Semaglutide in patients with obesity and heart failure with preserved ejection fraction: A systematic review and meta-analysis

BACKGROUND Obesity-related heart failure in patients is often associated with a high symptom burden. However, no treatments have been proven to specifically target obesity-related heart failure with preserved ejection fraction (HFpEF). AIM To evaluate the efficacy of semaglutide in patients with obesity and HFpEF. METHODS Per the PRISMA guidelines, studies reporting clinical outcomes of semaglutide in patients with obesity and HFpEF were included. The outcomes included percentage weight change and adjudicated heart failure events. Both random and common effects models were used for the data analysis. The random intercept logistic regression model was used to compute the proportions, and the Peto method was used to compute the odds ratios (OR). A P ≤ 0.05 was considered significant. RESULTS In total, three studies with 1463 patients with obesity and HFpEF were included in the study. The mean age of the patients was 68.8 ± 3.47 years. 50.7% of the patients were females. Patients who received semaglutide had statistically higher odds of achieving 10% (OR = 6.35; 95%CI: 1.54-26.21; P < 0.00001) and 15% (OR = 9.44; 95%CI: 2.91-30.60; P < 0.0001) weight reductions compared to those who received placebo. Additionally, patients who received semaglutide had lower odds of adjudicated heart failure event (OR = 0.29; 95%CI: 0.14-0.58; P = 0.0005) when compared to patients on placebo. CONCLUSION Our study demonstrates that semaglutide is significantly effective in reducing weight and potentially lowering the risk of heart failure events. This suggests that semaglutide could be a promising therapeutic option for managing obesity-related HFpEF.