Borlaug, B. A. et al. (2023) Semaglutide in HFpEF across obesity class and by body weight reduction: a prespecified analysis of the STEP-HFpEF trial. Nature Medicine, 29(9), pp. 2358-2365. (doi: 10.1038/s41591-023-02526-x) (PMID:37635157) (PMCID:PMC10504076)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
310913.pdf - Published Version Available under License Creative Commons Attribution. 2MB |
Abstract
In the STEP-HFpEF trial, semaglutide improved symptoms, physical limitations and exercise function and reduced body weight in patients with obesity phenotype of heart failure and preserved ejection fraction (HFpEF). This prespecified analysis examined the effects of semaglutide on dual primary endpoints (change in Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS) and body weight) and confirmatory secondary endpoints (change in 6-minute walk distance (6MWD), hierarchical composite (death, HF events, change in KCCQ-CSS and 6MWD) and change in C-reactive protein (CRP)) across obesity classes I–III (body mass index (BMI) 30.0–34.9 kg m−2, 35.0–39.9 kg m−2 and ≥40 kg m−2) and according to body weight reduction with semaglutide after 52 weeks. Semaglutide consistently improved all outcomes across obesity categories (P value for treatment effects × BMI interactions = not significant for all). In semaglutide-treated patients, improvements in KCCQ-CSS, 6MWD and CRP were greater with larger body weight reduction (for example, 6.4-point (95% confidence interval (CI): 4.1, 8.8) and 14.4-m (95% CI: 5.5, 23.3) improvements in KCCQ-CSS and 6MWD for each 10% body weight reduction). In participants with obesity phenotype of HFpEF, semaglutide improved symptoms, physical limitations and exercise function and reduced inflammation and body weight across obesity categories. In semaglutide-treated patients, the magnitude of benefit was directly related to the extent of weight loss. Collectively, these data support semaglutide-mediated weight loss as a key treatment strategy in patients with obesity phenotype of HFpEF. ClinicalTrials.gov identifier: NCT04788511.
| Item Type: | Articles |
|---|---|
| Additional Information: | This trial was sponsored by Novo Nordisk and is registered with ClinicalTrials.gov (NCT04788511). [...] B.A.B. is supported, in part, by National Institutes of Health (NIH) grants R01 HL128526, R01 HL162828 and U01 HL160226 and by US Department of Defense grant W81XWH2210245. M.J.D. is supported by Leicester National Institute for Health Research (NIHR) Biomedical Research Centre, Leicester General Hospital. D.W.K. is supported, in part, by NIH grants U01AG076928, R01AG078153, R01AG045551, R01AG18915, P30AG021332, U24AG059624 and U01HL160272. S.V. is supported by the Canadian Institutes of Health Research and the Heart and Stroke Foundation of Canada and holds the Canada Research Chair in Cardiovascular Surgery. M.C.P. is supported by the British Heart Foundation Centre of Research Excellence Award (RE/13/5/30177 and RE/18/6/34217+). S.J.S. was supported by research grants from the NIH (U54 HL160273, R01 HL107577, R01 HL127028, R01 HL140731 and R01 HL149423). D.W. is a member of SFB1425, funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Petrie, Professor Mark |
| Authors: | Borlaug, B. A., Kitzman, D. W., Davies, M. J., Rasmussen, S., Barros, E., Butler, J., Einfeldt, M. N., Hovingh, G. K., Møller, D. V., Petrie, M. C., Shah, S. J., Verma, S., Abhayaratna, W., Ahmed, F. Z., Chopra, V., Ezekowitz, J., Fu, M., Ito, H., Lelonek, M., Melenovsky, V., Núñez, J., Perna, E., Schou, M., Senni, M., van der Meer, P., Von Lewinski, D., Wolf, D., and Kosiborod, M. N. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Nature Medicine |
| Publisher: | Nature Research |
| ISSN: | 1078-8956 |
| ISSN (Online): | 1546-170X |
| Copyright Holders: | Copyright: © The Author(s) 2023 |
| First Published: | First published in Nature Medicine 29(9): 2358–2365 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information