Estimated Life-Years Gained Free of New or Recurrent Major Cardiovascular Events With the Addition of Semaglutide to Standard of Care in People With Type 2 Diabetes and High Cardiovascular Risk

<b>OBJECTIVE</b> <p>Semaglutide, a glucagon-like peptide-1 receptor agonist, reduced major adverse cardiovascular events (MACE) in people with type 2 diabetes (T2D) at high risk of cardiovascular disease (CVD) in a <i>post hoc</i> analysis of pooled data from SUSTAIN 6 and PIONEER 6. We estimated the benefit of adding semaglutide to standard of care (SoC) on life-years free of new/recurrent CVD events in people with T2D at high risk of CVD.</p> <p><b>RESEARCH DESIGN AND METHODS</b></p> <p>The DIAL competing-risk-adjusted lifetime CVD risk model for people with T2D was developed previously. Baseline characteristics from SUSTAIN 6 and PIONEER 6 (POOLED cohort; <i>N</i>=6,480) were used to estimate individual life expectancy free of CVD for patients in the POOLED cohort. The hazard ratio of MACE from adding semaglutide to SoC was derived from the POOLED cohort (hazard ratio 0.76 [95% CI 0.62–0.92]) and combined with an individual’s risk to estimate their CVD benefit.</p> <p><b>RESULTS</b></p> <p>Adding semaglutide to SoC was associated with a wide distribution in life-years free of CVD gained, with a mean increase of 1.7 (95% CI 0.5–2.9) life-years. Estimated life-years free of CVD gained with semaglutide was dependent on baseline risk (life-years free of CVD gained in individuals with established CVD vs those with cardiovascular risk factors only: 2.0 years vs 0.2 years) and age at treatment initiation. </p> <p><b>CONCLUSIONS</b></p> <p>Adding semaglutide to SoC was associated with a gain in life-years free of CVD events that was dependent on baseline CVD risk and age at treatment initiation. This study helps contextualize the results of semaglutide clinical trials.</p>