Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial

In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes. In this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI). In patients treated with semaglutide, weight loss continued over 65 weeks and was sustained for up to 4 years. At 208 weeks, semaglutide was associated with mean reduction in weight (-10.2%), waist circumference (-7.7 cm) and waist-to-height ratio (-6.9%) versus placebo (-1.5%, -1.3 cm and -1.0%, respectively; P < 0.0001 for all). Clinically meaningful weight loss occurred in both sexes and all races, body sizes and regions. Semaglutide was associated with fewer serious adverse events across BMI categories but increased rates of trial product discontinuation, which were higher as BMI class decreased. In SELECT, at 208 weeks, semaglutide produced clinically significant, durable weight loss and improvements in anthropometric measurements versus placebo. ClinicalTrials.gov identifier: NCT03574597.

Donna H. Ryan, Ildiko Lingvay, John Deanfield, Steven E. Kahn, Eric Barros, Bartolome Burguera, Helen M. Colhoun, Cintia Cercato, Dror Dicker, Deborah B. Horn, G. Kees Hovingh, Ole Kleist Jeppesen, Alexander Kokkinos, A. Michael Lincoff, Sebastian M. Meyhöfer, Tugce Kalayci Oral, Jorge Plutzky, André P. van Beek, John P. H. Wilding, Robert F. Kushner