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Ozempic Cuts Risk of Chronic Kidney Disease Complications, Study Finds

A major clinical trial showed such promising results that the drug’s maker halted it early.

By Dani Blum

Dani Blum has reported on Ozempic and similar drugs since 2022.

Semaglutide, the compound in the blockbuster drugs Ozempic and Wegovy , dramatically reduced the risk of kidney complications, heart issues and death in people with Type 2 diabetes and chronic kidney disease in a major clinical trial, the results of which were published on Friday. The findings could transform how doctors treat some of the sickest patients with chronic kidney disease, which affects more than one in seven adults in the United States but has no cure.

“Those of us who really care about kidney patients spent our whole careers wanting something better,” said Dr. Katherine Tuttle, a professor of medicine at the University of Washington School of Medicine and an author of the study. “And this is as good as it gets.” The research was presented at a European Renal Association meeting in Stockholm on Friday and simultaneously published in The New England Journal of Medicine .

The trial, funded by Ozempic maker Novo Nordisk, was so successful that the company stopped it early . Dr. Martin Holst Lange, Novo Nordisk’s executive vice president of development, said that the company would ask the Food and Drug Administration to update Ozempic’s label to say it can also be used to reduce the progression of chronic kidney disease or complications in people with Type 2 diabetes.

Diabetes is a leading cause of chronic kidney disease, which occurs when the kidneys don’t function as well as they should. In advanced stages, the kidneys are so damaged that they cannot properly filter blood. This can cause fluid and waste to build up in the blood, which can exacerbate high blood pressure and raise the risk of heart disease and stroke, said Dr. Subramaniam Pennathur, the chief of the nephrology division at Michigan Medicine.

The study included 3,533 people with kidney disease and Type 2 diabetes, about half of whom took a weekly injection of semaglutide, and half of whom took a weekly placebo shot.

Researchers followed up with participants after a median period of around three and a half years and found that those who took semaglutide had a 24 percent lower likelihood of having a major kidney disease event, like losing at least half of their kidney function, or needing dialysis or a kidney transplant. There were 331 such events among the semaglutide group, compared with 410 in the placebo group.

People who received semaglutide were much less likely to die from cardiovascular issues, or from any cause at all, and had slower rates of kidney decline.

Kidney damage often occurs gradually, and people typically do not show symptoms until the disease is in advanced stages. Doctors try to slow the decline of kidney function with existing medications and lifestyle modifications, said Dr. Melanie Hoenig, a nephrologist at Beth Israel Deaconess Medical Center who was not involved with the study. But even with treatment, the disease can progress to the point that patients need dialysis, a treatment that removes waste and excess fluids from the blood, or kidney transplants.

The participants in the study were extremely sick — the severe complications seen in some study participants are more likely to occur in people the later stages of chronic kidney disease, said Dr. George Bakris, a professor of medicine at the University of Chicago Medicine and an author of the study. Most participants in the trial were already taking medication for chronic kidney disease.

For people with advanced kidney disease, in particular, the findings are promising. “We can help people live longer,” said Dr. Vlado Perkovic, a nephrologist and renal researcher at the University of New South Wales, Sydney, and another author of the study.

While the data shows clear benefits, even the researchers studying drugs like Ozempic aren’t sure how, exactly, they help the kidneys. One leading theory is that semaglutide may reduce inflammation, which exacerbates kidney disease.

And the results come with several caveats: Roughly two-thirds of the participants were men and around two-thirds were white — a limitation of the study, the authors noted, because chronic kidney disease disproportionately affects Black and Indigenous patients. The trial participants taking semaglutide were more likely to stop the drug because of gastrointestinal issues, which are common side effects of Ozempic.

Doctors said they wanted to know whether the drug might benefit patients who have kidney disease but not diabetes, and some also had questions about the potential long-term risks of taking semaglutide.

Still, the results are the latest data to show that semaglutide can do more than treat diabetes or drive weight loss. In March, the F.D.A. authorized Wegovy for reducing the risk of cardiovascular issues in some patients. And scientists are examining semaglutide and tirzepatide, the compound in the rival drugs Mounjaro and Zepbound, for a range of other conditions , including sleep apnea and liver disease.

If the F.D.A. approves the new use, it could drive even more demand for Ozempic, which has faced recurrent shortages .

“I think it’s a game changer,” Dr. Hoenig said, “if I can get it for my patients.”

Dani Blum is a health reporter for The Times. More about Dani Blum

The World of Weight-Loss Drugs

What to Know: How do Ozempic and other drugs used for weight loss work? Here’s a primer .

What Happens if You Stop?: Many patients are eager to discontinue the drugs when their weight loss plateaus. But doctors say it’s difficult to go cold turkey .

