Description
The SOUL trial randomised 9,650 high‑risk adults with type 2 diabetes and ASCVD and/or CKD to oral semaglutide or placebo and showed a significant 14% relative reduction in three‑point MACE (12.0% vs 13.8%; HR 0.86) over a median 49.5 months.1 Secondary analyses highlighted a 26% reduction in nonfatal myocardial infarction and a 22% reduction in a heart‑failure composite among participants with pre‑existing HF, driven by benefit in HFpEF rather than HFrEF.2 The oral formulation expands access for needle‑averse patients and those facing cold‑chain barriers, while safety was reassuring, with no increase in serious adverse events. SOUL’s long follow‑up and CKM‑relevant enrolment criteria make its findings directly applicable to integrated cardiorenal‑metabolic care, supporting GLP‑1 therapy as a cardiovascular protective option in high‑risk type 2 diabetes.