Wegovy®▼(semaglutide injection) 2.4 mg recommended by NICE to reduce risk of major adverse cardiovascular events, including heart attacks and strokes, in adults with established cardiovascular disease and overweight or obesity (BMI ≥27 kg/m2)[1]

• The National Institute for Health and Care Excellence (NICE) recommended Wegovy^® ▼(semaglutide injection) 2.4 mg as an option alongside reduced-calorie diet and increased physical activity to reduce risk of major adverse cardiovascular vents (MACE) (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight (BMI ≥27 kg/m²).¹
• This is the first and only GLP-1 receptor agonist (RA) NICE has recommended specifically for reducing the risk of MACE including heart attacks and strokes in adults with established cardiovascular disease and overweight or obesity.
• The decision is based on results from the SELECT cardiovascular outcomes trial,² where semaglutide 2.4 mg on top of standard of care reduced the risk for first occurrence of MACE by 20% compared to placebo (hazard ratio, 0.80; 95% confidence interval, 0.72 to 0.90; p<0.001).² Over the trial period, MACE occurred in 6.5% of participants receiving semaglutide compared with 8.0% receiving placebo, representing an absolute risk reduction of 1.5 percentage points.² Further analysis found this cardiovascular risk reduction was independent of weight loss.³
• In its recommendation NICE stated that in this population "there is enough evidence to show that semaglutide provides benefits and value for money and can be used routinely" in existing NHS cardiovascular pathways in England.¹ 
• NICE made this recommendation in Final Draft Guidance (FDG) and Technology Appraisal Guidance (TAG) is expected by the end of April 2026.

GATWICK, England, April 1, 2026 /PRNewswire/ -- NICE has recommended Wegovy^® (semaglutide injection) 2.4 mg as the first GLP-1 RA to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight (BMI ≥27 kg/m²).¹ 

This comes after the SELECT trial demonstrated that semaglutide 2.4 mg on top of standard of care reduced the risk for first occurrence of MACE by 20% compared to placebo² (hazard ratio, 0.80; 95% CI, 0.72 to 0.90; p<0.001) and independent of weight loss.³ Over the trial period, MACE occurred in 6.5% of participants receiving semaglutide compared with 8.0% receiving placebo, representing an absolute risk reduction of 1.5 percentage points.²

Overall, the safety profile of semaglutide injection 2.4mg in SELECT was consistent with previous trial experience in STEP 1.^2,4 Serious adverse events were lower with those receiving semaglutide compared with placebo (33.4% vs 36.4%; p<0.001).² Adverse events leading to treatment discontinuation were more common with semaglutide injection 2.4mg vs placebo (16.6% vs 8.2%; p<0.001), and were primarily due to gastrointestinal symptoms.² 

Wegovy^® will be introduced within existing cardiovascular care pathways, enabling clinicians to consider semaglutide as another treatment option alongside standard care for the secondary prevention of cardiovascular events in people with overweight or obesity (BMI ≥27 kg/m²). In NICE's assessment it said that in this patient population, "semaglutide provides benefits and value for money, so it can be used routinely across the NHS".¹

Sebnem Avsar Tuna, General Manager Novo Nordisk UK said: 
"Today's NICE recommendation for Wegovy is an important step forward for people living with established cardiovascular disease and overweight or obesity. It means clinicians in England now have access to a further treatment that NICE has found to be cost effective, the first and only GLP–1 receptor agonist proven to reduce the risk of heart attack, stroke or cardiovascular death in this high–risk population."

Professor Derek Connolly, Consultant Preventative Cardiologist and Vice Chancellor Professorial Fellow in healthcare research at Aston University, Consultant Cardiologist in Birmingham and Council member of the Primary Care Cardiovascular Society said: 
"Cardiovascular disease remains one of the leading causes of death in the UK, and people who have already experienced a cardiovascular event continue to face a significant risk of further heart attacks and strokes. The SELECT trial showed that adding semaglutide to current optimal medical therapy reduces major cardiovascular events and was also associated with a reduction in total mortality, independent of weight loss. For clinicians, having another therapy supported by robust outcomes evidence gives us an important additional option to help reduce mortality and the burden of heart attacks and strokes."

Over eight million people in the UK are living with heart and circulatory conditions,⁵ and these diseases are responsible for around a quarter of all deaths each year, equivalent to around 170,000 deaths annually.⁵ While survival after heart attacks and strokes has improved, an ageing population means that the overall number of people living with cardiovascular disease is forecasted to continue to grow.⁵

Novo Nordisk is exploring ways to best support the NHS to implement NICE's recommendations, with input from NHS clinical experts and organisations.

About the SELECT trial²
SELECT was a randomised, double-blind, parallel-group, placebo-controlled trial designed to evaluate the efficacy of semaglutide 2.4 mg versus placebo as an adjunct to standard of care for reducing the risk of MACE in people with established cardiovascular disease with overweight or obesity with no prior history of diabetes at baseline. People included in the trial were aged ≥45 years with a BMI ≥27 kg/m².² 

The primary objective of the SELECT trial was to demonstrate the superiority of semaglutide 2.4 mg compared to placebo with respect to reducing the incidence of three-point MACE consisting of cardiovascular death, non-fatal heart attack (myocardial infarction) or non-fatal stroke.² The trial, initiated in 2018, enrolled 17,604 adults and was conducted in 41 countries at more than 800 clinical sites.

Overall, the safety profile of semaglutide injection 2.4mg in SELECT was consistent with previous trial experience in STEP 1.^2,4 Serious adverse events were lower with those receiving semaglutide compared with placebo.² Adverse events leading to treatment discontinuation were more common with semaglutide injection 2.4mg vs placebo (16.6% vs 8.2% of participants respectively), and were primarily due to gastrointestinal symptoms.² 

Notes to Editors

Wegovy^® (semaglutide injection) indications in adults
Cardiovascular Risk Reduction
Wegovy is indicated as an adjunct to a reduced-calorie diet and increased physical activity to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight (BMI ≥27 kg/m²).⁶

Weight Management in Adults
Wegovy is indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance, in adults with an initial Body Mass Index (BMI) of
•  ≥30 kg/m² (obesity), or
•  ≥27 kg/m² to <30 kg/m² (overweight) in the presence of at least one weight-related comorbidity.⁶

About Novo Nordisk
Novo Nordisk is a leading global healthcare company, founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat serious chronic diseases, built upon our heritage in diabetes. We do so by pioneering scientific breakthroughs, expanding access to our medicines, and working to prevent and ultimately cure disease. Novo Nordisk employs about 68,800 people in 80 countries and markets its products in around 170 countries. For more information visit: www.novonordisk.co.uk

References

1. National Institute for Health and Care Excellence. Final draft guidance: Semaglutide for reducing the risk of major adverse cardiovascular events in people with cardiovascular disease and overweight or obesity.
2. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389:2221-32. doi: 10.1056/NEJMoa2307563
3. Deanfield J, Lincoff AM, Kahn SE et al. Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial, The Lancet, 2025; 406, 2257-2268.
4. Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. doi:10.1056/NEJMoa2032183. [diabetesjournals.org]
5. British Heart Foundation. Global Cardiovascular Disease Factsheet. January 2026. Available at: https://www.bhf.org.uk/-/media/files/for-professionals/research/heart-statistics/bhf-cvd-statistics-global-factsheet-jan26.pdf?rev=db96d3d8fa944b3ea427c2dddb1e9075&hash=54CF3CCE6AD161C1E06B136449C9B10B (Accessed March 2026).
6. Wegovy SmPC. Last Updated January 2026.

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