Cardiovascular outcome trials in obesity: A review
Open accessAbstract
Summary: Obesity is a global epidemic associated with over 200 health complications and a significant risk of developing cardiovascular disease (CVD), partly by increasing classical risk factors such as lipid and glucose levels and blood pressure. Weight loss through lifestyle interventions, pharmacotherapy and/or bariatric surgery improves CV risk factors. Cardiovascular outcome trials (CVOTs) of anti‐obesity medications aim to evaluate the CV safety and benefits of pharmacotherapy. Many CVOTs in obesity have either failed to demonstrate a CV benefit or have been terminated prematurely because of safety issues, prompting regulatory agencies to define new requirements (based on those for CVOTs in type 2 diabetes [T2D]). CVOTs of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) in T2D have demonstrated that some GLP‐1RAs reduce CV risk and may help inform future CVOTs in obesity, given the approval of liraglutide 3.0 mg for obesity. In this review, the evidence for the link between obesity and CVD is considered in the context of studies showing that weight loss improves markers of CV risk and risk of adverse CV events. The review also examines the CVOTs in obesity that have been conducted to date and those under way, such as the SELECT trial with subcutaneous semaglutide of 2.4 mg.
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The larger evidence base for surgical outcomes compared with AOMs may have shaped clinical preferences.
“The larger body of evidence supporting surgical outcomes compared to AOMs may have influenced clinical preferences (31–33).”
From Regional trends and disparities in newer <scp>GLP1</scp> receptor agonist initiation among real‐world adult patients eligible for obesity treatment (2025) · cites this paper as [31]
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- Authors
- Wilding, J. P. H., & Jacob, S.
- Affiliations
- University of Liverpool (GB)
- Department of Internal Medicine, Division of Endocrinology/Diabetology Cardiometabolic Institute Villingen‐Schwenningen Germany
- Corresponding author
- Wilding, John P.H.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2020-09-07
- Volume
- 22
- Issue
- 1
- Pages
- e13112-e13112
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W3084047827
- Cited by
- 75
- References
- 16
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 13 · 2023: 18 · 2022: 15 · 2021: 11
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Obesity Reviews (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk Denmark
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- obesity, cardiovascular outcome trials, cardiovascular risk, anti-obesity drugs, cardiovascular safety, weight loss, GLP-1 receptor agonists, liraglutide, semaglutide, SELECT trial, cardiovascular risk factors, bariatric surgery, pharmacotherapy
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Liraglutide, Glucagon-Like Peptide-1 Receptor Agonists, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Obesity, Anti-Obesity Agents
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