Physicians' Academy for Cardiovascular Education

More remission and less development of metabolic syndrome with GLP-1RA

News - Sep. 21, 2022

Impact of once-weekly subcutaneous semaglutide 2.4 mg on metabolic syndrome in the 2-year randomized controlled STEP 5 trial

Presented at the EASD annual meeting 2022 by: Prof. Rachel Batterham, MD, PhD - London, UK

Introduction and methods

The STEP 5 trial was a RCT that investigated the effects of 2.4 mg once weekly semaglutide on body weight in 304 adults with overweight (BMI ≥30 kg/m² or ≥30 kg/m² with ≥1 weight-related comorbidity) and without T2DM. The results showed that change in body weight from baseline to week 104 was significantly greater with semaglutide vs. placebo (-15.2% vs. -2.6%).

This post hoc analysis of the STEP 5 trial aimed to investigate the 2-year effect of semaglutide 2.4 mg on metabolic syndrome. Metabolic syndrome was defined using the NCEP ATPIII criteria of ≥3 of the following:

- WC ≥88 cm (women) or ≥102 cm (men) (for Asian race ≥80 cm [women] and ≥90 cm [men])

- Triglycerides ≥150 mg/dL or taking lipid-lowering medication

- HDL-c <40 mg/dL (men) or <50 mg/dL (women) or HDL-raising medication

- SBP ≥130 mmHg or DBP ≥85 mmHg or taking antihypertensives

- FPG ≥100 mg/dL

Main results

- Among participants who had metabolic syndrome at baseline, 56.6% on semaglutide vs. 21.5% on placebo had remission of metabolic syndrome at week 104.

- A greater proportion of participants in the placebo group (25.9%) developed metabolic syndrome compared with those on semaglutide (7.1%) at week 104.

- The proportion of participants who had metabolic syndrome remission was similar between the overall population and a subgroup op participants with baseline BMI ≥40 kg/m². The effect of semaglutide vs. placebo on development of metabolic syndrome was more pronounced in the subgroup with baseline BMI ≥40 kg/m². 43.8% of participants on placebo developed metabolic syndrome compared with no participants on semaglutide.

Conclusion

This post hoc analysis of the STEP 5 trial showed that a greater proportion of adults with overweight achieved remission of metabolic syndrome and a smaller proportion developed metabolic syndrome with semaglutide vs. placebo.

-Our reporting is based on the information provided at the EASD annual meeting 2022-

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