Summary:
In adults with type 2 diabetes and chronic kidney disease, stratified by baseline use of SGLT2 inhibitors, weekly administration of semaglutide significantly reduced the risk of kidney failure, decline in kidney function, kidney death, or cardiovascular death compared to placebo. The benefits were evident in participants not on SGLT2 inhibitors but not in those using them. Secondary outcomes, such as improvements in kidney function and cardiovascular health, were favorable for semaglutide, though varied across subgroups.
| PICO | Description |
|---|---|
| Population (P) | Adults with type 2 diabetes and chronic kidney disease (N=3,533), stratified by baseline use of sodium-glucose cotransporter-2 inhibitors (SGLT2i; n=550 on SGLT2i, n=2,983 not on SGLT2i). |
| Intervention (I) | Participants were randomised to receive semaglutide, a glucagon-like peptide-1 receptor agonist, administered weekly. |
| Comparison (C) | Semaglutide was compared to a placebo across both SGLT2i and non-SGLT2i baseline subgroups. |
| Outcome (O) | Treatment with semaglutide reduced the primary composite outcome (kidney failure, ≥50% decline in estimated glomerular filtration rate [eGFR], kidney death, or cardiovascular death) by 24% compared to placebo (95% CI: 12%-34%). The benefits were significant in participants not on SGLT2i (HR 0.73; 95% CI: 0.63-0.85; P<0.001) but not in those on SGLT2i (HR 1.07; 95% CI: 0.69-1.67; P=0.755). Secondary outcomes, including eGFR decline and cardiovascular events, were consistently favorable for semaglutide, though significance varied by subgroup. |
Source: Johannes F. E. Mann, et al. “Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial.” Nature Medicine. Read article here.
