Presentation (CTI)

OBJECTIVES: To explore cardiovascular outcomes associated with semaglutide use in adults with obesity, with or without type 2 diabetes mellitus (T2DM), as reported in systematic literature reviews (SLRs) and meta-analyses.
METHODS: An umbrella review was conducted using PubMed to identify SLRs and meta-analyses reporting cardiovascular outcomes following semaglutide administration for obesity management, with or without T2DM.
RESULTS: From 322 initial records, 16 SLRs were included for qualitative analysis; 8 focused on patients with obesity alone and 8 on those with both obesity and T2DM. The number of included RCTs per SLR ranged from 2 to 168, and semaglutide-treated populations ranged from 300 to 26,859 patients. Ten SLRs examined the role of semaglutide in improving metabolic health using pooled data from the STEP trials, which assessed its safety and efficacy in obesity. All 16 SLRs reported favourable cardiovascular outcomes, such as reductions in major adverse cardiovascular events (MACE) (n=3), C-reactive protein (CRP) levels (n=1), and atrial fibrillation risk (n=2). Additional benefits included improvements in cholesterol and lipid profiles (n=7), blood pressure control (n=10), and weight loss and other metabolic parameters (n=9). None reported adverse cardiovascular outcomes.
CONCLUSIONS: Semaglutide has shown consistent cardiovascular benefits in adults with obesity, both with and without T2DM, including improvements in MACE, lipid profiles, blood pressure control, and overall metabolic health - without reports of cardiovascular adverse events. Overall, the cardiovascular benefits of semaglutide appear to outweigh its risks, reinforcing its role in obesity management. Nonetheless, a careful assessment of its benefit-risk profile remains essential for informed clinical decision-making.