GLP-1 Evidence

Not medical advice. A record of published research and our assessments of it. The limits

Comparing Cardiovascular Outcomes in New Users of Oral Semaglutide Versus Other Noninsulin Glucose-Lowering Therapies Among Adults with Type 2 Diabetes and Atherosclerotic Cardiovascular Disease

Design
Retrospective cohort · 10878 participants · Hard outcome
Match to healthy normal-weight adults aged 55–75
Population unclear[Auto] Population characteristics not extractable from abstract (age/BMI not reported in abstract). Needs manual review.
Could weight loss explain it?
Unknown[Auto] Not addressed in abstract.
Study tier
Study tier 3[Auto] Observational design; confounding by indication and healthy-user effects cannot be excluded (auto-provisional).
Assessment
Version 1 · automatic, not yet reviewed by a person · Sep 20, 2026

Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.

[Auto, unreviewed; quoted from abstract conclusions] Consistent with clinical trial evidence, oral semaglutide was associated with a lower risk of cardiovascular outcomes among people with T2D and ASCVD in real-world settings.

01Findings

What the study reported

Drugs
Semaglutide
Route
oral
Primary outcome
Not extracted
Effect
Not extracted
95% confidence interval
Not extracted
Follow-up
Not stated
Adverse events
Not extracted
Limitations
Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.

Who was studied

Diabetes status
diabetes mentioned
Cvd status
cardiovascular disease present in population (see abstract)
Sample size
10878

Study quality details

Study design
Retrospective cohort
Sample size
10878
Randomization
no
Blinding
not stated
Comparator
not stated
Follow up duration
not stated
Outcome type
hard
Replication
not assessed (auto)
Consistency with other evidence
not assessed (auto)
Population applicability
UNKNOWN
Statistical precision
not extracted
Risk of bias
not assessed (auto)
Funding conflicts
unclear
Peer review status
yes
02Funding

Funding and conflicts

Funding
not reported in abstract
Industry funded
Unclear
Manufacturer
Novo Nordisk
Sponsor role
not reported in abstract
Author conflicts
Declarations. Conflict of Interest: Xi Tan, Yuanjie Liang, Caichen Zhong, Lin Xie, Mico Guevarra, and Caroline Swift are employees of Novo Nordisk Inc. Adam de Havenon reports NIH/NINDS funding, investigator-initiated clinical research funding from AAN, consultant fees from Novo Nordisk, royalty fees from UpToDate, and equity in Titin KM and Certus. Ethical Approval: This study was conducted in accordance with the Declaration of Helsinki. This study involved retrospectively collected deidentified data, which was analyzed without interaction with the human subjects or reidentifying subjects. It was deemed to be exempt from institutional review board (IRB) review as determined by WCG IRB was exempt under 45 CFR § 46.104(d)(4). This study analyzed secondary data from Optum’s deidentified CDM Database data without direct subject contact or intervention; per 45 CFR 46, analyses of secondary, deidentified data are not human subjects research and do not require consent.
Independent replication
unknown
Notes
Authors declare relationships with the drug's manufacturer: Novo Nordisk

Funding is shown on every study and never used to score it.

04Source

The source, as retrieved

Abstract

[INTRODUCTION] Clinical trials have found semaglutide reduces the risk of major adverse cardiovascular events (MACE) among people with type 2 diabetes (T2D) at high risk of MACE. Less is known about oral semaglutide's impact on real-world cardiovascular risk. [METHODS] This observational cohort study used administrative claims data from Optum's deidentified Clinformatics® Data Mart Database to compare 3-, modified 3-, 5-, modified 5-, and 2-point MACE, ischemic stroke (IS), myocardial infarction (MI), and all-cause and cardiovascular-related death rates among people with T2D and atherosclerotic cardiovascular disease (ASCVD) who initiated oral semaglutide vs other noninsulin glucose-lowering therapies (ONIGLTs). Cardiovascular outcomes were compared between new users of oral semaglutide and propensity score-matched new users of dipeptidyl peptidase 4 inhibitors (DPP4is) or sodium-glucose cotransporter 2 inhibitors (SGLT2is). [RESULTS] Oral semaglutide users (n = 10,878) had risk reductions of 17% and 21% in 3- and modified 3-point MACE, respectively, and significant risk reductions in 5-, modified 5-, and 2-point MACE, IS, and all-cause death vs ONIGLT users (n = 28,639). People who initiated oral semaglutide (n = 7218) had 22% and 24% lower risks of 3- and modified 3-point MACE, respectively, and significantly lower risks of 5- and modified 5-point MACE, IS, and all-cause death vs people who initiated DPP4is (n = 7218). Compared with SGLT2i users (n = 21,572), oral semaglutide users (n = 7491) had 21% and 22% lower risks of 3- and modified 3-point MACE, respectively, and significantly lower risks of 5-, modified 5-, and 2-point MACE. [CONCLUSION] Consistent with clinical trial evidence, oral semaglutide was associated with a lower risk of cardiovascular outcomes among people with T2D and ASCVD in real-world settings.

Where this record came from

SourceRetrievedIdentifier
pubmedSep 20, 202642753116
first ingestion