Semaglutide was associated with a 10% reduction in total hospital admissions and a 11% reduction in days hospitalized compared to placebo in patients with obesity and CVD.
Does once-weekly subcutaneous semaglutide 2.4 mg reduce total hospital admissions and duration of hospital stay in patients with established cardiovascular disease and overweight or obesity without diabetes?
In patients with established cardiovascular disease and overweight or obesity without diabetes, once-weekly semaglutide 2.4 mg significantly reduces total hospital admissions and overall time spent in the hospital.
Absolute Event Rate: 0% vs 0%
Importance The primary analysis of the SELECT randomized clinical trial suggests that semaglutide reduced the rates of cardiovascular (CV) death, myocardial infarction, and stroke in patients with established CV disease (CVD) and overweight or obesity without diabetes. However, the effect of semaglutide on hospitalizations in this population remains unknown. Objective To determine the impact of semaglutide on total hospital admissions and duration of hospital stay. Design, Setting, and Participants The SELECT trial included patients aged 45 years or older with established CVD and a body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 27 or higher without diabetes at 804 clinical settings across North America, South America, Europe, Asia, Africa, and Australia. Patients were randomized from October 2018 to March 2021. This prespecified exploratory analysis was conducted from February 2024 to September 2025. Interventions Once-weekly subcutaneous semaglutide, 2.4 mg, or placebo. Main Outcomes and Measures The total number of hospital admissions and days in hospital between the semaglutide and placebo groups. Results A total of 17 604 patients (median IQR age, 61.0 55.0-68.0 years; 4872 female patients 27.7%; median IQR BMI, 32.1 29.7-35.7) were followed up for a median (IQR) period of 41.8 (33.0-47.0) months. There were 11 287 hospital admissions. The number of total hospitalizations was lower in the semaglutide group vs placebo for any indication (18.3 vs 20.4 admissions per 100 patient-years; mean ratio MR, 0.90; 95% CI, 0.85-0.95; P lt; .001) and for serious adverse events (15.2 vs 17.1 admissions per 100 patient-years; MR, 0.89; 95% CI, 0.84-0.94; P lt; .001). The number of days hospitalized for any indication per 100 patient-years was lower in the semaglutide group vs placebo (157.2 vs 176.2 days; rate ratio RR, 0.89; 95% CI, 0.82-0.98; P = .01), as well as hospitalizations for serious adverse events (137.6 vs 153.9 days; RR, 0.89; 95% CI, 0.81-0.98; P = .02). No heterogeneity was observed for the reduction of hospital admissions with semaglutide in selected subgroups, including BMI, age, and sex. Conclusions and Relevance In this prespecified exploratory analysis of the SELECT randomized clinical trial, the trial cohort had a high rate of hospital admissions. Treatment with once-weekly semaglutide was associated with significant reductions in hospital admissions and overall time spent in hospital, extending its benefits beyond CV risk reduction. Trial Registration ClinicalTrials.gov Identifier: NCT03574597
Nicholls et al. (Tue,) reported a other. Semaglutide was associated with a 10% reduction in total hospital admissions and a 11% reduction in days hospitalized compared to placebo in patients with obesity and CVD.