Ozempic (semaglutide) is a medication primarily used to treat type 2 diabetes. Recent studies have suggested that it may have potential benefits beyond glycemic control, including possible effects on kidney disease progression. Some research indicates that Ozempic may slow the progression of kidney disease in people with type 2 diabetes, though more studies are needed to confirm these findings and understand the mechanisms involved. It’s always essential for individuals to discuss potential treatment options and their implications with their healthcare providers.

Type 2 diabetes is a condition that results from the body no longer responding to insulin, the hormone that controls blood glucose levels. People with type 2 diabetes are at high risk of developing chronic kidney disease. Semaglutide sold under the brand name Ozempic is a drug that, in conjunction with diet and exercise, improves blood glucose (sugar) control in people with diabetes. Now, trial results show that semaglutide may also reduce the progression of kidney disease.

Chronic kidney disease affects one in three adults with diabetes. Both type 1 and type 2 diabetes increase the risk of chronic kidney disease if blood glucose (sugar) levels are not controlled. The resulting damage to blood vessels and nephrons in the kidneys means they cannot function effectively. As the early stages of kidney disease cause few or no symptoms, people with diabetes should manage their blood glucose, blood pressure, and cholesterol levels. They should also get regular checks from their doctor.
Semaglutide which is marketed as Ozempic, is one of a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. These mimic a hormone GLP-1 that makes the body produce more insulin, reduces appetite, and gives feelings of fullness.

The Food and Drug Administration (FDA) has approved Ozempic as a treatment for type 2 diabetes, in addition to diet and exercise. As well as helping control blood glucose, it may also reduce the risk of heart attack, stroke, or death in adults with type 2 diabetes and heart disease. One study has shown that it could also reduce inflammation, which may explain these other health effects.

Now, the manufacturer of Ozempic Novo Nordisk has announced headline results of their latest trial, suggesting that semaglutide can reduce the risk of kidney disease progression by 24% in people who have type 2 diabetes and chronic kidney disease. The detailed results of the FLOW trial will be presented at a scientific conference later this year. They have not yet appeared in a peer-reviewed journal. This is a very significant finding; over 500 million people have diabetes, and 30-40% have chronic kidney disease, and we need treatments to stop or reduce progression of the kidney disease as well as to reduce the burden of cardiovascular disease which is high in this population. People with [type 2 diabetes] and [chronic kidney disease] are at amplified risk for cardiovascular-related morbidity and mortality and progression to kidney failure. Treatment options capable of mitigating heart and kidney risk in this population are greatly needed, he told us.

Researchers on the FLOW trial recruited 3,533 people with type 2 diabetes and chronic kidney disease from 418 locations in 28 countries. They randomly allocated them to semaglutide or placebo. Participants self-administered both semaglutide and the visually identical placebo by weekly subcutaneous injection. Those in the semaglutide group started on a dose of 0.25 milligrams (mg) per week for 4 weeks, increasing the dose to 0.5 mg, then to 1 mg after 8 weeks and for the rest of the trial.

In addition, all participants received the maximum labeled or tolerated dose of a RAAS blocking agentTrusted Source unless contraindicated or not tolerated which helps control hypertension, acute myocardial infarctionTrusted Source (heart attack), chronic systolic heart failure, stroke, and diabetic renal disease. Participants had a mean age of 66.6 years, 69.7% were men and 65.7% were white. All participants had type 2 diabetes diagnosed, on average, 17.4 years before the start of the trial and chronic kidney disease. The trial was meant to run until the end of 2024 but was stopped early after it reached its primary endpoint. The endpoint is composed of kidney disease progression and cardiovascular and kidney death, and in particular progression to kidney failure and mortality of cardiovascular events. These are frequent in this population of [type 2 diabetes] with [chronic kidney disease], so that we can reduce this by 24% is important and meaningful for patients.

In the announcement, Novo Nordisk stated that the trial had achieved a statistically significant and superior reduction in kidney disease progression as well as cardiovascular and kidney death of 24% for people treated with semaglutide 1.0 mg compared to placebo. There needs to be repeated assessments with different samples of participants across the world. In the real world setting, people behave differently and have other conditions as well. So, we need more effectiveness trials [because] effectiveness trials find how well a medication works [unlike] efficacy trials that measure how well it works in RCT/lab studies. The recently released headline results are impressive, yet we await the presentation and publication of the complete trial results to fully understand the efficacy and safety outcomes of the trial.

Ozempic is not without side effects. While Ozempic (semaglutide) can be effective in managing type 2 diabetes, it’s important to be aware of potential side effects. Like many medications, Ozempic does carry the risk of side effects, some of which can be serious. It’s crucial for individuals to discuss these potential risks with their healthcare providers before starting the medication and to monitor for any adverse reactions while taking it.

REFERENCES:

https://www.medicalnewstoday.com/articles/ozempic-may-delay-kidney-disease-progression-latest-trial-results-show
https://www.healthline.com/health-news/ozempic-cuts-risk-of-kidney-disease-related-events-new-trial-shows
https://health.economictimes.indiatimes.com/news/pharma/pharma-industry/novo-nordisk-ozempic-trial-delays-progression-of-chronic-kidney-disease/108237567?utm_source=top_news&utm_medium=tagListing
https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-ozempic-trial-delays-progression-chronic-kidney-disease-2024-03-05/

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