Study wrapper · #1231
Semaglutide for primary prevention of major adverse cardiac and cerebrovascular events in patients with type 2 diabetes and comorbid rheumatoid arthritis: a target-trial emulation.
Editor's note
Target-trial emulation is the more disciplined end of observational design, with a new-user framework and propensity matching, but it is still not randomization and residual confounding by prescribing preference is plausible. The composite result rests almost entirely on incident heart failure, with no differences in death, myocardial infarction, or stroke, so it should be read narrowly. The lower rate of DMARD escalation is the novel observation here and is worth watching in a population that has been largely absent from the cardiovascular outcome trials.
Plain-language abstract
Using a large US electronic health-record database, researchers built a study designed to mimic a randomized trial, comparing 1,017 adults with obesity, type 2 diabetes, and rheumatoid arthritis who started semaglutide against 1,017 matched adults who started other second-line diabetes drugs. Over up to two years, the semaglutide group had fewer combined cardiovascular and cerebrovascular events, 12.7% versus 16.5%, driven mainly by fewer new heart-failure diagnoses. Escalation of rheumatoid arthritis medication was also less common in the semaglutide group.