Impact of oral semaglutide on serum urate levels in people with type 2 diabetes: A retrospective real-world analysis (URISEMA study)
Authors' conclusion
Oral semaglutide in real-world settings showed a modest reduction in SU levels in PWT2D, particularly linked to baseline hyperuricemia (with notable reduction figures) and switching from DPP-4 inhibitors.
Study context
- Population
- People with type 2 diabetes prescribed oral semaglutide (median age 64 years, BMI 33.8 kg/m², HbA1c 7.6 %, 40.7 % women, 52.3 % on SGLT2 inhibitors)
- Participants
- 236 people
- Outcome
- Achieving SU levels <6 mg/dL
- Follow-up
- 12 months
Methodological detailsobservational, real-world
- Observational
- Real-world
Main finding
As reported in the abstract
SU <6 mg/dL
Oral semaglutide
76 %
Observational data: associations, not effects.
Further findings
Baseline factors associated with achieving serum urate (SU) target (multivariate)
| OR (95 % CI) | ||
|---|---|---|
| SU ≥7 mg/dL | 4.54 (1.08–19.25) | |
| Switching from a DPP-4 inhibitor | 6.53 (1.57–27.32) | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Values |
|---|---|
| SU <6 mg/dL · 6 months | Oral semaglutide 70.7 % |
SU decrease · 6 months
- SU decreased
- 0.1 mg/dL (p = 0.52)
SU decrease · 12 months
- SU decreased
- 0.2 mg/dL (p = 0.01)
SU decrease in baseline SU >6 mg/dL (subgroup) · 6 and 12 months
- 6 months
- 0.6 mg/dL
- 12 months
- 0.8 mg/dl
- All p < 0.001
Changes in SU vs metabolic control, weight loss, baseline GLP-1 RA or SGLT2 inhibitor use
- Changes in SU levels were independent of improved metabolic control, weight loss, or baseline use of GLP-1 RAs or SGLT2 inhibitors
Original publication
Impact of oral semaglutide on serum urate levels in people with type 2 diabetes: A retrospective real-world analysis (URISEMA study). Semin Arthritis Rheum. Published 7 August 2025. doi:10.
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