New data show Wegovy's potential to reduce COVID-19 severity

When the COVID-19 pandemic disrupted clinical trials globally, the researchers behind the SELECT study of Novo Nordisk's weight-loss drug Wegovy (semaglutide) opted for an innovative approach. Rather than halting their study, they modified it to also include COVID-19 data. This decision has now yielded some unexpected findings. A new analysis, presented at the annual European Society of Cardiology (ESC) meeting and published in the Journal of the American College of Cardiology, showed that while Wegovy did not reduce the incidence of COVID-19 infections, it seemed to decrease the rate of COVID-19-related complications and fatalities in a high-risk group.

In the initial eight months of the pandemic, the US Centers for Disease Control and Prevention estimated that about 30% of COVID-19 hospitalizations involved patients with obesity. The SELECT study enrolled over 17,600 overweight and obese participants with established cardiovascular (CV) disease but without a history of diabetes. Last year, Novo Nordisk disclosed that Wegovy significantly reduced the risk of major adverse cardiovascular events (MACE) by 20% over a period of up to five years compared to a placebo.

This success emphasized that Wegovy could provide health benefits beyond just weight loss, a point Novo has stressed in its campaign for insurance companies to cover the treatment. The SELECT study's findings led to a label expansion earlier this year, including the reduction of MACE risk such as heart attacks and strokes. Medicare soon agreed to cover the cost of obesity drugs approved by the FDA for an additional "medically accepted indication."

The latest analysis further supports Wegovy's growing list of benefits. Approximately a quarter of SELECT study participants (n=4258) reported a COVID-19 diagnosis during the trial, with similar rates in both the Wegovy and placebo groups. Among these, 232 patients treated with Wegovy experienced serious COVID-19-related adverse events (2.6%), compared to 277 (3.1%) for those on placebo. Additionally, there were fewer COVID-19-related deaths in the Wegovy group, with 43 deaths compared to 65 in the placebo group, resulting in a 0.66 hazard ratio.

Jeremy Samuel Faust of Mass General Brigham commented in an editorial that the apparent effect size of semaglutide in reducing COVID-19 mortality warrants attention. He noted that if confirmed, the reduction in all-cause and COVID-19-specific mortality among semaglutide recipients compared to placebo is comparable to the benefits seen with aspirin and percutaneous coronary interventions for patients with acute ST-segment elevation myocardial infarction.

Faust also pointed out the broader implications of the SELECT trial, suggesting that semaglutide was effective in reducing SARS-CoV-2 mortality within a short time frame. He likened this to a vaccine against the indirect effects of a pathogen, with the expectation that the efficacy would increase over time rather than diminish. Moreover, Faust suggested that this benefit could potentially apply to various infections, not just SARS-CoV-2.

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