Latest updates for semaglutide: reduction of renal failure risk

Recent data presented at the 2024 European Society for Cardiology (ESC) conference analysed Novo Nordisk’s Ozempic (semaglutide) and its effectiveness in the management of chronic kidney disease (CKD). This follows previous analysis on semaglutide’s effect on heart disease and failure earlier this year. 

During a session on the topic of ‘Renal Failure and Cardiovascular Disease’, Professor Kenneth Mahaffey of Stanford University presented analysis of a FLOW trial in which participants with type 2 diabetes and CKD took Novo Nordisk’s semaglutide product Ozempic. Results demonstrated a reduction in the risk of cardiovascular death, myocardial infarction, and stroke in subgroups defined by differentiated levels of estimate glomerular filtration rate, albuminuria, and/or Kidney Disease: Improving Global Outcomes risk class. Additionally, Ozempic was demonstrated to reduce the risk of death in those defined by estimate glomerular filtration rate and kidney disease risk class. 

While the FLOW trial was limited by an insufficient numer of events to evaluate Ozempic’s treatment effects on subgroups defined by the severity of their chronic kidney disease, the trial joins an existing pool of research on Ozempic’s effect on kidney and heart outcomes. Earlier this year, Novo Nordisk release positive FLOW trial results on kidney outcomes. The study demonstrated that semglutide 1.0mg reduced the risk of kidney disease progression, as well as the risk of death from kidney and cardiovascular problems by 24%. Study leader Dr Vlado Perkovic, from the University of New South Wales, commented then that the trial results “reflect important clinical effects on kidney, cardiovascular, and survival outcomes among high-risk patients... and support a therapeutic role for semaglutide in this population.” 

Novo Nordisk’s other semaglutide product Wegovy, indicated for weight-loss, received US FDA approval around the same time for lowering the risk of stroke and heart attacks in those who are overweight or obese. Heart failure is prevalent in persons with obesity, with no existing therapy previously approved to target obesity-related heart failure with preserved ejection fraction. Full data from the study of Wegovy demonstrated a reduction of non-fatal heart attack risk by 28%, with additional reduction of non-fatal strokes by 7% and heart-related death by 15% in those with pre-existing heart conditions. 

With an aging population leading to an increasing prevalence of chronic kidney disease, as well as heart failure with preserved ejection fraction accounting for more than half of heart failure cases in the US, the market is in need for more therapeutic availability. Yet, while Ozempic and Wegovy demonstrate positive results in their trials for the treatment of these indications, widespread use of GLP-1 agonist drugs is slow, and the use of existing generic chronic kidney disease drugs may make it difficult for such branded therapies to be commonplace among patients.  

Ozempic and Wegovy are two of a number of GLP-1 receptor agonists currently available for a number of indications, most notably type 2 diabetes and obesity. 

Want to know more about GLP-1 drug products? Read more here. 

Sources: 

1. ESC 2024: Latest FLOW trial analysis highlights how Ozempic can benefit CKD patients [Accessed September 3, 2024] https://www.pharmaceutical-technology.com/newsletters/esc-2024-latest-flow-trial-analysis-highlights-how-ozempic-can-benefit-ckd-patients/?_hsenc=p2ANqtz-_foq9QXz8osoqksXkHuaemDoAmJz09mO5U8s259QiLbegfpKdHxADJ8r4ojXAMNC0h64jZaSRufDqEi7sHBMgmnINgpw&_hsmi=94108881&utm_campaign=type3_Pharmaceutical%20Technology-market&utm_medium=email&utm_content=Spotlight_News_Article&utm_source=email_NS&cf-view  

2. Kosiborod MN, Abildstrom SZ, Borlaug BA et al. Semaglutide in Patients with Heart Failure with PReserved Ejection Fraction and Obesity. N. Engl. J. Med. 389(12), 1– 16 (2023). https://www.nejm.org/doi/pdf/10.1056/NEJMoa2306963  

3. Novo Nordisk’s Ozempic slows diabetic kideny disease progression in trial [Accessed September 4, 2024] https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisks-ozempic-slows-diabetic-kidney-disease-progression-trial-2024-05-24/#:~:text=May%2024%20(Reuters)%20%2D%20Novo,stage%20trial%20presented%20on%20Friday.