Weight-loss drug approved for people suffering from heart disease

NHS England’s National Medical Director has warned that samaglutide is powerful and can be dangerous and is not a quick fix for “those who just want to lose a few pounds.”

The Medicines and Healthcare products Regulatory Agency (MHRA) has approved a weight-loss drug as a preventative treatment for people with established cardiovascular disease.

Semaglutide, sold under the brand name Wegovy, can be prescribed to those with a body mass index (BMI) score of 27 or above. The medicine makes people feel fuller and less hungry. It can be prescribed for the treatment of obesity for weight management alongside diet, physical activity and behavioural support.

A recent study found that the drug – taken as an injection once a week for up to five years – could lower a person’s risk of major cardiovascular events such as heart attack and stroke.

Shirley Hopper, MHRA Deputy Director of Innovative Medicines said: “We’re assured that the appropriate regulatory standards of safety, quality and effectiveness for the approval of this medicine have been met.

“This is an important step forward in tackling the serious health consequences of obesity. As with all medicines, we will keep its safety under close review.”

Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation said that nearly two thirds of adults in England are living with excess weight or obesity.

“Those that also have an established cardiovascular disease live with a very high risk that a serious event like a heart attack or stroke could happen. Several recent studies have shown us that semaglutide is an effective tool.”

“[Last year’s clinical trial of semaglutide] showed a 1.5% absolute risk reduction of death from cardiovascular causes, nonfatal myocardial infarction, or non-fatal stroke.”

Dr Martin Whyte, Associate Professor in Metabolic Medicine at the University of Surrey said it was “good news for patients”. 

He said: “The decision follows last year’s publication of a clinical trial of semaglutide (the SELECT trial). This showed a 1.5% absolute risk reduction (from 8.0% to 6.5%) of death from cardiovascular causes, nonfatal myocardial infarction, or non-fatal stroke. This is a 20% relative risk-reduction. 

“A subsequent analysis suggested that the benefit was not just due to weight loss – it may instead relate to cumulative reductions of blood pressure, glucose or even body inflammation.” 

The British Dietetic Association also welcomed the MHRA approval, when prescribed safely and appropriately. A spokesperson said: “To maximise the cardiovascular benefit this should be offered as part of an overall approach to reducing cardiovascular risk, including a cardio-protective diet, an increase in physical activity and stopping smoking.

“Registered dietitians are best placed to support people with optimising their diet to achieve the best outcomes and to also offer specific advice on any potential impact on appetite as a result of the medication.”

However, there have been concerns about misuse of the drug. In a speech at June’s NHS Confederation conference, Professor Stephen Powis, NHS England’s National Medical Director, said he was alarmed to hear reports of the drug being "used inappropriately".

He said: “These are powerful medications that have side-effects and complications. They can, in certain circumstances, be dangerous. They are absolutely not quick fixes for those who are otherwise healthy, who just want to lose a few pounds.”