Heart disease patients in future may take drugs like Ozempic as routine risk reduction

Top Australian heart institutes are preparing for a future in which taking weight-loss drugs such as Ozempic may be as common as taking a statin for those at risk of heart attacks.

Ozempic and other weight-loss drugs could be used to slash the death rate from heart disease.

Top Australian heart institutes are preparing for a future in which taking weight-loss drugs such as Ozempic may be as common as taking a statin for those at risk of heart attacks.

Heart doctors are hailing the drugs as likely to open up major opportunities to slash the death rate from heart disease, following the US Food and Drug Administration’s move recently to approve the drug semaglutide for treatment of heart disease.

The FDA’s decision followed a major study, published in the New England Journal of Medicine, that found semaglutide drug Wegovy reduced the risk of cardiovascular death, heart attack and stroke to a clinically significant extent in adults with heart disease who were overweight or obese.

What was especially significant about the study is that it indicated that the ability of semaglutide to reduce the incidence of heart and stroke events occurred even independent of significant weight loss.

Major Australian heart institutes have described as very ­significant the findings of that study and the prospect that the drugs in future may be used in routine management of heart disease treatment and risk ­reduction.

“It’s a really major step forward,” said professor Jason ­Kovacic, cardiologist and CEO of the Victor Chang Cardiac Research Institute.

“The data on semaglutide is promising on multiple fronts.

“Before this we only had effective therapies for blood pressure, cholesterol and blood sugar, and now we’ve got a fourth that can target obesity, and directly reduce cardiovascular risks.”

Diabetes drugs that are also used for weight loss, such as Ozempic and Mounjaro, are in critically short supply in Australia. But in future, when supply is no longer an issue, heart doctors would like to see them funded on the Pharmaceutical Benefits Scheme for heart disease patients and those at risk of heart attack and stroke, especially those with obesity.

“Once the supply issue is fixed and there is adequate supply, I ­believe that few will argue against the appropriate use of these drugs in overweight and obese persons, in particular overweight and obese patients with heart disease, regardless of whether they have diabetes or not,” Professor Kovacic said.

Professor Jason Kovacic.

The finding in the NEJM study was described as highly significant by cardiologists given they indicated that GLP-1 agonist drugs have some kind of independent action on reducing heart attack and stroke even without significant weight loss.

“That question of why that study indicated such an impressive reduction in heart attack and stroke events has been the topic of a lot of discussion,” Professor ­Kovacic said.

“It’s hard to explain these huge differences based on just the weight loss. It may be that there are other effects such as reduced inflammation in the vessels in the heart, or in the leg vessels. The medication has potentially got widespread anti-inflammatory properties.

“These drugs might reduce inflammation, potentially improve endothelial function, they may help reduce platelet activation and clumping, which reduces blood clotting. They may help to stabilise plaques. There’s a range of possible ways these drugs may work.

“In the future, when they are off-patent, cheap and widely available, taking a drug like Ozempic may become as routine as taking a statin.

“People question the safety of being on these drugs for years on end, and I don’t disagree that this is a valid concern that needs to be answered.

“But a reasonable counterpoint is to consider, ‘What would you prefer, to take a drug like Ozempic for the rest of your life, or being overweight or obese with an increased risk of a heart attack that could kill you?’.”