What the peptide community is saying — and living

Hunger pain and its reduction; qualitative insight from people with schizophrenia on semaglutide.

1. Int J Qual Stud Health Well-being. 2026 Dec 31;21(1):2717809. doi: 10.1080/17482631.2026.2717809. Epub 2026 Aug 18. Hunger pain and its reduction; qualitative insight from people with schizophrenia on semaglutide. Rasmussen BS(1), Simonÿ C(1)(2)(3), Poulsen ML(1), Uhrenholt NG(1)(4), Lundberg B(1)(5), Rønne ST(6), Uhrenholt PG(1)(7), Gæde PH(1)(3)(8), Arnfred SM(1)(7). Author information: (1)Department of Research, Central and Western Zealand Hospital, Copenhagen University Hospital, Slagelse, Denmark. (2)The Research and Implementation Unit PROgrez, Central and West Zealand Hospital, Slagelse, Denmark. (3)Institute of the Regional Health, University of Southern Denmark, Odense, Denmark. (4)Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark. (5)Central and Western Zealand Hospital, Psychiatry South, Vordingborg, Denmark. (6)Department of Research & Psychiatry Westh, Central and Western Zealand Hospital, Copenhagen University Hospital, Slagelse, Denmark. (7)Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. (8)Department of Internal Medicine, Central and Western Zealand Hospital, Geriatrics and Neurology, Slagelse, Denmark. PURPOSE: It is often reported that people with schizophrenia experience weight gain and disordered eating, partly due to antipsychotics. As part of the RCT "Home-based Intervention with Semaglutide Treatment of Neuroleptic-Related Prediabetes, HISTORI", the present study investigates experiences of hunger and eating habits in people using antipsychotics during semaglutide treatment. METHODS: Eleven semi-structured interviews were conducted 4 months to 1,5 years after treatment completion. Six women and 5 men were interviewed. The interviews were analysed using Braun & Clarke's reflexive thematic analysis. RESULTS: Three themes were identified; "Hunger pain induced by antipsychotic medicine", "Positive and negative experiences of reduced hunger", and "Eating habits and what influences them". The term "Hunger pain" was applied. It defines an excruciating combination of feeling extremely hungry, never achieving satiety, and relentless preoccupation with thoughts about food. The analysis suggested a focus on the patients' coping styles. CONCLUSION: The hunger pain, probably induced by antipsychotics, seemed to reinforce maladaptive coping styles. The relief from hunger pain due to semaglutide was in most cases a liberation. Yet, it is important also to pay attention to the negative effects of reduced hunger. It is relevant to assess patients' eating problems prior to semaglutide treatment. DOI: 10.1080/17482631.2026.2717809 PMCID: PMC13487855 PMID: 42610532 [Indexed for MEDLINE] Conflict of interest statement: The HISTORI RCT: Financial, material, and other support for the study was obtained from private foundations, including the Novo Nordisk Foundation; the Steno Diabetes Centre Sjaelland; the Steno Diabetes Centre Odense, Denmark; Slagelse Research Grants; and Region Zealand Health Research Foundation. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

My 2cents after losing 40 lbs

My 2cents after losing 40 lbs

ATR-FTIR spectroscopy coupled with multivariate analysis for monitoring degradation and secondary structure transitions in therapeutic peptide formulations.

Comparison of lifestyle, surgery, and semaglutide for weight management in endometrial cancer: a prospective observational study.

Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial.

