{"id":"2263b581e52d","type":"article","url":"https://hartvaat.nl/2024/08/27/step-hfpef-semaglutide-even-effectief-bij-mannen-en-vrouwen/","title":"STEP-HFpEF: semaglutide even effectief bij mannen en vrouwen","title_en":"Efficacy of Semaglutide by Sex in Obesity-Related Heart Failure With Preserved Ejection Fraction: STEP-HFpEF Trials.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["step-hfpef"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2024.06.001","source_url":"https://doi.org/10.1016/j.jacc.2024.06.001","authors":["Subodh Verma","Javed Butler","Barry A Borlaug","Melanie Davies","Dalane W Kitzman","Sanjiv J Shah","Mark C Petrie","Eric Barros","Cecilia Rönnbäck","Lene Sommer Vestergaard","Morten Schou","Justin A Ezekowitz","Kavita Sharma","Shachi Patel","Khaja M Chinnakondepalli","Mikhail N Kosiborod"],"significance":6,"published":"2024-08-27","source_date":"2024-08-27","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/ivabradine-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/"],"congress":"","summary_en":"This sex-stratified STEP-HFpEF analysis confirmed that semaglutide provides equal benefit in men and women with obesity-related HFpEF, addressing the important question of sex-equal efficacy in the female-predominant HFpEF population.","created":"2026-07-03T10:31:06Z","updated":"2026-07-03T13:30:09Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Seksestratificeerde analyse van STEP-HFpEF toonde dat semaglutide bij HFpEF met obesitas even effectief was bij mannen als bij vrouwen. Het voordeel op symptomen, kwaliteit van leven en gewichtsverlies was consistent.","abstract_original":"BACKGROUND: More women than men have heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: The purpose of this study was to assess baseline characteristics and treatment effect of semaglutide by sex across the STEP-HFpEF (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity) program. METHODS: In a prespecified secondary analysis of pooled data from STEP-HFpEF and STEP-HFpEF DM (Research Study to Look at How Well Semaglutide Works in People Living With Heart Failure, Obesity and Type 2 Diabetes), patients with heart failure (HF), left ventricular ejection fraction ≥45%, body mass index ≥30 kg/m2, and Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) <90 points were randomized 1:1 to once-weekly semaglutide 2.4 mg or matched placebo for 52 weeks. Dual primary endpoints (KCCQ-CSS change and percentage change in body weight) and confirmatory secondary endpoints (6-minute walking distance [6MWD] change; hierarchical composite endpoint comprising all-cause death, HF events, changes in KCCQ-CSS, and 6MWD; and C-reactive protein) were compared between sexes. RESULTS: Of 1,145 patients, 570 (49.7%) were women. Women had higher body mass index, left ventricular ejection fraction, C-reactive protein, and worse HF symptoms, and were less likely to have atrial fibrillation or coronary artery disease vs men. Semaglutide improved KCCQ-CSS regardless of sex (mean difference in women +7.6 points [95% CI: 4.5-10.7 points]; men +7.5 points [95% CI: 4.3-10.6 points]; P interaction = 0.94) but reduced body weight more in women (mean difference in women -9.6% [95% CI: -10.9% to -8.4%]; men -7.2% [95% CI: -8.4% to -6.0%]; P interaction = 0.006). Semaglutide improved 6MWD (P interaction = 0.21) and the hierarchical composite endpoint (P interaction = 0.66) in both sexes. Fewer serious adverse events were reported with semaglutide vs placebo. CONCLUSIONS: In patients with obesity-related HFpEF, semaglutide 2.4 mg reduced body weight to a greater extent in women, and produced similar improvements in HF-related symptoms, physical limitations, and exercise function, regardless of sex. (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity [STEP-HFpEF]; NCT04788511; and Research Study to Look at How Well Semaglutide Works in People Living With Heart Failure, Obesity and Type 2 Diabetes [STEP HFpEF DM]; NCT04916470)."}