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Phase 3 Completed N=703 Randomized Double-blind Treatment

Efficacy and Safety of Oral Semaglutide Versus Placebo in Subjects With Type 2 Diabetes Mellitus Treated With Diet and Exercise Only

Source: ClinicalTrials.gov NCT02906930 ↗
Enrolled (actual)
703
Serious AEs
2.6%
Results posted
Feb 2020
Primary outcomePrimary: Change in HbA1c — -0.9; -1.3; -1.5; -0.3 Percentage of HbA1c — p=<0.0001
◆ Published Evidence
Highly cited
461citations · ~66 / year
PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes.
Diabetes care · 2019 · Open access · High-confidence link

Summary

This trial is conducted globally. The aim of this trial is to investigate efficacy and safety of oral semaglutide versus placebo in subjects with type 2 diabetes mellitus treated with diet and exercise only.

Linked Publications (5)

  • PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes.
    Diabetes care · 2019 · 461 citations · Open access · High-confidence link
  • Efficacy and safety of oral semaglutide by subgroups of patient characteristics in the PIONEER phase 3 programme.
    Diabetes, obesity & metabolism · 2022 · 37 citations · Open access · High-confidence link
  • Fast tipping point sensitivity analyses in clinical trials with missing continuous outcomes under multiple imputation.
    Journal of biopharmaceutical statistics · 2022 · 11 citations · High-confidence link
  • Efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes: A post hoc subgroup analysis of the PIONEER 1, 3, 4 and 8 trials.
    Diabetes, obesity & metabolism · 2021 · 9 citations · Open access · High-confidence link
  • Impact of semaglutide on high-sensitivity C-reactive protein: exploratory patient-level analyses of SUSTAIN and PIONEER randomized clinical trials.
    Cardiovascular diabetology · 2022 · 68 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Change in HbA1c
-0.9; -1.3; -1.5; -0.3; -0.9; -1.4 <0.0001 sig
SECONDARY
Change in Body Weight (kg)
-1.5; -2.6; -4.0; -1.4; -1.8; -2.8 <0.0001 sig
SECONDARY
Change in Fasting Plasma Glucose
-0.89; -1.52; -1.92; -0.18
SECONDARY
Change in Mean 7-point SMPG Profile
-1.8; -2.1; -2.3; -0.5
SECONDARY
Change in Mean Postprandial Increment Over All Meals in SMPG
-0.4; -0.8; -1.2; -0.3
SECONDARY
Change in Fasting Insulin - Ratio to Baseline
1.12; 1.07; 0.98; 0.97
SECONDARY
Change in Fasting Pro-insulin - Ratio to Baseline
0.84; 0.74; 0.62; 0.89
SECONDARY
Change in Fasting Glucagon - Ratio to Baseline
1.00; 0.90; 0.89; 0.95
SECONDARY
Change in HOMA-IR (Insulin Resistance) - Ratio to Baseline
1.00; 0.88; 0.76; 0.92
SECONDARY
Change in HOMA-B (Beta-cell Function) - Ratio to Baseline
1.40; 1.51; 1.60; 1.01
SECONDARY
Change in CRP - Ratio to Baseline
0.89; 0.72; 0.81; 0.99
SECONDARY
Change in Body Weight (%)
-1.67; -2.85; -4.71; -1.37
SECONDARY
Change in BMI
-0.6; -0.9; -1.5; -0.5
SECONDARY
Change in Waist Circumference
-2.0; -2.3; -4.1; -0.9
SECONDARY
Change in Fasting Total Cholesterol - Ratio to Baseline
0.98; 0.98; 0.96; 1.01
SECONDARY
Change in Fasting LDL Cholesterol - Ratio to Baseline
0.95; 0.97; 0.95; 1.00
SECONDARY
Change in Fasting HDL Cholesterol - Ratio to Baseline
1.03; 1.05; 1.02; 1.03
SECONDARY
Change in Fasting Triglycerides - Ratio to Baseline
1.01; 0.90; 0.91; 1.00
SECONDARY
Participants Who Achieve HbA1c < 7.0 % (53 mmol/Mol) ADA Target (Yes/no)
92; 110; 123; 52; 75; 50
SECONDARY
Participants Who Achieve HbA1c ≤ 6.5 % (48 mmol/Mol) AACE Target (Yes/no)
60; 76; 102; 30; 107; 84
SECONDARY
Participants Who Achieve Body Weight Loss ≥ 5 % (Yes/no)
33; 43; 66; 25; 135; 117
SECONDARY
Participants Who Achieve Body Weight Loss ≥ 10 % (Yes/no)
4; 13; 23; 2; 164; 147
SECONDARY
Participants Who Achieve HbA1c < 7.0 % (53 mmol/Mol) Without Hypoglycaemia (Severe or BG-confirmed Symptomatic Hypoglycaemia) and Without Body Weight Gain (Yes/no)
62; 91; 110; 39; 105; 69
SECONDARY
Participants Who Achieve HbA1c Reduction ≥ 1.0% (10.9 mmol/Mol) and Weight Loss ≥ 3% (Yes/no)
30; 59; 81; 18; 137; 101
SECONDARY
Time to Additional Anti-diabetic Medication
16; 8; 7; 35 0.0043 sig
SECONDARY
Time to Rescue Medication
13; 4; 2; 27 0.0300 sig
SECONDARY
Number of Treatment-emergent Adverse Events (TEAEs)
290; 258; 304; 263
SECONDARY
Change in Amylase - Ratio to Baseline
1.05; 1.09; 1.12; 0.99
SECONDARY
Change in Lipase - Ratio to Baseline
1.14; 1.27; 1.33; 0.99
SECONDARY
Change in Pulse Rate
0; 1; 3; 1
SECONDARY
Change in Systolic Blood Pressure (SBP)
-3; -5; -5; -3
SECONDARY
Change in Diastolic Blood Pressure (DBP)
-1; -2; -1; -1
SECONDARY
Change in Electrocardiogram (ECG) Evaluation
102; 88; 96; 97; 11; 13
SECONDARY
Change in Physical Examination
163; 167; 167; 172; 12; 8
SECONDARY
Change in Eye Examination Category
109; 112; 109; 122; 59; 59
SECONDARY
Occurrence of Anti-semaglutide Binding Antibodies (Yes/no)
2; 1; 0
SECONDARY
Occurrence of Anti-semaglutide Neutralising Antibodies (Yes/no)
1; 0; 0
SECONDARY
Occurrence of Anti-semaglutide Binding Antibodies Cross Reacting With Native GLP-1 (Yes/no)
2; 1; 0
SECONDARY
Occurrence of Anti-semaglutide Neutralising Antibodies Cross Reacting With Native GLP-1 (Yes/no)
0; 0; 0
SECONDARY
Anti-semaglutide Binding Antibody Levels
15; 2; 7; 3; 3
SECONDARY
Number of Treatment-emergent Severe or Blood Glucose-confirmed Symptomatic Hypoglycaemic Episodes During Exposure to Trial Product
5; 2; 1; 1
SECONDARY
Participants With Treatment-emergent Severe or Blood Glucose-confirmed Symptomatic Hypoglycaemic Episodes During Exposure to Trial Product
5; 2; 1; 1
SECONDARY
SNAC Plasma Concentrations
443.5; 446.0; 449.4; 381.7; 367.3; 387.7
SECONDARY
Semaglutide Plasma Concentrations for Population PK Analysis
3.120; 2.765; 2.829; 3.073; 6.216; 6.461
SECONDARY
Change in SF-36v2 (Acute Version) Health Survey: Scores From the 8 Domains, the Physical Component Summary (PCS) and the Mental Component Summary (MCS)
0.14; 1.18; 1.05; 0.66; -0.41; -0.08
SECONDARY
IWQOL-Lite Clinical Trial Version: Total Score of the 22 Items (Used for Validation of the Questionnaire)
-0.17; -0.12; -0.13; -0.08; -0.13; -0.16
SECONDARY
PGI-S Item: Scores of the Two Individual Items (Used for Validation of the IWQOL Questionnaire)
6; 11; 11; 7; 50; 51
SECONDARY
PGI-C Item: Scores of the Two Individual Items (Used for Validation of the IWQOL Questionnaire)
0; 0; 1; 1; 1; 2

