More complete data from a clinical trial of Novo Nordisk’s Wegovy weight loss drug have rekindled the debate over how the treatment will affect patient demand for medical devices and procedures.
The findings from the SELECT study, presented at a major heart meeting over the weekend, showed a 20% reduction in risk on a composite goal of heart attack, stroke or cardiovascular death, compared to a placebo, in overweight and obese patients with heart disease. But the data were inconclusive on a narrower measure of cardiovascular death alone.
The data overall confirm a cardiovascular benefit for patients, but mixed results on secondary endpoints do not alter the outlook for heart device makers such as Boston Scientific, Medtronic and Edwards Lifesciences, Mizuho analyst Anthony Petrone said Monday in a report to clients.
“At first blush, we see the final SELECT data as neutral for cardiovascular names,” he wrote.
Shares in medical device companies have come under pressure since the initial SELECT study data pointing to the reduction in cardiovascular risk were released in August. Investors' concerns have centered on whether Wegovy and other GLP-1 agonists could reduce the need for medical devices to treat diabetes and cardiovascular diseases.
“Taken collectively, the data did not provide substantially more [cardiovascular]-benefit learnings versus the August 8th headline,” Petrone said.
The study also showed that Wegovy lowered pre-diabetic patients’ risk of developing an elevated HbA1c level by about 73%, according to Mizuho’s note, with implications for manufacturers of insulin pumps and continuous glucose monitors (CGMs).
“With SELECT now opening the potential for GLP-1s to be used as preventative measures in vulnerable populations, we expect this headwind to now be debated over the coming weeks/months for the outlooks of CGMs and insulin delivery solutions,” Petrone wrote.
CGM makers Abbott and Dexcom contend that patients who take GLP-1 medicines show greater use of their glucose monitors, demonstrating that the drugs and devices are complementary.
RBC Capital Markets analyst Shagun Singh noted that Dexcom is seeing higher CGM penetration and better outcomes after GLP-1 initiation in patients with Type 2 diabetes.
“Overall, we believe the SELECT data will benefit metabolic health, and expect CGM adoption to continue to increase in diabetes patients,” Singh wrote in a research note.
Interest in the new weight loss drugs has contributed to a slowdown in bariatric procedure growth, according to robotic surgery leader Intuitive Surgical, though company executives expect many of those patients eventually will consider surgery due to the drugs’ side effects and cost.
“Surgery headwinds could worsen in the near term as more patients delay procedures to try weight loss drugs,” William Blair analyst Brandon Vazquez wrote in a note to clients Monday. But the firm’s survey of bariatric surgeons showed 70% of the doctors believe delayed cases will be rescheduled, Vazquez said.