Study results show promising effects of semaglutide for people with diabetic kidney disease

The results from a recent clinical trial show promise for semaglutide as a treatment to help slow progression of kidney disease and reduce the risk of death from kidney disease or heart disease for people living with diabetic kidney disease.  

Semaglutide is a type of glucagon-like peptide-1 (GLP-1) drug that is taken as an injection once a week or as a daily oral medicine (depending on the type prescribed by your doctor). Semaglutide is currently approved by the Food and Drug Administration (FDA) to help regulate blood sugar levels in people with diabetes and to help with weight loss for people who are overweight or obese. On March 8, the FDA approved its use to reduce the risk of cardiovascular (heart) death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight. The drug acts like the GLP-1 hormones in your body, which are released when you eat and help control your blood sugar. GLP-1 drugs, like semaglutide, help to make sure your body has the right level of blood sugar. They also slow down digestion (so you stay full longer), reduce appetite and signal a feeling of fullness.

Diabetes is the leading cause of kidney failure in the United States, causing nearly half (44%) of new cases of kidney failure. If you have diabetes, the elevated sugar in your blood can damage the blood vessels in your kidneys. This can lead to kidney disease. 

In 2019, Novo Nordisk began a clinical trial called the FLOW trial to test if semaglutide affected kidney function or complications from kidney disease for people with diabetes and kidney disease. This was a large study, with 3,553 people enrolled from 28 countries at 400 investigator sites. All participants had type 2 diabetes and kidney disease.

The participants were divided into two groups: one received a weekly injection of 1 mg of semaglutide and the other received a placebo — which means they received a harmless injection without the drug. Both also continued receiving standard care for diabetic kidney disease. 

By a midpoint check-in for the trial, a data monitoring committee recommended stopping the trial early based on efficacy. 

The trial achieved its primary endpoint by showing delayed progression of kidney disease and reduction in the risk of death from kidney and cardiovascular disease-related complications in people treated with semaglutide as compared to placebo. 

In a press release announcing the results of the FLOW trial, officials at Novo Nordisk said, "We are very excited about the results from FLOW showing that semaglutide 1.0 mg reduces the risk of kidney disease progression… Approximately 40% of people with type 2 diabetes have chronic kidney disease, so the positive results from FLOW demonstrate the potential for semaglutide to become the first GLP-1 treatment option for people living with type 2 diabetes and chronic kidney disease."

Novo Nordisk is applying to get approval to expand the use of semaglutide to help with diabetic kidney disease and will also be presenting more details of their findings at a conference this year.

It is important to note that semaglutide is not currently FDA approved as a treatment for kidney disease. AKF will closely follow reporting around semaglutide and its potential impact on kidney disease.