Semaglutide linked to reduced albuminuria for adults with CKD without diabetes
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Key takeaways:
- Semaglutide reduced urine albumin-to-creatinine ratio by more than 50% for adults with CKD and overweight or obesity but without diabetes.
- Weight and blood pressure also declined significantly with semaglutide.
SAN DIEGO — Semaglutide, a GLP-1 receptor agonist approved for treatment of obesity and type 2 diabetes, improved kidney metrics for adults with overweight and obesity without diabetes, according study data.
“The FLOW trial demonstrated that semaglutide reduces the risk of a clinical kidney outcome in people with type 2 diabetes and chronic kidney disease. We had also shown previously that semaglutide reduced albuminuria in people with type 2 diabetes who are overweight or obese,” Hiddo Jan L. Heerspink, PhD, professor of clinical trials and personalized medicine and a clinical pharmacologist in the department of clinical pharmacy and pharmacology at the University Medical Center Groningen in the Netherlands, said during a press briefing. “In this study, we demonstrated that both semaglutide 1 mL per day, that's diabetes dose, and 2.4 mL per day reduced albuminuria compared to placebo.”
Heerspink and colleagues randomly assigned adults to either semaglutide (n = 50) or placebo (n = 51) for 12 weeks followed by a 16-week washout period. At baseline, participants had an eGFR at least 25 mL/min/1.73 m2 with urine albumin-to-creatinine ratio (UACR) between 30 mg/g and 3,500 mg/g and BMI of 27 kg/m2 or greater. None had diabetes or HbA1c greater than 6.5% or cardiovascular disease within 3 months. Eight participants in the semaglutide group and 11 in the placebo group were prescribed an SGLT2 inhibitor.
Compared with placebo, semaglutide was associated with a 52.1% (95% CI, 33.4-65.5) greater reduction in UACR. As semaglutide was titrated up every 4 weeks, UARC declined by about 50% and did not return to baseline by the end of the washout period, according to Heerspink. No between-group difference in eGFR was observed.
Participants in the semaglutide group had significant reductions in blood pressure, body weight, waist circumference and high-sensitivity C-reactive protein compared with placebo, according to Heerspink.
Adverse events were greater in the semaglutide group and were mostly gastrointestinal, consistent with the known safety profile.
Longer and larger clinical trials on clinical kidney outcomes are needed to assess the full potential of semaglutide, including for patients with lower BMI, Heerspink told Healio.
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Heerspink HJL, et al. FR-OR102. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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