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SEMA, as a treatment for obesity, has shown nephroprotective effects, with a 22% reduction in the composite renal endpoint in the SELECT33 trial in patients without diabetes, supporting the role of SEMA in the management of the cardio-renal-metabolic syndrome
Most providers follow the standard titration: 0.25 mg for 4 weeks, 0.5 mg for 4 weeks, 1.0 mg for 4 weeks, 1.7 mg for 4 weeks, and 2.4 mg as the target maintenance dose
However, this was a small study of 48 individuals and more research is needed to inform clinical decision making and treatment guidelines
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