One of the leading new obesity drugs, Wegovy, eased symptoms and raised the quality of life of patients with obesity and a common type of heart failure, a study funded by the drug’s maker found, adding to the evidence that the medications can produce health benefits beyond weight loss.
The study, published on Friday in The New England Journal of Medicine, evaluated the drug in people with a condition known as preserved ejection fraction in which the heart pumps normally but has lost the flexibility needed to fill with blood. The condition accounts for roughly half of all heart failure cases.
Patients given Wegovy in the trial showed greater improvements in physical fitness and in symptoms like fatigue and shortness of breath than those administered a placebo. The study, which included 529 participants and lasted for a year, was not designed to assess cardiac emergencies, but it found that 12 patients on the placebo and only one on Wegovy were hospitalized or required an urgent medical visit for heart failure.
The drug showed more pronounced relief of heart failure symptoms than other treatments, the study said.
“This is a huge patient population that is extremely symptomatic, for which we’ve had very few if any treatment options, and in which obesity is highly prevalent,” said Dr. Mikhail Kosiborod, a cardiologist at Saint Luke’s Mid America Heart Institute in Kansas City and the study’s lead investigator, who also consults for Novo Nordisk, the maker of Wegovy. “It’s going to be a true paradigm shift.”
Cardiologists used to see obesity as a condition that simply coexisted with heart failure. But the new study strengthened the evidence of obesity being a main driver of the disease.
“It’s a proof of concept that in many patients with this type of heart failure, where obesity is in fact causal, it needs to be treated as a root cause of heart failure and needs to be targeted as a therapeutic strategy,” Dr. Kosiborod said.
Another study evaluating the drug in heart failure patients with obesity and diabetes is expected to wrap up this year. If that study, too, produces promising results, Novo Nordisk has said it could seek to have the drug formally recommended for the treatment of heart failure.
Scientists who did not work on the trial said it would be important to study the drug over longer periods in more patients, allowing researchers to determine whether it actually reduced the likelihood of hospitalizations or deaths. But given the severity of physical limitations and symptoms in patients with this type of heart failure, the improvements on those measures alone were notable, they said.
On a 100-point measure of quality of life and physical abilities, patients given Wegovy experienced a greater improvement of their symptoms by roughly eight more points than patients on the placebo, according to the study. People on Wegovy also showed greater gains on a six-minute walk test.
“It’s a short trial, and so we can’t say much about long-term sustained benefits, but I think the magnitude of the benefit is impressive relative to what other interventions have shown in the same population,” said Dr. Daniel Drucker, a senior scientist at the Lunenfeld Tanenbaum Research Institute at Mt. Sinai Hospital in Toronto who has studied the new drugs. He has received fees from Novo Nordisk but was not involved in the latest trial.
Wegovy and another version of the same drug for diabetes patients, Ozempic, have quickly become popular for the significant weight loss results they have shown — so much so that Novo Nordisk has struggled to meet growing demand.
But the latest study built on other recent evidence that the drug does more than cut weight.
The company, for example, announced this month that Wegovy also slashed the risk of heart complications by 20 percent among a different pool of patients in a large trial, a result that was seen as crucial for persuading more insurers to cover the new weight loss drugs. Researchers are waiting for the company to release the underlying data to the study to examine the topline results.
“Obesity is associated with 200 other obesity-related diseases,” said Dr. Ania Jastreboff, an endocrinologist and obesity medicine specialist at Yale University who consults for makers of obesity drugs. “If we treat this one disease, we can potentially impact the health of so many patients in many different ways, and this is yet another important example.”
Experts believe that weight loss on its own probably accounted for some of the improvements in patients’ heart health. But determining exactly how big a role weight loss played and what other factors may have contributed will require more research.
The heart failure study released on Friday, for example, found indications that Wegovy may have reduced inflammation. Patients on the drug also had lower levels of an important marker of heart congestion, another sign that the drug is doing something that may have an effect on heart failure.
“We still need to understand that better,” Dr. Kosiborod said.
POST AUTHOR: Benjamin Mueller