Semaglutide eligibility identified for over half of chronic atherosclerotic disease patients in real-world registries
Background
Atherosclerotic Cardiovascular Disease (ASCVD) remains a leading cause of morbidity and mortality, necessitating effective secondary prevention strategies. While randomized clinical trials like SELECT and SOUL have demonstrated that semaglutide, a GLP-1 receptor agonist, significantly reduces major adverse cardiovascular events in patients with established coronary artery disease, the real-world applicability of these findings to broader patient populations is crucial. This study aimed to quantify the proportion of patients in cardiology practice who meet the regulatory criteria for semaglutide, addressing a key gap in understanding its potential impact and resource implications.
Study Design
Researchers identified patients with clinical characteristics comparable to those in the SELECT and SOUL trials from the START and BRING-UP prevention registries. Initially, 12,430 patients were screened, with 623 excluded due to severe renal impairment or ongoing GLP-1 receptor agonist therapy. The final analysis included 11,807 patients, comprising 8682 without diabetes and 3125 with diabetes. Eligibility for semaglutide was determined by applying criteria derived from the SELECT trial (overweight/obese with established coronary disease for non-diabetics) and the SOUL trial (individuals aged ≥50 years with cardiovascular disease for diabetics).
Results
Among the 8682 non-diabetic patients, 3689 (42.5%) met the SELECT-like criteria, defined as overweight or obese individuals with established coronary disease. For the 3125 diabetic patients, a substantial 3059 (97.9%) were found to be SOUL-like, meeting the criteria of individuals aged ≥50 years with cardiovascular disease. The overall analysis across both diabetic and non-diabetic cohorts revealed a significant proportion of eligible patients: > Overall, 6748 of the 12,430 patients initially screened (54.3%) theoretically fulfilled the eligibility criteria for semaglutide treatment in real-world cardiology practice. This indicates a broad potential target population for GLP-1 RA therapy in secondary cardiovascular prevention.
Key Findings
- 11,807 patients with chronic atherosclerotic disease were analyzed from real-world registries.
- 3689 (42.5%) of non-diabetic patients met SELECT-like criteria for semaglutide eligibility.
- 3059 (97.9%) of diabetic patients met SOUL-like criteria for semaglutide eligibility.
- Overall, 6748 of 12,430 patients (54.3%) were theoretically eligible for semaglutide treatment.
- A large proportion of cardiology patients with coronary artery disease may benefit from semaglutide.
Why It Matters
This study highlights the substantial real-world applicability of semaglutide for secondary cardiovascular prevention, extending beyond the specific trial cohorts. Clinicians can anticipate a large proportion of their chronic atherosclerotic disease patients, particularly those with diabetes, may be eligible for semaglutide therapy based on current regulatory guidelines. This insight is critical for healthcare authorities to estimate unmet clinical needs, plan resource allocation, and evaluate the sustainability of integrating innovative approaches like GLP-1 RA into standard cardiology practice. The findings underscore the potential for semaglutide to become a cornerstone in managing a broad spectrum of patients at high cardiovascular risk, potentially shifting current treatment protocols.
semaglutide
cardiovascular-disease
atherosclerotic-disease
glp-1-agonist
real-world-evidence
secondary-prevention