How to Choose: As patients consider drugs like Wegovy, Ozempic, Zepbound and Mounjaro to treat obesity, experts say the choices are not so simple .

The Allure of ‘Microdosing’ : Some people are taking tiny amounts of the medications, hoping to drop pounds while avoiding side effects. Does it work?

Shortage Ends: The F.D.A. declared an end to the two-year shortage of tirzepatide , the substance in Zepbound and Mounjaro. The change will expand access to the drugs.

New study finds first US obesity decline in 10 years. Is Ozempic a leading factor?

For the first time in a decade, adult obesity in the United States dropped last year, a new study has found, and researchers are curious how the rise in popularity of weight loss drugs like Ozempic may have played a role.

Published in JAMA Health Forum on Friday, the study, "Changes in Adult Obesity Trends in the US," found that between 2022 and 2023, obesity in American adults between ages 26-75 dropped about 0.15%.

"On the percentage level, the decrease appears quite small ... but when you actually look at the population, what that translates to is hundreds of thousands of people who were in an obese category and are no longer in that category," study author Benjamin Rader, scientific director at Boston Children's Hospital, told USA TODAY. "The population impact, we think, is quite big."

Before 2023, between 2013-2022, obesity numbers were on an uphill climb. But they plateaued in 2022 before taking a slight turn south.

John Brownstein, chief innovation officer at Boston Children's Hospital, who also contributed to the study, said the greatest decrease was among Black women ages 66-75. This tracks with national trends, he added.

The Intake Resource Center found in a survey of 1,000 Americans last year that 39% of women asked their medical practitioners to be prescribed Ozempic, compared to 23% of men. And another study published by market researcher CivicScience last year found that Black Americans are most likely − at 26% − to take Ozempic or another weight loss drug.

The study also found that the largest decrease of obesity occurred in the South. This corresponds with CivicScience's study, too. The top five states with the most online searches for Ozempic were Louisiana, Tennessee, West Virginia, Florida and Mississippi, CivicScience published.

How was the study conducted?

Researchers surveyed nearly 17 million American adults ages 26-75, with about 51% being female and 48% male, according to the study . Rader said the research team partnered with Optum , a clinical data aggregator, to collect body mass index (BMI) information from electronic medical records, such as doctors' notes and lab reports, and insurance claim data. The researchers analyzed BMI data collected between 2013 and 2023.

What other factors could have contributed to the obesity decline?

Brownstein said there's no way of knowing, right now, the exact cause for the dip in obesity, but weight loss drugs like Ozempic are likely a leading factor. Other contributing factors may include better access to healthcare and new food and drug guidelines, he added.

Obesity remains a prevalent disease

Despite results from the recent study, obesity remain prevalent in the U.S.

According to the Centers for Disease Control and Prevention , in 2023, more than one in three adults had obesity. For perspective, before 2013, no state had an adult obesity prevalence at or above 35%. Today, at least 20% of adults in each state live with obesity.

What is Ozempic?

Ozempic , the household name for semaglutide, is a prescription medicine used to treat type 2 diabetes and obesity in adults. It can be taken by injection or orally.

Greta Cross is a national trending reporter at USA TODAY. Follow her on X and Instagram @gretalcross. Story idea? Email her at [email protected] .

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Popular weight loss drugs linked to rare but severe stomach problems, study finds

People who take popular drugs for weight loss , such as Ozempic or Wegovy, may be at an increased risk of severe stomach problems, research published Thursday in the Journal of the American Medical Association finds.

The brief report is the first study of its kind, the researchers say, to establish a link between the use of such drugs, called GLP-1 agonists , for weight loss and the risk of such gastrointestinal conditions. GLP-1 agonists include semaglutide — the drug found in Ozempic and Wegovy — and liraglutide, the drug used in Saxenda. Both drugs are made by Novo Nordisk.

“Although rare, the incidence of these adverse events can happen. I’ve seen it happen,” said lead author Mohit Sodhi, a medical student at the University of British Columbia Faculty of Medicine in Vancouver. “People should know what they’re getting into.” 

The drugs were originally developed to help people with Type 2 diabetes manage their blood sugar levels but were later found to be effective for weight loss .

GLP-1 medications work, in part, by slowing down how quickly food passes through the stomach , leading people to feel fuller longer. But they can also lead to gastrointestinal side effects, including abdominal pain, nausea and vomiting, as shown in clinical trials and noted on drug labels.

More recently, as the drugs have skyrocketed in popularity, there have been reports of patients who developed stomach paralysis, or gastroparesis. In August, Novo Nordisk was sued over claims that Ozempic caused a woman's stomach paralysis . (Eli Lilly, which makes another GLP-1 drug, tirzepatide, was also included in the lawsuit.) 

