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Semaglutide & Kidney Function in Overweight/Obesity With or Without Type 2 Diabetes

In adults with overweight or obesity and type 2 diabetes, semaglutide improved urine albumin-to-creatinine ratio (UACR), data from the STEP 1 through 3 trials show. When patients had normal kidney function, semaglutide had no effect on the decline in estimated glomerular filtration rate (eGFR).

All participants in the STEP trials were adults with overweight/obesity; those in STEP 2 also had type 2 diabetes. The interventions were once-weekly subcutaneous semaglutide 1.0 mg (STEP 2 only), 2.4 mg, or placebo for 68 weeks, plus lifestyle intervention (STEP 1 and 2) or intensive behavioral therapy (STEP 3). The pooled results showed the following: “In STEP 2, 1,205 (99.6% total cohort) patients had UACR data; geometric mean baseline UACR was 13.7, 12.5, and 13.2 mg/g with semaglutide 1.0 mg, 2.4 mg, and placebo, respectively. At week 68, UACR changes were −14.8% and −20.6% with semaglutide 1.0 mg and 2.4 mg, respectively, and +18.3% with placebo (between-group differences [95% CI] vs. placebo: −28.0% [−37.3, −17.3], P < 0.0001 for semaglutide 1.0 mg; −32.9% [−41.6, −23.0], P = 0.003 for semaglutide 2.4 mg). UACR status improved in greater proportions of patients with semaglutide 1.0 mg and 2.4 mg versus placebo (P = 0.0004 and P = 0.0014, respectively). In the pooled STEP 1–3 analyses, 3,379 participants had eGFR data; there was no difference between semaglutide 2.4 mg and placebo in eGFR trajectories at week 68.”

Source: Diabetes Care