Reduction of Total Hospital Admissions via Once-Weekly Semaglutide in Non-Diabetic Patients

Article Impact Level: HIGH
Data Quality: STRONG
Summary of  JAMA Cardiology https://doi.org/10.1001/jamacardio.2025.4824  
Dr. Stephen J. Nicholls  et al.

Points

The SELECT trial exploratory analysis examined how once-weekly subcutaneous semaglutide affects the frequency and duration of hospital stays in patients with established cardiovascular disease and a body mass index.
Patients treated with semaglutide experienced eighteen point three admissions per one hundred patient-years compared to twenty point four in the placebo group resulting in a mean ratio of zero point ninety.
Hospitalizations specifically for serious adverse events were reduced to fifteen point two per one hundred patient-years in the treatment cohort versus seventeen point one in the group receiving the placebo agent.
Total days spent in the hospital were lower for the semaglutide group at one hundred fifty-seven point two days per one hundred patient-years compared to the placebo group’s higher rate.
Subgroup analyses involving age and sex demonstrated no heterogeneity in the findings which confirms that the observed reduction in hospital burden applies consistently across various patient demographics within the clinical trial.

Summary

This prespecified exploratory analysis of the SELECT trial evaluated the impact of once-weekly subcutaneous semaglutide (2.4 mg) on hospitalization burden in 17,604 adults with established cardiovascular disease (CVD) and a BMI of 27 kg/m2 or higher without diabetes. Between 2018 and 2021, participants were randomized to semaglutide or placebo across 804 global clinical settings. Over a median follow-up of 41.8 months, the study quantified total hospital admissions and duration of stay to determine if GLP-1 receptor agonism extends clinical benefits beyond primary cardiovascular events.

The analysis recorded 11,287 total hospitalizations, revealing a significant reduction in admission frequency for the semaglutide cohort. Compared to placebo, semaglutide was associated with fewer total hospitalizations for any indication, with 18.3 versus 20.4 admissions per 100 patient-years (mean ratio [MR], 0.90). Similarly, admissions for serious adverse events were lower in the treatment group, occurring at 15.2 versus 17.1 per 100 patient-years (MR, 0.89), demonstrating a consistent reduction in the frequency of inpatient clinical encounters.

Furthermore, semaglutide significantly decreased the total duration of hospital stays. The treatment group experienced 157.2 days hospitalized per 100 patient-years compared to 176.2 days for the placebo group (rate ratio [RR], 0.89). A comparable reduction was observed for serious adverse event durations, with 137.6 versus 153.9 days per 100 patient-years (RR, 0.89). Subgroup analyses across BMI, age, and sex showed no heterogeneity, suggesting that the reduction in healthcare resource utilization is broadly applicable across this high-risk patient population.

Link to the article: https://jamanetwork.com/journals/jamacardiology/article-abstract/2843245

References

Nicholls, S. J., Ryan, D. H., Deanfield, J., Ferreira, D., Lang, C. C., Lincoff, A. M., Lingvay, I., Lübker, C., Terns, P. P., Rasmussen, S., Stensen, S., Weeke, P. E., Kahn, S. E., SELECT Trial Investigators, Nibouche, D. E., Chettibi, M., Hammoudi, N., Porto, A., Oviedo, A., … Spriggs, D. (2025). Semaglutide and hospitalizations in patients with obesity and established cardiovascular disease: An exploratory analysis of the select randomized clinical trial. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2025.4824