MON-516 Effectiveness of Semaglutide on Cardiovascular Outcomes in Chronic Kidney Disease (CKD) Patients with Type 2 Diabetes Mellitus: A Systemic Review and Meta-analysis

Abstract Disclosure: F. Ahmed: None. H. Ahmad: None. M. Ali: None. K. Aman: None. U. Iftikhar: None. A. Zafar Masood: None. T. Mirza: None. M. Kakakhel: None. M. Abid: None. H. Zahid: None. N. Gohar: None. A. Ullah: None. R. Haider: None. M. Ahmed: None. S. Eltawansy: None. M. Bakr: None. Background: Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) face an elevated risk of cardiovascular (CV) events and mortality. While the glycemic control and weight-loss benefits of semaglutide are well-documented, its impact on CV outcomes in this high-risk population remains less studied. This analysis aims to evaluate the effectiveness of semaglutide in improving CV outcomes in patients with CKD and T2D. Methods: A comprehensive search was conducted across PubMed, Cochrane Library, and Embase databases from inception through December 2024, utilizing predefined keywords. Randomized controlled trials (RCTs) reporting CV outcomes in patients with CKD and T2D treated with semaglutide were included. Data were synthesized using a random-effects model to calculate pooled risk ratios (RR) with 95% confidence intervals (CI). The interstudy heterogeneity was assessed using I2 and X2 statistics (I2>50%=significant heterogeneity). Statistical analyses were conducted using RevMan 5.4. A p-value of <0.05 was indicative of statistical significance. The systematic review protocol was registered in advance with PROSPERO [CRD42024617222]. Results: The study included 5 RCTs having a total of 15,732 individuals with CKD and T2D. Semaglutide significantly reduced the risk of all-cause mortality (RR 0.80, 95% CI 0.73-0.88, P < 0.00001, I² = 0%) and cardiovascular mortality (RR 0.75, 95% CI 0.66-0.85, P < 0.00001, I² = 0%). The risk of major adverse cardiovascular events (MACE) was reduced by 17% (RR 0.83, 95% CI 0.76-0.91, P < 0.0001, I² = 0%) in the treatment group compared to placebo. However, semaglutide and placebo were comparable in terms of the risk of myocardial infarction (MI) (RR 0.87, 95% CI 0.73-1.04, P = 0.12, I² = 0%) and stroke (RR 1.04, 95% CI 0.77-1.41, P = 0.80, I² = 58%). The risk of serious adverse events (SAEs) was marginally reduced in the treatment group (RR 0.93, 95% CI 0.87-1.00, P = 0.05, I² = 34%). Conclusion: Semaglutide demonstrates a significant reduction in all-cause mortality, CV mortality and MACE in patients with CKD and T2D, with consistent effects across studies. While its impact on MI, SAEs and stroke risk remains inconclusive, our findings support semaglutide as an effective treatment option for improving cardiovascular outcomes in this high-risk population. Further studies are needed to evaluate its long-term safety and efficacy and to establish conclusive evidence regarding its impact on cardiovascular outcomes in this population. Presentation: Monday, July 14, 2025