Nephrology · Endocrinology · 54 min ago
Semaglutide Linked to Lower Mortality and Hospitalization in Dialysis Cohort
A U.S. target trial emulation using claims data compared semaglutide with dulaglutide or liraglutide in 3,913 people with diabetes receiving maintenance hemodialysis. Semaglutide use was associated with lower estimated rates of death on dialysis and hospitalization, although the observational design cannot establish causality.
- Cohort included 3,913 hemodialysis patients with diabetes.
- Semaglutide was associated with lower mortality and hospitalization.
- Comparisons with liraglutide showed no significant outcome benefit.
- Observational design limits causal interpretation.
Researchers used 2011–2022 U.S. Renal Data System and Medicare data to emulate a target trial comparing semaglutide with dulaglutide or liraglutide among people with diabetes receiving maintenance hemodialysis. The analysis included 1,312 semaglutide users and 2,601 users of dulaglutide or liraglutide. Overlap weighting adjusted for measured confounders; median follow-up was 1.1 years, and the weighted effective sample size was 3,200.
Compared with dulaglutide or liraglutide combined, semaglutide was associated with a lower subdistribution hazard of death on dialysis (sHR 0.82, 95% CI 0.70–0.97) and all-cause hospitalization (sHR 0.91, 95% CI 0.83–0.99). One-year cumulative incidences were 11% versus 13% for death and 57% versus 62% for hospitalization. Weight loss at one year was −4.8% with semaglutide and −3.4% with the comparators. In drug-specific comparisons, associations favored semaglutide over dulaglutide, while comparisons with liraglutide did not show statistically significant benefits for mortality or hospitalization.
The findings suggest a possible comparative advantage over dulaglutide in this population, but treatment was not randomized and residual confounding remains possible. The results do not establish that semaglutide causes better outcomes or support a change in practice on their own.
In practice
For people with diabetes receiving maintenance hemodialysis, this observational U.S. comparison found semaglutide use associated with lower estimated mortality on dialysis and hospitalization than dulaglutide or liraglutide combined; the drug-specific comparison showed statistically significant associations versus dulaglutide but not versus liraglutide. These results may inform discussion of comparative evidence, but they do not establish a causal treatment advantage. Because treatment was not randomized and residual confounding may remain, the findings alone do not justify changing treatment practice.
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Diabetes Care: Target Trial of Semaglutide Versus Dulaglutide or Liraglutide in Patients Receiving Hemodialysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.