Fact-check: Cleveland Clinic's one-minute SELECT result

What the video covers

A Cleveland Clinic cardiologist who worked on SELECT summarises it for a general audience: semaglutide is an effective diabetes drug that also reduces weight; the trial asked whether it would reduce cardiovascular events in people with overweight or obesity but no diabetes who had already had a heart attack, stroke or peripheral vascular disease; it reduced events by about 20 percent; and it is the first lifestyle or drug intervention shown to do that in this population.

What it gets right

The design and the headline are correct (PubMed 37952131). The population was secondary prevention without diabetes. The hazard ratiohazard ratioHow the rate of an event in one group compares with another over time; 0.80 means about 20% fewer events. for the primary composite was 0.80, which is the "about 20 percent" in the clip. The claim of a first is defensible: earlier weight-loss drugs either had no outcomes trial or, in the case of sibutramine, increased events, and lifestyle trials such as Look AHEAD did not reduce cardiovascular events.

What it leaves out or overstates

Relative risk is the only number given. The absolute figures are 6.5 percent against 8.0 percent over a mean of 39.8 months, a 1.5-point difference; the video gives no sense of scale, and 20 percent sounds larger than 1.5 points. The clip also omits that 16.6 percent of the semaglutide group stopped the drug for adverse events against 8.2 percent on placebo, which matters for anyone considering the trade-off.

The auto-generated caption reads "over 177,000 patients". The speaker is almost certainly saying "over 17,000"; the trial enrolled 17,604. We flag it because the caption is what many viewers read.

Finally, the closing line, that this "may be an important new therapy to be added to their regimen", is now a label indication: since March 2024 Wegovy is indicated to reduce major adverse cardiovascular eventsMACEA combined trial endpoint of heart attack, stroke and cardiovascular death. in adults with established cardiovascular disease and obesity or overweight. The clip predates that.

Where to go next

Watch the NEJM abstract for the numbers, then the longer Cleveland Clinic Q and A in this playlist for context. FormBlends Research has the digest with confidence intervalsconfidence intervalThe range within which the true effect probably lies; a wide interval means an imprecise estimate.. For how the finding compares with diabetes populations, see the SUSTAIN-6 entry there and the mechanism pages on FormBlends Science. CompoundedcompoundedMade by a pharmacy from raw ingredients for a prescription rather than by the brand manufacturer; not FDA approved and not interchangeable with the brand product. semaglutide, including the product at formblends.com/products/semaglutide, is not FDA approved and has no cardiovascular indication.