Theme

Semaglutide Drives Disease Regression

Source
Source: Tuttle KR, Bain SC, Bosch‐Traberg H, et al. Effects of Once‐Weekly Semaglutide on Kidney Disease Outcomes by KDIGO Risk Category in the SUSTAIN 6 Trial. Kidney Int Rep. 2024;9:2006–2015. This was a post hoc analysis of the SUSTAIN 6 trial (NCT01720446).

Significantly Increases Odds of Improving KDIGO Risk Categories While Reducing Renal Composite Endpoints

Population
3,238 Adults (T2D)
Est. CV Disease or High Risk
Design
Post hoc SUSTAIN 6
Stratified by KDIGO Risk
Comparison
Semaglutide vs. Placebo
0.5 mg / 1.0 mg OW
Likelihood to Improve
69%

Increase in odds of moving to a lower KDIGO risk category vs. Placebo (P < 0.0001).

Protection from Decline
29%

Reduction in odds of moving to a higher KDIGO risk category vs. Placebo.

KDIGO Category Shifts

OR > 1 favors Semaglutide for Improvement.

Efficacy in Moderate Risk

HR 0.42 for composite kidney endpoint.

UACR Reduction

Albuminuria improved irrespective of disease severity. Even in the Low-risk category, Semaglutide demonstrated a treatment ratio of 0.72 (28% reduction relative to baseline).

Clinical Recommendation

Position as Renoprotective-Regression Therapy.
Initiate Semaglutide early in T2D diagnosis to actively reverse risk categories and prevent progression.

AbbreviationsQuick
BMI, body mass index; CI, confidence interval; CKD, chronic kidney disease; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; CV, cardiovascular; eGFR, estimated glomerular filtration rate; GLP-1RA, glucagon‐like peptide‐1 receptor agonist; HbA1c, glycated hemoglobin; HR, hazard ratio; KDIGO, Kidney Disease: Improving Global Outcomes; OR, odds ratio; T2D, type 2 diabetes; UACR, urine albumin-to-creatinine ratio.
Bibliography8
  1. Tuttle KR, Bain SC, Bosch‐Traberg H, et al. Effects of Once‐Weekly Semaglutide on Kidney Disease Outcomes by KDIGO Risk Category in the SUSTAIN 6 Trial. Kidney Int Rep. 2024;9:2006–2015. (DOI: 10.1016/j.ekir.2024.04.028 | link)
  2. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016;375:1834–1844. (DOI: 10.1056/NEJMoa1607141)
  3. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO clinical practice guideline for Diabetes Management in chronic kidney disease. Kidney Int. 2020;98:S1–S115.
  4. de Boer IH, Khunti K, Sadusky T, et al. Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and kidney disease: improving global outcomes (KDIGO). Diabetes Care. 2022;45:3075–3090. (DOI: 10.2337/dci22‐0027)
  5. Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double‐blind, randomised placebo‐controlled trial. Lancet. 2019;394:121–130. (DOI: 10.1016/S0140‐6736(19)31149‐3)
  6. Marso SP, Daniels GH, Brown‐Frandsen K, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375:311–322. (DOI: 10.1056/NEJMoa1603827)
  7. Tuttle KR, Lakshmanan MC, Rayner B, et al. Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate‐to‐severe chronic kidney disease (AWARD‐7): a multicentre, open‐label, randomised trial. Lancet Diabetes Endocrinol. 2018;6:605–617. (DOI: 10.1016/S2213‐8587(18)30104‐9)
  8. Tuttle KR, Bosch‐Traberg H, Cherney DZI, et al. Post hoc analysis of SUSTAIN 6 and pioneer 6 trials suggests that people with type 2 diabetes at high cardiovascular risk treated with semaglutide experience more stable kidney function compared with placebo. Kidney Int. 2023;103:772–781. (DOI: 10.1016/j.kint.2022.12.028)