Nephrologists jumped on the GLP-1 bandwagon well before Novo Nordisk won FDA approval for Ozempic in chronic kidney disease (CKD), according to Spherix Global Insights.

The FDA expanded Ozempic’s label last week, clearing Novo to market the drug for use in adult Type 2 diabetes patients who also have CKD. But Spherix’s analysis of data from more than 1,000 non-dialysis CKD charts shows nephrologists were turned on to the potential for GLP-1 drugs to benefit their patients even before the agency gave Novo the greenlight in the population.

Endocrinologists and primary care physicians have historically been the main prescribers of GLP-1 drugs, Spherix said, but nephrologists are an increasingly important source of new scripts. Spherix’s assessment shows treatment rates in the analyzed CKD population nearly doubled from 2023 to 2024.

The rise covers a period in which the promise of Ozempic in CKD became clear. Novo stopped a phase 3b trial of semaglutide, the active ingredient in Ozempic, early for efficacy in October 2023 and shared data from the trial in March 2024.

While the analysis suggests Novo has begun to make inroads in CKD, Spherix said SGLT2 inhibitors remain the cornerstone of the treatment arsenal in that space. The use of SGLT2 inhibitors has risen in recent years as leading therapies such as AstraZeneca’s Farxiga and Eli Lilly and Boehringer Ingelheim’s Jardiance have secured expanded labels that cover the non-diabetic CKD population.

But Spherix said some prescribers are still cautious about SGLT2 inhibitors, particularly in people without diabetes, because of “lingering concerns over perceived benefits.” 

Similarly, the market intelligence firm said “hesitancy” about the benefits of Bayer’s mineralocorticoid receptor antagonist Kerendia is a barrier to growth of that drug in CKD. Safety, and notably instances of high potassium, is also an issue for Kerendia, Spherix said.

Many of the same products featured in GlobalData’s recent analysis of the heart failure market. The report tipped demand for GLP-1 drugs, SGLT2 inhibitors and Kerendia to help add $20 billion to the value of the market in 10 years.