Effectiveness of semaglutide on survival outcomes in patients with type 2 diabetes and chronic kidney disease.

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Open Heart Pub Date : 2025-07-08 DOI:10.1136/openhrt-2025-003382

Takefumi Kishimori, Takao Kato, Atsuyuki Wada, Akira Tani, Ryosuke Yamaji, Jumpei Koike, Yoshihiro Iwasaki, Takehiro Matsumoto, Takafumi Yagi, Masaharu Okada

{"title":"Effectiveness of semaglutide on survival outcomes in patients with type 2 diabetes and chronic kidney disease.","authors":"Takefumi Kishimori, Takao Kato, Atsuyuki Wada, Akira Tani, Ryosuke Yamaji, Jumpei Koike, Yoshihiro Iwasaki, Takehiro Matsumoto, Takafumi Yagi, Masaharu Okada","doi":"10.1136/openhrt-2025-003382","DOIUrl":null,"url":null,"abstract":"Background: Type 2 diabetes (T2D) and chronic kidney disease (CKD) significantly increase the risk of cardiovascular events, including death and heart failure (HF). The FLOW trial demonstrated that semaglutide reduces all-cause death, cardiovascular events and HF risk in patients with T2D and CKD. Since there is a difference in patient characteristics between clinical trials and real-world data, this study aims to investigate the association of semaglutide and all-cause death, acute HF or cardiovascular outcomes in patients with T2D and CKD using the data platform.Methods: This multicentre retrospective observational study using TriNetX, a global healthcare data platform. We identified 1 151 750 patients aged ≥18 years with T2D and CKD diagnosed before 31 December 2020. Among these, 14 511 patients initiated semaglutide and 69 700 initiated sitagliptin between 1 January 2018 and 31 December 2020. After propensity score matching, 13 703 patients were included in each group. The primary outcome was the 3-year incidence of all-cause death. Secondary outcomes included acute HF, acute myocardial infarction and stroke.Results: The 3-year risk of all-cause death in the semaglutide group relative to the sitagliptin group was significantly lower (7.2% (943/13 703) vs 9.5% (1196/13 703); p<0.001; HR, 0.76; 95% CI, 0.70 to 0.83). Similarly, the semaglutide group was less likely to have acute HF (12.1% vs 13.1%; HR, 0.92; 95% CI, 0.86 to 0.98). However, the risks of acute myocardial infarction and stroke in the semaglutide group relative to the sitagliptin group were not significant (9.6% vs 9.5%; HR, 1.01; 95% CI, 0.93 to 1.09 in acute myocardial infarction, and 9.2% vs 9.0%; HR, 1.02; 95% CI, 0.94 to 1.10 in stroke).Conclusions: In patients with T2D and CKD, semaglutide was associated with a lower 3-year risk of all-cause death compared with sitagliptin.","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243591/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Heart","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/openhrt-2025-003382","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Type 2 diabetes (T2D) and chronic kidney disease (CKD) significantly increase the risk of cardiovascular events, including death and heart failure (HF). The FLOW trial demonstrated that semaglutide reduces all-cause death, cardiovascular events and HF risk in patients with T2D and CKD. Since there is a difference in patient characteristics between clinical trials and real-world data, this study aims to investigate the association of semaglutide and all-cause death, acute HF or cardiovascular outcomes in patients with T2D and CKD using the data platform.

Methods: This multicentre retrospective observational study using TriNetX, a global healthcare data platform. We identified 1 151 750 patients aged ≥18 years with T2D and CKD diagnosed before 31 December 2020. Among these, 14 511 patients initiated semaglutide and 69 700 initiated sitagliptin between 1 January 2018 and 31 December 2020. After propensity score matching, 13 703 patients were included in each group. The primary outcome was the 3-year incidence of all-cause death. Secondary outcomes included acute HF, acute myocardial infarction and stroke.

Results: The 3-year risk of all-cause death in the semaglutide group relative to the sitagliptin group was significantly lower (7.2% (943/13 703) vs 9.5% (1196/13 703); p<0.001; HR, 0.76; 95% CI, 0.70 to 0.83). Similarly, the semaglutide group was less likely to have acute HF (12.1% vs 13.1%; HR, 0.92; 95% CI, 0.86 to 0.98). However, the risks of acute myocardial infarction and stroke in the semaglutide group relative to the sitagliptin group were not significant (9.6% vs 9.5%; HR, 1.01; 95% CI, 0.93 to 1.09 in acute myocardial infarction, and 9.2% vs 9.0%; HR, 1.02; 95% CI, 0.94 to 1.10 in stroke).

Conclusions: In patients with T2D and CKD, semaglutide was associated with a lower 3-year risk of all-cause death compared with sitagliptin.

查看原文本刊更多论文

西马鲁肽对2型糖尿病合并慢性肾病患者生存结局的影响

背景：2型糖尿病（T2D）和慢性肾脏疾病（CKD）显著增加心血管事件的风险，包括死亡和心力衰竭（HF）。FLOW试验表明，西马鲁肽可降低T2D和CKD患者的全因死亡、心血管事件和HF风险。由于临床试验和真实数据之间的患者特征存在差异，本研究旨在利用数据平台调查西马鲁肽与T2D和CKD患者的全因死亡、急性HF或心血管结局的关系。方法：使用TriNetX全球医疗数据平台进行多中心回顾性观察研究。我们确定了1 151 750例年龄≥18岁，在2020年12月31日之前诊断为T2D和CKD的患者。其中，14511名患者在2018年1月1日至2020年12月31日期间开始使用西格列汀，69700名患者开始使用西格列汀。经倾向评分匹配后，每组纳入13 703例患者。主要终点是3年内全因死亡发生率。次要结局包括急性心衰、急性心肌梗死和脑卒中。结果：与西格列汀组相比，西玛鲁肽组3年全因死亡风险显著降低(7.2% (943/13 703)vs 9.5% (1196/13 703)；结论：在T2D和CKD患者中，与西格列汀相比，西马鲁肽与较低的3年全因死亡风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.60

自引率

3.70%

发文量

145

审稿时长

20 weeks

期刊介绍： Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.