The Efficacy, Mechanism & Safety of Sodium Glucose Co-Transporter-2 Inhibitor & Glucagon-Like Peptide 1 Receptor Agonist Combination Therapy in Kidney Transplant Recipients

Prior treatment

• Acute coronary syndrome, transient ischemic attack or stroke within 30 days prior to screening
• Prior amputation or ischemic rest pain
• History of unstable diabetic retinopathy within 1 year prior to screening
• Use of SGLT2i or GLP-1RA within 30 days prior to screening.

Other illness

• Type 1 diabetes.
• History of multi-organ transplant
• Actively treated BK, CMV or EBV infection
• History of pancreatitis
• Personal or family history or medullary thyroid cancer or MEN2B
• Current history of DKA requiring medical intervention or hospitalization
• With known or suspected hypersensitivity to semaglutide or related products
• Any other clinical condition that, based on Investigator's judgement, would jeopardize patient safety during trial participation or would affect the study outcome (e.g. immunocompromised patients, active malignancy, patients who might be at higher risk of developing genital or mycotic infections, patients with chronic viral infections, uncontrolled hypertension, cardiorenal and/or hepatorenal syndrome etc.).

Lab values

• Impending need for kidney biopsy or rapid decline in eGFR within 30 days prior to screening

Other

• Recurrent pyelonephritis or need for indwelling or self-catheterization
• Women who are pregnant, nursing, or who plan to become pregnant whilst in the trial.
• Current and frequent episodes of hypoglycemia
• With current risk of volume depletion, hypotension and/or electrolyte imbalance
• Patient not able to understand and comply with study requirements, based on Investigator's judgment.

• Signed and dated written informed consent.
• Patients aged ≥18 years with KTR
• \>3 months post kidney transplantation
• Estimated glomerular filtration rate \[eGFR\] ≥20 ml/min/1.73m2
• BP \<160/100 and \>90/60 at screening
• Body-mass index \[BMI\] between 18.5-40kg/m2
• In patients with T2D or PTDM, HbA1c \<12.0%;