Oral semaglutide improves heart failure symptoms and weight in real-world HFpEF patients with T2DM and obesity | Research

The takeaway

Prospective real-world study of oral semaglutide in HFpEF patients with T2DM and obesity demonstrates improved health status and significant weight loss, providing the first real-world oral semaglutide HFpEF data.

Oral GLP-1 works for HFpEF
First real-world data showing oral semaglutide improves health status in HFpEF patients with diabetes and obesity—no injection needed

What the researchers found

Oral semaglutide in HFpEF + T2DM + obesity: improved health status (symptoms, function). Significant weight loss. First real-world oral semaglutide HFpEF data. Triple-pathology population.

Why it matters

Oral semaglutide offering HFpEF benefit eliminates the injection barrier for heart failure patients, potentially improving access and adherence for this common condition.

How the study worked

Prospective real-world study of oral semaglutide in HFpEF patients with T2DM and obesity.

What this study cannot tell us

Real-world observational. No control group. Small sample likely. Short follow-up. Oral semaglutide doses are lower than injectable.

How to read the evidence

Prospective real-world study. Good for feasibility but lacks control group.

When this study was published

Published in 2025.

The bigger picture

This confirms oral GLP-1 therapy can provide HFpEF benefit in everyday practice, complementing the injectable STEP-HFpEF trial data.

Questions still open

Is oral semaglutide as effective as injectable for HFpEF?
What is the minimum oral dose needed for HFpEF benefit?
Would tirzepatide pills provide even greater HFpEF benefit?

Common questions

Can oral semaglutide help heart failure?

This first real-world study suggests yes. Patients with heart failure (HFpEF), diabetes, and obesity showed improved symptoms and significant weight loss on oral semaglutide tablets—no injections needed. This complements clinical trial data showing injectable semaglutide benefits HFpEF.

Is the pill as effective as the injection for heart failure?

This study suggests oral semaglutide provides meaningful HFpEF benefit in real practice. While direct comparison with injectable forms is limited, the results support oral semaglutide as a viable option for heart failure patients who prefer or need oral therapy.

Read the original research

Efficacy and safety of once-daily oral semaglutide in patients with heart failure with preserved ejection fraction, type 2 diabetes and obesity: a real-world study.

European journal of internal medicine, 139, 106378

View on PubMed ↗Publisher’s paper ↗

Citation

Trenas, Alicia; Pérez-Velasco, Miguel A; Bernal-López, Maria-Rosa; López-Carmona, María-Dolores; Gómez-Doblas, Juan J; Martínez-Esteban, María-Dolores; Bouarich, Oumayma; García-Casares, Natalia; Fernández-García, Diego; de Lucas, María-Dolores García; Gómez-Huelgas, Ricardo; Pérez-Belmonte, Luis M. (2025). Efficacy and safety of once-daily oral semaglutide in patients with heart failure with preserved ejection fraction, type 2 diabetes and obesity: a real-world study.. European journal of internal medicine, 139, 106378. https://doi.org/10.1016/j.ejim.2025.06.007