A recent meta-analysis in the International Journal of Obesity reveals that semaglutide, a GLP-1 receptor agonist, offers significant cardiovascular benefits and aids weight loss in overweight and obese patients, though its side effects warrant caution. Developed initially for diabetes management, semaglutide has gained popularity for its ability to reduce cardiovascular risks in non-diabetic individuals as well.
According to the study, which analyzed 38 clinical trials with over 50,000 participants, semaglutide demonstrated significant cardiovascular benefits. It reduced the risk of cardiovascular death by 17%, heart failure hospitalization by 76%, non-fatal heart attacks by 24%, and stroke in individuals with diabetes by 35%. These improvements are attributed to the drug's ability to stabilize atherosclerotic plaques, reduce inflammation and improve lipid profiles.
Common gastrointestinal side effects like nausea, vomiting, diarrhea and constipation were reported, leading to treatment discontinuation in some cases. Higher doses of semaglutide, up to 2.4 mg subcutaneous or 50 mg oral, were linked to increased gastrointestinal issues. Treatment cessation rates ranged from 9% to 11% for subcutaneous semaglutide and increased with higher oral doses up to 25 mg.
Experts suggest starting patients on lower doses of semaglutide and gradually adjusting the dosage to mitigate the adverse gastrointestinal effects. Bariatric surgeon Dr. Mir Ali emphasizes the importance of slow eating and adopting a low-carbohydrate diet to help minimize these symptoms. In severe cases, anti-nausea medication may also be prescribed.
Oral semaglutide had fewer side effects and lower mortality rates than the subcutaneous version, likely because of better patient adherence. Despite challenges, the study shows the importance of ongoing semaglutide treatment for managing obesity, similar to how chronic diseases like diabetes or high blood pressure are managed.
This meta-analysis provides valuable insights into the cardiovascular benefits and potential side effects of semaglutide, aiding healthcare professionals in making informed treatment decisions for their patients.
