Projected life-year gains with semaglutide in individuals with cardiovascular disease without type 2 diabetes in the UK

In the SELECT cardiovascular (CV) outcomes trial, semaglutide 2.4 mg significantly reduced all-cause mortality or non-fatal CV events versus placebo in patients with CV disease (CVD) and overweight/obesity, without type 2 diabetes (T2D). By applying results from SELECT to a UK real-world population, this present cohort study evaluated the impact of semaglutide on life expectancy and CV event-free life-years. Included were individuals from the Discover electronic health record database who met SELECT eligibility criteria (≥45 years old; body mass index ≥27 kg/m2; established CVD; no T2D). The Discover database comprises linked primary and secondary care data covering people residing in North West London, UK. Cohort entry was the first date between 2004 and 2019 when all inclusion criteria were met. Effect estimates from SELECT were applied using actuarial life tables, estimating the effect of semaglutide on life expectancy overall and by age group. Life expectancy gains and CV event-free life expectancy were estimated using the Arriaga and the Sullivan methods, respectively. In total, 19,117 individuals aged ≥45 years were included in the main analysis (63% men; mean age: 65.4 years). The estimated gain in life expectancy with semaglutide treatment was 1.9 years. A CV event-free life-year gain of 2.0 years was predicted with semaglutide. Life-year gains were observed across all age groups, but were higher for younger age groups. Based on SELECT data, semaglutide is predicted to increase life expectancy and CV event-free life-years in a real-world population with overweight/obesity and CVD, particularly in younger people.