Phase 3
N=1,606
Research Study to Compare Three Doses of Semaglutide Tablets Taken Once Daily in People With Type 2 Diabetes
Diabetes Mellitus, Type 2
Bottom Line
View on ClinicalTrials.gov: NCT04707469 ↗Enrolled (actual)
1,606
Serious AEs
9.6%
Results posted
Apr 2024
Primary outcome: Primary: Change From Baseline in Glycated Haemoglobin (HbA1c) (Week 52) — -1.5; -1.9; -2.1 Percentage point of HbA1c — p=0.0006
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Oral semaglutide (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novo Nordisk A/S
- Primary completion
- Mar 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline in Glycated Haemoglobin (HbA1c) (Week 52) |
-1.5; -1.9; -2.1 | 0.0006 sig |
| SECONDARY Change From Baseline in Body Weight (Week 52) |
-4.4; -7.1; -8.3 | — |
| SECONDARY Change From Baseline in HbA1c (Week 68) |
-1.5; -1.8; -2.0 | — |
| SECONDARY Change From Week 12 in HbA1c (Week 52) |
-0.4; -0.8; -1.0 | — |
| SECONDARY Change From Baseline in Fasting Plasma Glucose (FPG) (Week 52) |
-2.4; -3.0; -3.2 | — |
| SECONDARY Change From Baseline in FPG (Week 68) |
-2.4; -3.0; -3.2 | — |
| SECONDARY Percentage of Participants Who Achieved HbA1c Less Than (<) 7.0 (Percent [%]) (Week 52) |
39; 50.5; 63 | — |
| SECONDARY Percentage of Participants Who Achieved HbA1c < 7.0 % (Week 68) |
39.2; 49.9; 58.9 | — |
| SECONDARY Percentage of Participants Who Achieved HbA1c Less Than or Equal to (<=) 6.5 % (Week 52) |
25.8; 39.6; 51.2 | — |
| SECONDARY Percentage of Participants Who Achieved HbA1c <= 6.5 % (Week 68) |
23.6; 35.8; 46.2 | — |
| SECONDARY Time to Event Analyses of Rescue Medication |
NA; NA; NA | — |
| SECONDARY Change From Baseline in Body Weight (Week 68) |
-4.5; -7.1; -8.2 | — |
| SECONDARY Percentage Change From Baseline in Body Weight (Week 52) |
-4.7; -7.3; -8.5 | — |
| SECONDARY Percentage Change From Baseline in Body Weight (Week 68) |
-4.7; -7.2; -8.4 | — |
| SECONDARY Percentage Change From Week 12 in Body Weight (Week 52) |
-1.5; -3.8; -5.4 | — |
| SECONDARY Change From Baseline in Body Mass Index (BMI) (Week 52) |
-1.6; -2.5; -2.9 | — |
| SECONDARY Change From Baseline in BMI (Week 68) |
-1.6; -2.5; -2.9 | — |
| SECONDARY Change From Baseline in Waist Circumference (Week 52) |
-4; -5; -6 | — |
| SECONDARY Change From Baseline in Waist Circumference (Week 68) |
-4; -6; -7 | — |
| SECONDARY Percentage of Participants Who Achieved Weight Loss Greater Than or Equal to (>=) 5 % (Week 52) |
41; 60; 67.5 | — |
| SECONDARY Percentage of Participants Who Achieved Weight Loss >= 5 % (Week 68) |
42.2; 58.5; 65.7 | — |
| SECONDARY Percentage of Participants Who Achieved Weight Loss >= 10 % (Week 52) |
13.9; 29; 37.2 | — |
| SECONDARY Percentage of Participants Who Achieved Weight Loss >= 10 % (Week 68) |
14.3; 29.4; 34.7 | — |
| SECONDARY Change From Baseline in Total Cholesterol (Week 52) |
-0.04; -0.15; -0.06 | — |
| SECONDARY Change From Baseline in Total Cholesterol (Week 68) |
-0.03; -0.08; -0.06 | — |
| SECONDARY Change From Baseline in Low Density Lipoproteins (LDL) (Week 52) |
0.04; -0.01; 0.11 | — |
| SECONDARY Change From Baseline in LDL (Week 68) |
0.07; 0.06; 0.08 | — |
| SECONDARY Change From Baseline in High Density Lipoproteins (HDL) (Week 52) |
0.06; 0.07; 0.08 | — |
| SECONDARY Change From Baseline in HDL (Week 68) |
0.06; 0.08; 0.09 | — |
| SECONDARY Change From Baseline in Triglycerides (Week 52) |
-0.46; -0.65; -0.71 | — |
| SECONDARY Change From Baseline in Triglycerides (Week 68) |
-0.51; -0.65; -0.70 | — |
