A new study co-led by Dr. Subodh Verma and published in the New England Journal of Medicine found that the medication semaglutide can significantly improve symptoms, physical limitations and exercise function, and reduce inflammation and body weight, in patients with a common type of heart failure. Semaglutide is the active ingredient in the diabetes drug Ozempic.

Heart failure with preserved ejection fraction (HFpEF) is a common condition where the heart’s main pumping chamber (left ventricle) becomes too stiff to fill properly. Patients with HFpEF often experience debilitating symptoms, physical limitations, and poor quality of life, and evidence suggests that obesity plays a major role in the development and progression of the condition.

There are currently no drug therapies available to treat obesity-related HFpEF, highlighting a significant and urgent unmet healthcare need worldwide.  

The study outlines the findings of the STEP-HFpEF (Semaglutide Treatment Effect in People with Obesity and HFpEF) trial. Verma, a cardiac surgeon and scientist at St. Michael’s Hospital, was on the executive steering committee of the STEP-HFpEF trial.

STEP-HFpEF tested if 2.4 mg of semaglutide taken weekly may help treat people with obesity and HFpEF in two placebo-controlled clinical trials. A total of 529 patients with HFpEF were randomized to either the semaglutide group or placebo group.

The trials found semaglutide substantially improved the symptoms of HFpEF compared to placebo. The mean percentage change in body weight for the semaglutide group was -13.3 per cent and -2.6 per cent for the placebo group, a difference of -10.7 percentage points.

Semaglutide also resulted in fewer heart failure hospitalizations or urgent visits among the semaglutide- versus placebo-treated patients and fewer serious adverse events. 

“This ushers in a new era in the treatment of patients with heart failure and preserved ejection fraction, who also are overweight or obese,” said Verma. “Heart failure with a preserved ejection fraction remains a recalcitrant problem that is on the rise globally. There are very few treatments to address this grave disease. The magnitude of the benefit seen in our trial is larger than any other contemporary trial in heart failure. This is great news for our patients.”

The STEP-HFpEF is the first trial of its kind to specifically target obesity-related HFpEF and given that semaglutide is currently available and approved for the treatment of obesity, the findings can be “readily translated into clinical care,” the study authors conclude.

The STEP-HFpEF and STEP-HFpEF DM trials were funded by Novo Nordisk, which manufactures Ozempic. Verma receives speaking, consulting and research funding from Novo Nordisk.

By: Marlene Leung

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