Semaglutide improves walking ability in patients with peripheral artery disease and type 2 diabetes

1. Maximum walking distance at 52 weeks was significantly improved with semaglutide.

2. There were fewer treatment-related serious adverse events in the semaglutide group compared to placebo.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Peripheral artery disease (PAD) is a serious condition affecting circulation in the legs and is common among individuals with type 2 diabetes. Few therapies are available to improve walking and quality of life for these patients. This randomized controlled trial aimed to assess whether weekly subcutaneous semaglutide could improve walking performance, symptoms, and health outcomes in people with PAD and type 2 diabetes. The primary outcome of this study was a change in maximum walking distance after 52 weeks, while a key secondary outcome was improvement in symptoms and quality of life. According to study results, semaglutide significantly increased walking distance compared to placebo. Although this study was well done, it was limited by its focus on patients with both PAD and diabetes, rendering the benefits for those without diabetes unclear.

Click to read the study in The Lancet

Relevant Reading: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes

In-depth [randomized controlled trial]: Between Oct 1, 2020, and Jul 12, 2024, 1363 patients were screened for eligibility across 112 outpatient trial sites in 20 countries. Included were patients ≥ 18 years with type 2 diabetes, PAD, an ankle–brachial index of ≤ 0.90 or a toe-brachial index of ≤ 0.70. Altogether, 792 patients (396 each in the semaglutide and placebo groups) were included in the final analysis. The primary outcome of change in maximum walking distance at 52 weeks showed a significant improvement with semaglutide compared to placebo (1.21 vs. 1.08, estimated treatment ratio 1.13, p=0.0004). The secondary outcome of symptom relief and quality of life also favoured semaglutide, with fewer treatment-related serious adverse events (1% vs. 2%). Findings from this study suggest that semaglutide may improve functional capacity and well-being in patients with peripheral artery disease and type 2 diabetes.

Image: PD

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