Ozempic Might Help with Chronic Kidney Disease

Ozempic Might Help with Chronic Kidney Disease

Ozempic and Wegovy are used to treat type 2 diabetes and obesity, respectively, but they may also be useful for patients with chronic kidney disease (CKD).

According to new research, semaglutide—the active compound found in these medications—was found to significantly reduce the risk of kidney complications, heart issues, and death in patients with type 2 diabetes and CKD.

The findings come from two recent studies, which were both presented in May at the 61st European Renal Association (ERA) Congress in Stockholm, Sweden.

People who have CKD have damaged kidneys, which leads to a buildup of waste and fluid in the body. In late stages, CKD can lead to kidney failure and early heart disease.

This potential expansion of Ozempic and Wegovy’s benefits could have significant effects—experts say it may change how doctors treat patients with severe kidney disease and ultimately improve these patients’ quality of life.

“As a practicing kidney specialist and researcher who has spent years researching chronic kidney disease in diabetes and ways to prevent or treat it, this is wonderful news,” Frank Brosius, MD, professor of medicine in the division of nephrology at the University of Arizona, who was not a part of the research, told Health. “I know my patients are already better off receiving these new treatments, including semaglutide.”

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Beyond the current scope of what semaglutide is approved to treat, anecdotal evidence and early research have opened the conversation about other potential off-label benefits connected to GLP-1 drugs, including curbing addiction and alleviating sleep apnea. In a similar vein, researchers wanted to examine how Ozempic and Wegovy may affect kidney health.

The first of the two studies was a major clinical trial, both presented at the ERA Congress and published in The New England Journal of Medicine.

The study included 3,533 people with type 2 diabetes and chronic kidney disease. Roughly half of the group took a weekly injection of semaglutide, and the other half took a weekly placebo injection.

About three and a half years later, researchers followed up with study participants and found that those who took semaglutide had a 24% lower chance of having a major kidney disease event, such as needing dialysis, getting a kidney transplant, losing at least half of their kidney function, or dying from kidney-related or cardiovascular causes.

“These findings offer great promise in reshaping treatment strategies for individuals at high risk of diabetes-related complications, offering a new avenue for kidney and cardiovascular protection,” Vlado Perkovic, PhD, study author and dean of medicine at the University of New South Wales, Sydney, said in a press release.

For the second study, researchers evaluated data over the span of three and a half years from a previous randomized trial that included about 17,600 individuals who were obese or overweight, and who had cardiovascular disease. Roughly half of the participants received a weekly injection of semaglutide, and the other half received a placebo injection.

They looked at which participants experienced any significant decline in kidney function, the onset of persistent macroalbuminuria (a risk factor for complications of kidney disease), the need to begin chronic kidney replacement therapy (dialysis or transplantation), or death.

They found that compared to the placebo group, 24% fewer people experienced kidney-related events in the group who received the weekly semaglutide injection. Researchers also found no increased risk of acute kidney injury associated with semaglutide treatment.

Authors of both studies noted that there was a lack of diversity among participants, which was a major limitation. In the first study, roughly two-thirds of the participants were men and were white. Because CKD disproportionately affects Black and Indigenous people, more research is needed to include these populations.

With CKD, people gradually lose kidney function over time. The kidneys are responsible for filtering waste products and excess fluids from the blood, which are then excreted in the urine. But when the kidneys are damaged, this filtering capability is impaired, leading to buildup of waste products. This can cause a number of health complications, including end-stage kidney disease, where a person needs dialysis or a transplant to survive.

CKD is also closely linked to diabetes—about one in three adults with type 2 diabetes also have CKD. And in fact, kidney disease is often caused by diabetes.

High blood sugar, which can be caused by type 2 diabetes, can damage blood vessels in the kidneys and impair their function. Diabetes can also cause nerve damage, making it hard to urinate or empty the bladder. If urine remains in the bladder for too long, it can lead to pressure that can injure the kidneys.

But that’s where semaglutide comes in—in addition to helping people lose weight and improve their blood pressure, it also lowers blood sugar, which can avoid these negative effects for patients with diabetes.

“Semaglutide use has [also] been associated with improving cardiovascular outcomes, which is critically important in patients with chronic kidney disease who have a high prevalence of cardiovascular disease,” Aleksandra Kukla, MD, a transplant nephrologist at the Mayo Clinic, told Health.

However, semaglutide’s ability to lower blood sugar and help the heart may not totally explain the related kidney benefits—something else may be in play.

“It is unlikely that the blood sugar lowering effects of the medication are the sole or even major reason for its protective effects,” said Brosius. “There are multiple mechanisms by which this class of medication may protect the kidneys, but at this point, no one knows what the most important ones are.”

Though earlier research has suggested that Ozempic and Wegovy may be beneficial for kidney health, these new studies have confirmed that semaglutide could be a useful treatment particularly for people with both CKD and type 2 diabetes.

“I’m optimistic about the potential impact of these findings,” said Brosius. “For people with type 2 diabetes and CKD, Ozempic represents a potential first-in-class treatment for protecting kidney function in this high-risk population. This is a great step forward for people managing both of these chronic conditions.”

Drugmaker Novo Nordisk said it plans to apply for an expansion of Ozempic’s label in the U.S. sometime in 2024.

In terms of access, most insurance plans already cover Ozempic for type 2 diabetes. But it can have a hefty price tag, especially for those who are uninsured. Average monthly costs for Ozempic and Weogvy can range between $1,000 and $1,600, depending on the pharmacy.

“It is critically important that this population with a high risk for adverse outcomes is able to receive medications such as semaglutide to improve outcomes,” said Kukla. “We are very excited to see more options for our patients. These and similar medications will improve overall health and prolong survival of our patients.”

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