Evidence synthesis · §4
Incretin receptor agonists in heart failure with preserved ejection fraction and obesity — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
§4Summary of findings
§4.1Summary of findings
Table 7. Summary of findings for Incretin receptor agonists in heart failure with preserved ejection fraction and obesity.
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Change in Kansas City Cardiomyopathy Questionnaire clinical summary scoreThe outcome the Institute designates as anchor for this indication. | 1,876 (3) | Moderate certainty evidence indicates an improvement in symptom scores and in six-minute walk distance, and one trial reports a reduction in a… | Moderate | publication bias |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 1,397 (1) | Reported per contributing trial; see the included-studies table | Moderate | imprecision |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 1,509 (2) | Reported per contributing trial; see the included-studies table | Low | publication bias |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 1,787 (1) | Reported per contributing trial; see the included-studies table | Low | risk of bias |
| Change in six-minute walk distanceA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 945 (2) | Reported as a secondary outcome in a subset of contributing trials | Low | inconsistency, imprecision |
| Composite of cardiovascular death and worsening heart-failure eventsA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 1,647 (2) | Reported as a secondary outcome in a subset of contributing trials | Low | imprecision, publication bias |
| Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes. | ||||
§4.2Forest plot
Study estimatePooled estimate
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | No concern | No serious concern identified in this domain. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | No concern | No serious concern identified in this domain. |
| Imprecision | No concern | No serious concern identified in this domain. |
| Publication bias | Serious | The evidence base is small, recent and wholly sponsor-generated. |
| Overall: Moderate certainty. The true effect is likely to be close to the estimate, but there is a possibility that it is substantially different. Further research is likely to have an important impact on confidence in the estimate. | ||
References cited on this page
References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.
- Kosiborod MN, Abildstrøm SZ, Borlaug BA, Butler J, Rasmussen S, Davies M, Hovingh GK, Kitzman DW, Lindegaard ML, Møller DV, Shah SJ, Treppendahl MB, Verma S, Abhayaratna W, Ahmed FZ, Chopra V, Ezekowitz J, Fu M, Ito H, Petrie MC. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. New England Journal of Medicine 2023;389(12):1069–1084. doi:10.1056/NEJMoa2306963 · PMID 37622681
Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.
Compound Evidence Institute · CEI-ES-009/4 · https://compoundevidence.com/syntheses/hfpef-incretins/summary-of-findings/ · retrieved 30 July 2026