Wegovy, the blockbuster weight-loss medication from Novo Nordisk A/S, alleviated heart failure symptoms in patients with obesity, according to a late-stage trial that adds to the drug’s potential benefits.
A weekly dose reduced patients’ ills that can include shortness of breath, fatigue, swelling in the legs and irregular heartbeat, according to findings published Friday in the New England Journal of Medicine.
Novo’s findings are “very important,” said Eugene Yang, a cardiologist at the University of Washington who’s chair of the American College of Cardiology’s prevention of cardiovascular disease council. “As cardiologists, we want to make people feel better. Patients who are able to walk longer distances is beneficial, people losing weight and optimizing other risk factors is beneficial.”
People with obesity are typically at greater risk for developing a form of heart failure that occurs when its lower chamber pumps less blood than the body needs. In the U.S., an estimated 2.5 million people have this condition, called heart failure with preserved ejection fraction, and more than 80% of those patients also have obesity. It’s most common in older people, and it can be progressive and lethal.
Novo shared some results from the heart failure study in a company presentation earlier this month, but they were eclipsed by excitement over another trial showing that Wegovy lowered patients’ risk of heart attack and stroke. Both studies are important as Novo seeks broad reimbursement and Medicare coverage for Wegovy, which can cost more than $10,000 a year, according to Bloomberg Intelligence analyst Michael Shah.
The Danish company is waiting for results expected in the fourth quarter from a study of Wegovy in heart failure patients with type 2 diabetes, said Martin Lange, Novo’s head of development. If those are positive, the drugmaker plans to seek expansion for its label to include treatment of heart failure with obesity, Lange said.
That would give Wegovy an edge over Eli Lilly & Co.’s rival drug Mounjaro, Shah said. Mounjaro is expected to get U.S. approval for obesity this year and is also in late-stage studies for heart failure, but Lilly is unlikely to share those results until mid-2024.
Novo’s study enrolled 529 patients with a median age of 69 years between March 2021 and March 2022. More than half were women, two-thirds were severely obese and almost all were White. About two-thirds had limitations in physical activity due to heart failure, while the rest had even more difficulty performing daily activities.
Patients who received Wegovy saw significant improvements in a measure of symptoms and physical limitations. They also had lower blood pressure and reductions in inflammation, two important markers of heart health, compared with those who received a placebo.
The study didn’t directly measure outcomes like hospitalization and death, and there are no treatments shown to improve long-term survival in patients with the form of heart failure looked at in the study.
“Understanding if semaglutide could change that is really important,” said Sadiya Khan, a cardiovascular epidemiologist at Northwestern University Feinberg School of Medicine who wasn’t involved in the study.
Those treated lost an average of about 31 pounds, or 13.3% of their body weight, according to study, which was also presented at the annual European Society of Cardiology conference in Amsterdam.
Other medications can help lower heart failure patients’ chances of hospitalization. AstraZeneca Plc’s Farxiga, got extended approval for the condition earlier this year, and Novartis AG’s Entresto is also approved to treat adults with chronic heart failure. Lilly’s drug Jardiance is approved as an investigational heart failure treatment for patients with type 2 diabetes.
“We need to move away from calling something a diabetes drug or a heart disease drug or a kidney drug,” Khan said. “Clearly there are benefits for people who have obesity related to all of these conditions.”
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