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Abstract: SA-PO265

Semaglutide Improves eGFR Slope vs. Placebo Regardless of Baseline HbA1c and Blood Pressure in People With Type 2 Diabetes: A Post Hoc Analysis of SUSTAIN 6 and PIONEER 6

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Cherney, David, University Health Network, Toronto, Ontario, Canada
  • Bosch-Traberg, Heidrun, Novo Nordisk AS, Søborg, Denmark
  • Hadjadj, Samy, L’institut du thorax, Nantes, France
  • Kuhlman, Anja Birk, Novo Nordisk AS, Søborg, Denmark
  • Rasmussen, Soren, Novo Nordisk AS, Søborg, Denmark
  • Tuttle, Katherine R., University of Washington, Spokane, Washington, United States
  • L Heerspink, Hiddo Jan, University Medical Center Groningen, Groningen, Netherlands
Background

Previous analyses of SUSTAIN 6 and PIONEER 6 cardiovascular (CV) outcome trials indicate that semaglutide (respectively, subcutaneous and oral) reduces the decline rate (slope) of estimated glomerular filtration rate (eGFR) vs placebo in people with type 2 diabetes on standard of care antidiabetes medication at high CV risk. The effect was more pronounced in those with a comparatively lower eGFR (<60 mL/min/1.73 m2). This post hoc analysis evaluated whether the effect of semaglutide vs placebo on eGFR slope was consistent across different levels of glycemic control (HbA1c) or blood pressure (BP) at baseline.

Methods

Pooled SUSTAIN 6 and PIONEER 6 data were analyzed for change in eGFR slope from baseline in HbA1c (<8 and ≥8%) and BP (<140/90 and ≥140/90 mmHg) subgroups. A sensitivity analysis was performed adjusting for age, sex, diabetes duration, antidiabetes medication, smoking status, prior CV events, geographic region, and eGFR at baseline. Groups were also analyzed by baseline eGFR (<60 and ≥60 mL/min/1.73 m2).

Results

Baseline characteristics were similar across HbA1c and BP subgroups. The mean urine albumin:creatinine ratio, measured in SUSTAIN 6 only, was higher in HbA1c ≥8% and BP ≥140/90 mmHg subgroups (29.6 and 39.1 mg/g, respectively) than the HbA1c <8% and BP <140/90 mmHg subgroups (17.2 and 17.0 mg/g, respectively). Semaglutide consistently reduced eGFR slope decline vs placebo in all subgroups (Figure), as supported by the sensitivity and eGFR subgroup analyses.

Conclusion

Semaglutide reduces eGFR slope decline vs placebo regardless of glycemic control or BP level, suggesting a consistent effect of semaglutide on eGFR preservation.

Estimated annual eGFR slopes according to treatment, and HbA1c and BP subgroups at baseline

Funding

  • Commercial Support