Semaglutide SOUL and SELECT Cardiovascular Outcomes Baseline-Aspirin Subgroup Analyses Published in Diabetes, Obesity and Metabolism
Wiley's Diabetes, Obesity and Metabolism published in August 2026 pooled subgroup analyses from Novo Nordisk's Phase 3 SOUL (oral semaglutide 14 mg in type 2 diabetes with ASCVD/CKD) and SELECT (semaglutide 2.4 mg in overweight/obesity with established cardiovascular disease) trials examining whether cardiovascular benefit of semaglutide varies by baseline aspirin use. Analyses (Müller-Wieland et al.) concluded that semaglutide significantly reduces major adverse cardiovascular events irrespective of baseline aspirin therapy in individuals with T2DM or overweight/obesity without diabetes at high cardiovascular risk. The pooled MACE benefit is directionally consistent in aspirin users and non-users. Clinical implication: cardiovascular protection from semaglutide is additive to baseline antiplatelet therapy and does not require aspirin discontinuation, addressing a long-standing question about interaction between the GLP-1 receptor agonist class and standard secondary-prevention regimens in older cardiovascular patients.