| SECONDARY Number of Adverse Events |
1641; 2055; 2115 | — |
| SECONDARY Number of Clinically Significant Hypoglycaemic Episodes (Level 2) (<3.0 mmol/L (54 Milligram Per Decilitre [mg/dL]) or Severe Hypoglycaemic Episodes (Level 3) |
65; 44; 35; 0; 0; 1 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (Week 52) |
-4; -6; -6 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (Week 68) |
-4; -6; -5 | — |
| SECONDARY Change From Baseline in Diastolic Blood Pressure (Week 52) |
-2; -2; -2 | — |
| SECONDARY Change From Baseline in Diastolic Blood Pressure (Week 68) |
-3; -3; -2 | — |
| SECONDARY Change From Baseline in Pulse (Week 52) |
2; 2; 3 | — |
| SECONDARY Change From Baseline in Pulse (Week 68) |
1; 2; 2 | — |
Summary
This study compares three doses of once daily semaglutide tablets in people with type 2 diabetes who were previously treated with other oral anti-diabetic medicines. Participants will be initiated on the lowest starting dose of 3 mg and gradually increased until they reach the final trial dose of 14 mg, 25 mg or 50 mg once daily semaglutide tablets. The final three doses will be randomized (i.e., decided by chance). Participants will be administered one tablet per day for 68 weeks. Women cannot take part if they are pregnant, breast-feeding or planning to become pregnant during the study period. Women who can get pregnant will be checked for pregnancy via urine tests. Once daily semaglutide tablets (3 mg, 7 mg and 14 mg) are approved for the treatment of type 2 diabetes in the US, in the EU and in some other countries, under the brand name Rybelsus®.
Eligibility Criteria
Inclusion Criteria
- Male or female, age above or equal to 18 years at the time of signing informed consent.
- Diagnosed with type 2 diabetes mellitus at least 180 days prior to the day of screening.
- HbA1c of 8.0-10.5% (64-91 mmol/mol) (both inclusive).
- BMI equal to or above 25 kg/m^2
- Stable daily dose(s) for 90 days prior to the day of screening of any of the following treatment regimens:
- No more than 3 of the following oral anti-diabetic drugs and at least 1 marked with a *:
- Metformin (equal to or above1500 mg or maximum tolerated or effective dose).
- Sulfonylureas (SU) (equal to or above half of the maximum approved dose according to local label or maximum tolerated or effective dose).
- Sodium/glucose cotransporter 2 (SGLT2) inhibitors (maximum tolerated dose).
- Dipeptidyl peptidase-4 (DPP-4) inhibitors (maximally indicated dose as per local label).
- Subjects, on treatment with stable dose of DPP-4 inhibitors at inclusion, must be willing to discontinue DPP-4 inhibitor treatment at randomisation (with no wash-out).
Exclusion Criteria
- Treatment with any medication indicated for the treatment of diabetes or obesity other than stated in the inclusion criteria within the past 90 days prior to the day of screening. However, short term insulin treatment for a maximum of 14 days prior to the day of screening is allowed.
- Renal impairment measured as estimated glomerular filtration rate (eGFR) value of below 30 mL/min/1.73 m^2 according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation as defined by kidney disease improving global outcomes (KDIGO 2012) classification.
- Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days prior to screening or in the period between screening and randomisation. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
Data sourced from ClinicalTrials.gov (NCT04707469). 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.