1. J Med Econ. 2026 Dec;29(1):1258-1278. doi: 10.1080/13696998.2026.2646078. Epub 2026 Apr 21. Cost-effectiveness of tirzepatide versus semaglutide for patients with obesity or overweight in the US: evidence from the SURMOUNT-5 head-to-head phase-3 trial. Johansson E(1), Wilding JPH(2)(3), Upadhyay N(1), van Hest N(4), Kirk M(5), Spaepen E(6), Zimner-Rapuch S(1), Annemans L(7), Bays H(8). Author information: (1)Eli Lilly and Company, Indianapolis, Indiana, USA. (2)Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK. (3)Clinical Sciences Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK. (4)Costello Medical, Bristol, UK. (5)Costello Medical, Manchester, UK. (6)HaaPACS GmbH, Schriesheim, Germany. (7)Interuniversity Center of Health Economic Research (ICHER), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. (8)Louisville Metabolic and Atherosclerosis Research Center, Louisville, Kentucky, USA. PURPOSE: This study evaluated the cost-effectiveness (from the United States [US] societal perspective) of tirzepatide at its maximum-tolerated-dose (MTD) compared to semaglutide (MTD), both administered adjunct to a reduced-calorie diet and increased physical activity. The analysis focused on individuals with obesity (body mass index [BMI] ≥ 30 kg/m2), or overweight (BMI ≥27 to <30 kg/m2 + ≥1 obesity-related complication), using data from the head-to-head Phase-3 SURMOUNT-5 trial (patients without type 2 diabetes [T2D]). PATIENTS AND METHODS: This patient-level simulation modeling study assessed the cost and long-term clinical outcomes of tirzepatide (MTD) versus semaglutide (MTD), using data from the SURMOUNT-5 trial population. The modeled population were at risk of developing obesity-related complications including cardiovascular disease (CVD) and obstructive sleep apnea (OSA), amongst others. These outcomes were modeled using cardiometabolic parameters including weight, systolic blood pressure, high-density lipoprotein, glycated hemoglobin (HbA1c) and total cholesterol, by assessing their impact on healthcare and wider societal costs, quality of life, and mortality. Incremental cost-effectiveness ratios (ICERs; cost/quality-adjusted life year [QALY]) and incremental net health benefit (iNHBs) were calculated, and uncertainty was assessed through sensitivity and scenario analyses. RESULTS: Tirzepatide (MTD) was estimated to be less costly and more efficacious compared to semaglutide (MTD) with per patient cost savings of $41,688, 0.506 QALYs gained and positive iNHB of 0.784, indicating a net health benefit for tirzepatide. The model predicted that per 1,000 patients, 70 fewer patients will develop T2D, 10 fewer will develop CVD with tirzepatide (MTD) and patients spend 3.07 more years living with moderate/severe OSA when treated with semaglutide (MTD). CONCLUSION: Based on this simulation model, using head-to-head SURMOUNT-5 trial data, tirzepatide (MTD) had lower total costs and higher QALYs compared to semaglutide (MTD). This supports that tirzepatide (MTD) is a cost-effective treatment option for individuals with obesity or overweight compared to semaglutide (MTD). Plain Language Summary: This study focused on evaluating the cost-effectiveness of two weight management drugs, tirzepatide and semaglutide, for adults in the US who are overweight or have obesity. Using data from the SURMOUNT-5 trial, the analysis showed that tirzepatide was more effective and less costly, providing better weight loss and health benefits compared to semaglutide.The findings revealed that for every 1,000 individuals treated with tirzepatide, there were 70 fewer cases of type 2 diabetes and 10 fewer cases of heart disease compared to those treated with semaglutide. Additionally, patients on semaglutide experienced a longer duration living with moderate or severe sleep

GLP-1 receptor agonists in stroke prevention: a narrative review on emerging therapeutic frontiers.

