Evidence-grade change

Semaglutide graded A for cardiovascular risk reduction on SELECT evidence

We set semaglutide's cardiovascular-outcome grade to A after the SELECT trial's 20% reduction in major cardiovascular events in people with obesity but without diabetes.

Evidence grade changed

Cardiovascular risk reduction: B (Supported) → A (Established)

What happened

We graded semaglutide’s cardiovascular risk reduction outcome as A — Established, on the strength of the SELECT trial (NEJM 2023), which reported a roughly 20% reduction in major adverse cardiovascular events in adults with overweight or obesity and established cardiovascular disease but without diabetes.

Why it matters

Before SELECT, cardiovascular benefit was best established in the diabetes population (SUSTAIN-6). SELECT extended a hard-endpoint benefit to a much larger group and moved this outcome from “supported” to “established.”

What did not change

This grade applies to the specific populations studied, not to everyone who takes semaglutide for weight loss. The weight-loss and glycemic grades were already A and are unaffected.

Affected compounds

References

  1. Lincoff AM et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT). NEJM 2023

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