The expert panel discussed the results of the Step-HFpEF DM trial focusing on once-weekly semaglutide in patients with heart failure with preserved ejection fraction (HFpEF), obesity, and type 2 diabetes. The discussion highlighted the challenges of managing HFpEF and the importance of finding effective therapies for this population. One question raised during the discussion was about the study design and choice of endpoints. The panelist expressed concern about using weight loss as a co-primary endpoint and questioned why other endpoints, like six-minute walk distance or heart failure-related measures, were not chosen. The response emphasized that when the trial was designed, there was limited information on the expected weight loss with semaglutide in this patient group, and the selection of endpoints was based on available knowledge at that time. Another question addressed the lack of racial diversity in the study population, mainly white participants with fewer women than expected for an HFpEF study. The panel acknowledged the importance of diversity in clinical trials and highlighted efforts to improve representation in future studies of incretin-based therapies for HFpEF. In summary, the expert panel discussed the rationale behind the study design and endpoints chosen for the Step-HFpEF DM trial and the need for greater diversity in clinical trial populations to ensure broader applicability of study findings.

American College of Cardiology (ACC) Congress 2024, 6th April – 8th April 2024, Atlanta, Georgia, USA