Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial
Authors' conclusion
The benefits of semaglutide in reducing kidney outcomes were consistent in participants with/without baseline SGLT2i use; power was limited to detect smaller but clinically relevant effects.
Study context
- Population
- FLOW trial participants with T2D and CKD, stratified by baseline SGLT2i use or no usestratified by baseline SGLT2i use 550 · or no use 2,983
- Comparison
- Semaglutide vs placebo, with and without baseline SGLT2i use
- Primary endpoint
- Composite of:
- Kidney failure
- ≥50% eGFR reduction
- Kidney death
- Cardiovascular (CV) death
Methodological detailssubgroup analysis by baseline SGLT2i use, stratified by baseline SGLT2i use
- Subgroup analysis by baseline SGLT2i use
- Stratified by baseline SGLT2i use
Primary result
As reported in the abstract
Primary composite outcome by baseline SGLT2i use
Semaglutide (SGLT2i at baseline)
41 of 277
events
Placebo (SGLT2i at baseline)
38 of 273
events
Semaglutide (no SGLT2i at baseline)
290 of 1,490
events
Placebo (no SGLT2i at baseline)
372 of 1,493
events
Hazard ratio (95% CI)P value
Semaglutide (SGLT2i at baseline)vs Placebo (SGLT2i at baseline)
1.07(0.69–1.67)
P = 0.755Semaglutide (no SGLT2i at baseline)vs Placebo (no SGLT2i at baseline)
0.73(0.63–0.85)
P < 0.001Secondary outcomes
| Outcome | Treatment difference (ml min-1/1.73 m²/year) (CI) | |
|---|---|---|
| Total eGFR slope (ml min-1/1.73 m²/year), confirmatory secondarySemaglutide (SGLT2i subgroup)vs Placebo (SGLT2i subgroup)Favoring semaglutide | 0.75 (−0.01 to 1.5) | |
| Total eGFR slope (ml min-1/1.73 m²/year), confirmatory secondarySemaglutide (non-SGLT2i subgroup)vs Placebo (non-SGLT2i subgroup)Favoring semaglutide | 1.25 (0.91–1.58) | |
| −1012Difference, ml min-1/1.73 m²/year (linear scale) |
| Outcome | P value |
|---|---|
| Total eGFR slope (ml min-1/1.73 m²/year), confirmatory secondaryBetween SGLT2i subgroup and Non-SGLT2i subgroup | P interaction 0.237 |
| MACE and all-cause death, confirmatory secondaryBetween SGLT2i use and No SGLT2i use | P interaction 0.741 |
| MACE and all-cause death, confirmatory secondaryBetween SGLT2i use and No SGLT2i use | P interaction 0.901 |
Primary composite outcome, all participants
- Risk 24% lower with semaglutide vs placebo
- 24% (95% CI: 34%, 12%)
MACE and all-cause death, confirmatory secondary
- Semaglutide benefits on MACE and all-cause death similar regardless of SGLT2i use
Original publication
Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial. Nat Med. Published 24 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →