# FLOW Trial Cardiovascular Subgroups: Semaglutide's Numbers Needed to Treat FLOW cardiovascular subgroup analyses give numbers needed to treat of 22, 13 and 17 over three years to prevent one kidney outcome, with null interaction tests across cardiovascular status. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/twenty-two-thirteen-seventeen Updated: 2026-09-18 Published: 2026-09-17 [← Research](https://thisglp.com/research) Evidence # FLOW Trial Cardiovascular Subgroups: Semaglutide's Numbers Needed to Treat The FLOW subgroup analysis publishes numbers needed to treat of 22, 13 and 17, a hazard ratio translated into people. Every interaction test came back null. [This GLP Editorial Team](https://thisglp.com/about)September 20266 min readUpdated September 2026 People treated for 3 years to prevent one kidney outcome · heart failure · 13 · high CV risk · 17 · established ASCVD · 22 · Every subgroup interaction test came back null. **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - Subgroup analyses of the FLOW trial split participants with type 2 diabetes and chronic kidney disease by baseline cardiovascular status. - Numbers needed to treat over three years to prevent one primary kidney outcome were 22 with established atherosclerotic disease, 13 with heart failure, and 17 at high cardiovascular risk. - Every interaction test was null — 0.62, 0.40 and 0.99 for the kidney outcome and 0.79, 0.74 and 0.63 for all-cause death. - FLOW used semaglutide 1.0 mg, a diabetes dose, in people with diabetes and kidney disease. It is not a weight-management trial. Most results on this site arrive as hazard ratios, which describe a proportion and not a person. This analysis of the FLOW trial publishes numbers needed to treat, which is the same information in a form somebody can act on [\[1\]](https://thisglp.com/research/twenty-two-thirteen-seventeen#ref-1). The broader kidney evidence is in [the kidney disease evidence](https://thisglp.com/research/semaglutide-and-kidney-disease). To prevent one primary kidney outcome over three years, you would treat 22 people with established atherosclerotic cardiovascular disease, 13 with heart failure, or 17 at high cardiovascular risk without established disease. The primary outcome is a composite: a fall in kidney function of 50% or more, an eGFR below 15, dialysis, transplantation, or death from kidney or cardiovascular causes. Thirteen is a striking figure for a chronic disease outcome. It means that in a heart failure clinic, treating a room of thirteen people for three years prevents one of them from reaching dialysis, transplant or death from these causes — and the people in that room are the ones most likely to get there. Some subgroup intervals cross 1, and that is not a failure The ASCVD subgroup gave a hazard ratio of 0.80 with an interval from 0.63 to 1.02, and all-cause death in the heart failure subgroup gave 0.75 (0.54–1.05). Both cross no effect. Subgroups are smaller than whole trials and have less power by construction, so reading them as “it worked here and not there” is the error the interaction test exists to prevent. Every interaction test here came back null, which is the finding: the benefit did not depend on cardiovascular status. That pattern — dramatic-looking subgroup differences dissolving into null interaction tests — is the same one described in [the frailty analysis](https://thisglp.com/research/frailty-did-not-change-the-answer) and [the HFpEF sex analysis](https://thisglp.com/research/same-benefit-different-route-by-sex). It keeps recurring because trials are powered for their whole population and journalism is drawn to the slices. One boundary is worth marking clearly. FLOW enrolled people with type 2 diabetes and chronic kidney disease, and used semaglutide at 1.0 mg — the diabetes dose, not the 2.4 mg weight product. These numbers describe kidney protection in diabetic kidney disease and do not transfer to someone taking a weight-management dose without either condition, nor to people already on dialysis, which is a separate question covered in [the dialysis cohort](https://thisglp.com/research/dialysis-the-evidence-base-just-grew). ## Frequently asked What does a number needed to treat of 13 mean? Treating thirteen people for three years prevents one of them reaching the primary kidney outcome — a 50% fall in kidney function, an eGFR below 15, dialysis, transplantation, or kidney or cardiovascular death. Did it work better in some groups than others? No. Every interaction test comparing subgroups was null, so the benefit did not depend on whether someone had atherosclerotic disease, heart failure, or high cardiovascular risk. Does this apply to weight-management doses? No. FLOW used semaglutide 1.0 mg in people with type 2 diabetes and chronic kidney disease, which is a different dose, indication and population from weight management. ## Sources 1. \[1\] Tuttle KR, Bakris GL, Baeres FMM, Bang CN, et al. (2026). Kidney and Survival Benefits of Semaglutide in Diabetes With Chronic Kidney Disease: FLOW Trial Cardiovascular Subgroup Analyses Journal of the American College of Cardiology. [PMID 42233552](https://pubmed.ncbi.nlm.nih.gov/42233552/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. 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