Eligibility Criteria

Inclusion Criteria: - Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial - Male or female, age above or equal to 18 years at the time of signing informed consent.For Japan only: Male or female, age above or equal to 20 years at the time of signing informed consent. For Algeria only: Male or female, age above or equal to 19 years at the time of signing informed consent - Diagnosed with type 2 diabetes mellitus for at least 30 days prior to day of screening - HbA1c (glycosylated haemoglobin) between 7.0-9.5% (53-80 mmol/mol) (both inclusive) - Treatment with diet and exercise for at least 30 days prior to day of screening Exclusion Criteria: - Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using an adequate contraceptive method (adequate contraceptive measure as required by local regulation or practice) For Japan only: Adequate contraceptive measures are abstinence (not having sex), diaphragm, condom (by the partner), intrauterine device, sponge, spermicide or oral contraceptives.For Czech Republic only: Adequate contraceptive measures are always one highly reliable method (such as intrauterine device, sterilisation of one of the partners, hormonal birth control methods) plus one supplementary barrier method (such as condom, diaphragm) with a spermicide. In justified cases, this combination may be replaced with a double-barrier method with a spermicide. Total sexual abstinence may also be considered contraception. (Please note: hormonal contraception should always be discussed with a gynaecologist) - Any disorder, which in the investigator's opinion might jeopardise subject's safety or compliance with the protocol - Family or personal history of multiple endocrine neoplasia type 2 or medullary thyroid carcinomas - History of pancreatitis (acute or chronic) - History of major surgical procedures involving the stomach potentially affecting absorption of trial product (e.g. subtotal and total gastrectomy, sleeve gastrectomy, gastric bypass surgery) - Any of the following: myocardial infarction, stroke or hospitalisation for unstable angina or transient ischaemic attack within the past 180 days prior to the day of screening and randomisation - Subjects presently classified as being in New York Heart Association Class IV. - Planned coronary, carotid or peripheral artery revascularisation known on the day of screening - Subjects with alanine aminotransferase above 2.5 x upper normal limit - Renal impairment defined as estimated glomerular filtration rate below 60 mL/min/1.73 m^2 as per Chronic Kidney Disease Epidemiology Collaboration formula - Treatment with any medication for the indication of diabetes or obesity in a period of 90 days before the day of screening. An exception is short-term insulin treatment for acute illness for a total of below or equal to 14 days - Proliferative retinopathy or maculopathy requiring acute treatment. Verified by fundus photography or dilated fundoscopy performed within 90 days prior to randomisation - History or presence of malignant neoplasms within the last 5 years (except basal and squamous cell skin cancer and in-situ carcinomas)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02906930) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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