The SELECT trial established semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, as effective in reducing cardiovascular events by 20% in people considered to be overweight or obese who have cardiovascular disease without diabetes. But SELECT went far beyond the impact of this GLP-1 receptor agonist on cardiovascular disease. Semaglutide also was shown to have profound effects on glucose metabolism, A1C, prediabetes progression and remission, weight loss, cardiovascular disease risk factors, heart failure, and inflammation.
“Given that there were more than 17,000 people in the study, SELECT provides the opportunity to look for the first time at the potential of GLP-1 receptor agonists to improve glucose control in individuals who are overweight or obese with cardiovascular disease but who do not have diabetes,” said Steven E. Kahn, MB, ChB, Professor of Medicine in the Division of Metabolism, Endocrinology and Nutrition at the University of Washington (UW) and Veterans Affairs Puget Sound Health Care System and Director of the UW Diabetes Research Center and the VA Puget Sound Diabetes Research Group. “Many of those in the study had prediabetes, so we were able to address the question regarding the impact of the intervention on glucose levels in causing regression to normal glucose and slowing progression to diabetes.”
Dr. Kahn is one of four SELECT investigators who will offer insights beyond the headline results during SELECT Trial: New Looks at Glycemia, Inflammation, and Heart Failure on Saturday, June 22. The symposium will be held from 8:00 a.m. – 9:30 a.m. ET in Room W415B, the Valencia Ballroom, of the Orange County Convention Center and be livestreamed on the virtual meeting platform for registered meeting participants. It also will be available on-demand following the 84th Scientific Sessions.
“This symposium will highlight the benefits that are occurring beyond weight loss and cardiovascular disease in this cohort, the impact of semaglutide in people who are at increased risk of developing diabetes,” Dr. Kahn said. “SELECT was not designed as a diabetes prevention study, but we see clinical benefits that come as part of the approach to prevent cardiovascular disease. There is a good chance that using this medication can reduce the risk of progressing to diabetes or extend the time over which you might progress to diabetes, providing an added benefit.”
Donna H. Ryan, MD, Professor Emerita, Pennington Biomedical Research Center, will open with an overview of SELECT and new data on the body weight outcomes that have been the subject of much attention in the popular media, including changes in body anthropometrics across multiple subgroups. Dr. Ryan will also analyze anthropometric changes by BMI category at baseline and by changes during the study.
Dr. Kahn will address the impact of semaglutide on glycemia, focusing on the effect of the GLP-1 receptor agonist to reduce the progression to diabetes and to induce regression to a normal glycemia in those who had prediabetes at baseline. He will address the impact of baseline glucose and body weight on semaglutide response and the impact of weight change treatment on glycemia.
Ildiko Lingvay, MD, MPH, MSCS, Professor of Endocrinology, the University of Texas Southwestern Medical Center, will provide new data on the impact of glycemia on cardiovascular outcomes. One key question is whether individuals in this population with pre-existing cardiovascular disease but without overt diabetes who started SELECT with more effective glucose control had better cardiovascular outcomes.
The second key question is whether changes in glucose control seen during the study impacted cardiovascular outcomes.
Jorge Plutzky, MD, Director of Preventive Cardiology, Brigham and Women’s Hospital and Associate Professor of Medicine, Harvard Medical School, will explore heart failure and inflammation outcomes, including C-reactive protein and other markers of inflammation at baseline and changes over time.
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