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ForumsSemaglutide (Ozempic / Wegovy)Semaglutide cardiovascular benefit: SELECT trial deep dive — looking for input Page 7

Semaglutide cardiovascular benefit: SELECT trial deep dive — looking for input

MaxMetOK Tue, Dec 17, 2024 at 2:04 PM 56 replies 2,950 viewsPage 7 of 12
lisa_labSD
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Jan 8, 2025 at 8:57 AM#31

One concrete data point for the thread. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

Last edited: Jan 8, 2025 at 11:57 AM
43 16stefan_berlin, Dr.EM_Chicago, pete_RVA and 40 others
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Dr.PathRoch
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Jun 2024
Rochester, MN
Jan 9, 2025 at 4:34 PM#32

Following on from Dr.LeslieOBGYN — and this may be the naive question:

What the dose-response curve actually looks like above 1.7mg, because the trial means hide how few people account for the extra loss?

44 17InsuranceTom, WendyG_ATL, SaraMom3 and 41 others
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tyler_CSCS
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Phoenix, AZ
Jan 11, 2025 at 12:11 AM#33
lisa_labSD said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off losartan entirely! My cardiologist is thrilled.

If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.

Last edited: Jan 11, 2025 at 2:11 AM
45 18Dr.SportsMedIN, amy_econ_NJ, bbq_ray_KC and 42 others
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sean_dublin
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Dublin, IE
Jan 12, 2025 at 7:47 AM#34
lisa_labSD said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].

Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.

These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.

References:
[1] Hogan AE, et al. Diabetologia. 2014;57(4):781-784.
Last edited: Jan 12, 2025 at 8:47 AM
46 19NurseLeah_Nash, gary_naperville, sean_dublin and 43 others
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MikeKY_noInsulin
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Louisville, KY
Jan 13, 2025 at 3:22 PM#35
lisa_labSD said:
For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Genuinely useful, thank you. I had the facts and not the framework. Printing the relevant bit and taking it with me.

47 20bbq_ray_KC, oliver_london, tane_welly and 44 others
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