Semaglutide reduces mortality in patients living with obesity

New results from the SELECT trial show that semaglutide 2.4 mg significantly reduces all-cause mortality in patients with obesity and cardiovascular disease, including deaths related to COVID-19.

The trial, one of the largest of its kind, offers promising evidence for the use of semaglutide in lowering death rates across a broad range of causes in individuals with a body mass index (BMI) of 27 kg/m² or higher.

The SELECT trial enrolled 17,604 participants aged 45 and older with established cardiovascular disease and no diabetes. Participants were randomised to receive either a once-weekly subcutaneous injection of semaglutide 2.4 mg or a placebo, with the trial spanning an average of 3.3 years.

A total of 833 deaths occurred during the study, with 58 per cent due to cardiovascular causes and 42 per cent attributed to non-cardiovascular causes. Researchers found that all-cause mortality was reduced by 19 per cent in the semaglutide group compared to placebo and cardiovascular death rates were 15 per cent lower in the semaglutide group, although this reduction was not statistically significant. They also found that non-cardiovascular death was reduced by 23 per cent, largely due to fewer infectious deaths.

One of the standout findings of the trial was semaglutide’s effect on COVID-19–related outcomes. While the medication did not reduce the likelihood of contracting COVID-19, it reduced the risk of serious complications and death in participants who became infected by 34 per cent and those participants experienced fewer severe COVID-19 adverse events.

These findings underscore semaglutide’s ability to reduce mortality, particularly in the context of infectious diseases like COVID-19, which was a major cause of non-cardiovascular death during the study period.

The SELECT trial’s results are significant for patients living with obesity and cardiovascular disease, who are at elevated risk of death from various causes. While semaglutide’s benefits in cardiovascular disease were previously recognised, this study demonstrates its potential to improve survival more broadly, including reducing infectious deaths.

Semaglutide’s success in reducing mortality, both cardiovascular and non-cardiovascular, suggests it may be an important therapeutic option for patients with obesity. The medication's ability to reduce deaths linked to infections during the COVID-19 pandemic further highlights its role in protecting vulnerable populations.