Wong Nathan D, Karthikeyan Hridhay, Fan Wenjun
Heart Disease Prevention Program, Division of Cardiology, C240 Medical Sciences, University of California, Irvine, CA, 92697, USA.
Cardiovasc Drugs Ther. 2025 Feb;39(1):75-84. doi: 10.1007/s10557-023-07488-3. Epub 2023 Aug 14.
Semaglutide 2.4 mg benefits weight loss and reduction of cardiovascular disease (CVD) risk factors in adults with obesity. We estimated the US population eligibility for semaglutide 2.4 mg (based on the weight management indication) and the impact on obesity and CVD events.
We applied STEP 1 trial eligibility criteria to US adults aged ≥ 18 years in the US National Health and Nutrition Examination Survey (NHANES) 2015-2018 to estimate the US eligible population. Semaglutide weight changes in STEP 1 were applied to estimate the population impact on weight changes and obesity prevalence. We also estimated 10-year CVD risks utilizing the BMI-based Framingham CVD risk scores. The difference in estimated risks with and without semaglutide "treatment" multiplied by the eligible NHANES weighted population represented the estimated "preventable" CVD events.
We identified 3999 US adults weighted to an estimated population size of 93.0 million [M] (38% of US adults) who fit STEP 1 eligibility criteria. Applying STEP 1 treatment effects on weight loss resulted in an estimated 69.1% (64.3 M) and 50.5% (47.0 M) showing ≥ 10% and ≥ 15% weight reductions, respectively, translating to a 46.1% (43.0 M) reduction in obesity (BMI ≥ 30 kg/m) prevalence. Among those without CVD, estimated 10-year CVD risks were 10.15% "before" and 8.34% "after" semaglutide "treatment" reflecting a 1.81% absolute (and 17.8% relative) risk reduction translating to 1.50 million preventable CVD events over 10 years.
Semaglutide treatment in eligible US adults may substantially reduce obesity prevalence and CVD events, which may dramatically impact associated healthcare costs.
司美格鲁肽2.4毫克有助于肥胖成人减轻体重并降低心血管疾病（CVD）风险因素。我们估计了美国符合使用司美格鲁肽2.4毫克的人群（基于体重管理适应症）及其对肥胖和CVD事件的影响。
我们将STEP 1试验的纳入标准应用于2015 - 2018年美国国家健康与营养检查调查（NHANES）中年龄≥18岁的美国成年人，以估计美国符合条件的人群。应用STEP 1中司美格鲁肽引起的体重变化来估计人群体重变化和肥胖患病率的影响。我们还使用基于BMI的弗雷明汉姆CVD风险评分来估计10年CVD风险。使用司美格鲁肽“治疗”和不使用司美格鲁肽“治疗”时估计风险的差异乘以符合条件的NHANES加权人群，代表估计的“可预防”CVD事件。
我们确定了3999名美国成年人，加权后估计人群规模为9300万[M]（占美国成年人的38%），符合STEP 1纳入标准。应用STEP 1的减肥治疗效果后，估计分别有69.1%（6430万）和50.5%（4700万）的人体重减轻≥10%和≥15%，这意味着肥胖（BMI≥30 kg/m²）患病率降低了46.1%（4300万）。在无CVD的人群中，估计10年CVD风险在司美格鲁肽“治疗”“前”为10.15%，“后”为8.34%，绝对风险降低了1.81%（相对风险降低了17.8%），这意味着10年内有150万可预防的CVD事件。
在美国符合条件的成年人中使用司美格鲁肽治疗可能会大幅降低肥胖患病率和CVD事件，这可能会对相关医疗成本产生巨大影响。
