Semaglutide reduces cardiovascular risk in type 2 diabetes

Leiter LA, Bain SC, Hramiak I et al (2019) Cardiovascular risk reduction with once-daily semaglutide in subjects with type 2 diabetes: a post hoc analysis of gender, age, and baseline CV risk profile in the SUSTAIN 6 trial. Cardiovasc Diabetol 18: 73

• Guidelines for the management of diabetes recommend multifactorial cardiovascular (CV) risk management, as CV disease is the leading cause of morbidity and mortality in people with type 2 diabetes. 
• The CV outcome trial Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN 6) found a 26% reduction in major adverse CV events (MACE) in high-risk patients with type 2 diabetes taking semaglutide. This post-hoc analysis examined the effects of age, gender and baseline CV on outcomes in SUSTAIN 6 participants.
• Investigators separated the 3,297 participants into subgroups according to their gender, age (50–65 years or over 65 years) and CV risk profile at baseline. They analysed time to first MACE, myocardial infarction, stroke, CV death, hospitalisation for unstable angina or heart failure and revascularisation as well as the effects age and gender had on HbA_1c, body weight and side effects.
• Just over 60% of participants were male and 43% were aged over 65. Over three-quarters (76.8%) of participants had established CV disease and 41.5% had a history of stroke or myocardial infarction at baseline.
• There were consistent increases in time to first MACE and the components of MACE with semaglutide versus placebo in all subgroups. 
• Semaglutide was consistently associated with reduced revascularisations, lower HbA_1c and body weight. Adverse gastrointestinal events were more common in women, however the number of men and women discontinuing treatment was similar.
• Investigators concluded that once-weekly semaglutide consistently reduced the risk of MACE regardless of age, gender or CV risk.

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