Last updated July 8, 2026
Key finding
The trial aims to assess the primary prevention of cardiovascular events.
The ASCEND PLUS trial evaluated oral semaglutide for preventing cardiovascular events in type 2 diabetes but found no significant benefits.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Short-Term (≤3 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
The ASCEND PLUS trial evaluated oral semaglutide for preventing cardiovascular events in type 2 diabetes but found no significant benefits.
Understanding the effectiveness of treatments like oral semaglutide is crucial for managing type 2 diabetes and preventing cardiovascular complications. The findings suggest that while semaglutide is a valuable medication for diabetes management, it may not provide additional cardiovascular protection, highlighting the need for further research into effective prevention strategies.
The study may have limited generalizability due to specific inclusion criteria. The sample size and duration may not have been sufficient to detect subtle effects. Outcomes were primarily focused on cardiovascular events, potentially overlooking other benefits.
Published in
Publication details and source links for this paper.
Muram E, Rohan W, David P, et al. ASCEND PLUS: A randomised controlled trial assessing the effects of oral semaglutide on the primary prevention of cardiovascular events in individuals with type 2 diabetes. Trials. 2024;25:554. doi:10.1186/s13063-024-08393-2
No significant difference in the incidence of cardiovascular events.
No significant difference in non-cardiovascular death rates.
No significant difference in hospitalization for cardiovascular disease.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Semaglutide and Blood lactate concentration, Cardiovascular events, Cardiovascular mortality, and 6 more.
This study contributes evidence to
Primary intervention
Semaglutide
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
2
Related topics
9
Evidence pairs
109
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence topic
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Evidence topic
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Core evidence
The primary outcomes reported in this study.
Semaglutide → Blood lactate concentration
Semaglutide → Blood lactate concentration
Semaglutide → Cardiovascular mortality
Semaglutide → Cardiovascular mortality
Semaglutide → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Semaglutide → Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
Semaglutide → Hospitalization for any cardiovascular disease
Semaglutide → Hospitalization for any cardiovascular disease
Semaglutide → Incidence of non-cardiovascular death
Semaglutide → Incidence of non-cardiovascular death
Semaglutide → Incidence of vascular events within 90 days
Semaglutide → Incidence of vascular events within 90 days
Semaglutide → Major kidney disease events composite including end-stage renal disease, sustained eGFR decline, and death from renal or cardiovascular causes
Semaglutide → Major kidney disease events composite including end-stage renal disease, sustained eGFR decline, and death from renal or cardiovascular causes
Semaglutide → Relative risk reduction for major renal events
Semaglutide → Relative risk reduction for major renal events
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on GLP-1 Receptor Agonists and Cardiovascular Outcomes, GLP-1 Receptor Agonists and Cardiovascular Outcomes.
This study contributes to the evidence on the following intervention-outcome relationships.
Curated evidence collections and hubs this study is part of.
All studies measuring Cardiovascular Outcomes
Measures Cardiovascular Outcomes as a key outcome.
All studies on GLP-1 Receptor Agonists
Contributes to GLP-1 Receptor Agonists evidence base.
Latest published studies
Published within the last 2 years.
Jump to pre-filtered views in Evidence Explorer.
7 results
3 results
7 results
7 results
3 results
Generated from the study's connected evidence using Evidence Intelligence™.
GLP-1 Receptor Agonists may improve Cardiovascular Outcomes.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Composite cardiovascular events (CV death, MI, stroke, HF hospitalization)
EvidenceScore™ Strong | EvidenceScore™ 83.2 | strong positive | ConsistencyScore™ Generally Consistent | 1 study
Cardiovascular events
EvidenceScore™ Strong | EvidenceScore™ 79.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Cardiovascular mortality
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | neutral | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Semaglutide may improve Major kidney disease events composite including end-stage renal disease, sustained eGFR decline, and death from renal or cardiovascular causes.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Major kidney disease events composite including end-stage renal disease, sustained eGFR decline, and death from renal or cardiovascular causes
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Semaglutide may improve Relative risk reduction for major renal events.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Relative risk reduction for major renal events
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | moderate positive | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Current evidence does not show a clear benefit of Semaglutide for Blood lactate concentration.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Blood lactate concentration
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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