Media release
From: The University of New South WalesA popular diabetes medication has been found to prevent kidney failure and reduce deaths in people with type 2 diabetes and chronic kidney disease.
Semaglutide, more widely known by brand names Ozempic, significantly reduces the risk of kidney failure, substantial loss of kidney function and death from kidney or cardiovascular causes, new research published in The New England Journal of Medicine on Friday shows.
The international clinical trial found a small weekly dose of semaglutide reduced the risk of major kidney events by 24 per cent. The risk of cardiovascular events, such as heart attack and stroke, were also reduced by 18 per cent, while risk of death from any cause fell by 20 per cent.
Lead study author and Scientia Professor Vlado Perkovic, Provost at UNSW Sydney, said the benefits of semaglutide for those with type 2 diabetes and chronic kidney disease were greater than expected.
“We would be saving kidneys, hearts and lives in this population by making this drug available to them and that’s quite extraordinary for one treatment to be able to do,” Prof. Perkovic said.
The clinical trial
The placebo-controlled trial was conducted between June 2019 and May 2021 and involved more than 3500 participants with type 2 diabetes and chronic kidney disease from 28 countries, including Australia, the USA and China.
Half of the participants were given 1.0mg of semaglutide per week, a lower dose than what is generally used for diabetes or weight loss treatment, while the remainder received a placebo.
The trial was funded by pharmaceutical company Novo Nordisk A/S, the supplier of Ozempic.
“It’s the same chemical compound but we used a lower dose ... we did that deliberately because people with kidney disease tend to be more sensitive to the effects and side effects of drugs,” Prof. Perkovic said.
“That’s helpful in terms of being able to perhaps have the drug more widely used than might have otherwise been the case given the current supply limitations.”
Semaglutide also slowed down loss of kidney function, lowered systolic blood pressure, and reduced body weight among participants, the trial found.
Where to next?
It’s hoped the findings could soon help the growing number of people with kidney disease, which now affects about 850 million people worldwide, Prof. Perkovic said.
“One of the most common causes of kidney disease is diabetes, particularly type 2 diabetes, which has also been growing dramatically in recent decades,” he said.
In addition to loss of kidney function, kidney disease increases the risk of a range of other health conditions, particularly heart disease and stroke, and is associated with poorer quality of life.
While there has been an increase in treatments for chronic kidney disease in recent years, Prof. Perkovic said more needed to be done.
“We're really starting to dramatically improve outcomes for people with diabetes and kidney disease. But that will only happen if the results are translated into action at the clinical coalface, so that's an important next step,” he said.
Prof. Perkovic said Novo Nordisk would need to seek regulatory approval for semaglutide to be used to treat those with chronic kidney disease, but expected this would be granted.
Overcoming supply shortages of semaglutide would then be a key challenge, as well as the general lag in implementing research in clinical settings. More research is also needed to determine the optimal way to use semaglutide in combination with other existing treatments.
“The challenge is to get these results into clinical practice, to get the drug used by the people who will benefit from it, who will live longer without dialysis, without heart attacks, without strokes, if they take this drug.”
