# Orale semaglutide verlaagt cardiovasculaire uitkomsten bij diabetes en ASCVD — real-world studie

*geplaatst 2026-09-25 · Hartfalen · Diabetes therapy : research, treatment and education of diabetes and related disorders · doi 10.1007/s13300-026-01919-8 · https://hartvaat.nl/2026/09/17/orale-semaglutide-verlaagt-cardiovasculaire-uitkomsten-bij-diabetes-en-ascvd-rea/*

Een real-world cohortstudie onder 39.500 patiënten met type 2-diabetes en atherosclerotische cardiovasculaire ziekte (ASCVD) toont aan dat nieuw gebruik van orale semaglutide gepaard gaat met een significante daling van MACE, ischemische beroerte en alle-oorzaaksterfte vergeleken met andere niet-insuline glucoseverlagende middelen en DPP-4-remmers. Ten opzichte van SGLT2-remmers bleek het cardiovasculaire profiel vergelijkbaar, met licht lagere risico's op MACE. Deze bevindingen bevestigen de resultaten van gerandomiseerde trials in de dagelijkse praktijk en ondersteunen het gebruik van orale semaglutide als cardiovasculair beschermende therapie bij deze risicogroep.

## English: Comparing Cardiovascular Outcomes in New Users of Oral Semaglutide Versus Other Noninsulin Glucose-Lowering Therapies Among Adults with Type 2 Diabetes and Atherosclerotic Cardiovascular Disease.

A propensity-matched cohort study of nearly 40,000 patients with type 2 diabetes and established ASCVD found that initiating oral semaglutide was associated with significantly lower risks of MACE, ischemic stroke, and all-cause mortality compared with other noninsulin glucose-lowering agents and DPP-4 inhibitors. When compared directly with SGLT2 inhibitors, oral semaglutide showed a slightly more favorable cardiovascular risk profile, with modest reductions in composite MACE endpoints. These real-world findings align with randomized trial data and support the use of oral semaglutide for cardiovascular risk reduction in patients with diabetes and ASCVD.

## Abstract (original, from the publication)

INTRODUCTION: Clinical trials have found semaglutide reduces the risk of major adverse cardiovascular events (MACE) among people with type 2 diabetes (T2D) at high risk of MACE. Less is known about oral semaglutide's impact on real-world cardiovascular risk. METHODS: This observational cohort study used administrative claims data from Optum's deidentified Clinformatics® Data Mart Database to compare 3-, modified 3-, 5-, modified 5-, and 2-point MACE, ischemic stroke (IS), myocardial infarction (MI), and all-cause and cardiovascular-related death rates among people with T2D and atherosclerotic cardiovascular disease (ASCVD) who initiated oral semaglutide vs other noninsulin glucose-lowering therapies (ONIGLTs). Cardiovascular outcomes were compared between new users of oral semaglutide and propensity score-matched new users of dipeptidyl peptidase 4 inhibitors (DPP4is) or sodium-glucose cotransporter 2 inhibitors (SGLT2is). RESULTS: Oral semaglutide users (n = 10,878) had risk reductions of 17% and 21% in 3- and modified 3-point MACE, respectively, and significant risk reductions in 5-, modified 5-, and 2-point MACE, IS, and all-cause death vs ONIGLT users (n = 28,639). People who initiated oral semaglutide (n = 7218) had 22% and 24% lower risks of 3- and modified 3-point MACE, respectively, and significantly lower risks of 5- and modified 5-point MACE, IS, and all-cause death vs people who initiated DPP4is (n = 7218). Compared with SGLT2i users (n = 21,572), oral semaglutide users (n = 7491) had 21% and 22% lower risks of 3- and modified 3-point MACE, respectively, and significantly lower risks of 5-, modified 5-, and 2-point MACE. CONCLUSION: Consistent with clinical trial evidence, oral semaglutide was associated with a lower risk of cardiovascular outcomes among people with T2D and ASCVD in real-world settings.

Auteurs: Xi Tan, Yuanjie Liang, Caichen Zhong, Lin Xie, Mico Guevarra, Caroline Swift, Adam de Havenon

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Bron: Diabetes therapy : research, treatment and education of diabetes and related disorders, https://doi.org/10.1007/s13300-026-01919-8. Bijgewerkt 2026-09-18T01:23:34Z. 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.