#6005 COMPARISON OF SEMAGLUTIDE ORAL VS SUBCUTANEOUS IN CHRONIC KIDNEY DISEASE (CKD)

Abstract

Abstract Background and Aims The use of GLP-1 receptor agonist (ra) has become one of the cornerstones for CKD type 2 diabetic patients (T2DM) treatment. Oral formulation of semaglutide appeared as new therapeutical tool to increase the use of drugs with proved renal benefit. However, method of administration of the oral formulation and oral absorption limitations in CKD patients could adversely affect drug efficacy. The aim of this study was to compare the efficacy of semaglutide sbc vs oral in CKD patients Method Prospective, real-world study performed in T2DM-CKD patients with indication of initiation of GLP-1ra therapy in which semaglutide sbc or oral was initiated. Patients were assigned to sbc or oral formulation according to drug accessibility and patient preferences. Patients previously treated with any other GLP-1ra were excluded. Results 70 patients were included, 50 with sbc and 20 with oral semaglutide with mean follow up time of 407 [180-753] and 154 [75.5-205] days respectively (mean, IQR) Basal characteristic of the patients are shown in the table. More male patients were included but age eGFR and UACR showed no significant differences between groups. 80% and 50% of the patients were on maximum semaglutide dose (1.0 mg sbc and 14 mg or respectively) and 12% and 45% were on the low dose (0.25 mg sbc and 3mg or respectively). We observed similar percentage of HbA1C reduction sbc: -6.2% [-10.8 a 0] and oral -6.2% [-11.5 a 0] (p 0.9). Differences on BMI and weight loss were slightly higher on sbc group though non-significant. We observed no significant effects on eGFR or UACr, nor on blood pressure during the observation period. and main side effect was gastrointestinal intolerance, similar in both groups (7 (14%) in subc and 3 (20%) in oral group, pv alue 0.9. Conclusion Oral formulation of semaglutide was equally effective in terms of glucose control and body weight in patients with T2DM and CKD even with more patients on the low-medium doses. Gi side effects were similar with both formulations though the lower number of patients on the higher oral dose does not allow further conclusions.