One of the leading new obesity drugs, Wegovy, eases symptoms and increases the quality of life of patients with obesity and a common type of heart failure, a funded study has found by the drug maker, adding to the evidence that the drugs can produce health benefits beyond weight loss.
The study, published Friday in the The New England Journal of Medicine, the drug is being tested in people with a condition known as preserved ejection fraction in which the heart pumps normally but has lost the flexibility needed to fill with blood. The condition accounts for nearly half of all heart failure cases.
Patients given Wegovy in the trial showed greater improvements in physical fitness and in symptoms such as fatigue and shortness of breath than those given a placebo. The study, which included 529 participants and lasted a year, was not designed to assess cardiac emergencies, but it found that 12 patients on the placebo and only one on Wegovy were hospitalized or required a medical emergency. that visit for heart failure.
The drug showed more pronounced relief of heart failure symptoms than other treatments, the study said.
“This is a large patient population that is highly symptomatic, where we have very few treatment options, and where obesity is highly prevalent,” said Dr. Mikhail Kosiborod, a cardiologist at Saint Luke’s Mid America Heart Institute in Kansas City and the study’s lead investigator, who also consulted for Novo Nordisk, is the maker of Wegovy. “It’s going to be a real paradigm shift.”
Cardiologists see obesity as a condition that goes hand in hand with heart failure. But the new study strengthens the evidence of obesity as a major driver of the disease.
“This is a proof of concept that in many patients with this type of heart failure, where obesity is in fact the cause, it needs to be considered as a root cause of heart failure and needs to be targeted as a therapeutic approach,” Dr. Kosiborod said.
Another study testing the drug in heart failure patients with obesity and diabetes is expected to be completed this year. If that study, too, yields promising results, Novo Nordisk said it could aim to have the drug formally recommended for the treatment of heart failure.
Scientists who did not work on the trial said it is important to study the drug over a longer period of time in more patients, allowing researchers to determine if it really reduces the likelihood of hospitalizations or deaths. But given the severity of the physical limitations and symptoms in patients with this type of heart failure, improvements in those measures alone are remarkable, they said.
On a 100-point measure of quality of life and physical ability, patients given Wegovy experienced a greater improvement in their symptoms by about eight points than placebo patients, according to the study. student Wegovy people also showed greater gains in the six-minute walk test.
“This is a short trial, and so we can’t say anything about the long-term sustainable benefits, but I think the magnitude of the benefit is impressive compared to what other interventions have shown in the same population,” said Dr. . Daniel Drucker, a senior scientist at the Lunenfeld Tanenbaum Research Institute in Mt. Sinai Hospital in Toronto who studied new drugs. He received fees from Novo Nordisk but was not involved in the latest trial.
Wegovy and another version of the same drug for diabetes patients, Ozempic, quickly became popular for the significant weight loss results they showed – so Novo Nordisk struggled to meet the growing demand. .
But the latest study builds on other recent evidence that the drug does more than just reduce weight.
The company, for example, announced this month that Wegovy also reduced the risk of heart complications by 20 percent in different groups of patients in a large trial, a result seen as important for encouraging the more insurers to cover new weight loss drugs. . The researchers are waiting for the company to release the underlying study data to evaluate the topline results.
“Obesity is associated with 200 other obesity-related diseases,” said Dr. Ania Jastreboff, an endocrinologist and obesity medicine specialist at Yale University who consults for obesity drug makers. “If we treat this one disease, we can affect the health of so many patients in so many different ways, and this is another important example.”
Experts believe that the weight loss itself likely accounted for some of the improvements in the patients’ heart health. But determining exactly how much of a role weight loss played and what other factors may have contributed will require more research.
The heart failure study released Friday, for example, found indications that Wegovy may reduce inflammation. Patients on the drug also had lower levels of an important marker of heart congestion, another sign that the drug is doing something that could have an effect on heart failure.
“We still need to understand that better,” said Dr. Kosiborod.
