Research suggests that using Ozempic lowers the likelihood of severe ailments and fatality in individuals with diabetes and kidney issues.
Diabetes significantly raises the chances of experiencing kidney problems, which is a major reason for death not just in the United States but globally; approximately 1 out of 3 diabetics suffer from chronic kidney disease, as per the US Centers for Disease Control and Prevention.
However, a recent study reports that weekly semaglutide injections reduce the likelihood of serious consequences from diabetes-related kidney issues by 24%.
These life-threatening events, which include significant decrease in kidney function, kidney failure, and death caused by either kidney or cardiovascular issues, occurred 331 times in the participants getting semaglutide injections, while they happened 410 times among those taking the placebo. Adjusted by the duration each person stayed in the trial, these figures translate to 5.8 events for every 100 years of follow-up for the semaglutide recipients and 7.5 events for the placebo recipients.
High blood sugar levels can inflict damage on the kidneys' blood vessels, and it can also put a strain on the heart. As per the new research, semaglutide treatment exhibited benefits far beyond these harmful effects of diabetes for those with existing kidney disease.
The rate of kidney function deterioration was slower overall, the risk of significant cardiovascular events, such as heart attacks, was 18% lower, and the risk of death caused by any cause was 20% lower among those treated with semaglutide rather than the placebo, the findings reveal.
The study, published on Friday in the New England Journal of Medicine and also presented at the European Renal Association Congress, is based on findings from a drug trial involving roughly 3,500 individuals with both type 2 diabetes and kidney disease from 28 countries. Approximately half of these individuals received regular 1-milligram injections of semaglutide (the approved therapy for treating type 2 diabetes under the brand name Ozempic in the US), and the remaining individuals got a placebo treatment.
Observers were followed for around 3.5 years on average. Given the promising outcomes at the midpoint check-in, the trial was terminated two years ahead of the originally intended schedule.
“In this study, we are able to show how semaglutide can have a profound impact on people with diabetes and kidney disease,” noted Dr. Vlado Perkovic, nephrologist and provost at the University of New South Wales Sydney. He is the chair of the trial’s steering committee and the principal investigator of the new study.
“The effect size was greater than anticipated, and hence, the results were highly statistically significant. Therefore, the likelihood of this result being random is almost nil, and I believe we can be very confident that the outcomes are accurate and not a fluke.”
Four other medications have previously been shown to be beneficial for those with diabetic kidney disease, but the researchers observe in the new study that "healthcare professionals and patients will have to make choices concerning the sequence and priority of using semaglutide."
Both individually and in combination, these treatments may prove crucial, as numerous participants were receiving other forms of treatment for their diabetes as well.
“Semaglutide demonstrated benefits on top of the existing standard of care,” remarked Martin Holst Lange, executive vice president of development for Novo Nordisk. The Danish drug manufacturer is the only company with semaglutide products approved for use in the US – Ozempic for treating diabetes and Wegovy for treating obesity, and they financed the new study.
Benefits were observed across all levels of initial kidney function, but a particular focus was placed on those at the highest risk of severe consequences such as kidney failure, cardiovascular events, or death. Over 66% of trial participants were classified as very high risk.
Focusing on this high-risk cohort provides a clearer image of the advantages of treatment, yet many people are unaware of the severity of kidney disease – both with diabetes and in general. During the course of this trial, around 8% of participants experienced severe kidney problems; nearly 5% of individuals died each year.
“Diabetic kidney disease, attributed to diabetes, is among the most widespread and fatal complications of diabetes. However, there's generally low awareness about it,” said Dr. Katherine Tuttle, chair of the Diabetic Kidney Disease Collaborative for the American Society of Nephrology, as well as the executive director for research at Providence Inland Northwest Health, an investigator with the Institute of Translational Health Sciences, and a professor of medicine at the University of Washington. “One of the reasons this is a dilemma is because the condition is typically symptom-free until it has reached later stages, so physicians and patients must be particularly proactive in identifying kidney disease.”
It's advised that individuals with diabetes get tested for kidney disease twice a year with blood or urine exams. Unfortunately, not everyone adheres to this suggestion, though some might wait until they develop symptoms such as tiredness, swelling, or changes in urinating frequency.
Diabetes therapies are in high demand due to the widespread nature of the illness, according to Tuttle, who was additionally involved in the new study. However, semaglutide is especially exciting as it appears to offer advantages that apply to various complications that can occur as a result of diabetes. Besides lowering blood sugar, semaglutide-based medications have demonstrated potential for aiding with weight loss, treating heart failure, and possibly inhibiting addictive tendencies.
Tuttle commented, "I believe drugs that influence multiple final pathways are extremely effective, as when we attempt to solely address one risk factor, it's almost like plugging only one hole in a dam. The problem is that you can't seal all the leaks. Semaglutide, in my opinion, addresses a wide range of risks. It effectively reduces weight, lowers glucose levels, and slightly decreases blood pressure. Additionally, we believe it may positively impact the kidneys."
A major issue in the US is the significant variation in diabetes occurrence and kidney disorders among different ethnic groups. According to CDC research, Black, Hispanic, and American Indian adults are almost twice as likely to have diabetes compared to White adults. Moreover, Black people are approximately three times more at risk for kidney failure than White adults.
Despite this, the majority of the subjects in the semaglutide trial were White, and the consequences couldn't be evaluated among key subgroups.
"Once we have discovered an effective treatment, we also need to focus on getting it to patients," Tuttle said. The problem is that numerous individuals with the highest risk for developing issues related to diabetes may be denied access to the needed treatment.
"We now have a highly effective therapy that can significantly improve patient lives by maintaining kidney function, prolonging life, and reducing the likelihood of cardiovascular events. Nevertheless, all this only matters if people receive the treatment," she added. "So now, our major challenge is to speed up the process from generating evidence to putting it into practice."
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Semaglutide, the active ingredient in Ozempic, has been shown to reduce the risk of serious complications from diabetes-related kidney issues by 24%, as revealed in a recent study. This is particularly significant for those with diabetes, as approximately 1 out of 3 diabetics suffer from chronic kidney disease.
The findings of the study suggest that semaglutide treatment may offer benefits beyond the harmful effects of diabetes for individuals with existing kidney disease. This includes a slower rate of kidney function deterioration, a lower risk of significant cardiovascular events, and a lower risk of death due to any cause.
Source: edition.cnn.com
