Post hoc analyses presented at ADA 2026 show semaglutide may reduce risk of obstructive sleep apnea, improve asthma outcomes, lower blood pressure, and deliver favorable liver and cardiometabolic effects. Findings highlight potential benefits beyond weight loss but remain exploratory and not yet approved for these indications.
Written By: Kirti Kumbhar, M. Pharm (QA)
Reviewed By: Pharmacally Editorial Team
Novo Nordisk presented new post hoc analyses at the American Diabetes Association (ADA) 2026 Scientific Sessions highlighting semaglutide’s potential impact across multiple obesity-related complications. Findings from the SELECT, STEP, ESSENCE, and OASIS clinical trial programs suggest semaglutide may deliver benefits beyond weight reduction, including reduced risk of obstructive sleep apnea (OSA), improved asthma outcomes, lower blood pressure, and favorable liver and cardiometabolic measures.
Obstructive Sleep Apnea Risk Reduction
A SELECT cardiovascular outcomes analysis (NCT03574597) evaluated semaglutide 2.4 mg in adults with overweight or obesity and established cardiovascular disease. At baseline, 2,550 participants (14.5%) reported OSA. Among those without OSA, semaglutide was associated with a 52% lower risk of incident OSA versus placebo (HR 0.48; 95% CI, 0.31–0.74). Of 95 new OSA cases, 30 occurred in the semaglutide arm compared with 65 in placebo. Semaglutide also reduced major adverse cardiovascular events (MACE) regardless of baseline OSA status.
Asthma Outcomes in SELECT
A subgroup analysis of 1,190 participants with self-reported asthma showed semaglutide treatment was linked to fewer asthma-related adverse events and serious adverse events (27 vs 46; HR 0.58; 95% CI, 0.36–0.93).
Investigators reported a 38.9% reduction in high-sensitivity C-reactive protein (hsCRP) through week 104, suggesting a favorable effect on systemic inflammation. Blood eosinophil and neutrophil counts remained stable.
Blood Pressure Improvements Across STEP and OASIS
Pooled post hoc analyses from the STEP 1 (NCT03548935), STEP 3 (NCT03611582), STEP 5–9, and OASIS 4 (NCT05564117) clinical trials involving 597 adults with overweight or obesity and uncontrolled hypertension demonstrated that semaglutide led to significant blood pressure reductions. Compared with placebo, semaglutide lowered systolic blood pressure by -5.48 mmHg (95% CI, -7.78 to -3.19; p<0.0001) and diastolic by -2.73 mmHg (95% CI, -4.19 to -1.27; p=0.0003). These findings reinforce semaglutide’s potential to improve cardiovascular risk factors beyond weight loss.
Liver and Cardiometabolic Benefits in MASH
Part 1 of the ongoing Phase 3 ESSENCE trial (NCT04822181) in adults with metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis showed consistent improvements in HbA1c, body weight, waist-to-height ratio, blood pressure, triglycerides, non-HDL cholesterol, and hsCRP. Liver-related parameters including ALT, controlled attenuation parameter, Enhanced Liver Fibrosis score, FibroScan-AST score, and stiffness also improved through week 72. Benefits were observed regardless of baseline glycemic status. Supporting data from STEP 1 showed reductions in fatty liver index scores with semaglutide 2.4 mg.
Implications for Practice Regulatory Direction
Experts emphasized that the ADA 2026 analyses expand understanding of semaglutide’s potential across obesity-related complications.
Andrea Traina, Pharm.D., Senior Medical Director for Obesity and Liver Health at Novo Nordisk, noted that the findings build upon a growing body of evidence supporting semaglutide’s role in obesity, cardiovascular disease, and MASH.
Domenica Rubino, MD, Director of the Washington Center for Weight Management & Research, underscored that obesity is a chronic disease affecting multiple organ systems, and these results highlight semaglutide’s potential to improve outcomes beyond weight reduction alone.
At the same time, investigators cautioned that the analyses were exploratory post hoc evaluations and should be considered hypothesis-generating. Semaglutide is currently approved for chronic weight management and cardiovascular risk reduction in specific populations, but not for obstructive sleep apnea, asthma, hypertension, or MASLD/MASH-related indications.
The safety and efficacy of semaglutide for these conditions remain unestablished, and confirmatory studies will be required to determine future regulatory pathways.
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About the Writer
Kirti Kumbhar (LinkedIn) is an M.Pharm graduate with experience in Quality Assurance at Lupin Limited and a strong interest in clinical research, regulatory affairs, and Trial Master File (TMF) management. She has developed knowledge of regulatory documentation, quality systems, compliance, and healthcare research through her professional experience. Passionate about clinical development and continuous learning, Kirti is committed to supporting high-quality healthcare documentation, regulatory excellence, and research-driven healthcare advancements.