Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial

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2024年5月25日

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Helen M. Colhoun,
Ildiko Lingvay,
Paul M. Brown,
John Deanfield,
Kirstine Brown-Frandsen,
Steven E. Kahn,
Jorge Plutzky,
Koichi Node,
Alexander Parkhomenko,
Lars Rydén,
John P. H. Wilding,
Johannes F. E. Mann,
Katherine R. Tuttle,
Thomas Idorn,
Naveen Rathor,
A. Michael Lincoff

摘要

The SELECT trial previously reported a 20% reduction in major adverse cardiovascular events with semaglutide (n = 8,803) versus placebo (n = 8,801) in patients with overweight/obesity and established cardiovascular disease, without diabetes. In the present study, we examined the effect of once-weekly semaglutide 2.4 mg on kidney outcomes in the SELECT trial. The incidence of the pre-specified main composite kidney endpoint (death from kidney disease, initiation of chronic kidney replacement therapy, onset of persistent estimated glomerular filtration rate (eGFR) < 15 ml min⁻¹ 1.73 m⁻², persistent ≥50% reduction in eGFR or onset of persistent macroalbuminuria) was lower with semaglutide (1.8%) versus placebo (2.2%): hazard ratio (HR) = 0.78; 95% confidence interval (CI) 0.63, 0.96; P = 0.02. The treatment benefit at 104 weeks for eGFR was 0.75 ml min⁻¹ 1.73 m⁻² (95% CI 0.43, 1.06; P < 0.001) overall and 2.19 ml min⁻¹ 1.73 m⁻² (95% CI 1.00, 3.38; P < 0.001) in patients with baseline eGFR <60 ml min⁻¹ 1.73 m⁻². These results suggest a benefit of semaglutide on kidney outcomes in individuals with overweight/obesity, without diabetes.

ClinicalTrials.gov identifier: NCT03574597.