1708-P: Comparing Major Adverse Kidney Events (MAKE) among New Users of Oral Semaglutide (SEMA) vs. Select Oral Antidiabetic Medications (ADMs) among U.S. Adults with Type 2 Diabetes (T2D) and Chronic Kidney Disease (CKD)

Introduction and Objective: This study compared MAKE among US adults with T2D and CKD treated with SEMA vs. select oral ADMs (Sulfonylureas, DPP4i, TZD) in real-world settings. Methods: This observational study used the Komodo's Healthcare Map database (Jan 2016-Mar 2025) to compare MAKE, a composite outcome defined as onset of kidney failure, a ≥50% reduction in the eGFR from baseline, or all-cause death, among people with T2D and CKD who initiated SEMA vs. select ADMs. An eGFR >25 and <90 ml/min/1.73m2 and no evidence of MAKE was required during the 12 months before drug initiation. Patients were followed until index drug discontinuation or change, end of continuous enrollment, death, or end of study period. Incidence rates (per 100 person-years) and adjusted Cox proportional hazard ratios (HR) were reported. A subgroup analysis was conducted among people with CKD stage 3 or higher. Results: A total of 11,514 and 66,056 patients were included in the SEMA and ADM cohorts. Mean ages were 63.6 and 67.4 years, respectively. Most patients have CKD stage 2 (SEMA: 76.5%; ADMs: 71.7%) or stage 3 (SEMA: 19.0%; ADMs: 22.7%). MAKE was lower in SEMA group than in ADM group (5.8 vs. 9.6 per 100 person-years). After adjusting for baseline demographic and clinical characteristics in the Cox regression, SEMA was associated with 25% lower risk of MAKE (HR: 0.75; 95% confidence interval, 0.69-0.80; p<0.001). In the subgroup analysis for people with CKD stage 3 or higher, SEMA was associated with 18% lower risk of MAKE (HR: 0.82; 95% confidence interval, 0.73-0.91; p<0.001). Conclusion: Among people with T2D and CKD, oral semaglutide was associated with reduced risks of major adverse kidney events compared with those treated with select oral antidiabetic medications. Disclosure L. Xie: None. G. Zhang: Employee; Current; Novo Nordisk. S. Mehanna: Employee; Current; Novo Nordisk A/S. J. Noone: Employee; Current; Novo Nordisk. C. Swift: Employee; Current; Novo Nordisk. Stock/Shareholder; Current; Novo Nordisk. M. Weir: Consultant; Current; AstraZeneca, CSL Behring, Bayer AG, Boehringer Ingelheim International GmbH, Novo Nordisk.