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April 30, 2026Diabetes Obesity and MetabolismOpen Access

Semaglutide 2.4 mg Cardiometabolic Long‐Term Effects in Patients With Obesity or Overweight in a Real‐World Setting: A Retrospective Cohort Study in the United States ( SMILE )

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Authors

ARAleksandrina RusevaWMWojciech MichalakMBMatthew Bassan

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Overview

Retrospective cohort study evaluates cardiovascular risk reduction from semaglutide in patients with obesity, suggesting significant health benefits.

Key Points

  • This study aims to understand the impact of semaglutide 2.4 mg on cardiometabolic health in adults with obesity or overweight.
  • Retrospective cohort analysis using US claims data from the Komodo Research Database (2016-2024).
  • Comparison of patients using semaglutide 2.4 mg for ≥ 12 months with non-users using propensity score weighting.
  • Measurements included cardiometabolic comorbidities, biomarkers, and ASCVD risk scores at 12 months.
  • At 12 months, semaglutide users showed a greater reduction in ASCVD risk score (-1.0%, p < 0.001).
  • Significant reductions in SBP (-6.2 mmHg), HbA1c (-0.4%), LDL cholesterol (-7.7 mg/dL), and triglycerides (-28.6 mg/dL) with all p < 0.001.
  • Fewer users were classified at intermediate-high ASCVD risk (14.9%-9.3% vs. 17.7%-18.7%; OR 0.3 [95% CI: 0.1, 0.6], p < 0.001).

Cite This Study

Ruseva et al. (2026) studied this question.

synapsesocial.com/papers/69f2f19c1e5f7920c63874efhttps://doi.org/10.1111/dom.70746
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