MUSC involved in study that found weight loss drug reduced risk of heart problems

Several patients at the Medical University of South Carolina were among the more than 17,000 adults around the world enrolled in a clinical trial that found a new weight loss drug reduced the risk of major cardiovascular events by 20%. That includes heart attacks and strokes.

Patrick O’Neil, Ph.D., director of the MUSC Health Weight Management Center, led MUSC’s role in the research. He said participants had to meet certain criteria. 

“We were recruiting people who were already suffering some of the ravages of obesity, the really serious ones from cardiovascular disease. It was very gratifying to be a small part of this very large study that showed that people with those kinds of diseases could indeed benefit from this medication.”

Participants also had to be at least 45 and have a body mass index of at least 27. They could not have diabetes.

 

Some got a weekly injection containing 2.4 milligrams of the obesity drug semaglutide, which is marketed as Wegovy. Others got a placebo. All continued to get regular care from their doctors along with standard nutritional counseling through the study.

The study was double-blinded, meaning neither the patients nor the researchers knew who was getting Wegovy and who was getting the placebo.

The executive vice president for Development at Novo Nordisk, which makes Wegovy, called it a landmark trial. “People living with obesity have an increased risk of cardiovascular disease but to date, there are no approved weight management medications proven to deliver effective weight management while also reducing the risk of heart attack, stroke or cardiovascular death,” said Martin Holst Lange.

It may be a landmark study, but there isn’t a lot of detailed information yet. As the New York Times noted, Novo Nordisk hasn’t said how much weight people lost or mentioned any side effects they dealt with or how many quit the trial.

But Novo Nordisk said it plans to give more specifics in a scientific conference later this year. O’Neil said he also expects data from the trial to appear ultimately in a peer-reviewed scientific journal, giving the public a clearer picture of what researchers found.

“Once the peer reviewed paper is out and published and people have a chance to fully digest all the findings, it should be reassuring to physicians regarding the possibility of using a medication like this with patients that they're treating who already have cardiovascular disease to help them avoid even more serious consequences down the road.”

This isn’t the first time Wegovy has made news. There’s been a lot of publicity about its remarkable success in helping people lose weight – and its side effects. 

Wegovy is in a class of medications called GLP-1 agonists. They include not only weight loss drugs but also diabetes medications. O’Neil said they mimic hormones produced in the gastrointestinal system, making people feel full longer. They can also cause nausea, vomiting, diarrhea and constipation, but O’Neil said those effects tend to wane over time.

He emphasized that Wegovy is not intended for people who just want to drop a few pounds. “This is a medication. It's designed for the treatment of obesity, and it's not meant to be used frivolously or thoughtlessly for minor weight loss. But the study does show the importance of treating obesity and the importance of finding as many tools as we can that will help people. We have to deal with obesity.”

But dealing with it can be expensive. Wegovy, for example, can cost well over $1,000 a month, according to GoodRx.

“I hope the study will increase the odds of insurance covering it. I think it'll probably be the result of a great deal of media attention paid to it – and more public pressure on insurance plans to cover treatment of obesity,” O’Neil said.

He’s been studying ways to help people reach a healthy weight for decades. O’Neil is a former president of the Obesity Society and a professor in the Department of Psychiatry and Behavioral Sciences in the MUSC College of Medicine. His experience gives him a good perspective on how significant the new research is.

“We're very fortunate in that our team has been participating in this field of clinical research for decades at this point. And so we've had a great vantage point to see the good, the bad and the ugly in the world of obesity medication development over the years. And it's just a really exciting time to be working in this area now that the treatments are potentially so much more impactful and can make so much of a difference, as witnessed by the results in this study.”

O’Neil is a principal investigator on numerous corporately sponsored clinical trials involving potential obesity treatments, including Novo Nordisk. He also participates in educational consulting and non-promotional information sessions with pharmaceutical and other corporations in the obesity treatment discipline.