Health Canada has cleared Novo Nordisk’s once-weekly injection Ozempic to slow the progression of chronic kidney disease and cut the risk of end-stage kidney failure and heart-related deaths in adults with type 2 diabetes. The move, announced on 19 August, makes the glucagon-like peptide-1 drug the first therapy in Canada that is simultaneously authorised to control blood sugar and protect both the kidneys and the heart in this patient group. The decision is based on data from the international FLOW phase 3 trial, which followed 3,533 adults with diabetic kidney disease for a mean 3.4 years. A 1-milligram dose of semaglutide reduced the composite risk of kidney-related death, major cardiac events or dialysis by 24% versus placebo, on top of standard treatments to manage blood pressure and glucose levels. Novo Nordisk estimates that about 40% of people with type 2 diabetes develop chronic kidney disease, affecting roughly four million Canadians. Ozempic received a similar kidney-protective label expansion in the United States earlier this year, as the Danish drugmaker and rival Eli Lilly race to broaden the clinical uses of their competing GLP-1 medicines beyond weight control and diabetes. The broader uptake comes amid heightened scrutiny of semaglutide’s safety and off-label use. Kenya’s Pharmacy and Poisons Board on Tuesday warned consumers against using Ozempic for weight loss without medical supervision, and more than 1,800 U.S. lawsuits have been filed alleging severe gastrointestinal and other side-effects. Novo Nordisk says it will continue to monitor adverse events as the drug’s indications expand.