Semaglutide Improves eGFR Slope vs. Placebo Regardless of Baseline HbA1c and Blood Pressure in People With Type 2 Diabetes: A Post Hoc Analysis of SUSTAIN 6 and PIONEER 6
Bibliographic record
Abstract
Background: Previous analyses of SUSTAIN 6 and PIONEER 6 cardiovascular (CV) outcome trials indicate that semaglutide (respectively, subcutaneous and oral) reduces the decline rate (slope) of estimated glomerular filtration rate (eGFR) vs placebo in people with type 2 diabetes on standard of care antidiabetes medication at high CV risk. The effect was more pronounced in those with a comparatively lower eGFR (<60 mL/min/1.73 m2). This post hoc analysis evaluated whether the effect of semaglutide vs placebo on eGFR slope was consistent across different levels of glycemic control (HbA1c) or blood pressure (BP) at baseline. Methods: Pooled SUSTAIN 6 and PIONEER 6 data were analyzed for change in eGFR slope from baseline in HbA1c (<8 and ≥8%) and BP (<140/90 and ≥140/90 mmHg) subgroups. A sensitivity analysis was performed adjusting for age, sex, diabetes duration, antidiabetes medication, smoking status, prior CV events, geographic region, and eGFR at baseline. Groups were also analyzed by baseline eGFR (<60 and ≥60 mL/min/1.73 m2). Results: Baseline characteristics were similar across HbA1c and BP subgroups. The mean urine albumin:creatinine ratio, measured in SUSTAIN 6 only, was higher in HbA1c ≥8% and BP ≥140/90 mmHg subgroups (29.6 and 39.1 mg/g, respectively) than the HbA1c <8% and BP <140/90 mmHg subgroups (17.2 and 17.0 mg/g, respectively). Semaglutide consistently reduced eGFR slope decline vs placebo in all subgroups (Figure), as supported by the sensitivity and eGFR subgroup analyses. Conclusions: Semaglutide reduces eGFR slope decline vs placebo regardless of glycemic control or BP level, suggesting a consistent effect of semaglutide on eGFR preservation. Funding: Commercial Support - Novo Nordisk A/SEstimated annual eGFR slopes according to treatment, and HbA1c and BP subgroups at baseline
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.010 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".