STRIDE: Functional improvements with semaglutide in PAD plus T2D, irrespective of sex

In the STRIDE trial, the benefits of semaglutide were observed in patients with peripheral artery disease (PAD) and type 2 diabetes regardless of sex. While females had different baseline profiles from males, the data suggested that females may have higher Ankle Brachial index (ABI)/ toe (T)BI values despite similar PAD severity and functional limitations at baseline. 

The STRIDE trial (NCT04560998) showed that once-weekly administration of semaglutide for 1 year improved functional outcomes and quality-of-life in patients with PAD and type 2 diabetes [1]. The current analysis evaluated the outcomes stratified by sex. Prof. Subodh Verma (University of Toronto, Canada) presented the late-breaking results [2].

Prof. Verma reported that females (n=195) had different baseline profiles compared with males (n=597). Females were younger, had a lower prevalence of current or previous smoking, and had less coronary artery disease or heart failure than males. Although functional parameters, quality-of-life outcomes, and PAD severity measures were comparable between sexes, females had slightly higher geometric mean ABI (0.79 vs 0.74) and TBI (0.51 vs 0.47) than males, suggesting that disease burden in females may be underestimated by haemodynamic measures alone.

The primary endpoint, pain-free walking distance at week 52,  increased for both females and males on semaglutide compared with placebo (estimated treatment ratio 1.18 vs 1.14; P-interaction=0.25), with no interaction effect of sex on the relationship between treatment and pain-free walking distance. Secondary efficacy measures likewise showed no interaction effect of sex on the treatment outcomes.

“These findings support the use of semaglutide as a novel therapy to improve function and outcomes in PAD with type 2 diabetes, regardless of sex,” concluded Prof. Verma.

1. Bonaca MP, et al. Lancet. 2025;405(10489):1580-1593
2. Verma S, et al. STRIDE outcomes by sex: semaglutide in PAD and type 2 diabetes. Late-breaking clinical science: cardiometabolic medicine, ESC Congress 2025, 29 August – 1 September, Madrid, Spain.

Medical writing support was provided by Robert van den Heuvel.

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Posted on 3 September 20257 November 2025