"Novo Nordisks NOVOb.CO https topselling diabetes drug Victoza cut the risk of heart attack stroke and cardiovascular death by  percent in a closely watched study but the result disappointed investors who had hoped for more.  The logo of Danish multinational pharmaceutical company Novo Nordisk is pictured on the facade of a production plant in Chartres northcentral France April  . REUTERSGuillaume SouvantPoolFile Photo The stock fell around  percent in Copenhagen on Tuesday.  Victoza is only the second diabetes drug to show such heart benefits after Eli Lilly LLY.N https and Boehringer Ingelheims pill Jardiance. Victozas effect was evident across risks.  To me the impressive thing about this trial is the consistency across clinical endpoints and its robustness said John Buse professor of medicine at the UNC School of Medicine who worked on the study.  He believes doctors approach to type  diabetes treatment will now start to shift to a greater focus on minimising overall risks rather than simply cutting blood sugar levels.  Because about half of deaths in people with diabetes are caused by heart disease reducing heart risk is considered essential to their care.  But investors had been anticipating a bigger effect. Jefferies analyst Jeffrey Holford said market expectations had been for a midtohigh teens percent reduction in complications.  There was also concern that Victoza did not appear to lower heart risks in American patients monitored in the study despite doing so in other parts of the world and producing a solid result globally.  Novo the worlds biggest diabetes company had said in March that Victoza cut heart risks significantly in the study but the scale of the benefit was only disclosed on Monday.  Researchers told the American Diabetes Associations ADA annual meeting that . percent of patients on Victoza died from cardiovascular causes or suffered nonfatal heart attacks or strokes against . percent of those on placebo.  Deaths from heart disease were  percent lower in the Victoza group.  The Jardiance trial last year showed a similar  percent overall relative risk reduction and a  percent reduction in cardiovascular deaths.  The Victoza trial known as Leader had been designed to show Novos drug did not increase heart risk so its superiority is welcome news for the company especially as Sanofis SASY.PA https rival Lyxumia failed to show heart benefits in an earlier test.  Victoza which had sales of . billion last year is the biggest seller in a class of drugs known as GLP analogues that stimulate insulin production.  I think physicians will look to GLPs with greater enthusiasm Buse said in an interview.  Oncedaily Victoza is typically prescribed as a third or fourth option after patients have first tried various oral medicines.  The significance of this is that now we can start to change the conversation around diabetes management from one of lets manage your blood sugar to one of lets manage your risk of complications Buse said.  Mads Krogsgaard Thomsen Novos chief science officer said the results should encourage doctors to use Victoza earlier since they could now see it offered lifeexpanding treatment.  The findings which involved following  patients for a median . years were also published online in the New England Journal of Medicine.  Gastrointestinal upset was the biggest side effect with Victoza. There were fewer cases of pancreatitis which has been viewed as a potential problem but more cases of pancreatic cancer although the difference was not statistically significant.  ADVERTISING Since  U.S. regulators have demanded studies for new diabetes medicines to show there is no increase in heart risk opening a new battleground between different treatments. Lilly is conducting a similar large study to try and prove the heart benefits of its onceweekly GLP drug Trulicity.  The Leader study was funded by Novo and the U.S. National Institutes of Health.  Editing by Jason Neely and Keith Weir Our StandardsThe Thomson Reuters Trust Principles. httpthomsonreuters.comenaboutustrustprinciples.html"