N Engl J Med
Does oral semaglutide deliver cardiovascular benefits in type 2 diabetes patients with known ASCVD or CKD?
June 2, 2025

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Oral semaglutide was linked to significantly lower major adverse cardiovascular event (MACE) risk vs. placebo, without upping serious adverse event incidence, in type 2 diabetes patients with known atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), or both, in this randomized placebo-controlled trial.
- Study: 9650 adults ages 50+ years with type 2 diabetes (HbA1c, 6.5 to 10.0%) and ASCVD, CKD, or both were randomized to oral semaglutide (max dose, 14 mg once daily) vs. placebo, along with standard care. Primary outcome: MACE (composite of CV death, nonfatal MI, nonfatal stroke). Median follow-up was 49.5 months.
- Results: MACE events occurred in 12.0% of the oral semaglutide group (3.1 events/100 person-years) vs. 13.8% of the placebo group (3.7 events/100 person-years), resulting in a hazard ratio of 0.86 (P=0.006).
- Serious adverse event incidence: 47.9% for the oral semaglutide group vs. 50.3% for the placebo group. Incidence of gastrointestinal disorders was 5.0% for the semaglutide group and 4.4% for the placebo group.
Source:
McGuire DK, et al. (2025, May 29). N Engl J Med. Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes. https://pubmed.ncbi.nlm.nih.gov/40162642
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