Clinical Report: Is Stroke Risk Lower with Semaglutide?
Overview
Semaglutide may be associated with a lower risk of stroke compared to empagliflozin in adults with type 2 diabetes, based on a real-world observational study. The study included over 15,000 patients and found a lower incidence of stroke with semaglutide.
Background
The management of stroke risk in patients with type 2 diabetes is critical due to their increased cardiovascular risk. GLP-1 receptor agonists, such as semaglutide, have emerged as potential therapies that may reduce cardiovascular events, including stroke. Understanding the comparative effectiveness of these agents is essential for optimizing treatment strategies in this population.
Data Highlights
| Outcome | Semaglutide (HR) | Empagliflozin (HR) |
|---|---|---|
| Composite Outcome (Mortality, MI, Stroke) | 0.89 (95% CI 0.78–1.02) | - |
| Stroke | 0.62 (95% CI 0.43–0.89) | - |
| Myocardial Infarction | 0.85 (95% CI 0.68–1.05) | - |
| All-Cause Mortality | 0.97 (95% CI 0.81–1.15) | - |
| Weight Loss (12 months) | 4.3 kg (SD 7.6) | 3.2 kg (SD 6.2) |
| HbA1c Reduction | 0.34% (SD 1.52) | 0.18% (SD 1.32) |
Key Findings
- Semaglutide showed a lower cumulative incidence of the composite outcome (5.9%) compared to empagliflozin (6.9%) at 3 years.
- The hazard ratio for stroke incidence with semaglutide was 0.62, indicating a reduction compared to empagliflozin.
- Patients treated with semaglutide experienced greater weight loss and better glycemic control than those treated with empagliflozin.
- Subgroup analyses indicated greater benefits for patients younger than 65 years and those with baseline HbA1c below 7%.
- The study's observational design and reliance on prescription records were noted as limitations.
Clinical Implications
Clinicians should consider individual patient characteristics, such as age and baseline HbA1c, when selecting treatment options.
Conclusion
This study provides evidence that semaglutide may lower stroke risk compared to empagliflozin in adults with type 2 diabetes.
Related Resources & Content
- Annals of Internal Medicine, 2024 -- Is Stroke Risk Lower with Semaglutide?
- conexiant — Oral Semaglutide Cuts Cardiovascular Event Risk
- European Journal of Preventive Cardiology — Forecasting cardiovascular risk reduction with semaglutide in overweight and obese with heart disease: a nationwide cohort study
- reuters — Oral Diabetes Drug Lowers Heart Risks by 14%: Study
- conexiant — Semaglutide, Tirzepatide Linked to Lower Dementia Risk
- Oral Semaglutide Cuts Cardiovascular Event Risk
- Forecasting cardiovascular risk reduction with semaglutide in overweight and obese with heart disease: a nationwide cohort study
- Oral Diabetes Drug Lowers Heart Risks by 14%: Study
- 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2026 | Diabetes Care | American Diabetes Association
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- Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes | New England Journal of Medicine
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