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Some patients on gabapentin may experience slightly delayed pain relief initially due to semaglutide's gastrointestinal effects, but this typically resolves within 23 weeks as tolerance develops

The modified drug would need to remain active 24 h/d, be as or more potent than native GLP-1, and remain physically stable for long periods of time

Finally, some clinical case studies and short series suggest their benefits also in patients with CKD stage 5D, although it should be recalled that this indication is not included in the labeling of arGLP-1 s.114,115 The Effect of semaglutide versus placebo on the progression of renal impairment in subjects with type 2 diabetes and chronic kidney disease (FLOW), a phase 3 clinical trial involving more than 3,000 patients with type 2 DM and moderate-severe CKD (eGFR 2575 ml/min/1.73 m2 and Urine Alb/Cr ratio of 3005,000 mg/g) is currently underway (NCT03819153)

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