus structural problems or continuous requirement for diuretic treatment. Clients were randomized 1:1 to once-weekly semaglutide 2.4 mg or placebo for 52 weeks. The double primary endpoints were modification in KCCQ-CSS (a requirement step of heart failure-related signs and physical restrictions) and percentage modification in body weight from baseline to 52 weeks. Clients were stratified by baseline diuretic usage (none, non-loop diuretic just, loop diuretic). A total of 1,145 clients were consisted of (529 in STEP-HFpEF and 616 in STEP-HFpEF DM) from 129 websites across 18 nations in Asia, Europe, North America, and South America. The typical age was ~ 70 years and ~ 50% were ladies. At standard, 220 patients were not receiving diuretics, 223 were getting non-loop diuretics only, and 702 were receiving loop diuretics.Regarding the first main endpoint of change in heart failure-related symptoms and physical restrictions from standard to 52 weeks, semaglutide enhanced KCCQ-CSS in all diuretic subgroups, but the magnitude of improvement was greater in patients getting loop diuretics compared to those not on loop diuretics, with an adjusted mean difference vs. placebo of +9.3 (95% self-confidence interval [CI] +6.5, +12.1) vs. +4.7 points (+1.3, +8.2), respectively; p interaction=0.042. For the 2nd primary endpoint of portion change in body weight from baseline to 52 weeks, semaglutide had a constant beneficial effect throughout diuretic use categories. The adjusted mean distinction vs. placebo varied from -8.8% (95% CI -10.3, -6.3) to -6.9% (95% CI -9.1, -4.7) from no diuretics to the greatest loop diuretic dose classification; p interaction=0.39. Semaglutide had consistent helpful impacts on all secondary efficacy endpoints (consisting of six-minute walk range) throughout diuretic subgroups (p interaction=0.24-0.92). Between standard and 52 weeks, loop diuretic dose reduced by 17% in the semaglutide group vs. a 2.4% increase in the placebo group (p<< 0.0001). Semaglutide (vs. placebo) was most likely to lead to loop diuretic dose reduction (chances ratio [OR] 2.67, 95% CI 1.70, 4.18) and less likely to result in loop diuretic dose increase (OR 0.35, 95% CI 0.23, 0.53); p<< 0.001 for both. There were fewer serious unfavorable events with semaglutide vs. placebo throughout diuretic subgroups.Conclusion by Dr. Kavita SharmaStudy author Dr. Kavita Sharma of Johns Hopkins University School of Medicine, Baltimore, United States, stated: "Semaglutide improved symptoms, physical restrictions and caused higher weight reduction across diuretic usage classifications in patients with HFpEF. In addition, there was proof of a considerable decrease in typical loop diuretic dose, a lower likelihood of diuretic treatment escalation, and a greater possibility of diuretic treatment de-escalation with semaglutide versus placebo-- specifications that indicate disease-modifying impacts of semaglutide, and are connected with much better long-term scientific results in this patient population."NotesThe STEP-HFpEF analysis will be presented throughout the session Late Breaking Clinical trials: LVAD, HFpEF and hypertrophic cardiomyopathy which takes location on May 13, 2024 at 13:57 WEST in Room 1."Heart failure with maintained ejection portion: JACC Scientific Statement" by Barry A. Borlaug, Kavita Sharma, Sanjiv J. Shah and Jennifer E. Ho, 1 May 2023, Journal of the American College of Cardiology.DOI: 10.1016/ j.jacc.2023.01.049"Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity" by Mikhail N. Kosiborod, Steen Z. Abildstrøm, Barry A. Borlaug, Javed Butler, Søren Rasmussen, Melanie Davies, G. Kees Hovingh, Dalane W. Kitzman, Marie L. Lindegaard, Daniél V. Møller, Sanjiv J. Shah, Marianne B. Treppendahl, Subodh Verma, Walter Abhayaratna, Fozia Z. Ahmed, Vijay Chopra, Justin Ezekowitz, Michael Fu, Hiroshi Ito, Małgorzata Lelonek, Vojtech Melenovsky, Bela Merkely, Julio Núñez, Eduardo Perna, Morten Schou, Michele Senni, Kavita Sharma, Peter Van der Meer, Dirk von Lewinski, Dennis Wolf and Mark C Petrie, 20 September 2023, New England Journal of Medicine.DOI: 10.1056/ NEJMoa2306963"Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes" by Mikhail N. Kosiborod, Mark C. Petrie, Barry A. Borlaug, Javed Butler, Melanie J. Davies, G. Kees Hovingh, Dalane W. Kitzman, Daniél V. Møller, Marianne B. Treppendahl, Subodh Verma, Thomas J. Jensen, Karoline Liisberg, Marie L. Lindegaard, Walter Abhayaratna, Fozia Z. Ahmed, Tuvia Ben-Gal, Vijay Chopra, Justin A. Ezekowitz, Michael Fu, Hiroshi Ito, Małgorzata Lelonek, Vojtěch Melenovský, Bela Merkely, Julio Núñez, Eduardo Perna, Morten Schou, Michele Senni, Kavita Sharma, Peter van der Meer, Dirk Von Lewinski, Dennis Wolf and Sanjiv J. Shah, 17 April 2024, New England Journal of Medicine.DOI: 10.1056/ NEJMoa2313917Funding: The STEP-HFpEF Programme was moneyed by Novo Nordisk.
