Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
Marso SP, Bain SC, Consoli A, et al. New England Journal of Medicine 2016;375:1834-1844.
What it found
In people with type 2 diabetes at high cardiovascular risk, cardiovascular death, non-fatal heart attack or non-fatal stroke occurred in 6.6% on semaglutide vs 8.9% on placebo (hazard ratio 0.74). New or worsening kidney disease was less frequent, but diabetic eye complications were more frequent with semaglutide (hazard ratio 1.76). More people stopped semaglutide because of side effects, mainly gastrointestinal.
Limitations
Designed to rule out harm (non-inferiority), not to prove benefit, so the reduction in events was not a pre-planned superiority test. Relatively few events overall. The eye finding was unexpected and not fully explained.
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