Award winning Dr Fozia Ahmed is a Consultant Cardiologist at Manchester University NHS Foundation Trust (MFT). She is also the national lead and co-chair of the Global Expert Panel for STEP HFpEF – a pivotal global heart failure research study.
In her blog Fozia reveals how the exciting outcomes of the STEP HFpEF study could transform the landscape of heart failure treatment. She also discusses what this means for the next steps in heart failure research, and the importance of equality, diversity and inclusivity, sharing her first-hand experiences of this.
STEP-HFpEF study
The breakthrough STEP-HFpEF study is the first research of its kind, which has found that a diabetes and weight-loss drug can significantly reduce heart failure symptoms, with the potential to transform treatment globally for millions of people with the condition.
This medication is already standard care in diabetes treatment and improves symptoms, reduces physical limitations in people with obesity related heart failure, and significantly reduces body weight. The findings of this research will potentially expand the use of this drug, offering new treatment options for a type of heart failure where there are presently very few effective treatments available.
Almost one million people in the UK have heart failure, a condition where the heart is unable to pump blood around the body properly – which usually develops because the heart has become too weak or stiff.
For the majority of patients, heart failure is an incurable condition characterised by debilitating symptoms, including breathing difficulties, fatigue, weakness and reduced life expectancy. For this reason, there is an urgent need to research new treatments that improve symptoms and extend life expectancy.
The “Research study to investigate how well Semaglutide works in people living with heart failure and obesity (STEP-HFpEF)” recently found that Semaglutide – also known under the brand names Wegovy – was three times more effective than existing treatments for combating the symptoms of heart failure.
MFT, was one of 10 sites selected in the UK to carry out this study and one of only two North West locations to carry out the research, which looked at changes in body weight and heart failure symptoms over 12 months.
The trial included 529 patients from more than 13 countries with a body mass index (BMI) of more than 30, as well as heart failure symptoms and physical limitations. Half were randomised to receive a once-weekly 2.4mg jab of Semaglutide for a year while the others were given a placebo drug.
Patients with heart failure and obesity on Semaglutide lost on average 13 per cent of their body weight over a 12-month period compared with 2.6 per cent, in the placebo group. Also, those on treatment were able to walk approximately 21.5 metres further in six minutes, compared to 1.2m in the placebo group.
For some people, living with heart failure can make everyday activities difficult or even impossible. Semaglutide helped people with heart failure have less shortness of breath and better exercise function. The kind of improvements seen in this study, such as being able to walk further, better quality of life and losing large amounts of body weight, could have a significant effect on someone’s quality of life.
I am tremendously honoured to have been entrusted with a leadership role in a research project that has national and global significance especially given that this study is likely to change the way we treat patients with heart failure and obesity, in clinical practice.
My hope for the future is that we begin to see obesity as a target for treatment in people with heart failure.
Equality, Diversity and Inclusivity in research
It is well-established that the commonest type of heart failure disproportionately affects women more than men. Despite this, women have historically been under- represented in heart failure studies. STEP-HFpEF was different; 56 per cent of the participants in this trial were female – the highest proportion of females recruited in major heart failure studies of this kind, to date.
This is an important step in the right direction, but we still have a long way to go. Our studies should also represent the communities who are affected by heart failure. This is why I am really pleased that the “Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With Heart Failure and Inflammation (HERMES)”, another heart failure study, that I am leading nationally, has a dedicated diversity, equity and inclusion panel. The panel is committed to ensuring that we make research of new treatments inclusive and accessible to all patients; including across all ethnic groups and under-represented communities.
To address bias in research, we must focus on diversity and inclusion at all levels; from the patients we recruit to the people who write the grants. Representation is essential, but inclusion is where change really happens.
I am proud to have co-authored papers on this important study in two prestigious journals, The New England Journal of Medicine (NEJM) and Nature, in the same week and I hope that I can encourage and inspire other women from Black, Asian and Minority Ethnic backgrounds to pursue a career in research and reach the highest tiers of leadership, which is frequently elusive, despite equivalent qualifications.