STRIDE study: GLP1s vs peripheral artery disease (PAD)
Walk farther with GLP1s -- results from the STRIDE study show Semaglutide effective for treating Peripheral Artery Disease (PAD)
The benefits of GLP Receptor Agonists are well known these days – they're incredibly popular for weight loss, and some are taking them for things you might not expect, like Sleep apnea.
Check out our quick explainer
The difference between GLP1s and almost all other weight-loss "cures" or methodologies that came before it is the amount of clinical research data that is behind GLP1s. We're excited to see more published data, and the STRIDE study is another data point on the benefits of GLP1s.
The paper itself is available for direct reading via The Lancet:
What is Peripheral Artery Disease (PAD)?
Peripheral Artery Disease is a very common ailment:
Contributors to Wikimedia projects
PAD is the narrowing of arteries that are not in the heart or brain. We're familiar with the disastrous effects of arteries narrowing in the heart or brain (heart attacks, strokes), so PAD is a serious health condition.
Novo Nordisk reports that over 230 million people globally suffer from PAD:
Approximately 230 million people globally have PAD, a severe form of atherosclerotic cardiovascular disease3, and nearly one in three people with PAD have type 2 diabetes4.
Movement is one of the recommended treatments for PAD. It is common to see commercials for small machines that move the feet on TV channels aimed at elderly people – while it's not clear that those work or are as effective as an actual walk, it's encouraging that GLP1 can be applied to this problem now and deliver research-backed relief.
In the United States specifically, approximately 12 million people are impacted by PAD.
What was the STRIDE study?
The STRIDE study was:
- Double-blind
- Randomized
- Placebo-controlled
- 112 trial sites in 20 countries
- 52 weeks
- Participants 18 years or older (wide range)
- 792 participants (396 semaglutide, 396 placebo)
The STRIDE study measured was walking distance over the course of the year, on a constant load treadmill.
This is a quite outcome-focused study – rather than reducing a specific biomarker or internal measurement, the ability of patients to walk was measured directly, taking a holistic view of the treatment and lifestyle across patients.
The clinical trial data is also available online:
What were the results?
While not a forgone conclusion, the results were positive (championed by Novo Nordisk):
Ozempic® improved maximum walking distance by 13% vs placebo in adults with type 2 diabetes and peripheral artery disease (PAD) in the phase 3 STRIDE trial1.
The double-blind, randomised, placebo-controlled STRIDE trial achieved its primary endpoint, with semaglutide 1.0 mg demonstrating a superior and clinically meaningful improvement of 13% in maximum walking distance and a mean treatment difference of 39.9 meters on a steep incline, compared to placebo at week 52.
The trial also demonstrated superiority to placebo for all confirmatory secondary outcomes assessed, including pain-free walking distance at week 52, health-related quality of life (Vascular Quality of Life Questionnaire-6) at week 52, and maximum walking distance at week 571.
What this means practically is that people who took once-weekly semaglutide at 1.0mg (without going up in dosage) were able to achieve a better quality of life after a year.
This is great news, and more importantly it's great to have better research outcomes and data to support the use of GLP1s in medical settings to help those who may not have had compelling options before.
Were there any side effects?
Side effects stayed consistent with known side-effects of Semaglutide, which means there weren't many "new" issues.
Serious adverse events (SAEs) were reported in 74 (19%) participants in the semaglutide arm and 78 (20%) participants in the placebo arm, and SAEs that were possibly/probably treatment-related occurred in 5 (1%) and 6 (2%) participants, respectively.
The most frequent SAE across both groups was serious gastrointestinal events (2 [1%] vs 3 [1%]). SAEs leading to permanent treatment discontinuation of semaglutide or placebo were reported in 11 (2.8%) and 13 (3.3%) participants in the semaglutide and placebo groups, respectively.
SAEs led to the death of 3 (1%) and 8 (2%) participants in the semaglutide and placebo arms, respectively; however, no SAEs leading to death were treatment-related.1,4
While taking Semaglutide or other GLP1s is not risk free it is relatively low risk to many of the other treatments that came before, and almost certainly lower risk than doing nothing, when serious medical issues like type 2 diabetes or obesity are in play.
That said, negative side effects (SAEs as above) did cause some participants to have to discontinue their use of semaglutide – this is important to note, and why it is always a good idea to speak with a medical professional and monitor use of GLP1s closely.
