# Semaglutide Drug · id `cardio:semaglutide` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Also called: Semaglutide Browse, organ or system: Metabolism Browse, condition area: Diabetes and metabolic disease ## In plain language The medicine inside Ozempic and Wegovy. It is a GLP-1 receptor agonist given as an injection once a week. The SELECT trial tested semaglutide 2.4 mg in adults with heart disease and overweight or obesity but no diabetes. The FLOW trial tested semaglutide 1.0 mg in people who have both type 2 diabetes and chronic kidney disease. ## Technical summary RxNorm ingredient 1991302. A member of the GLP-1 receptor agonist class by established pharmacologic class (RxClass, DailyMed relationships). In SELECT the primary cardiovascular outcome hazard ratio was 0.80 (95% CI 0.72 to 0.90); in FLOW the primary kidney outcome hazard ratio was 0.76 (95% CI 0.66 to 0.88). ## Claims, with the population each applies to ## Context: Adults with type 2 diabetes together with chronic kidney disease (FLOW) Recipient: Adult; Population: Patients who have both type 2 diabetes and chronic kidney disease, defined by an eGFR of 50 to 75 ml per minute per 1.73 m2 with a urinary albumin-to-creatinine ratio above 300 and below 5000, or an eGFR of 25 to below 50 with a ratio above 100 and below 5000. The registry gives a minimum age of 18 years.; Care setting: Multicenter trial. The care setting is not described further in the sources read.; Geography: Multinational. The registry lists the sites by country on the study page.; Life stage: Adults aged 18 years or older (registry minimum age 18 years); Follow-up: Median follow-up 3.4 years, after early cessation of the trial was recommended at a prespecified interim analysis. ### In FLOW, 3533 patients who had both type 2 diabetes and chronic kidney disease were randomly assigned to semaglutide 1.0 mg once a week or placebo (1767 and 1766 patients). Over a median of 3.4 years, the risk of the primary outcome, a composite of kidney failure, at least a 50% drop in eGFR, or death from kidney-related or cardiovascular causes, was 24% lower on semaglutide (331 against 410 first events; hazard ratio 0.76, 95% CI 0.66 to 0.88; P=0.0003). The kidney-specific components together had a hazard ratio of 0.79 (95% CI 0.66 to 0.94) and death from cardiovascular causes 0.71 (0.56 to 0.89). All confirmatory secondary outcomes favored semaglutide, including major cardiovascular events (0.82; 0.68 to 0.98) and death from any cause (0.80; 0.67 to 0.95). Serious adverse events were reported in 49.6% of the semaglutide group and 53.8% of the placebo group. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Patients who have both type 2 diabetes and chronic kidney disease, defined by an eGFR of 50 to 75 ml per minute per 1.73 m2 with a urinary albumin-to-creatinine ratio above 300 and below 5000, or an eGFR of 25 to below 50 with a ratio above 100 and below 5000. The registry gives a minimum age of 18 years.; Care setting: Multicenter trial. The care setting is not described further in the sources read.; Geography: Multinational. The registry lists the sites by country on the study page.; Life stage: Adults aged 18 years or older (registry minimum age 18 years); Follow-up: Median follow-up 3.4 years, after early cessation of the trial was recommended at a prespecified interim analysis. - Limitations: The trial was stopped early: the abstract says early cessation was recommended at a prespecified interim analysis, and it does not give the reason in the sentence read. The dose tested was 1.0 mg weekly, not the 2.4 mg used in SELECT. Funded by Novo Nordisk (named in the abstract). Only the PubMed abstract was read. - Last checked: 2026-10-14 - Sources: 1. Supports: Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2. Retrieved 2026-10-14T18:18:48Z. Source state: Current. Snapshot hash: e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad. How it applies: Primary outcome first events and hazard ratio. 2. Supports: Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3; Abstract, RESULTS, sentence 4. Retrieved 2026-10-14T18:18:48Z. Source state: Current. Snapshot hash: e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad. How it applies: Kidney-specific components, cardiovascular death and the confirmatory secondary outcomes. 3. Supports: Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 5. Retrieved 2026-10-14T18:18:48Z. Source state: Current. Snapshot hash: e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad. How it applies: Serious adverse events by arm. 4. Supports: Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:48Z. Source state: Current. Snapshot hash: e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad. How it applies: The authors conclusion. 5. Background: Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 2; Abstract, METHODS, sentence 3. Retrieved 2026-10-14T18:18:48Z. Source state: Current. Snapshot hash: e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad. How it applies: Definition of the primary outcome. 