Late-Breaking Science: What are the effects of semaglutide on HF outcomes in patients with T2D and CKD?
31 Aug 2024
Late-Breaking Science In yesterday’s Late-Breaking Science clinical trial updates session on semaglutide, Professor Richard Pratley (AdventHealth Translational Research Institute - Orlando, USA) presented an analysis of heart failure (HF) outcomes in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD) from the FLOW trial.
Earlier this year, the glucagon-like peptide 1 receptor agonist (GLP-1RA), semaglutide, was found to reduce the risk of clinically important kidney outcomes and CV death by 24% vs. placebo in patients with T2D and CKD in the phase 3 FLOW trial.1 As presented yesterday, a pre-specified analysis of FLOW examined the effects of semaglutide on HF outcomes.
Of the 3,533 randomised trial population, 19% had a history of HF at baseline. Participants with a history of HF compared with those without were more likely to be female (36% vs. 29%), have a higher median body mass index (33 kg/m2 vs. 31 kg/m2) and HbA1c (7.9% vs. 7.5%) and were more likely to have a history of a CV event (40% vs. 19%) (all ≤0.001), with no difference between baseline estimated glomerular filtration rate and urine albumin‐to‐creatinine ratio.
In the full analysis set, semaglutide decreased the risk of HF events or CV death by 27% vs. placebo (hazard ratio [HR] 0.73; 95% CI 0.62 to 0.87; p=0.0005). The risk of HF events alone was reduced to a similar extent (HR 0.73; 95% CI 0.58 to 0.92; p=0.0068). Notably, the risk reduction for HF events or CV death was similar in participants with a history of HF at baseline (HR 0.73; 95% CI 0.54 to 0.98) and without HF (HR 0.72; 95% CI 0.58 to 0.89; pinteraction=0.9266).
Prof. Pratley concludes, “FLOW was the first dedicated kidney outcomes trial with a GLP-1RA. Knowing that semaglutide also improves HF outcomes in patients with T2D and CKD, regardless of HF history, further extends its clinical benefit in this high-risk population.”
References
- Perkovic V, et al. N Engl J Med. 2024;391:109–121.
