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on key thoughts nejm.org/doi/full/10.10 Excellent trial conduct Vital status known in 98.6% High rates of treatment adherence (89% throughout trial) Study treatment discontinuation modest (26%) but reasonable given #FLOW conducted "intra-pandemic" (recruitment June '19 to May '21) & long follow-up (3.4 years)Large, clinically meaningful, & compelling effects on all key endpoints: Kidney disease progression CV outcomes Mortality Sema mortality by 20% (driven by CV death!) w an NNT of just 39 to prevent a death over 3y Curves visually appear to separate after 12mo.No unexpected safety signals Safety profile largely consistent with trials of prior #GLP1RA and incretin-based therapies SAEs with semaglutide driven by lower infections & CV events AEs leading to drug discontinuation, expectedly related to GI side effects#FLOW also affirms #CKD as a modifiable pathway to CV risk Cardiologists must be key partners in implementation of kidney #GDMT in high-risk patients Especially as "pillars" for #CKM largely overlapping in 2024
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When combined with: Strength training Adequate protein Sleep optimization Hormone balance Mitochondrial support Supportive lifestyle strategies can further enhance results: distribute protein across daily meals, limit processed foods and trans fats, choose other foods that are nutrient-dense, consider a low fat diet if appropriate, ensure adequate vitamin D intake, and include functional movements like climbing stairs in your routine
To understand AOD-9604, it helps to understand growth hormone first
However, administration of N-acetylcysteine to -glutamyl transpeptidase deficient mutant mice for two weeks restored their fertility [39]