6. Background: Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 2. Retrieved 2026-10-14T18:18:48Z. Source state: Current. Snapshot hash: e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad. How it applies: Funding line. ## Context: Adults 45 and over with existing cardiovascular disease and overweight or obesity, without diabetes (SELECT) Recipient: Adult; Population: Adults aged 45 years or older with preexisting cardiovascular disease and a body-mass index of 27 or greater, with no history of diabetes.; Care setting: Multicenter trial. The abstract and the registry fields read do not describe the care setting further.; Geography: Multinational. The registry lists the sites by country on the study page.; Life stage: Adults aged 45 years or older (registry minimum age 45 years); Follow-up: Mean follow-up 39.8 months. Mean duration of exposure to semaglutide or placebo 34.2 months. ### In SELECT, adults aged 45 and over with existing cardiovascular disease, a body-mass index of 27 or more and no history of diabetes took semaglutide 2.4 mg once a week or placebo. Over a mean follow-up of 39.8 months, a first major cardiovascular event (death from cardiovascular causes, nonfatal heart attack or nonfatal stroke) occurred in 569 of 8803 people (6.5%) on semaglutide and 701 of 8801 (8.0%) on placebo (hazard ratio 0.80, 95% CI 0.72 to 0.90). More people on semaglutide stopped the medicine permanently because of an adverse event: 1461 (16.6%) against 718 (8.2%) on placebo. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Adults aged 45 years or older with preexisting cardiovascular disease and a body-mass index of 27 or greater, with no history of diabetes.; Care setting: Multicenter trial. The abstract and the registry fields read do not describe the care setting further.; Geography: Multinational. The registry lists the sites by country on the study page.; Life stage: Adults aged 45 years or older (registry minimum age 45 years); Follow-up: Mean follow-up 39.8 months. Mean duration of exposure to semaglutide or placebo 34.2 months. - Limitations: One double-blind trial, funded by Novo Nordisk (named in the abstract). It enrolled people with existing cardiovascular disease and overweight or obesity who did not have diabetes, so it says nothing about people with diabetes, people without existing cardiovascular disease, or adults under 45. Only the PubMed abstract was read, not the full paper. The abstract reports no certainty grade. - Last checked: 2026-10-14 - Sources: 1. Supports: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3. Retrieved 2026-10-14T18:18:47Z. Source state: Current. Snapshot hash: dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245. How it applies: Primary end-point events by arm and the hazard ratio. 2. Supports: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1; Abstract, RESULTS, sentence 2. Retrieved 2026-10-14T18:18:47Z. Source state: Current. Snapshot hash: dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245. How it applies: Numbers randomized to each arm and the follow-up time. 3. Supports: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4. Retrieved 2026-10-14T18:18:47Z. Source state: Current. Snapshot hash: dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245. How it applies: Adverse events that led to permanent discontinuation, by arm. 4. Supports: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:47Z. Source state: Current. Snapshot hash: dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245. How it applies: The authors conclusion, with the primary end point and the follow-up. 5. Background: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 1; Abstract, METHODS, sentence 2; Abstract, METHODS, sentence 3. Retrieved 2026-10-14T18:18:47Z. Source state: Current. Snapshot hash: dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245. How it applies: Population, dose and primary end point. 6. Background: Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 2. Retrieved 2026-10-14T18:18:47Z. Source state: Current. Snapshot hash: dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245. How it applies: Funding line in the abstract. ## Connected pages - FDA established pharmacologic class: GLP-1 Receptor Agonist: GLP-1 receptor agonists (drug class) (`cardio:glp1-receptor-agonists`) - The FLOW trial looked at a kidney outcome in people with type 2 diabetes: Chronic kidney disease (CKD) (`cardio:chronic-kidney-disease`) [a claim, not a settled fact; see claim `cardio:claim-flow-kidney-effect` and its context] - SELECT: fewer major cardiovascular events than placebo in adults with existing cardiovascular disease and overweight or obesity, without diabetes: Obesity (`core:obesity`) [a claim, not a settled fact; see claim `cardio:claim-select-primary-effect` and its context] - Filed under this front: Medicines (`cardio:front-medicines`) - Contained in: Semaglutide injection for diabetes (Ozempic) (`cardio:ozempic`) - Contained in: Semaglutide injection for weight management (Wegovy) (`cardio:wegovy`) - Investigated in: FLOW: semaglutide and kidney outcomes in type 2 diabetes with chronic kidney disease (`cardio:flow-trial`) - Investigated in: SELECT: semaglutide and cardiovascular outcomes in overweight or obesity (`cardio:select-trial`) ## Provenance Content hash: 8ce2be3b6c7bf04232e2640648216d2b3181cefd8faa95ec1758ff403603417a Last substantive edit: 2026-10-15 Evidence last checked: Not recorded