Following the primary analysis of the SELECT trial, which demonstrated that semaglutide reduces major adverse cardiovascular events, a new exploratory analysis suggests the treatment also significantly lowers the rate and duration of hospitalisations in patients with established cardiovascular disease (CVD) and overweight or obesity, but without diabetes.¹
Methodology
This prespecified exploratory analysis used data from the SELECT trial, a randomised clinical trial involving 17,604 patients from 804 sites across multiple continents. Eligible participants were aged 45 years or older, had pre-existing CVD, and a body mass index (BMI) of 27 kg/m² or higher, with no history of diabetes.
Patients were randomised to receive either once-weekly subcutaneous semaglutide 2.4 mg or a matching placebo. This analysis focused on the total number of hospital admissions and the total number of days spent in hospital over a median follow-up period of 41.8 months.
Results
The analysis revealed that the trial cohort experienced a high rate of hospital admissions overall. Treatment with semaglutide was associated with a significantly lower number of total hospitalisations for any indication compared with placebo (18.3 vs 20.4 admissions per 100 patient-years; mean ratio [MR], 0.90; 95% CI, 0.85–0.95; P < .001).
Furthermore, the total number of days patients spent in hospital was also reduced in the semaglutide group. The rate of days hospitalised for any indication per 100 patient-years was 157.2 for the semaglutide group versus 176.2 for the placebo group (rate ratio [RR], 0.89; 95% CI, 0.82–0.98; P = .01). These reductions in both admissions and hospital days were also observed for hospitalisations related to serious adverse events. The benefits of semaglutide on reducing hospital admissions were consistent across key subgroups, including those based on BMI, age, and sex.
In Practice/Interpretation
These findings from the SELECT trial suggest that the clinical benefits of once-weekly semaglutide 2.4 mg extend beyond cardiovascular risk reduction in this high-risk population. By decreasing both the frequency of hospital admissions and the overall time patients spend in hospital, the treatment could help to alleviate the significant burden that hospitalisations place on patients and healthcare systems.
This study was funded by Novo Nordisk A/S.
References
1. Nicholls SJ, Ryan DH, Deanfield J, et al. Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease: An Exploratory Analysis of the SELECT Randomized Clinical Trial. JAMA Cardiol. Published online December 23, 2025. https://doi.org/10.1001/jamacardio.2025.4824.
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