- Question
- Does semaglutide improve symptoms, functional capacity and body weight in patients with heart failure with preserved ejection fraction and obesity?
- Design
- Phase 3, randomized, double-blind, placebo-controlled trial enrolling 529 patients with 52 weeks of treatment.
- Population
- Patients with heart failure with preserved ejection fraction and a body-mass index of 30 or higher.
- Intervention
- Once-weekly semaglutide 2.4 mg, with gradual dose escalation over the first 16 weeks, added to standard of care.
- Control
- Once-weekly placebo with the same escalation schedule, added to standard of care.
- Primary outcome
- Dual primary endpoints: change from baseline in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS) and change in body weight at 52 weeks.
- Results
- KCCQ-CSS improved by 16.6 points with semaglutide and 8.7 with placebo (estimated difference 7.8 points; 95% CI 4.8 to 10.9; P<0.001), and body weight changed by -13.3% versus -2.6% (difference -10.7 percentage points; 95% CI -11.9 to -9.4; P<0.001). The 6-minute walk distance increased by 20.3 m more with semaglutide (95% CI 8.6 to 32.1; P<0.001).
- Safety
- Serious adverse events were reported in 35 participants (13.3%) in the semaglutide group and 71 (26.7%) in the placebo group.
- Conclusion
- In patients with heart failure with preserved ejection fraction and obesity, semaglutide reduced symptoms and physical limitations, improved exercise function and produced greater weight loss than placebo.
- Why it matters
- It was among the first trials to show that an obesity-directed therapy can meaningfully improve clinical status in this heart failure phenotype, for which treatment options were limited.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 7, 2026