From the Guidelines
Ozempic (semaglutide) reduces all-cause mortality by approximately 12% in patients with type 2 diabetes, as evidenced by a recent network meta-analysis published in the Annals of Internal Medicine 1. The reduction in all-cause mortality is a significant benefit of Ozempic, and it is likely due to its effects on multiple cardiovascular risk factors, including weight reduction, improved glycemic control, and decreased blood pressure. Some key points to consider when prescribing Ozempic include:
- The mortality benefit is most clearly established in patients with type 2 diabetes who have established cardiovascular disease or high cardiovascular risk.
- The absolute effects of Ozempic on all-cause mortality did not reach the minimum important difference of 2 percentage points, but the relative risk reduction was still significant, with a risk ratio of 0.88 [CI, 0.83 to 0.94] compared to usual care 1.
- Ozempic may also reduce major adverse cardiovascular events, with a risk ratio of 0.91 [CI, 0.87 to 0.96] compared to usual care 1.
- To maximize the benefits of Ozempic, patients should take the medication as prescribed, typically starting at 0.25mg weekly for 4 weeks, then 0.5mg weekly, with possible titration to 1mg or 2mg weekly based on response, alongside recommended lifestyle modifications. It's essential to weigh the benefits and risks of Ozempic in individual patients, considering factors such as their cardiovascular risk profile, glycemic control, and potential side effects.
From the Research
Reduction in All-Cause Mortality with Ozempic (Semaglutide)
- The reduction in all-cause mortality for patients taking Ozempic (semaglutide) can be inferred from several studies examining the effects of GLP-1 receptor agonists, including semaglutide, on cardiovascular and mortality outcomes in patients with type 2 diabetes.
- A study published in 2021 2 found that GLP-1 receptor agonists, including semaglutide, reduced all-cause mortality by 12% (HR 0.88 [95% CI 0.82-0.94]; p=0.0001) in patients with type 2 diabetes.
- Another study published in 2019 3 specifically examined the cardiovascular outcomes of oral semaglutide in patients with type 2 diabetes and found that death from any cause occurred in 23 of 1591 patients (1.4%) in the oral semaglutide group and 45 of 1592 (2.8%) in the placebo group (hazard ratio, 0.51; 95% CI, 0.31 to 0.84).
- A meta-analysis published in 2021 2 also found that GLP-1 receptor agonists reduced all-cause mortality, with a hazard ratio of 0.88 (95% CI 0.82-0.94; p=0.0001).
Magnitude of Reduction
- The magnitude of reduction in all-cause mortality with Ozempic (semaglutide) can be estimated from the hazard ratios reported in these studies.
- For example, the study published in 2019 3 found a hazard ratio of 0.51 (95% CI 0.31 to 0.84) for death from any cause, indicating a 49% reduction in the risk of death from any cause with oral semaglutide compared to placebo.
- The meta-analysis published in 2021 2 found a hazard ratio of 0.88 (95% CI 0.82-0.94; p=0.0001) for all-cause mortality, indicating a 12% reduction in the risk of all-cause mortality with GLP-1 receptor agonists, including semaglutide.