1. Ann Med. 2026 Dec;58(1):2660386. doi: 10.1080/07853890.2026.2660386. Epub 2026 Apr 18. GLP-1 receptor agonists in stroke prevention: a narrative review on emerging therapeutic frontiers. Chikatimalla R(1), Shah A(2), Shah T(3), Perry G(4), Banker H(5), Aggarwal K(6), Jain R(7). Author information: (1)Kamineni Institute of Medical Sciences, Narketpally, India. (2)GMERS Medical College, Gotri, Vadodara, India. (3)GMERS Medical College, Valsad, India. (4)Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA. (5)Maulana Azad Medical College, New Delhi, India. (6)Dayanand Medical College and Hospital, Ludhiana, Punjab, India. (7)Division of Hospital Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA. OBJECTIVES: To evaluate the current evidence supporting the cerebrovascular protective effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in individuals with type 2 diabetes mellitus (T2DM), and to outline their mechanisms of action in stroke prevention. METHODS: A narrative review was conducted by synthesising data from cardiovascular outcome trials, meta-analyses and mechanistic studies involving GLP-1RAs such as semaglutide, liraglutide and dulaglutide. The search included literature on ischaemic stroke incidence, molecular pathways and clinical outcomes associated with GLP-1RA therapy. RESULTS: GLP-1RAs exhibit multiple protective mechanisms, including anti-inflammatory, antioxidant, neuroprotective and endothelial-stabilising effects. Long-acting agents demonstrate superior efficacy in reducing nonfatal and ischaemic stroke risk, with relative risk reductions ranging from 15% to 39% across major trials. These benefits are observed independent of glycemic control and appear most prominent in patients with preserved renal function and shorter diabetes duration. In contrast, short-acting exendin-based GLP-1RAs show limited cerebrovascular benefit. Treatment response may vary based on factors such as stroke subtype, baseline vascular risk and comorbidities. CONCLUSION: GLP-1RAs offer significant promise as adjunctive pharmacotherapy for stroke prevention in individuals with T2DM. Their multifactorial benefits extend beyond glucose regulation and may influence clinical outcomes through systemic vascular and neuroprotective mechanisms. However, inconsistencies in trial outcomes and limited data in non-diabetic or high-risk populations underscore the need for targeted stroke-specific studies. Personalised treatment approaches and broader risk stratification may optimise their use in cerebrovascular disease management. Plain Language Summary: GLP-1 receptor agonist (GLP-1RA) therapy should be incorporated into a broad approach for risk reduction for stroke in patients with type 2 DM, especially in situations where prevention of ischaemic stroke is of high importance.Long-acting GLP-1 receptor agonists (e.g., semaglutide and dulaglutide) are preferred over shorter-acting preparations for their cerebrovascular protective effects, properties of which are more consistent and beneficial for the risk of ischaemia.GLP-1RA therapy could provide a special advantage to patients with multiple risk factors for cardiometabolic diseases such as obesity, hypertension, dyslipidemia and documented atherosclerotic cardiovascular disease.On the other hand, the neuroprotective properties of GLP-1RAs, which occur through anti-inflammatory, antioxidant, endothelial-stabilising or mitochondrial-protective actions, provide rationale for the use.Treatment should be individualised for renal function, tolerance, potential for compliance, cost and accessibility. This allows for maximal long-term cerebrovascular benefits. DOI: 10.1080/07853890.2026.2660386 PMCID: PMC13094292 PMID: 41999297 [Indexed for MEDLINE] Conflict of interest statement: No potential conflict of interest was reported by the authors.

A qualitative study exploring experiences about using semaglutide for weight loss in a rural setting in Denmark - 'she is probably on the meds'.

1. Scand J Prim Health Care. 2026 Dec;44(1):2636584. doi: 10.1080/02813432.2026.2636584. Epub 2026 Mar 16. A qualitative study exploring experiences about using semaglutide for weight loss in a rural setting in Denmark - 'she is probably on the meds'. Guldhammer A(1), Drivsholm T(1), Tomova-Olsen SA(1), Tranberg Jensen K(1). Author information: (1)The Section of General Practice and the Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. INTRODUCTION: Semaglutide has gained attention for its efficacy in weight loss. However, little is known about patients' experiences. This study explores patient experiences with using Semaglutide for weight loss (SEMA-WL) in a rural Danish context. METHODS: We conducted semi-structured interviews with nine participants from a rural Danish municipality, recruited from a local clinic. The sample included six women and three men, aged 33-65, who had been prescribed SEMA-WL for at least two months. Data was analysed using systematic text condensation. FINDINGS: We identified four themes. First, we highlight different experiences of negative perceptions from the local community for using SEMA-WL, often perceived as 'cheating' or as 'an easy way out'. Furthermore, we describe how SEMA-WL is experienced to provide more energy in the participants everyday lives but also viewed as a short-term intervention rather than a permanent solution, assisted by concerns of weight regain. Finally, we show how the participants continuously outweigh the risks of using new medication fearing potential long-term side effects versus living with obesity. CONCLUSION: The study highlights the complex social dynamics and personal experiences of using SEMA-WL. While medication offers benefits, it also presents challenges such as social stigma, concerns about long-term effectiveness and side effects, and financial costs. Future research should focus on investigating the experiences of using SEMA-WL in other and more diverse settings as well as the contact and information exchange between patients and healthcare providers. DOI: 10.1080/02813432.2026.2636584 PMCID: PMC12997375 PMID: 41838446 [Indexed for MEDLINE] Conflict of interest statement: No potential conflict of interest was reported by the author(s).

