Nephrologists Embrace GLP-1 Drugs for CKD Treatment, Paving Way for Ozempic's Expanded Use

Novo Nordisk's Ozempic (semaglutide) has received FDA approval for use in adult Type 2 diabetes patients with chronic kidney disease (CKD), but nephrologists were already ahead of the curve in recognizing the potential benefits of GLP-1 drugs for this patient population.

GLP-1 Adoption in CKD Treatment

According to data from Spherix Global Insights, nephrologists have increasingly turned to GLP-1 drugs for CKD treatment, even before the FDA's recent label expansion for Ozempic. Analysis of over 1,000 non-dialysis CKD charts reveals that treatment rates with GLP-1 drugs nearly doubled from 2023 to 2024.

This surge in adoption coincides with significant developments in Ozempic's CKD clinical program. In October 2023, Novo Nordisk halted a phase 3b trial of semaglutide early due to efficacy, with data subsequently shared in March 2024.

Shifting Prescriber Landscape

While endocrinologists and primary care physicians have traditionally been the primary prescribers of GLP-1 drugs, nephrologists are emerging as an increasingly important source of new prescriptions. This shift indicates a growing recognition of the potential benefits of GLP-1 drugs in managing CKD among patients with Type 2 diabetes.

SGLT2 Inhibitors and Other Treatment Options

Despite the rising interest in GLP-1 drugs, SGLT2 inhibitors remain the cornerstone of CKD treatment. Drugs like AstraZeneca's Farxiga and Eli Lilly and Boehringer Ingelheim's Jardiance have seen increased use following label expansions to include non-diabetic CKD patients.

However, Spherix notes that some prescribers remain cautious about SGLT2 inhibitors, particularly in non-diabetic patients, due to "lingering concerns over perceived benefits." Similarly, Bayer's mineralocorticoid receptor antagonist Kerendia faces challenges in the CKD market, with hesitancy about its benefits and safety concerns, particularly regarding instances of high potassium.

As the pharmaceutical landscape continues to evolve, the interplay between GLP-1 drugs, SGLT2 inhibitors, and other treatment options will likely shape the future of CKD management, potentially contributing to significant market growth in related therapeutic areas.