Semaglutide Reduces Hospital Admissions of Obese Patients Beyond Cardiovascular Benefits: JAMA
Australia: In a prespecified exploratory analysis of the SELECT randomized clinical trial, participants were found to have a high baseline burden of hospital admissions. Treatment with once-weekly semaglutide was linked to meaningful reductions in both the frequency of hospital admissions and the overall duration of hospital stay, suggesting benefits that go beyond cardiovascular risk reduction in patients living with obesity.
The analysis, published in JAMA Cardiology, was led by Stephen J. Nicholls from the Monash Victorian Heart Institute and Monash University, Melbourne, Australia, along with an international team of investigators. While the primary SELECT trial previously demonstrated that semaglutide lowers the risk of major adverse cardiovascular events—including cardiovascular death, myocardial infarction, and stroke—among individuals with established cardiovascular disease and overweight or obesity without diabetes, its impact on broader health care utilization had not been fully explored.
To explore this, researchers assessed semaglutide’s effect on total hospital admissions and length of stay. The SELECT trial enrolled adults ≥45 years with established cardiovascular disease and BMI ≥27, excluding those with diabetes. Participants from 804 sites worldwide were randomized between October 2018 and March 2021 to receive weekly subcutaneous semaglutide 2.4 mg or placebo. The exploratory analysis ran from February 2024 to September 2025.
A total of 17,604 participants were included, with a median age of 61 years and a median BMI of 32.1. Women accounted for just over a quarter of the study population. Participants were followed for a median duration of nearly 42 months, during which more than 11,000 hospital admissions were recorded, highlighting the substantial baseline hospitalization burden in this high-risk group.
The following were the key findings:
- Treatment with semaglutide was associated with a lower risk of first hospital admission for any cause and fewer total hospitalizations compared with placebo.
- Overall, hospital admissions for all indications, including those related to serious adverse events, were reduced in patients receiving semaglutide.
- Semaglutide use was linked to fewer total days spent in hospital for both all-cause admissions and serious adverse events, indicating a consistent reduction in hospitalization burden.
- The reduction in hospital admissions was consistent across key subgroups, with no significant differences based on age, sex, or baseline body mass index.
- These findings suggest that the hospitalization benefits of semaglutide are broadly applicable among patients with obesity and established cardiovascular disease.
According to the authors, these results extend the clinical relevance of semaglutide beyond its established cardiovascular protective effects. By lowering the frequency and duration of hospital stays, semaglutide may also help reduce health care utilization and associated costs in this high-risk population.
The investigators emphasized that this was an exploratory analysis and should be interpreted in that context. Nevertheless, the findings provide important insights into the wider health benefits of semaglutide and support its role as a therapy that not only improves cardiovascular outcomes but also lessens the overall burden of hospitalization among patients with obesity and cardiovascular disease.
Reference:
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. doi:10.1001/jamacardio.2025.4824
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