Scott Buzby , 2025-06-21 22:09:00
Key takeaways:
- Researchers presented a new subanalysis of the STRIDE trial.
- Ozempic improved walking distance in patients with type 2 diabetes and early peripheral artery disease, regardless of baseline diabetes characteristics.
CHICAGO — Semaglutide 1 mg improves walking distance in patients with early peripheral artery disease and type 2 diabetes, regardless of baseline diabetes duration, HbA1c, BMI and concomitant medication use.
Subodh Verma, MD, PhD, FRCSC, professor of medicine, cardiac surgeon and the Canada Research Chair in Cardiovascular Surgery at University of Toronto, presented new insights from the recently reported STRIDE trial looking at the effect of semaglutide 1 mg (Ozempic, Novo Nordisk) in patients with peripheral artery disease (PAD) and diabetes based on baseline diabetes characteristics.
Adults with early peripheral artery disease and type 2 diabetes had improved walking distance with semaglutide, regardless of baseline diabetes characteristics. Image: Adobe Stock
“Current vascular [guidelines], and other guidelines globally, have echoed the fact that … finding solutions to improve symptoms and delay the progression of peripheral arterial disease is paramount. The STRIDE trial really ushers in what we believe to be an entirely novel paradigm — a paradigm that has been ignored thus far with the evolution of SGLT2 inhibitors and GLP-1 receptor agonists as foundational pillars for [major adverse cardiac event] protection,” Verma said during a press conference at the American Diabetes Association Scientific Sessions. “The No. 1 risk factor for peripheral arterial disease is diabetes. Peripheral arterial disease is one of the most common and often initial manifestations of cardiovascular events in people with diabetes … as they say, ‘painful legs, aching heart.’”
As Healio previously reported, the STRIDE trial enrolled 792 patients with diabetes and early symptomatic PAD (mean age, 68 years; 25% women). Participants were randomly assigned semaglutide 1 mg or placebo. All patients had intermittent claudication and an ankle-brachial index of 0.9 or less or a toe-brachial index of 0.7 or less.
Subodh Verma
Semaglutide was found to improve walking distance compared with placebo in this patient population. The primary endpoint of estimated median ratio to baseline in maximum walking distance on a constant load treadmill at 52 weeks was 1.21 in the semaglutide group compared with 1.08 in the placebo group (estimated treatment ratio [ETR], 1.13; 95% CI, 1.06-1.21; P = .0004).For the new subanalysis, researchers evaluated the treatment effect of semaglutide vs. placebo, stratified by baseline diabetes characteristics including HbA1C, diabetes duration and diabetes intensity.
Median diabetes duration was 12.2 years, baseline average HbA1c was 7.1% and baseline BMI was 28.7 kg/m2. Two-thirds of patients were taking an SGLT2 inhibitor and 31.7% were using insulin.
The researchers reported comparable improvements in maximum walking distance among those assigned semaglutide regardless of:
- diabetes duration (ETR, 1.15 for < 10 years vs. 1.13 for 10 years; P = .8);
- BMI (ETR, 1.12 for < 30 kg/m2 vs. 1.16 for 30 kg/m2 P = .58);
- HbA1c (ETR, 1.13 for < 7% vs. 1.13 for 7%; P = .99);
- SGLT2 inhibitor use (ETR, 1.15 for use vs. 1.15 for nonuse; P = .954); and
- insulin use (ETR, 1.14 for use vs. 1.17 nonuse; P = .723).
In addition, semaglutide improved pain-free walk distance across all subgroups (P for all > 0.1).
The safety profile of semaglutide was consistent across all subgroups, according to the results.
The study was simultaneously published in Diabetes Care.
“We don’t believe that weight is driving this benefit; there was a very small 4 kg weight loss in this population. There is really no correlation between weight and outcomes here,” Verma said during the presentation. “We think this marks a transformative change in the management of peripheral arterial disease, and it moves the field forward, after 25 years, for a problem that is debilitating for patients.”
Reference:
Sources/Disclosures
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Rasouli N, et al. Symposium – Diabetes and peripheral artery disease – Evolving role of GLP-1 RA and new insights from the STRIDE trial. Presented at: American Diabetes Association’s Scientific Sessions; June 20-23, 2025; Chicago.
Disclosures:
The STRIDE trial was supported by Novo Nordisk. Verma reports various financial relationships, including with Novo Nordisk. Please see the study for the authors’ relevant financial disclosures.
