Cardiovascular data has reframed how GLP-1 drugs are positioned. SELECT was the first major trial to show MACE reduction (20%) in non-diabetic adults with obesity. Heart-failure work followed: a Mass General Brigham analysis in JAMA of 90,000+ HFpEF patients reported a 42% reduction in heart-failure hospitalization or all-cause mortality on semaglutide, and 58% on tirzepatide versus sitagliptin.
The atherosclerosis-prevention data is more preliminary but consistent. A Scientific Reports study found early intervention with tirzepatide or semaglutide reduced atherosclerotic plaque in ApoE-knockout mice; clinical follow-up is in progress. Cardiometabolic peptide candidates outside the GLP-1 family — Merck's enlicitide-decanoate (PCSK9), Takeda's rusfertide for polycythemia vera — also land here.
Stories below cover the readouts, registry data, and payer rulings.
Novo Nordisk announced May 1 that Ozempic (semaglutide) tablets at 1.5 mg, 4 mg, and 9 mg will be available across 70,000+ U.S. pharmacies starting Monday, May 4, for adults with type 2 diabetes. The product is the only FDA-approved oral peptide GLP-1 medication cleared for both primary and secondary cardiovascular risk reduction in adults with T2D, manufactured end-to-end in the United States. Insured patients can access the pill for as little as $25 for up to a 3-month supply; self-pay patients face $149–$299/month depending on dose strength.
Eli Lilly announced positive topline results from ACHIEVE-4, the longest Phase 3 study of Foundayo (orforglipron) to date in 2,700+ adults with type 2 diabetes across 15 countries. The pre-planned analysis showed a 57% lower risk of all-cause death (HR 0.43, p=0.002), while meeting non-inferiority for the prespecified cardiovascular endpoint (HR 0.84). Lilly plans to submit Foundayo for type 2 diabetes to the FDA by end of Q2.
A study of 220,043 patients published in Diabetes, Obesity and Metabolism found that combining GLP-1 receptor agonists with SGLT2 inhibitors reduced all-cause mortality by 29%, the cardiovascular composite outcome by 19%, and heart failure risk by 22% compared to SGLT2 inhibitor use alone over 1.3 years of median follow-up.
A Mass General Brigham study of over 90,000 HFpEF patients published in JAMA found semaglutide reduced heart failure hospitalization or all-cause mortality by 42%, while tirzepatide achieved a 58% risk reduction compared with sitagliptin. Both drugs showed acceptable safety profiles with benefits appearing early in treatment.
A study in Scientific Reports found that early intervention with tirzepatide or semaglutide significantly reduced atherosclerotic plaque formation in ApoE-knockout mice, suggesting GLP-1 drugs may have preventive cardiovascular benefits beyond their metabolic effects when initiated before disease progression.
A new review highlights GLP-1 RAs achieving a 55% reduction in apnea-hypopnea index and 14.9% mean weight loss in non-diabetic populations, with pleiotropic effects across cardiovascular, renal, and skeletal systems.
The FLOW trial showed semaglutide reduced major kidney disease events by ~24%, while the SELECT trial found a 20% reduction in major adverse cardiovascular events among 17,600+ adults.
A study of ~175,000 Type 1 diabetes patients found GLP-1 receptor agonists reduced five-year cardiovascular event risk by 15% and end-stage kidney disease by 19%, with no increase in severe hypoglycemia. Published in Nature Medicine.
Under new UK guidance, GPs can prescribe semaglutide (Wegovy) to overweight patients who have had heart attacks, strokes, or serious circulation problems, expanding its use beyond weight management.
A condition-by-condition guide examining what's proven, promising, and untested for GLP-1 drugs beyond weight loss — covering cardiovascular disease, addiction, kidney disease, and neurological conditions.
The European Medicines Agency formally approved semaglutide with cardiovascular and stroke-related benefits — a first for any GLP-1 receptor agonist in Europe.