Stopping Ozempic-like drugs can increase heart attack risk
What's the story
A recent study has found that discontinuing GLP-1 medications such as semaglutide, the active ingredient in Ozempic and Wegovy, could significantly increase the risk of cardiovascular events. The research was conducted by scientists who analyzed medical records of veterans with type 2 diabetes on these drugs. They found that those who stayed on GLP-1s for at least two years were less likely to suffer major cardiovascular events like heart attacks than those on other common treatments.
Health impact
Heart benefits of GLP-1s fade quickly after stopping therapy
The study also noted that the heart benefits of GLP-1s quickly faded in those who stopped the therapy. "Stopping GLP-1 drugs has a price," said Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis and one of the authors of the study. He emphasized that while these drugs are effective for weight loss, their discontinuation can have serious health implications beyond just regaining lost weight.
Metabolic effects
Study analyzed data from over 300,000 people
Al-Aly, who is also the director of the Clinical Epidemiology Center at the Veterans Affairs St. Louis Health Care System, led a study that analyzed data from over 300,000 people with type 2 diabetes between 2017 and 2023. The team found that those who stayed on GLP-1s throughout had an 18% lower risk of major cardiovascular events compared to a control group. However, once they stopped taking these drugs, their risk for heart problems began to rise again within months.
Risk factors
Weight comes back along with metabolic reversal
Al-Aly warned that when people stop these drugs, the weight comes back but also a "metabolic reversal" happens. This includes inflammation surging, blood pressure climbing, and cholesterol rising. He said this silent process increases the risk of heart attacks and strokes after stopping GLP-1 therapy. The team's findings were published in BMJ Medicine on Wednesday.
Demographic analysis
Similar trends found in women and other demographic groups
The researchers also found similar trends when they looked at smaller groups of women and other demographic groups. They used a newer statistical method called target trial emulation for their study, which is meant to strengthen conclusions from observational data. Al-Aly stressed that people who benefit from these drugs should likely stay on them for the long haul.
Therapy maintenance
Maintaining GLP-1 therapy challenging for many users
Al-Aly acknowledged that maintaining GLP-1 therapy hasn't been easy for users due to gastrointestinal side effects, loss of insurance coverage, or unsustainable out-of-pocket prices. These interruptions could have serious consequences in people who keep going on and off GLP-1 therapy. "One thing that keeps us up at night is the yo-yo pattern," Al-Aly said, adding they suspect repeated cycling may erase cardiovascular protection entirely or leave people worse off than if they had never started these drugs.