New NICE recommendation with comments from our CEO. Source: NICE Website Original Article

Although semaglutide (Wegovy) is widely known as a weight loss treatment, today’s recommendation is specifically about preventing heart attacks and strokes. The injection is an additional treatment, which will be offered on top of the medicines people are already taking such as statins, and alongside a reduced-calorie diet and increased physical activity for those at high risk of another serious event.

Evidence from a clinical trial shows the injection reduces the risk of a heart attack, stroke, or cardiovascular death. Importantly, this benefit was seen early in the clinical trial, before significant weight loss occurred, suggesting the drug works directly on the heart and blood vessels, not just through weight loss.

NICE’s independent committee has recommended semaglutide as an option for adults who have previously had a heart attack, a stroke, or a serious circulation problem in the legs (known as peripheral arterial disease), and who have a body mass index (BMI) of at least 27 kg/m². A BMI of 27 is in the overweight range, which means this recommendation covers a different group of people than NICE’s existing guidance for weight management, where the BMI threshold is higher.

“We know that people who have already had a heart attack or stroke are living with real fear that it could happen again. Today’s decision gives thousands of people in that situation an extra layer of protection, on top of the medicines they are already taking.

Our role is to help practitioners get the best care to people while ensuring value for the taxpayer, and we are confident this rigorous, transparent recommendation strikes the right balance between clinical effectiveness and the best use of limited NHS resources.”

Helen Knight, Director of Medicines Evaluation at NICE

Mrs Knight added: “The evidence from the clinical trial is compelling. It showed that people taking semaglutide alongside their existing heart medicines were significantly less likely to have another heart attack or stroke.”

Heart and circulatory disease remain one of the leading causes of early death and ill health in England. Each year in the UK, there are around 100,000 hospital admissions due to heart attacks, another 100,000 people experience a stroke and around 350,000 people live with peripheral arterial disease. People who have already had one of these events face a significantly higher risk of another and are usually prescribed a number of medicines to reduce that.

Around 1.2 million people could use semaglutide to help protect them against having further heart attacks or strokes as the medicine is made available for this condition.

In the SELECT trial, 17,604 people who took semaglutide alongside their existing cardiovascular medicines — including cholesterol-lowering drugs such as statins — were 20% less likely to have a serious cardiovascular event than those who took a placebo alongside the same medicines. Both groups received standard care throughout the trial.

NICE’s independent committee looked carefully at the evidence and concluded that semaglutide offers good value for the NHS. When assessing new treatments, NICE considers both how long a medicine helps people live and how much it improves their quality of life. For semaglutide, the cost of achieving those benefits came in well within the range NICE considers acceptable.

“In my GP surgery, I see patients who have already been through the ordeal of a heart attack or stroke and are doing everything right such as taking their medicines, watching what they eat, trying to stay active but still living with the fear that it could happen again.

This recommendation gives GPs like me an important new tool to help those patients. For the right person, this weekly injection could offer a meaningful extra layer of protection on top of the medicines they are already taking.

NICE guidance exists to help clinicians make the best decisions for their patients, and I’d encourage anyone who thinks they might be eligible to have a conversation with their GP at their next routine appointment.”

Dr Sunil Gupta, GP clinical advisor at NICE

How will patients access this treatment?

Patients will not be automatically prescribed semaglutide. A GP or specialist will assess whether it is the right option based on individual circumstances.

To be considered, patients must:

• have previously had a heart attack, stroke, or be living with peripheral arterial disease (a condition affecting blood flow in the legs)
• have a body mass index (BMI) of 27 kg/m² or above
• be willing to make changes to their diet and increase physical activity alongside taking the medication

If eligible, patients will receive a weekly injection, which they can self-administer at home. The treatment works alongside and not instead of a healthy lifestyle, including a reduced-calorie diet and increased physical activity.

“I see the human cost of cardiovascular disease every day – lives slowly shrinking, not all at once, but bit by bit.

I am excited about treatments like semaglutide because they offer the chance to change that story, to reshape people’s trajectory. To intervene earlier, to reduce risk, and to give people a real chance of living well for longer. There are further opportunities as we learn about this class of treatment. We need to recognise that medication alone isn’t the only answer; sometimes people need the key to unlock opportunity, and it must sit alongside education, support, and a system that truly prioritises prevention. That’s where the real impact lies.”

Dr Nick Hartshorne-Evans, CEO of UK heart failure charity the Pumping Marvellous Foundation

Today’s recommendation makes semaglutide available for treating cardiovascular disease and sits alongside NICE’s existing guidance recommending semaglutide for weight management in adults living with obesity or overweight. Together, these decisions reflect the growing body of evidence that this class of medicines offers benefits extending beyond weight loss.

Source: https://www.nice.org.uk/news/articles/semaglutide-injection-to-help-prevent-heart-attacks-and-strokes