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Writer's pictureDave Knapp

SELECT Trial Update: Semaglutide's Cardiovascular Benefits and Psychiatric Safety Profile Highlighted at Obesity Week 2024

As Obesity Week unfolds, Novo Nordisk has shared some exciting, in-depth data from the SELECT trial that’s been the talk of the community. This groundbreaking study sheds light on the long-term impacts of semaglutide (Wegovy) beyond weight loss. Here’s a breakdown of what we’ve learned so far and why it’s such a big deal for the GLP-1 community.



Cardiovascular Benefits that Go Beyond Weight Loss

One of the most significant takeaways from the SELECT trial data is that the cardiovascular benefits of semaglutide appear to be independent of the amount of weight lost. In other words, patients saw improvements in heart health regardless of how much weight they actually shed. This information is extremely meaningful, as it suggests that semaglutide may offer heart-protective effects for people with obesity, even in patients who don't lose as much weight with semaglutide.


Lower Doses, Sustained Benefits

Interestingly, many participants in the SELECT trial didn’t need to escalate to the higher doses of semaglutide. In fact, some didn’t even reach the maximum 2.4 mg dose over the entire four-year study period. The trial was designed to keep people on the medication, not to max out on dosage. Some even paused treatment during the 4 year study. Despite this, they still experienced significant benefits. This reinforces that semaglutide's effectiveness doesn’t necessarily rely on higher doses, which could make treatment more accessible and manageable for those who might struggle with the full dosage.



Sustained Weight Loss Over Four Years

The trial also demonstrated that the weight loss achieved with semaglutide was sustained over four years, which is a noteworthy finding. Maintaining weight loss over such an extended period is notoriously challenging, particularly for people with obesity. This long-term data provides a hopeful outlook for those considering GLP-1 treatments as a sustainable option for weight management.


Reduced All-Cause Mortality

One of the most compelling data points from the trial is the reduced rate of all-cause mortality among those using semaglutide. This decrease in overall mortality highlights the potential for semaglutide to improve not just specific health markers but also general survival outcomes for people dealing with obesity. Such a reduction in mortality could make a strong case for broader adoption of semaglutide-based treatments in obesity care.

Psychiatric Safety Profile: Low Rates of Suicide and Self-Injury in SELECT Trial

The SELECT trial data also provided an in-depth look at the rates of psychiatric adverse events, specifically focusing on suicide and self-injury, for both the semaglutide and placebo groups. Across the trial’s 8,803 participants in the semaglutide group and 8,801 in the placebo group, the occurrence of psychiatric events related to suicide and self-injury remained low, with a reported rate of 0.1% in both groups.


These findings reinforce that the use of semaglutide does not appear to introduce any increased risk for psychiatric adverse events when compared to a placebo. This consistent safety profile is particularly reassuring for patients and healthcare providers, as it suggests that semaglutide’s benefits in weight management and cardiovascular health are not accompanied by elevated psychiatric risks.


This analysis aligns with the broader data on GLP-1 medications, which have generally not shown a causal link to psychiatric complications. As more long-term studies on GLP-1 treatments become available, the continued monitoring of psychiatric outcomes remains essential to ensure these therapies’ safety across diverse populations.


Stay tuned to On The Pen for more updates as Obesity Week continues. I'll be covering additional insights and developments from the conference that could shape the future of obesity treatment.

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