Design, synthesis, and stability evaluation of semaglutide-derived lactam-stapled peptide scaffolds for GLP-1R targeting.

1. J Enzyme Inhib Med Chem. 2026 Dec;41(1):2714331. doi: 10.1080/14756366.2026.2714331. Epub 2026 Aug 11. Design, synthesis, and stability evaluation of semaglutide-derived lactam-stapled peptide scaffolds for GLP-1R targeting. Liu T(1), Ren X(1), Li Y(1), Wang J(1), Chen J(1), Lin R(1), Zhang J(1). Author information: (1)School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Xi'an, China. Glucagon-like peptide-1 receptor (GLP-1R) ligands including semaglutide play an important role in drug discovery. Herein, a short semaglutide-derived GLP-1R-engaging segment was used as the basis for scaffold construction, and conformational restabilisation was introduced through lactam stapling and bulky aromatic non-natural amino acid substitution. A total of 108 stapled peptide candidates were designed by structure-guided modelling and virtual screening. Among them, 35 peptides were synthesised and characterised. Most stapled analogues showed improved serum and proteolytic stability relative to semaglutide, and 11CP-17B, 11CP-17N, and 11CP-19N showed the most favourable stability profiles. Molecular dynamics simulations and MM-GBSA analysis were consistent with receptor-compatible poses and favourable predicted interaction patterns for these representative analogues. Collectively, these results define a practical strategy for constructing stabilised semaglutide-derived peptide scaffolds and provide a basis for subsequent functional optimisation of GLP-1R-targeting peptides. DOI: 10.1080/14756366.2026.2714331 PMID: 42578506 [Indexed for MEDLINE]

Reprogramming NAD(+) homeostasis and FOXO3a-Nrf2 signaling mitigates bleomycin-driven pulmonary fibrosis.

1. Toxicol Appl Pharmacol. 2026 Nov;516:118045. doi: 10.1016/j.taap.2026.118045. Epub 2026 Sep 19. Reprogramming NAD(+) homeostasis and FOXO3a-Nrf2 signaling mitigates bleomycin-driven pulmonary fibrosis. Mo'men M(1), Saber S(2), Amer AE(3), El-Kashef HA(4). Author information: (1)Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa 11152, Egypt. (2)Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa 11152, Egypt. Electronic address: sameh.saber@deltauniv.edu.eg. (3)Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa 11152, Egypt. Electronic address: ahmed.amer@deltauniv.edu.eg. (4)Department of Pharmacology, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa 11152, Egypt; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt. Pulmonary fibrosis arises from intertwined oxidative, inflammatory, and profibrotic processes, whereas current therapies target only parts of this network. Here, we evaluated an adjunctive strategy in which nicotinic acid (NA), a NAD+-supporting supplement/adjuvant, was added to semaglutide (SEMA), a GLP-1 receptor agonist. The prespecified objective was to determine whether adding NA to SEMA provides greater protection than SEMA alone in bleomycin (BLM)-induced pulmonary fibrosis. Rats were challenged with BLM and treated with SEMA, NA, or SEMA+NA for 21 days. Biochemical, molecular, histological, and western blot endpoints were assessed, and the fixed-dose Highest Single Agent (HSA) and Bliss independence models were used as exploratory interaction metrics. BLM induced oxidative stress, inflammatory cytokine elevation, NAD+ and SIRT1 depletion, FOXO3a suppression, TGF-β/SMAD activation, and collagen deposition. Compared with SEMA alone, SEMA+NA produced broader protection, restoring NAD+/SIRT1-FOXO3a-Nrf2 pathway-associated readouts and suppressing NF-κB/TGF-β-linked inflammatory and fibrotic markers. Exploratory HSA and Bliss analyses suggested enhanced fixed-dose effects across several endpoints but were interpreted descriptively, not as definitive pharmacological synergy. These findings indicate that NA-driven NAD+ metabolic support can amplify the protective profile of SEMA in experimental pulmonary fibrosis. Dose-response matrices, pathway-inhibition studies, temporal profiling, and lung-function testing remain required to establish definitive synergy, mechanism, and translational relevance. Copyright © 2026 Elsevier Inc. All rights reserved. DOI: 10.1016/j.taap.2026.118045 PMID: 42763059 [Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Analytical methods for the determination of semaglutide in pharmaceutical formulations and biological matrices: A comprehensive review.

