Glucagon-Like Peptide-1 (GLP-1) receptor agonists

Semaglutide (Wegovy®)(up to a maintenance dose of 2.4 mg once weekly) can be used, within its marketing authorisation, alongside a reduced-calorie diet and increased physical activity, as an option for reducing the risk of a major adverse cardiovascular event (that is, cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) in adults with both:

Established cardiovascular disease (CVD), defined as at least 1 of the following:

• Previous myocardial infarction
• Previous ischaemic or haemorrhagic stroke
• Symptomatic peripheral arterial disease (they have intermittent claudication with an ankle-brachial index of less than 0.85 at rest, or have had a peripheral arterial revascularisation procedure or an amputation because of atherosclerotic disease)

AND a body mass index (BMI) of at least 27 kg/m2.

Please note: Semaglutide (Wegovy®) for the indication of managing overweight and obesity continues to be restricted for prescribing only from specialist weight management services, and should not be prescribed in primary care for this indication. See the Kent and Medway Position Statement for more information.

Key prescribing points:

• Prescribe semaglutide by brand.
• Clearly document the treatment indication within the patient record and, where possible, on the prescription, particularly where multiple indications coexist.
• For cardiovascular risk reduction under NICE TA1152, prescribe Wegovy® in accordance with the product licence and NICE guidance.
• Patients established on Ozempic® for glycaemic management do not routinely require switching to Wegovy® solely on the basis of TA1152.
• Ensure appropriate lifestyle advice and/or signposting is provided at treatment initiation.