Stopping medications like Ozempic and Wegovy can quickly diminish their cardiovascular benefits, according to a study published Wednesday in BMJ Medicine. Researchers at Washington University in St. Louis followed over 333,000 adults with Type 2 diabetes for three years, finding that even short interruptions in treatment with glucagon-like peptide-1 receptor agonists (GLP-1RAs) increased the risk of heart attack, stroke, and death.
The study revealed that patients who consistently took GLP-1RAs experienced an 18% reduction in cardiovascular risk over the three-year period. However, discontinuing the drugs for as little as six months largely erased this protection, raising the risk by 4% compared to those who continued treatment. A two-year gap in treatment led to a 22% increase in risk. The majority of participants in the study were taking Novo Nordisk’s Ozempic.
“GLP-1s do ‘much, much more than weight loss,’” said Dr. Ziyad Al-Aly, a clinical epidemiologist and nephrologist at WashU Medicine, and the study’s lead author. “They’re reducing all these back problems, reducing cholesterol, reducing blood pressure, reducing insulin resistance, reducing inflammation and really offering cardiovascular protection.”
The findings underscore the importance of consistent adherence to GLP-1RA therapy for patients with Type 2 diabetes. Researchers noted that building cardiovascular protection with these drugs takes years, even as the benefits can be undone relatively quickly upon discontinuation. The study also suggests an asymmetry in the process – it takes longer to establish protection than it does to lose it.
Approximately one in eight Americans has taken or is currently using GLP-1RAs, including Ozempic, Wegovy, Mounjaro, and Zepbound, to treat diabetes, heart disease, or obesity, according to a recent study from Washington University. About 12% of Americans have used a semaglutide GLP-1 drug like Ozempic for weight loss, making them among the most widely used drugs in the nation.
A separate clinical trial led by Dr. Samuel Klein, director of the Center for Human Nutrition at WashU Medicine, is investigating the impact of semaglutide, with and without exercise, on muscle mass. The trial will also assess the drugs’ effects on metabolic health, including blood sugar control, blood lipids, blood pressure, and bone health, as well as muscle strength and physical performance. Dr. Klein’s research indicates that up to 15% of weight loss achieved with these drugs can be from muscle, rather than fat, potentially posing a risk for individuals with low muscle mass, particularly older women.
The WashU Medicine study in Nature Medicine, published in January, identified widespread associations between GLP-1RA use and benefits to cognitive and behavioral health, while also revealing increased risks for pancreatitis and kidney conditions. Researchers are continuing to evaluate the long-term effects of these medications across various organ systems.
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