1. J Chromatogr B Analyt Technol Biomed Life Sci. 2026 Nov 1;1283:125267. doi: 10.1016/j.jchromb.2026.125267. Epub 2026 Aug 26. Analytical methods for the determination of semaglutide in pharmaceutical formulations and biological matrices: A comprehensive review. Kavibharathi V(1), Thirusha KM(2), Vijayadevan G(2), Vijayakumar R(2), Nalini CN(2). Author information: (1)Department of Pharmaceutical Analysis, C.L Baid Metha College of Pharmacy, Chennai, India. Electronic address: kavib8720@gmail.com. (2)Department of Pharmaceutical Analysis, C.L Baid Metha College of Pharmacy, Chennai, India. Semaglutide is a potent long-acting glucagon-like peptide-1 receptor agonist with outstanding therapeutic efficacy for type 2 diabetes and obesity. Because of its widespread clinical use, there is an increasing demand for analytical techniques to identify semaglutide in pharmaceutical formulations and biological matrices. The current study provides an overview of analytical methodologies for determining semaglutide across various disciplines. The material may be analysed using the following techniques: chromatography, spectroscopy, electrophoresis, and mass spectrometry. Some of these approaches include reversed-phase high-performance liquid chromatography, liquid chromatography/tandem mass spectrometry, ultraviolet-visible spectrophotometry, Fourier-transform infrared spectroscopy, Raman spectroscopy and others. The reported methodological characteristics, including validation parameters are discussed. In addition, a comparison and discussion of analytical performance, approaches, advantages, and disadvantages are presented. Chromatographic techniques are presented as the most effective, sensitive, and reliable analytical methods for semaglutide determination, but alternative approaches are also described. The current study may provide a comprehensive and informative guide for further investigations into semaglutide analysis and related research. Copyright © 2026 Elsevier B.V. All rights reserved. DOI: 10.1016/j.jchromb.2026.125267 PMID: 42664897 [Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Lipid-lowering and hepatoprotective effects of Ocimum sanctum L. (Thai holy basil) flower against MASLD and liver inflammation in rats.

1. Food Res Int. 2026 Oct 31;242(Pt 3):119968. doi: 10.1016/j.foodres.2026.119968. Epub 2026 Jul 10. Lipid-lowering and hepatoprotective effects of Ocimum sanctum L. (Thai holy basil) flower against MASLD and liver inflammation in rats. Inchai J(1), Phatsara M(2), Yoonakorn R(3), Holasut P(4), Saithong T(5), Tunkaew K(6), Ontawong A(7), Yasanga T(8), Nuengchamnong N(9), Lailerd N(10), Amornlerdpison D(11), Vaddhanaphuti CS(12). Author information: (1)Innovative Research Unit of Epithelial Transport and Regulation (iETR), Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: jakkapong.inc@gmail.com. (2)Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: msethadavit@gmail.com. (3)Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: ratchadaporn_yo@cmu.ac.th. (4)Innovative Research Unit of Epithelial Transport and Regulation (iETR), Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: ompnth@gmail.com. (5)Innovative Research Unit of Epithelial Transport and Regulation (iETR), Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: icethuntakarn@gmail.com. (6)Innovative Research Unit of Epithelial Transport and Regulation (iETR), Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: kornwalai_tu@cmu.ac.th. (7)Division of Physiology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand. Electronic address: atcharaporn.on@up.ac.th. (8)Medical Science Research Equipment Center, Faculty of Medicine, Chiangmai University, Chiang Mai 50200, Thailand. Electronic address: thippawan.y@cmu.ac.th. (9)Science Laboratory Centre, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand. Electronic address: nitran@nu.ac.th. (10)Nutrition Research Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: narissara.lailerd@cmu.ac.th. (11)Center of Excellence in Agricultural Innovation for Graduate Entrepreneur, Maejo University, Chiang Mai 50290, Thailand. Electronic address: doungpornfishtech@gmail.com. (12)Innovative Research Unit of Epithelial Transport and Regulation (iETR), Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: chutima.srimaroeng@cmu.ac.th. Metabolic dysfunction-associated steatotic liver disease (MASLD) has been defined as the fatty liver disease associated with systemic metabolic dysregulation, lipid dysregulation, and inflammation. Although the U.S. FDA has approved semaglutide and resmetirom as the options for treatment of non-alcoholic steatohepatitis or metabolic dysfunction-associated steatohepatitis, warnings on hepatotoxicity and drug interactions remain. Therefore, alternative candidates exhibiting lipid-lowering activity against MASLD are still required. Aqueous extract from Ocimum sanctum L. flowers (OSLE) has recently been reported to interfere with choline metabolism in high-fat diet (HFD)-induced MASLD rats. However, the hepatoprotective mechanisms of OSLE against MASLD remain inconclusive. This study aims to clarify the mechanisms of OSLE in HFD-induced MASLD rats. Normal and MASLD rats were supplemented for 12 weeks with OSLE (1000 mg/kg BW), atorvastatin (10 mg/kg BW), or their combination. The molecular mechanisms underlying the effects of OSLE were identified using histological analyses, qPCR, and western blotting. The results demonstrated that OSLE improved lipid profiles and reduced hepatic lipid accumulation by increasing cholesterol excretion. Additionally, OSLE activated AMPK and promoted hepatic lipophagy, as evidenced by inc

