Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes
2024 · paper · Clinical trials
A randomized trial of weekly semaglutide versus placebo in 3533 people with type 2 diabetes and chronic kidney disease. Major kidney events, including kidney failure and kidney or cardiovascular death, were 24% less frequent with semaglutide over a median 3.4 years.
2 findings
Substance Figure 2 gives the 'Other' race subgroup as '11/56' (semaglutide) and '21/69' (placebo), but Table 1 gives 'Other' race as '95 (5.4)' and '109 (6.2)' under the same definition. As a result the Figure 2 race rows do not sum to the trial totals.
- p. 10 Figure 2, Race or ethnic group, Other
11/56
- p. 4 Table 1, Race or ethnic group, Other
95 (5.4)
- p. 11 Figure 2 legend
“other” includes American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and “not reported.”
- p. 10 Figure 2, Race or ethnic group, Other
11/56 ... 21/69
Only the authors can say what is right here.
Judge's note: The Table 1 footnote † (p4) and the Figure 2 legend (p11) define 'Other' identically, including 'not reported'. In Figure 2 the Asian, Black and White rows match Table 1 exactly (439/407, 78/82, 1155/1168), but the Other row is 56/69 rather than 95/109. The race rows therefore sum to 1728/1726 participants and 323/400 events, against 1767/1766 and 331/410. Most other complete subgroups (sex, age, region, insulin, metformin, SGLT2) sum to the totals. One reviewer's placebo sum of 1699 is wrong; the correct sum is 1726. Nothing in the paper explains the gap.
Second check: another model agreed
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Reference or label 'the effect of semaglutide was unrelated to changes in body weight regardless of whether the eGFR was computed with serum creatinine, cystatin C, or both,18,19' cites only ref 18 (dulaglutide, AWARD-7) and ref 19 (tirzepatide, SURPASS-4), neither of which concerns semaglutide.
- p. 11 Discussion, mechanisms paragraph
the effect of semaglutide was unrelated to changes in body weight regardless of whether the eGFR was computed with serum creatinine, cystatin C, or both,18,19
- p. 13 References 18 and 19
Body weight and eGFR during dulaglutide treatment
- p. 13 References 18 and 19
Body weight and eGFR during dulaglutide treatment in type 2 diabetes
Only the authors can say what is right here.
Judge's note: Reference list (p13): ref 18 'Body weight and eGFR during dulaglutide treatment in type 2 diabetes and moderate-to-severe chronic kidney disease (AWARD-7)'; ref 19 'Effects of tirzepatide versus insulin glargine on cystatin C-based kidney function: a SURPASS-4 post hoc analysis'. The clause that follows reports this trial's own finding separately ('identified in this trial'), so the semaglutide claim rests on studies of other drugs. Either the drug named or the citations need correcting; only the authors can say which.
Second check: another model agreed
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3 minor (typos and the like; most checked by the judge only)
Wording The Figure 1 legend lists the kidney-specific components of the primary outcome and death from cardiovascular causes among the 'several confirmatory secondary outcomes', but Methods name only three ('Three key confirmatory secondary outcomes were defined').
- p. 7 Figure 1 legend
several confirmatory secondary outcomes: kidney-specific components of the primary outcome
- p. 3 Trial Outcomes
Three key confirmatory secondary outcomes were defined
Judge's note: Methods (p3) define three confirmatory secondary outcomes: total eGFR slope, major cardiovascular events and death from any cause. Table 2 (p8, upright) puts the kidney-specific composite and CV death outside the 'Confirmatory secondary outcomes' heading. The Fig. 1 legend (p7) classes them as confirmatory secondary outcomes, so the endpoint tier is mislabelled in the legend.
Second check: another model agreed
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Typo In the death-from-any-cause result a comma, not a semicolon, comes before the P value: '0.80; 95% CI, 0.67 to 0.95, P = 0.01' (abstract and Results). The adjacent result reads '0.82; 95% CI, 0.68 to 0.98; P=0.029'.
- p. 7 Confirmatory secondary outcomes, death from any cause
0.80; 95% CI, 0.67 to 0.95, P = 0.01
- p. 1 Abstract
0.80; 95% CI, 0.67 to 0.95, P = 0.01
Judge's note: The images of p1 and p7 confirm the comma in both places, while the major-cardiovascular-events result uses a semicolon. This is cosmetic punctuation only.
Second check: none (judge only)
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Typo A Figure 2 subgroup label reads 'Previous myocardial infarction of stroke'; it should be 'or stroke'.
- p. 10 Figure 2, Cardiovascular disease subgroup
Previous myocardial infarction of stroke
Judge's note: The p10 image shows the misprint in the figure itself. The row above reads 'No previous myocardial infarction or stroke', and Table 1 reads 'Previous myocardial infarction or stroke'.
Second check: none (judge only)