Semaglutide
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.
Also called Semaglutide
- Drug
- In this atlas
Overview
Technical summary
RxNorm ingredient 1991302. A member of the GLP-1 receptor agonist class by FDA 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).
About this drug
- Level
- Substance
- Mechanism
- Not reported
Claims and evidence
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.
Eligibility: 3 inclusion criteria; 1 exclusion criterion
- Included
- Age 45 years or older
- Preexisting cardiovascular disease
- Body-mass index of 27 or greater
- Excluded
- History of diabetes
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.
Applies to Adult- Adults aged 45 years or older with preexisting cardiovascular disease and a body-mass index of 27 or greater, with no history of diabetes.
- Multicenter trial. The abstract and the registry fields read do not describe the care setting further.
- Multinational. The registry lists the sites by country on the study page.
- Adults aged 45 years or older (registry minimum age 45 years)
- Certainty method
- Not assessed
- 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
- Next evidence check due
- Not scheduled
Sources and citations (6)
-
Supports Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
- Locator
- Abstract, RESULTS, sentence 3
- How it applies
- Primary end-point events by arm and the hazard ratio.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Supports Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
- Locator
- Abstract, RESULTS, sentence 1; Abstract, RESULTS, sentence 2
- How it applies
- Numbers randomized to each arm and the follow-up time.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Supports Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
- Locator
- Abstract, RESULTS, sentence 4
- How it applies
- Adverse events that led to permanent discontinuation, by arm.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Supports Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
- Locator
- Abstract, CONCLUSIONS, sentence 1
- How it applies
- The authors conclusion, with the primary end point and the follow-up.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Background Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
- Locator
- Abstract, METHODS, sentence 1; Abstract, METHODS, sentence 2; Abstract, METHODS, sentence 3
- How it applies
- Population, dose and primary end point.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Background Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes
- Locator
- Abstract, CONCLUSIONS, sentence 2
- How it applies
- Funding line in the abstract.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
dabd7cd9d6c08b9c07da39a19d0b48266bfb7ddbbaacefe2e11025d105708245- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
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.
Eligibility: 2 inclusion criteria; exclusion criteria not stated
- Included
- 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
- Excluded
- None stated
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.
Applies to Adult- 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.
- Multicenter trial. The care setting is not described further in the sources read.
- Multinational. The registry lists the sites by country on the study page.
- Adults aged 18 years or older (registry minimum age 18 years)
- Certainty method
- Not assessed
- 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
- Next evidence check due
- Not scheduled
Sources and citations (6)
-
Supports Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
- Locator
- Abstract, RESULTS, sentence 2
- How it applies
- Primary outcome first events and hazard ratio.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Supports Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
- Locator
- Abstract, RESULTS, sentence 3; Abstract, RESULTS, sentence 4
- How it applies
- Kidney-specific components, cardiovascular death and the confirmatory secondary outcomes.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Supports Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
- Locator
- Abstract, RESULTS, sentence 5
- How it applies
- Serious adverse events by arm.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Supports Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
- Locator
- Abstract, CONCLUSIONS, sentence 1
- How it applies
- The authors conclusion.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Background Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
- Locator
- Abstract, METHODS, sentence 2; Abstract, METHODS, sentence 3
- How it applies
- Definition of the primary outcome.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
-
Background Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
- Locator
- Abstract, CONCLUSIONS, sentence 2
- How it applies
- Funding line.
- Retrieved
- Source effective date
- Not reported
- Source state
- Current
- Snapshot hash
e381f1095bd3a4caeafb165ad51c78bdf3ac532bd21f4c2eaa04a3206b5d5fad- Reuse basis
- PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.
Clinical links
Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.
-
Claim, not a settled fact The FLOW trial looked at a kidney outcome in people with type 2 diabetes: Chronic kidney disease (CKD)
Applies to Adult- 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.
- Multicenter trial. The care setting is not described further in the sources read.
- Multinational. The registry lists the sites by country on the study page.
- Adults aged 18 years or older (registry minimum age 18 years)
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.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.
-
Claim, not a settled fact SELECT: fewer major cardiovascular events than placebo in adults with existing cardiovascular disease and overweight or obesity, without diabetes: Obesity
Applies to Adult- Adults aged 45 years or older with preexisting cardiovascular disease and a body-mass index of 27 or greater, with no history of diabetes.
- Multicenter trial. The abstract and the registry fields read do not describe the care setting further.
- Multinational. The registry lists the sites by country on the study page.
- Adults aged 45 years or older (registry minimum age 45 years)
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.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.
Record details
- Record id
cardio:semaglutide- Content hash
dabc7a75b31cd75deaf23c02d2c2c1db43615c215a9f169a3b5a113203204c87