The new research, based on health insurance claims from 2006 to 2020 from more than 5,000 patients in the U.S., looked at how many people developed one of four serious gastrointestinal problems — biliary disease, gastroparesis, pancreatitis or bowel obstructions — after they were prescribed one of the weight loss drugs. About 4,100 of the patients were prescribed liraglutide, about 600 semaglutide and 650 the weight loss drug bupropion-naltrexone, which is not a GLP-1 medication.

Wegovy was not approved until 2021. However, Ozempic, which has the same active ingredient semaglutide, was approved in 2017 and some doctors prescribe it off-label for weight loss.

People included in the analysis all had records of obesity and did not have diabetes, which itself can cause gastroparesis. 

Compared to people taking bupropion-naltrexone, people taking a GLP-1 drug had a higher risk of pancreatitis, bowel obstruction and gastroparesis, the study found. There was no increase in risk for biliary disease, which includes conditions that affect the gallbladder, the liver and the bile ducts, as its incidence was similar for both types of drugs.

Pancreatitis, or inflammation of the pancreatitis, occurred at a rate of about 5 cases per 1,000 users of semaglutide and 8 cases per 1,000 users of liraglutide. The condition causes severe abdominal pain and, in some cases, requires hospitalization and surgery. 

Gastroparesis was seen at a rate of about 10 cases per 1,000 semaglutide users and 7 cases per 1,000 liraglutide users. The condition, which can be difficult to treat, causes severe nausea, vomiting and abdominal pain.

It can have “a significant impact on the quality of life,” Sodhi said.

Bowel obstructions — which occur when a blockage prevents food or liquid from moving through the intestines  — were seen at a rate of 8 cases per 1,000 users of liraglutide. There were no observed cases in semaglutide users. Depending on the severity, surgery may be needed to treat a bowel obstruction.

Sodhi said that although the conditions are rare, the medications’ widespread popularity means that if 1 million people are prescribed those drugs, tens or even hundreds of thousands of people could experience them.

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Allison Schneider, a spokesperson for Novo Nordisk, said in a statement that "patient safety is a top priority." The product labels for Wegovy and Saxenda include information about potential side effects, including pancreatitis, acute gallbladder disease, ileus and delayed gastric emptying, she added. (Ileus refers to a type of bowel obstruction.)

“We work closely with the U.S. Food and Drug Administration to continuously monitor the safety profile of our medicines,” Schneider said.

Dr. Andres Acosta, a gastroenterologist at the Mayo Clinic, said the findings tell us that GLP-1 medications are generally safe but may carry a risk of serious gastrointestinal side effects. 

“I’ve been telling my patients all along that we need to understand that all medications, including GLP-1s, have potential risks,” said Acosta, who was not involved with the research. “And we know that the GLP-1 medications have a risk of nausea, vomiting and delay of gastric emptying.”

Still, Acosta was not overly swayed by the study’s findings, saying some of the side effects listed in it could be the result of patients’ rapid weight loss, not the medications. He said he would like to see a large randomized controlled clinical trial looking at people who received the medications or placebos.  (The clinical trials that drug companies conducted prior to the drugs’ approval were not large enough to detect rarer side effects, Sodhi said.)

Dr. Shauna Levy, a specialist in obesity medicine and the medical director of the Tulane Bariatric Center in New Orleans, said she is unlikely to change her prescribing practices for GLP-1 medications after having reviewed the study’s findings.

“We still need to be careful,” Levy said. “This just further emphasizes, like many of things in the past, that these medications need to be regulated by a physician or a medical provider who is going to take a good history, monitor the patient closely and stop the medication if they have these side effects.” 

She said the rare side effects do not scare her as much as the health conditions that come from obesity or being overweight.

“I can go into the hospital, have pancreatitis treated and stop taking the medication,” Levy said. “ But if I die of a heart attack, no it doesn’t work.”

Dr. Susan Spratt, an endocrinologist and the senior medical director for the Population Health Management Office at Duke Health in North Carolina, advised that patients prescribed GLP-1 drugs should be counseled about starting the lowest dose and gradually increasing it, waiting at least four to six weeks before they escalate to the next dose.

Doctors should also discuss the risk of pancreatitis, which includes a history of gallstones or past cases of pancreatitis, and avoid its risk factors, which include drinking alcohol while using the medication.

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Berkeley Lovelace Jr. is a health and medical reporter for NBC News. He covers the Food and Drug Administration, with a special focus on Covid vaccines, prescription drug pricing and health care. He previously covered the biotech and pharmaceutical industry with CNBC.