{ "release_id": "f6f6f1b6f50379ed", "id": "cardio:semaglutide", "owner": "cardio", "kind": "drug", "slug": "semaglutide", "name": "Semaglutide", "aliases": [ "Semaglutide" ], "atlases": [ "cardio" ], "summary_plain": "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.", "summary_technical": "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).", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": null, "next_review_due": null, "identifiers": [ { "scheme": "rxnorm", "value": "1991302", "normalized_value": "1991302", "match": "exact", "version": null, "label": null, "from_source": false } ], "navigation": { "cardio": { "system": [ "metabolism" ], "condition-area": [ "diabetes-and-metabolic-disease" ] } }, "payload": { "level": "substance", "mechanism": null }, "content_digest": "8ce2be3b6c7bf04232e2640648216d2b3181cefd8faa95ec1758ff403603417a", "review": { "content_digest": "8ce2be3b6c7bf04232e2640648216d2b3181cefd8faa95ec1758ff403603417a", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "f6f6f1b6f50379ed", "id": "cardio:claim-flow-kidney-effect", "owner": "cardio", "subject_entity_id": "cardio:semaglutide", "category": "effect", "statement": "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.", "context": { "id": "cardio:ctx-flow-adults-type-2-diabetes-ckd", "label": "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_note": "Adults aged 18 years or older (registry minimum age 18 years)", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Median follow-up 3.4 years, after early cessation of the trial was recommended at a prespecified interim analysis.", "eligibility": { "inclusion": [ "Type 2 diabetes", "eGFR 50 to 75 ml per minute per 1.73 m2 with albumin-to-creatinine ratio above 300 and below 5000, or eGFR 25 to below 50 with ratio above 100 and below 5000" ], "exclusion": [] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "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.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 2", "applicability_note": "Primary outcome first events and hazard ratio.", "snapshot": { "id": "cardio:pubmed-38785209-2026-10-14", "retrieved_at": "2026-10-14T18:18:48Z", "content_hash": "e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2403347", "source_type": "publication", "title": "Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2403347", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2403347", "normalized_value": "10.1056/nejmoa2403347", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "38785209", "normalized_value": "38785209", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-07-11", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. 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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.", "context": { "id": "cardio:ctx-select-adults-cvd-overweight-obesity-no-diabetes", "label": "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_note": "Adults aged 45 years or older (registry minimum age 45 years)", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Mean follow-up 39.8 months. Mean duration of exposure to semaglutide or placebo 34.2 months.", "eligibility": { "inclusion": [ "Age 45 years or older", "Preexisting cardiovascular disease", "Body-mass index of 27 or greater" ], "exclusion": [ "History of diabetes" ] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "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. 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