domains/health/glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints.md

@@ -32,10 +32,16 @@ For value-based care models and capitated payers, this multi-organ protection cr
 
 
 ### Additional Evidence (extend)
-*Source: [[2025-12-23-jama-cardiology-select-hospitalization-analysis]] | Added: 2026-03-16*
+*Source: 2025-12-23-jama-cardiology-select-hospitalization-analysis | Added: 2026-03-16*
 
 SELECT trial exploratory analysis (N=17,604, median 41.8 months) shows semaglutide reduces ALL-CAUSE hospitalizations by 10% (18.3 vs 20.4 per 100 patient-years, P<.001) and total hospital days by 11% (157.2 vs 176.2 days per 100 patient-years, P=.01). Critically, benefits extended beyond cardiovascular causes to total hospitalization burden, suggesting systemic effects across multiple organ systems.
 
+
+### Additional Evidence (confirm)
+*Source: [[2024-05-29-nejm-flow-trial-semaglutide-kidney-outcomes]] | Added: 2026-03-16*
+
+FLOW trial demonstrated 29% reduction in cardiovascular death (HR 0.71, 95% CI 0.56-0.89) and 18% lower risk of major cardiovascular events in a kidney-focused trial. This confirms multi-organ protection extends beyond the primary endpoint - a kidney trial produced substantial cardiovascular benefits. Additive benefits when used with SGLT2 inhibitors per separate Nature Medicine analysis.
+
 ---
 
 Relevant Notes:

domains/health/semaglutide-reduces-kidney-disease-progression-24-percent-and-delays-dialysis-creating-largest-per-patient-cost-savings.md

@@ -28,6 +28,12 @@ This is the first dedicated kidney outcomes trial with a GLP-1 receptor agonist,
 - FDA indication expansion to T2D patients with CKD (2024)
 - Dialysis cost benchmark: $90K+/year per patient
 
+
+### Additional Evidence (confirm)
+*Source: [[2024-05-29-nejm-flow-trial-semaglutide-kidney-outcomes]] | Added: 2026-03-16*
+
+FLOW trial (N=3,533, median 3.4 years follow-up) showed 24% reduction in major kidney disease events (HR 0.76, P=0.0003), with annual eGFR slope less steep by 1.16 mL/min/1.73m2 (P<0.001). Trial stopped early for efficacy. FDA subsequently expanded semaglutide indications to include T2D patients with CKD. This is the first dedicated kidney outcomes trial with a GLP-1 receptor agonist, published in NEJM.
+
 ---
 
 Relevant Notes:

entities/internet-finance/metadao.md

@@ -58,13 +58,14 @@ The futarchy governance protocol on Solana. Implements decision markets through
 - **2024-03-02** — [[metadao-increase-meta-liquidity-dutch-auction]] passed: completed Dutch auction and liquidity provision, moving all protocol-owned liquidity to Meteora 1% fee pool
 - **2025-01-27** — [[metadao-otc-trade-theia-2]] proposed: Theia offers $500K for 370.370 META at 14% premium with 12-month vesting
 - **2025-01-30** — [[metadao-otc-trade-theia-2]] passed: Theia acquires 370.370 META tokens for $500,000 USDC
-- **2023-11-18** — [[metadao-develop-lst-vote-market]] proposed: first product development proposal requesting 3,000 META to build Votium-style validator bribe platform for MNDE/mSOL holders
-- **2023-11-29** — [[metadao-develop-lst-vote-market]] passed: approved LST Vote Market development with projected $10.5M enterprise value addition
+- **2023-11-18** — metadao-develop-lst-vote-market proposed: first product development proposal requesting 3,000 META to build Votium-style validator bribe platform for MNDE/mSOL holders
+- **2023-11-29** — metadao-develop-lst-vote-market passed: approved LST Vote Market development with projected $10.5M enterprise value addition
 - **2023-12-03** — Proposed Autocrat v0.1 migration with configurable proposal slots and 3-day default duration
 - **2023-12-13** — Completed Autocrat v0.1 migration, moving 990,000 META, 10,025 USDC, and 5.5 SOL to new program despite unverifiable build
 - **2024-01-24** — Proposed AMM program to replace CLOB markets, addressing liquidity fragmentation and state rent costs (Proposal CF9QUBS251FnNGZHLJ4WbB2CVRi5BtqJbCqMi47NX1PG)
 - **2024-01-29** — AMM proposal passed with 400 META on approval and 800 META on completion budget
 - **2024-08-31** — Passed proposal to enter services agreement with Organization Technology LLC, creating US entity vehicle for paying contributors with $1.378M annualized burn rate. Entity owns no IP (all owned by MetaDAO LLC) and cannot encumber MetaDAO LLC. Agreement cancellable with 30-day notice or immediately for material breach.
+- **2024-03-19** — Colosseum proposed $250,000 OTC acquisition of META from treasury with TWAP-based pricing and 12-month vesting; proposal passed 2024-03-24
 ## Key Decisions
 | Date | Proposal | Proposer | Category | Outcome |
 |------|----------|----------|----------|---------|

inbox/archive/2024-05-29-nejm-flow-trial-semaglutide-kidney-outcomes.md

@@ -7,9 +7,13 @@ date: 2024-05-29
 domain: health
 secondary_domains: []
 format: paper
-status: unprocessed
+status: enrichment
 priority: high
 tags: [glp-1, semaglutide, CKD, kidney-disease, FLOW-trial, organ-protection]
+processed_by: vida
+processed_date: 2026-03-16
+enrichments_applied: ["semaglutide-reduces-kidney-disease-progression-24-percent-and-delays-dialysis-creating-largest-per-patient-cost-savings.md", "glp-1-multi-organ-protection-creates-compounding-value-across-kidney-cardiovascular-and-metabolic-endpoints.md"]
+extraction_model: "anthropic/claude-sonnet-4.5"
 ---
 
 ## Content
@@ -38,3 +42,14 @@ Additive benefits when used with SGLT2 inhibitors (separate analysis in Nature M
 PRIMARY CONNECTION: [[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]
 WHY ARCHIVED: Kidney protection is where GLP-1 downstream savings are largest per-patient — dialysis prevention is the economic mechanism most favorable to the VBC cost-saving thesis
 EXTRACTION HINT: Focus on the economic implications of slowed kidney decline for capitated payers, not just the clinical endpoint
+
+
+## Key Facts
+- FLOW trial enrolled 3,533 patients with type 2 diabetes and chronic kidney disease
+- Median follow-up was 3.4 years before early stopping
+- Trial was stopped at prespecified interim analysis due to efficacy
+- Primary composite endpoint showed HR 0.76 (P=0.0003)
+- Cardiovascular death HR 0.71 (95% CI 0.56-0.89)
+- Annual eGFR slope difference was 1.16 mL/min/1.73m2 (P<0.001)
+- FDA expanded semaglutide (Ozempic) indications to include T2D patients with CKD
+- Additive benefits observed when used with SGLT2 inhibitors per Nature Medicine analysis