Helen Colhoun, MD: Semaglutide 2.4 mg (Wegovy) Reduces Kidney Outcomes in SELECT

A new analysis of the SELECT trial is highlighting even more potential benefits from semaglutide 2.4 mg (Wegovy) than was seen in the original trial read-out at AHA 2023.

Presented at the 61st European Renal Association Congress, the analysis of semaglutide’s effect on kidney outcomes demonstrates use of the GLP-1 receptor agonist was associated with a 22% risk reduction in major kidney events relative to placebo therapy among patients with overweight or obesity and a history of cardiovascular disease.

Published simultaneously in Nature Medicine and presented by Helen Colhoun, MD, professor of Medical Informatics and Epidemiology at University of Edinburgh, the analysis leveraged data from the more than 16,000 participants within SELECT to assess for a composite kidney outcome comprised of death from kidney disease, initiation of chronic kidney replacement therapy, persistent eGFR less than 15 ml/min/1.73m², a persistent reduction of 50% or more in eGFR, and persistent macroalbuminuria.

After a median follow-up of 182 weeks, the primary outcome event rate was 1.8% in the semaglutide group compared to 2.2% in the placebo group. In-trial analysis indicated a 22% relative risk reduction for the primary outcome with semaglutide (HR, 0.78; 95% CI, 0.63 to 0.96; P = .02), while on-treatment analysis showed a 25% reduction (HR, 0.75; 95% CI, 0.59 to 0.94; P = .01). According to investigators, this reduction was primarily driven by a decrease in macroalbuminuria onset and persistent eGFR reduction of 50% or more.

Further analysis of eGFR at 104 weeks suggested there was a relative benefit of 0.75 ml/min/1.73m² (95% CI, 0.43 to 1.06; P <.001) overall and 2.19 ml/min/1.73m2 (95% CI, 1.00 to 3.38; P <.001) in patients with a baseline eGFR less than 60 ml/min/1.73m2.

To learn more about the analysis and how it adds to the understanding of the effects of GLP-1 receptor agonists on kidney health, check out our interview with Colhoun from ERA 24.

Relevant disclosures of interest for Colhoun include Bayer, Novo Nordisk, IQVIA, and Roche.

References:

Colhoun HM, Lingvay, I, Brown PM, et al. Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial. Nat Med. Published May 25, 2024. https://doi.org/10.1038/s41591-024-03015-5.

Campbell P. Semaglutide (Wegovy) receives FDA label expansion to include cardiovascular risk reduction. HCP Live. March 8, 2024. Accessed May 26, 2024. https://www.hcplive.com/view/semaglutide-wegovy-receives-fda-label-expansion-to-include-cardiovascular-risk-reduction.