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Semaglutide · Phase 3 · Completed

SELECT

In SELECT, a phase 3 trial of semaglutide in patients 45 years or older with preexisting cardiovascular disease and BMI of 27 or greater, no history of diabetes (n=17,604), the primary endpoint, death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke, occurred in 6.5% on semaglutide against 8.0% on placebo, a hazard ratio of 0.80 (95% CI 0.72 to 0.90) (Lincoff AM et al. N Engl J Med 2023 (SELECT)).

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Results

The primary endpoint, death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke, occurred in 6.5% on semaglutide against 8.0% on placebo, a hazard ratio of 0.80 (95% CI 0.72 to 0.90).

Side effects reported

In SELECT, discontinuation because of adverse events was 16.6% on semaglutide 2.4 mg, against 8.2% on placebo.

EventSemaglutide 2.4 mgPlacebo
Discontinuation for adverse events16.6%8.2%

Design

Trial design and sources

Compound
Semaglutide
Phase
3
Population
Patients 45 years or older with preexisting cardiovascular disease and BMI of 27 or greater, no history of diabetes
Participants randomised
17,604
Duration
Not published
Primary endpoint
Composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke (time to first event)
Estimand
Not stated in the source read
Read out
11 November 2023

Event-driven cardiovascular outcomes trial; mean follow-up 39.8 months. The abstract states no body-weight figure.

  • Lincoff AM et al. N Engl J Med 2023 (SELECT) open · checked 23 September 2026
  • ClinicalTrials.gov NCT03574597 open · checked 23 September 2026
  • Registry: NCT03574597

Questions

SELECT, answered

What did SELECT find?

In SELECT, a phase 3 trial of semaglutide in patients 45 years or older with preexisting cardiovascular disease and BMI of 27 or greater, no history of diabetes (n=17,604), the primary endpoint, death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke, occurred in 6.5% on semaglutide against 8.0% on placebo, a hazard ratio of 0.80 (95% CI 0.72 to 0.90) (Lincoff AM et al. N Engl J Med 2023 (SELECT)).

What side effects were reported in SELECT?

In SELECT, discontinuation because of adverse events was 16.6% on semaglutide 2.4 mg, against 8.2% on placebo.