From evidence to practice: Identifying candidates for semaglutide in chronic atherosclerotic disease.

1. Int J Cardiol. 2026 Oct 15;461:134646. doi: 10.1016/j.ijcard.2026.134646. Epub 2026 Jun 26. From evidence to practice: Identifying candidates for semaglutide in chronic atherosclerotic disease. Maggioni AP(1), Orso F(2), Lucci D(2), De Luca L(3), Colivicchi F(4). Author information: (1)ANMCO Research Center, HCF Fondazione ANMCO per il Tuo cuore ETS, Firenze, Italy. Electronic address: maggioni@heartcarefoundation.it. (2)ANMCO Research Center, HCF Fondazione ANMCO per il Tuo cuore ETS, Firenze, Italy. (3)Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. (4)Clinical and Rehabilitation Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, Roma, Italy. BACKGROUND AND AIM: Randomised clinical trials (SELECT and SOUL) demonstrated that semaglutide, a GLP-1 receptor agonist, reduces the combined outcome measure of atherothrombotic events or cardiovascular mortality in patients with coronary artery disease, both with and without diabetes. Because real-world populations may differ from trial cohorts, we assessed the proportion of patients potentially eligible for semaglutide using the criteria set out by the regulatory authorities based on the SELECT and SOUL results. METHODS AND RESULTS: Patients whose clinical characteristics were comparable to those of patients enrolled in the SELECT and SOUL trials were identified within the START and BRING-UP prevention registries. Among 12,430 patients, 623 were excluded because of severe renal impairment or ongoing GLP-1 receptor agonist therapy. The final population included 11,807 patients: 8682 without diabetes and 3125 with diabetes. Among non-diabetic patients, 3689 (42.5%) were SELECT-like, defined as overweight or obese individuals with established coronary disease. Among diabetic patients, 3059 (97.9%) were SOUL-like, defined as individuals aged ≥50 years with cardiovascular disease. Overall, 6748 of 12,430 patients (54.3%) theoretically fulfilled eligibility criteria for semaglutide treatment in real-world cardiology practice. CONCLUSIONS: According to the criteria set out by the regulatory authorities based on the SELECT and SOUL trial results, a large proportion of patients with coronary artery disease managed by cardiologists may be potentially eligible for semaglutide therapy. Identifying the target population for this therapeutic strategy may help clinicians and healthcare authorities estimate unmet clinical needs and evaluate the sustainability of innovative approaches for secondary cardiovascular prevention. Copyright © 2026 Elsevier B.V. All rights reserved. DOI: 10.1016/j.ijcard.2026.134646 PMID: 42361988 [Indexed for MEDLINE]