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Weekly injections of semaglutide drugs like Ozempic significantly reduce the risk of serious kidney effects, major cardiovascular events and death in people with type 2 diabetes and chronic kidney disease, a new study suggests.
Diabetes, one of the leading causes of death in the United States and worldwide, is the key to kidney disease; About 1 in 3 people with diabetes have chronic kidney disease, according to the US Centers for Disease Control and Prevention.
But a new study shows that a weekly injection of semaglutide reduces the risk of diabetic kidney disease by about 24%.
These serious effects – including severe kidney failure, kidney failure, and death from kidney or cardiovascular causes – occurred 331 times among trial participants treated with semaglutide compared to 410 events among those who received placebo. Weighted by the number of years each person was in the trial, there were 5.8 events per 100 years of follow-up among those receiving semaglutide compared with 7.5 events per 100 years among those receiving placebo.
High levels of sugar in the blood of diabetics damage the blood vessels of the kidneys, which puts pressure on the heart. The new study found more widespread benefits of semaglutide treatment among people with diabetic kidney disease.
Kidney function generally declined more slowly, the risk of major cardiovascular events such as heart failure decreased by 18%, and the risk of dying from any cause decreased by 20%. The study looked at people who were treated with semaglutide compared to those who received a placebo.
The study, published Friday in the New England Journal of Medicine and presented at the European Renal Society Congress, is based on the results of a drug trial involving nearly 3,500 people in 28 countries. About half of the participants received a weekly 1-milligram injection of semaglutide — the dose Ozympic is approved to treat type 2 diabetes in the U.S. — and the rest received a placebo.
Overall, the study participants were followed for an average of 3 ½ years. The trial was originally expected to last four or five years, but the findings at the midpoint entry were so promising that an independent monitoring committee recommended it be stopped earlier.
“In this trial, we were able to demonstrate the benefits of semaglutide in people with diabetes and kidney disease,” said Dr. Vlado Perkovic, a nephrologist and provost at the University of New South Wales, Sydney. He was the chairman of the steering committee of the court and the chief editor of the new study.
“The effect size was a little bit higher than we expected, and so the results were statistically significant. So the chance of this happening is extremely small, and I think we can be very confident that the results are robust and real.”
Three other drug treatments have been shown to provide benefits for people with diabetes, and the researchers said in the new study that “clinicians and patients should consider the order and priority of semaglutide use.”
A combination of treatments may be necessary, and many of the trial participants were receiving other treatments for their diabetes.
“Semaglutide has shown some advantages over what is currently considered therapeutic,” said Martin Holst Lange, Novo Nordisk's executive vice president of development. The Danish company is the only drugmaker whose semaglutide products are approved for use in the U.S. — Ozempic for the treatment of diabetes and Wegovi for the treatment of obesity — and funded the new study.
Similar benefits were found at all stages of renal dysfunction but were particularly pronounced in those at high risk. More than two-thirds of trial participants are considered to be at very high risk of serious outcomes, including kidney failure, cardiovascular events, or death, according to risk calculators outlined in International Clinical Practice. Instructions.
In part, focusing on this high-risk group provides a clearer understanding of treatment benefits. But, experts say, many people don't realize they have kidney disease until it's too late — and many don't realize how dangerous it is. Each year in this trial, 8% of participants had a major kidney event, and about 5% died.
“Diabetes-induced kidney disease, or diabetic kidney disease, is one of the most common and fatal complications of diabetes. However, unfortunately, the surrounding awareness is very low,” said Dr. Kathryn Tuttle, chair of the American Society of Nephrology's Diabetic Kidney Disease Collaborative. She is also an executive director of research at Providence Inland Northwest Health, an investigator at the Translational Health Sciences Institute, and a professor of medicine at the University of Washington.
“Part of the problem is that doctors and patients have to be intentional about identifying kidney disease because the disease doesn't cause any symptoms until it's late.”
People with diabetes are recommended to have a blood or urine test for kidney disease every six months. But this doesn't always happen, and some people wait until they notice symptoms like fatigue, bloating, or changes in urinary frequency.
The treatment of diabetes is in high demand because it is such a common disease, says Tuttle, who is part of the new study. But semaglutide is very promising because it seems to have benefits that can be applied to a number of problems that can be caused by it. In addition to reducing blood sugar, semaglutide products help in weight loss. Heart problem And it can be inhibited. Addictive properties.
“I think these drugs that affect multiple final common pathways are very effective because when we try to treat just one risk factor, it's like sticking your finger in the dick. You can't plug all the holes. “For me, what semaglutide really does is address a broader risk factor,” she said. “It reduces weight, it lowers glucose, it lowers blood pressure a little bit, and we think it has a direct effect on the kidneys. It's really the whole package.”
There are significant differences in the prevalence of diabetes and kidney disease in the US. Black, Hispanic, and American Indian adults are nearly twice as likely as white adults to develop diabetes, the CDC says. Data. And black adults in America are three times more likely to develop kidney failure than white adults.
However, the majority of participants in the semaglutide trial were white, and the findings could not be compared between important subgroups.
“When we have something that works, we have to keep our eyes open for treatment for patients,” Tuttle said. But most of the high-risk people who could benefit the most from treatment don't get it.
“We now have a very effective treatment that reduces the things that are most important to patients, families and communities—preserving kidney function, preserving life, and reducing the rate of cardiovascular events. But that's only good if people get the treatment,” she said. “So now, really. , the challenge for all of us is to move faster from evidence generation to implementation.”