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Semaglutide Reduces Need for Diuretics in Heart Failure

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Medication also has beneficial effect on change in body weight across diuretic use categories

By Lori Solomon HealthDay Reporter

THURSDAY, May 16, 2024 (HealthDay News) — Semaglutide reduces the need for loop diuretics and has positive effects on symptoms, physical limitations, and body weight in patients with heart failure with preserved ejection fraction (HFpEF), regardless of diuretic use, according to a study presented at the European Society of Cardiology Heart Failure 2024, held from May 11 to 14 in Lisbon, Portugal.

Kavita Sharma, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues used data from 1,145 participants in a multisite, international trial, in which participants with obesity-related HFpEF were randomly assigned (1:1) to once-weekly semaglutide (2.4 mg) or placebo for 52 weeks.

The researchers found that semaglutide improved the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score in all diuretic subgroups, but the magnitude of improvement was greater in patients receiving loop diuretics versus those not on loop diuretics (adjusted mean difference of 9.3 versus 4.7 points, respectively). Semaglutide had a consistent beneficial effect on percentage change in body weight across diuretic use categories (adjusted mean difference ranged from −8.8 to −6.9 percent for no diuretics to the highest loop diuretic dose category). There were consistent beneficial effects for semaglutide on all secondary efficacy end points (including six-minute walk distance) across diuretic subgroups.

“There was evidence of a significant reduction in average loop diuretic dose, a lower likelihood of diuretic treatment escalation, and a greater likelihood of diuretic treatment de-escalation with semaglutide versus placebo — parameters that indicate disease-modifying effects of semaglutide — and are associated with better long-term clinical outcomes in this patient population,” Sharma said in a statement.

The study was funded by Novo Nordisk, and one author disclosed ties to the pharmaceutical industry.

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