Observational studyOpen heart2025

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

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

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Open heart, 2025. The graph read 3 numbers from its abstract, feeding 2 cells of the map: it . Cited by 1 paper.

3numbers the graph read from it
2cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
1 · no effect
Strokesemaglutide vs sitagliptinno clear difference · t2d, ckdfeeds one cell of the map
HR 1.020.94 to 1.10
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).
Acute myocardial infarctionsemaglutide vs sitagliptinno clear difference · t2d, ckdfeeds one cell of the map
HR 1.010.93 to 1.09
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).
All-cause deathsemaglutide vs sitagliptinfavours the treatment · t2d, ckdfeeds one cell of the map
HR 0.760.70 to 0.83
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).

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×cardiovascular events

No readable resultOpen on the map →What to test next →

13 readable studies in this cell: 7 favour the treatment, 2 find no difference, 4 favour the comparator.

Belief with this paper
0.50contested · 7 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0399313226,774 enrolled · 2018
HR 1.010.91 to 1.11
NCT0357459717,604 enrolled · 2018
HR 0.800.72 to 0.89
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
OR 1.951.28 to 3.00
NCT05564039282 enrolled · 2022
OR 20.48.40 to 49.8

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

GLP-1 receptor agonists×all-cause mortality

No readable resultOpen on the map →What to test next →

11 readable studies in this cell: 7 favour the treatment, 4 find no difference, 0 favour the comparator.

Belief with this paper
0.88replicated · 7 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT0399313226,774 enrolled · 2018
HR 0.990.83 to 1.18
NCT0357459717,604 enrolled · 2018
HR 0.800.72 to 0.89
NCT013949529,901 enrolled · 2011
HR 0.880.79 to 0.99
NCT039143269,651 enrolled · 2019
HR 0.860.77 to 0.96
NCT011790489,341 enrolled · 2010
HR 0.870.78 to 0.97
NCT038191533,533 enrolled · 2019
HR 0.760.66 to 0.88
NCT017204463,297 enrolled · 2013
HR 0.740.58 to 0.95
NCT026927163,183 enrolled · 2017
HR 0.790.57 to 1.11
HR 1.100.57 to 2.14

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

10 authors.

Takefumi KishimoriDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.ORCID http://orcid.org/0009-0000-9639-5470
Takao KatoDepartment of Cardiovascular Medicine, Kyoto University Graduate School of Medicine Faculty of Medicine, Kyoto, Japan tkato75@kuhp.kyoto-u.ac.jp.ORCID http://orcid.org/0000-0001-8213-7999
Atsuyuki WadaDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Akira TaniDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Ryosuke YamajiDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Jumpei KoikeDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Yoshihiro IwasakiDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Takehiro MatsumotoDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Takafumi YagiDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.
Masaharu OkadaDepartment of Cardiovascular Medicine, Omi Medical Center, Kusatsu, Japan.

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundType 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.

methodsThis 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.

resultsThe 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).

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

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like PeptidesRenal Insufficiency, ChronicAgedCause of DeathFemaleFollow-Up StudiesGlucagon-Like Peptide 1HumansHypoglycemic AgentsIncidenceMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsGlucagon-Like Peptide 1Glucagon-Like PeptidesHypoglycemic AgentsSemaglutideDiabetes MellitusPharmacology, ClinicalRISK FACTORS

Identifiers

PMID40628673
PMCPMC12243591

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.