Semaglutide may improve heart failure symptoms, reduce need for diuretics

ISLAMABAD, MAY 20 (ONLINE): Semaglutide is commonly used to treat type 2 diabetes and aid weight loss, but scientists are also exploring how this GLP-1 receptor agonist can help treat other health conditions.
New research reports that semaglutide reduces the need and dose of loop diuretics in people with heart failure with preserved ejection fraction (HFpEF).

The findings show semaglutide provided a positive impact on the symptoms, physical limitations, and body weight of people with HFpEF regardless of their use of diuretics.
With the recent popularity of glucagon-like peptide-1 (GLP-1) receptor agonists for treating type 2 diabetes and weight loss, scientists are examining the treatment possibilities of this class of medications for other conditions.

These include sleep apneaTrusted Source, high blood pressureTrusted Source, nonalcoholic fatty liver diseaseTrusted Source, polycystic ovary syndrome (PCOS)Trusted Source, Alzheimer’s diseaseTrusted Source, and cardiovascular diseasesTrusted Source such as strokeTrusted Source and heart failureTrusted Source.

For instance, a recent study found that semaglutide — the active ingredient in Ozempic and Wegovy — may help reduce symptoms of heart failure with preserved ejection fraction (HFpEF) in people with obesity and type 2 diabetes.

Now, new research presented May 11–14 at Heart Failure 2024, a scientific congress of the European Society of Cardiology (ESC), reports that semaglutideTrusted Source reduces the need for and dose of loop diuretics in people with HFpEF.

The scientists found that semaglutide provided a positive impact on the symptoms, physical limitations, and body weight of people with HFpEF regardless of their use of diuretics.

Semaglutide lowers loop diuretics dose
This study pooled data from two trials — “Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity” published in August 2023, and “Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes” published in March 2024 — for a combined 1,145 study participants with an average age of 70.

In both trials, participants had obesity-related HFpEF and a Kansas City Cardiomyopathy Questionnaire Clinical Summary Score Trusted Source(KCCQ-CSS) of less than 90. This questionnaire assesses the quality of life of people with heart failure.

Study participants randomly received either semaglutide or a placebo for 52 weeks. Participants were divided into those not receiving diuretics, a subset receiving non-loop diuretics only, and a subset receiving loop diuretics.

After analyzing the pooled data, researchers found that participants who took semaglutide improved their KCCQ-CSS regardless of taking diuretics or not. However, the improvement was greater in participants receiving loop diuretics compared to those not taking them.

In those taking semaglutide and receiving loop diuretics, their loop diuretics dose decreased by 17% after 52 weeks.

“Diuretics can help with fluid overload, but they don’t necessarily target the underlying mechanisms behind HFpEF,” Rigved Tadwalkar, MD, a board certified consultative cardiologist at Providence Saint John’s Health Center in Santa Monica, CA — not involved in this study — told Medical News Today.

“To see the diuretic data that these individuals can potentially reduce their diuretic dose, they need to escalate their diuretic dose less, and they just have a lesser need to have diuretics at all once they’re treated with semaglutide is excellent because it moves their care forward.”

Semaglutide aids weight loss for people with HFpEF
Scientists found that semaglutide helped participants lose weight during the 52 weeks.

Participants not taking diuretics lost an average of 8.8% of their starting weight. The participants in the highest loop diuretic dose category lost 6.9% of their body weight on average.

“Semaglutide improved symptoms, physical limitations, and led to greater weight loss across diuretic use categories in patients with HFpEF,” study author Kavita Sharma, MD, associate professor of medicine in Advanced Heart Failure/Transplant Cardiology in the Division of Cardiology at Johns Hopkins University School of Medicine and director of the Johns Hopkins Heart Failure with Preserved Ejection Fraction Program, said in a news release.

“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.”