improved kidney function

New clinical trials confirm new benefits of the compound on which Ozempic and Wegoby are based: semaglutide reduces the risk of kidney failure and mortality in diabetics and is positioned as a powerful therapy for kidney disease.

semaglutidecompound used in the drug Ozempic and its specific indications for obesity, Wegobyadds another beneficial effect to the list of disorders that it helps alleviate, as it is also effective for kidney disease.

The latest clinical studies presented this week in Stockholm and published in New England Journal of Medicineshow that this hypoglycemic hormone GPL-1 sharply reduces risk of kidney failure and death in people with type 2 diabetes And chronic kidney disease.

Kidney failure occurs when one or both kidneys stop functioning on their own and can be treated with dialysis or a kidney transplant; Semagluid can prevent this. Anti-obesity drugs have another superpower: controlling inflammation.

Scientists hope these new findings will be the first step toward a new target for semaglutide, and that semaglutide will eventually be shown to be beneficial for the general population with kidney disease, the journal reports. Nature.

Novo Nordisk, based in Bagsvärd, Denmark, had already announced in October that it had stopped a kidney disease trial due to an independent safety monitoring board’s recommendation: ” the results were extremely positive that it was unethical to continue giving placebo to control group participants and deprive them of the benefits they observed in patients who were given the drug during the interim phase of the study.

The full findings of this investigation have now been published and are compelling. Researchers studied a total of 3,533 participants over three years and four months (1,767 in the semaglutide group and 1,766 in the placebo group). The risk of renal events decreased by 24%, both alone and in combination with cardiovascular disease (CVD), and the risk of CVD alone decreased by 18%.

GLP-1 “reduced the risk of clinically important renal outcomes and cardiovascular mortality in patients with type 2 diabetes and chronic kidney disease,” note the authors of the study, which was funded by Nordisk.

This is the last test first to focus on progression of kidney disease and suggests that semaglutide may slow kidney damage and degradation.

Wegoby in a pharmacy in Utah, USA, November 2023. George Frey

Specifically, “a phase IIIb study found that those who received weekly semaglutide injections were 24% less likely to suffer from “serious kidney disease,” including kidney failure and death from kidney complications, than those who received placebo.” semaglutide “They were also 29% less likely to die from heart attacks and other serious cardiovascular events than those who received placebo, and 20% less likely to die from any cause.”

These results are promising because “the connection between kidney and heart disease is closely related and they strengthen themselves“, he notes in Nature Samir Parikh, a nephrologist at the University of Texas Southwestern Medical Center in Dallas.

“People with type 2 diabetes and chronic kidney disease often die from heart disease before their kidney problems progress to kidney failure. Add that to the mix, and type 2 diabetes is like throwing gunpowder on the fire,” since diabetes can damage small blood vessels, including those in the heart and kidneys.

Researchers are delighted. Although the death rate from heart disease fell by 30% between 1990 and 2019 due to advances in pharmacology, surgery and lifestyle improvements, fundamentally To give up smoking, mortality did not fall in the same proportion in people with chronic kidney disease. The availability of semaglutide as a potential treatment could be a game changer.

Historically, doctors have treated chronic kidney disease with medications, including blood pressure medications, but these protect the kidneys to a very limited extent.

In the last decade, the latest generation of drugs have appeared. antidiabetic drugsfrom the group of SGLT2 inhibitors (SGLT2) may delay the progression of chronic kidney disease and protect against major cardiovascular events, but many patients remain at residual risk.

Diabetic kidney disease is the leading cause of chronic kidney disease worldwide, accounting for 50% of kidney failure cases in wealthy countries. More treatments are needed, and all indications are that the hypoglycemic effect of semaglutide will take that place.

Participants taking the drug maintained a healthier estimated glomerular filtration rate and less albumin in their urine, an indicator of loss of kidney function.

It will also be necessary to delve deeper into why semaglutide benefits the kidney, perhaps through an anti-inflammatory mechanism, and will need to evaluate what specific effects it will have in non-diabetic kidney patients and whether its effect can be optimized in combination with other drugs. with SGLT2 inhibitors.

NEZHM doi: 10.1056/NEJMoa2403347

https://doi.org/10.1038/d41586-024-01564-w

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