Kidney Week

Abstract: SA-OR93

Semaglutide Reduced Risks of Major Kidney Outcomes Irrespective of CKD Severity in the FLOW Trial

Session Information

• High-Impact Clinical Trials - 2
  October 26, 2024 | Location: Hall D, Convention Center
  Abstract Time: 11:15 AM - 11:30 AM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Tuttle, Katherine R., Providence Health and Services, Spokane, Washington, United States

Katherine R. Tuttle, MD, FASN

• Mann, Johannes F., KfH Nierenzentrum fur Kinder und Jugendliche Munster, Munster, Nordrhein-Westfalen, Germany

Johannes F. Mann, MD

• Sokareva, Ekaterina, Novo Nordisk A/S, Bagsvaerd, Hovedstaden, Denmark

Ekaterina Sokareva

• Rayner, Brian, Groote Schuur Hospital, Observatory, South Africa

Brian Rayner, MBChB, PhD

• Pugliese, Giuseppe, Universita degli Studi di Roma La Sapienza, Rome, Lazio, Italy

Giuseppe Pugliese, MD, PhD

• Pratley, Richard E., AdventHealth Central Florida, Orlando, Florida, United States

Richard E. Pratley, MD

• Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia

Vlado Perkovic, MBBS, PhD, FASN

• Mahaffey, Kenneth W., Stanford University School of Medicine, Stanford, California, United States

Kenneth W. Mahaffey, MD

• Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan

Naoki Kashihara, MD, PhD

• Jeppesen, Ole K., Novo Nordisk A/S, Bagsvaerd, Hovedstaden, Denmark

Ole K. Jeppesen, MSc

• Gumprecht, Janusz, Slaski Uniwersytet Medyczny w Katowicach Wydzial Nauk Medycznych w Zabrzu, Zabrze, Województwo śląskie, Poland

Janusz Gumprecht, PhD, MD

• Correa-Rotter, Ricardo, Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Ciudad de Mexico, Mexico City, Mexico

Ricardo Correa-Rotter, MD

• Cherney, David, Toronto General Hospital, Toronto, Ontario, Canada

David Cherney, MD, PhD

• Bosch-Traberg, Heidrun, Novo Nordisk A/S, Bagsvaerd, Hovedstaden, Denmark

Heidrun Bosch-Traberg, MD, DrMed

• Arici, Mustafa, Hacettepe Universitesi, Ankara, Ankara, Turkey

Mustafa Arici, MD

• Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Capital Region of Denmark, Denmark

Peter Rossing, MD, DrMed

Background

Semaglutide reduced risks of major kidney outcomes, cardiovascular (CV) events, and death from any cause in participants with type 2 diabetes (T2D) and chronic kidney disease (CKD) in the FLOW trial. The aim of this analysis was to assess kidney outcomes by baseline CKD severity.

Methods

Participants had T2D with eGFR 50–75 mL/min/1.73m² and urine albumin–creatinine ratio (UACR) >300–<5000 mg/g, or eGFR 25–<50 mL/min/1.73m² and UACR >100–<5000 mg/g. They were randomized to subcutaneous semaglutide 1 mg once weekly or placebo. The FLOW primary outcome was a composite of kidney failure (initiation of chronic kidney replacement therapy, eGFR <15 ml/min/1.73m²), >50% eGFR decline, or death due to kidney or CV causes. Participants were categorized by baseline eGFR and UACR.

Results

Among 3533 participants, 30% (n=1069) were women. At baseline, their mean age was 67 years, mean eGFR was 47 mL/min/1.73 m², and median UACR was 568 mg/g. The hazard ratio for the primary outcome was 0.76 (95% CI 0.66–0.88) for semaglutide versus placebo over a median of 3.4 years. Consistent results were observed across eGFR and UACR categories (Figure).

Conclusion

Semaglutide safely reduced risks of major kidney outcomes irrespective of CKD severity defined by baseline eGFR or UACR in participants with T2D and CKD in the FLOW trial.

Funding

• Commercial Support – Novo Nordisk