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Drs Piña and Borlaug discuss the CMR substudy from the SUMMIT trial of tirzepatide in HFpEF/obesity. How does weight loss affect pericardial fat and skeletal muscle? https://www.medscape.com/viewarticle/how-do-glp-1s-affect-cardiac-structure-and-skeletal-muscle-2025a10001qm?src=soc_yt --TRANSCRIPT-- Ileana L. Piña, MD, MPH: Hello. I’m Ileana Piña, from Thomas Jefferson University in Philadelphia, Pennsylvania, and this is my blog. It’s a little bit different blog because I’m really interviewing a good friend about these glucagon-like peptide 1 (GLP-1) inhibitors. Some of our heart failure patients are getting their GLP-1 inhibitors from their primary care physicians, but many questions have arisen with the trial called SUMMIT. With us today is Barry Borlaug, who is in charge of the research section with the cardiovascular section of Mayo, and that is Mayo, Rochester, where it must be much colder even than here in Philadelphia. Barry, congratulations on that trial. Tell our audience a little bit about how the trial was structured because it’s important how we get into your information. SUMMIT Recap Barry A. Borlaug, MD: Thanks, Ileana. SUMMIT was a randomized, double-blind, placebo-controlled trial, testing the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide vs placebo in patients with heart failure with preserved ejection fraction (HFpEF). Unlike some other trials, this was real HFpEF with an ejection fraction of 50% or above. Patients were randomized 1:1 to tirzepatide, titrated up to 15 mg once weekly, or placebo and treated for a minimum of 52 weeks. The dual primary endpoints were worsening heart failure or cardiovascular death and quality of life by the Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score. The median duration of follow-up was 2 years. We continued follow-up until the last patient enrolled completed the full 52-week period of treatment. We found that, as compared to placebo, tirzepatide reduced the risk of worsening heart failure or cardiovascular death by 38%, which was statistically significant, and also improved the KCCQ clinical summary score. In addition to that, we also looked at other patient-centered outcomes like 6-minute walk distance and biochemical markers like C-reactive protein (CRP). We saw that there was also a significant improvement in exercise function measured by 6-minute walk distance and about a 40% decrease in CRP levels. Piña: How long did the total trial last, including the time that the drugs were being administered? Borlaug: The longest duration of follow-up was 3 years, and the median follow-up was 2 years. Piña: Were any of these patients also on sodium-glucose cotransporter 2 ( SGLT2) inhibitors ? Borlaug: Yeah, a minority of patients were also on SGLT2 inhibitors, about 17%. Piña: What was the baseline KCCQ score? Borlaug: Very poor. A s you know, physician-reported heart failure severity often doesn’t agree with patient reports. Overall, 72% of the patients were judged by their physicians to have class II heart failure, but the mean KCCQ score was just over 53, so pretty severe patient-reported limitations or severe HFpEF. Despite this — and this is often the case in HFpEF and obesity-related HFpEF — the median N-terminal pro-B-type natriuretic peptide ( NT-proBNP) was only 175. Piña: I was very surprised at that. Very surprised. That really is low. That was NT-proBNP. That wasn’t BNP. Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/how-do-glp-1s-affect-cardiac-structure-and-skeletal-muscle-2025a10001qm?src=soc_yt

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Semaglutide is a medication that has gained popularity in recent years for its effectiveness in weight loss. Originally developed as a treatment for type 2 diabetes, semaglutide has been found to have additional benefits in promoting weight loss when used at higher doses. Research has shown that individuals who have struggled to lose weight through other methods have found success with semaglutide, with some patients experiencing significant reductions in body weight.

Understanding Semaglutide Protocol

Semaglutide works by mimicking the effects of a hormone in the body called glucagon-like peptide-1 (GLP-1). This hormone helps to regulate blood sugar levels and plays a role in appetite control. When taken at a higher dose than what is typically prescribed for diabetes management, semaglutide can help to reduce hunger and cravings, leading to lower caloric intake and ultimately weight loss.

It is important to note that semaglutide is not a magic pill for weight loss. While it can be an effective tool in achieving weight loss goals, it is most successful when used in conjunction with a healthy diet and regular exercise. Semaglutide should be viewed as a complement to a comprehensive weight loss plan, rather than a standalone solution.

Before starting a semaglutide protocol for weight loss, it is essential to consult with a healthcare provider who can evaluate whether this medication is a suitable option for you. Your healthcare provider will consider factors such as your medical history, current medications, and weight loss goals to determine if semaglutide is the right choice for you. They can also provide guidance on the proper dosage and monitoring to ensure safe and effective use of the medication.

Tips for Success with Semaglutide

One key aspect of a successful semaglutide protocol is consistency. It is important to take the medication as prescribed by your healthcare provider and to adhere to a regular schedule. Consistent use of semaglutide can help to maintain steady blood levels of the medication, maximizing its effectiveness in promoting weight loss.

In addition to consistency, monitoring your progress is crucial when using semaglutide for weight loss. Keeping track of your weight, dietary habits, and physical activity can help you and your healthcare provider assess the effectiveness of the medication and make any necessary adjustments to your treatment plan. Regular check-ins with your healthcare provider are essential for monitoring your progress and addressing any concerns that may arise during treatment.

It is also important to be realistic in your expectations when starting a semaglutide protocol for weight loss. While some individuals may experience significant weight loss with this medication, results can vary from person to person. It is important to approach weight loss with patience and perseverance, as sustainable results may take time to achieve.

Side Effects and Considerations

Like any medication, semaglutide can have side effects that should be considered before starting treatment. Common side effects of semaglutide include nausea, vomiting, diarrhea, and constipation. These side effects are typically mild and tend to lessen over time as your body adjusts to the medication. However, if you experience severe or persistent side effects, it is important to contact your healthcare provider for further guidance.

In addition to side effects, there are certain precautions to be aware of when using semaglutide for weight loss. Semaglutide should not be used in individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. It is important to disclose any relevant medical history to your healthcare provider before starting treatment with semaglutide to ensure its safety and effectiveness for you.

Overall, semaglutide can be a valuable tool in achieving weight loss goals for individuals who have struggled with other methods. By following a comprehensive weight loss plan, staying consistent with treatment, monitoring your progress, and being mindful of potential side effects and considerations, you can optimize the effectiveness of semaglutide in your weight loss journey.

Summary and Frequently Asked Questions

In conclusion, semaglutide is a promising medication for weight loss that works by mimicking the effects of a hormone in the body that regulates blood sugar levels and appetite control. When used in conjunction with a healthy diet and regular exercise, semaglutide can be an effective tool in achieving weight loss goals. However, it is important to consult with a healthcare provider before starting a semaglutide protocol to ensure its safety and effectiveness for you.

Below are some frequently asked questions about semaglutide and its use for weight loss:

Q: How long does it take to see results with semaglutide?
A: Results with semaglutide can vary from person to person, but some individuals may start to see weight loss within a few weeks of starting treatment.

Q: Can semaglutide be used long-term for weight loss?
A: Long-term use of semaglutide for weight loss can be effective for maintaining weight loss results, but it is important to discuss with your healthcare provider to determine the best treatment plan for you.

Q: Are there any dietary restrictions when taking semaglutide?
A: While there are no specific dietary restrictions with semaglutide, following a healthy and balanced diet can further enhance the weight loss benefits of the medication.

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