Ozempic and Wegovi are used to treat type 2 diabetes and obesity, respectively, but may also be effective in people with chronic kidney disease (CKD).
A new study has found that the active ingredient in these drugs, semaglutide, significantly reduces the risk of kidney complications, heart disease and death in people with type 2 diabetes and CKD.
The findings come from two recent studies, both presented at the 61st Congress of the European Society of Nephrology (ERA) in Stockholm, Sweden, in May.
People with CKD have damaged kidneys, which causes waste products and fluids to build up in the body. In the end stages, CKD can lead to kidney failure and early heart disease.
Expanding the benefits of Ozempic and Wegovi could have a big impact: It could change the way doctors treat people with severe kidney disease and ultimately improve their quality of life, experts say.
“As a nephrologist and researcher who has spent many years studying chronic kidney disease in diabetes and how to prevent and treat it, this is fantastic news.” Frank Brosius, MD “The study is a step forward for the treatment of rheumatoid arthritis,” said Dr. health“My patients are already finding that they are better off with these new treatments, including semaglutide.”
Beyond the therapeutic range for which semaglutide is currently approved, anecdotal evidence and early studies have sparked discussion about other potential off-label benefits associated with GLP-1 drugs, such as curbing addiction and easing sleep apnea. Similarly, researchers wanted to explore how Ozempic and Wegovy might affect kidney health.
The first of the two studies was a large-scale clinical trial presented at the ERA meeting. New England Journal of Medicine.
The study involved 3,533 people with type 2 diabetes and chronic kidney disease, with roughly half receiving weekly injections of semaglutide and the other half receiving weekly injections of a placebo.
About three and a half years later, the researchers followed up with the study participants and found that those who took semaglutide were 24% less likely to develop serious kidney disease, such as needing dialysis, undergoing a kidney transplant, losing more than half of their kidney function, or dying from kidney-related or cardiovascular causes.
“These findings hold great promise for reshaping treatment strategies for people at high risk of diabetes-related complications and provide new avenues for kidney and cardiovascular protection.” Dr. Vlado Perkovicstudy author and dean of medicine at the University of New South Wales in Sydney. press release.
In the second study, researchers evaluated 3.5 years of data from a previous randomized trial of nearly 17,600 people who were obese or overweight and had cardiovascular disease. About half of the participants received weekly injections of semaglutide and the other half received a placebo injection.
The researchers looked at which participants experienced a significant decline in kidney function, development of persistent macroalbuminuria (a risk factor for complications of kidney disease), the need to start chronic renal replacement therapy (dialysis or transplant), or death.
The researchers found that 24% fewer people who received weekly semaglutide injections experienced kidney-related symptoms compared to the placebo group. The researchers also found no increased risk of acute kidney injury associated with semaglutide treatment.
The authors of both studies noted that a major limitation was the lack of diversity among participants. In the first study, roughly two-thirds of participants were male and white. Because CKD disproportionately affects Black and Indigenous people, further research is needed in these populations.
CKD causes a gradual decline in kidney function over time. The kidneys are responsible for filtering waste products and excess fluid from the blood and excreting them in urine. However, when the kidneys are damaged, this filtering ability is impaired and waste products build up. This can lead to a variety of health complications, including end-stage renal failure, which can require dialysis or a transplant to survive.
CKD is also closely linked to diabetes, with approximately one in three adults with type 2 diabetes also having CKD. In fact, kidney disease is often caused by diabetes.
High blood sugar caused by type 2 diabetes can damage blood vessels in the kidneys and impair kidney function. Diabetes can also cause nerve damage, making it difficult to urinate and empty the bladder. If urine remains in the bladder for too long, it can build up pressure and damage the kidneys.
But this is where semaglutide comes in: not only does it help with weight loss and improve blood pressure, it also lowers blood sugar levels, helping to avoid these negative effects for people with diabetes.
“The use of semaglutide [also] “It is associated with improved cardiovascular outcomes, which is crucial for patients with chronic kidney disease, who have a high prevalence of cardiovascular disease.” Alexandra Kukula, MDA transplant nephrologist at the Mayo Clinic said: health.
But semaglutide's ability to lower blood sugar levels and help the heart may not fully explain the associated benefit to the kidneys – something else may be at play.
“The blood sugar-lowering effect of this drug is unlikely to be the only or even primary reason for its protective effect,” Brosius said. “There are multiple mechanisms by which this class of drugs protects the kidneys, and at this point no one knows which are the most important mechanisms.”
Previous studies have suggested that Ozempic and Wegovi may have benefits for kidney health, but these new studies confirm that semaglutide may be a useful treatment, especially for people with both CKD and type 2 diabetes.
“I am optimistic about the potential impact of these study results,” Brosius said. “For patients with type 2 diabetes and CKD, Ozempic has the potential to be a first-in-class treatment to protect kidney function in this high-risk population. This is a major step forward for those managing these two chronic diseases.”
Drugmaker Novo Nordisk said it plans to apply for an expanded label for Ozempic in the United States in 2024.
In terms of availability, most insurance plans already cover the type 2 diabetes drug Ozempic. But prices can be steep, especially for the uninsured. The average monthly cost for Ozempic and Wegoby ranges from $1,000 to $1,600, depending on the pharmacy.
“It is crucial that this population at high risk for poor outcomes has access to medications such as semaglutide to improve outcomes,” said Kukla. “We are excited about the additional options available to patients. These medications and others like them will improve patients' overall health and extend their survival.”