Research Study to Compare Three Doses of Semaglutide Tablets Taken Once Daily in People With Type 2 Diabetes

Novo Nordisk A/S1,606 enrolled

Overview

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®.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

1,606

Conditions

Diabetes Mellitus, Type 2

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

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.

Locations (228)

American Clinical Trials

Buena Park, California, United States

Valley Research

Fresno, California, United States

Velocity Clin Res San Diego

La Mesa, California, United States

First Valley Medical Group

Lancaster, California, United States

Pacific Clinical Studies

Los Alamitos, California, United States

Outcomes

Primary Outcomes

Change From Baseline in Glycated Haemoglobin (HbA1c) (Week 52)

Change from baseline (week 0) in glycosylated haemoglobin (HbA1c) was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment. Percentage point refers to arithmetic difference between two percentages.

Time frame: Baseline (week 0), week 52

Secondary Outcomes

Change From Baseline in Body Weight (Week 52)

Change from baseline (week 0) in body weight was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 52

Change From Baseline in HbA1c (Week 68)

Change from baseline (week 0) in HbA1c was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment. Percentage point refers to arithmetic difference between two percentages.

Time frame: Baseline (week 0), week 68

Change From Week 12 in HbA1c (Week 52)

Change in HbA1c was evaluated from week 12 to week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment. Percentage point refers to arithmetic difference between two percentages.

Time frame: Week 12, Week 52

Change From Baseline in Fasting Plasma Glucose (FPG) (Week 52)

Change from baseline (week 0) in fasting plasma glucose (FPG) was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 52

Change From Baseline in FPG (Week 68)

Change from baseline (week 0) in FPG was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 68

Percentage of Participants Who Achieved HbA1c Less Than (<) 7.0 (Percent [%]) (Week 52)

Percentage of participants who achieved HbA1c \<7.0 % at week 52 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 52

Percentage of Participants Who Achieved HbA1c < 7.0 % (Week 68)

Percentage of participants who achieved HbA1c \<7.0 % at week 68 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 68

Percentage of Participants Who Achieved HbA1c Less Than or Equal to (<=) 6.5 % (Week 52)

Percentage of participants who achieved HbA1c \<=6.5 % at week 52 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 52

Percentage of Participants Who Achieved HbA1c <= 6.5 % (Week 68)

Percentage of participants who achieved HbA1c \<=6.5 % at week 68 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 68

Time to Event Analyses of Rescue Medication

Time to event analyses of rescue medication was evaluated from baseline (week 0) to week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 68

Change From Baseline in Body Weight (Week 68)

Change from baseline (week 0) in body weight was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 68

Percentage Change From Baseline in Body Weight (Week 52)

Percentage change from baseline (week 0) in body weight was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 52

Percentage Change From Baseline in Body Weight (Week 68)

Percentage change from baseline (week 0) in body weight was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 68

Percentage Change From Week 12 in Body Weight (Week 52)

Percentage change in body weight was evaluated from week 12 to week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Week 12, Week 52

Change From Baseline in Body Mass Index (BMI) (Week 52)

Change from baseline (week 0) in body mass index (BMI) was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 52

Change From Baseline in BMI (Week 68)

Change from baseline (week 0) in BMI was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 68

Change From Baseline in Waist Circumference (Week 52)

Change from baseline (week 0) in waist circumference was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 52

Change From Baseline in Waist Circumference (Week 68)

Change from baseline (week 0) in waist circumference was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline (week 0), week 68

Percentage of Participants Who Achieved Weight Loss Greater Than or Equal to (>=) 5 % (Week 52)

Percentage of participants who achieved weight loss \>= 5 % at week 52 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 52

Percentage of Participants Who Achieved Weight Loss >= 5 % (Week 68)

Percentage of participants who achieved weight loss \>= 5 % at week 68 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 68

Percentage of Participants Who Achieved Weight Loss >= 10 % (Week 52)

Percentage of participants who achieved weight loss \>= 10 % at week 52 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 52

Percentage of Participants Who Achieved Weight Loss >= 10 % (Week 68)

Percentage of participants who achieved weight loss \>= 10 % at week 68 are presented. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: At week 68

Change From Baseline in Total Cholesterol (Week 52)

Change from baseline (week 0) in total cholesterol was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 52

Change From Baseline in Total Cholesterol (Week 68)

Change from baseline (week 0) in total cholesterol was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 68

Change From Baseline in Low Density Lipoproteins (LDL) (Week 52)

Change from baseline (week 0) in LDL was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 52

Change From Baseline in LDL (Week 68)

Change from baseline (week 0) in LDL was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 68

Change From Baseline in High Density Lipoproteins (HDL) (Week 52)

Change from baseline (week 0) in HDL was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 52

Change From Baseline in HDL (Week 68)

Change from baseline (week 0) in HDL was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 68

Change From Baseline in Triglycerides (Week 52)

Change from baseline (week 0) in triglycerides was evaluated at week 52. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 52

Change From Baseline in Triglycerides (Week 68)

Change from baseline (week 0) in triglycerides was evaluated at week 68. Results are based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of additional anti-diabetic medication or discontinuation of trial treatment.

Time frame: Baseline, Week 68

Number of Adverse Events

An adverse event (AE) defined as any unfavourable and unintended sign, including an abnormal laboratory finding, symptom or disease (new or exacerbated) temporally associated with the use of an investigational medicinal products (IMP). Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: From baseline (week 0) up to week 73

Number of Clinically Significant Hypoglycaemic Episodes (Level 2) (<3.0 mmol/L (54 Milligram Per Decilitre [mg/dL]) or Severe Hypoglycaemic Episodes (Level 3)

Hypoglycaemic episodes were classified according to the American Diabetes Association 2018/ International Hypoglycaemia Study Group 2017, where glycemic criteria for level 2 was \< 3.0 mmol/L (54 mg/dL) and level 3 had no specific glucose threshold. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: From baseline (week 0) up to week 68

Change From Baseline in Systolic Blood Pressure (Week 52)

Change from baseline (week 0) in systolic blood pressure at week 52 are presented. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: Baseline (week 0), week 52

Change From Baseline in Systolic Blood Pressure (Week 68)

Change from baseline (week 0) in systolic blood pressure at week 68 are presented. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: Baseline (week 0), week 68

Change From Baseline in Diastolic Blood Pressure (Week 52)

Change from baseline (week 0) in diastolic blood pressure at week 52 are presented. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: Baseline (week 0), week 52

Change From Baseline in Diastolic Blood Pressure (Week 68)

Change from baseline (week 0) in diastolic blood pressure at week 68 are presented. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: Baseline (week 0), week 68

Change From Baseline in Pulse (Week 52)

Change from baseline (week 0) in pulse at week 52 are presented. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: Baseline (week 0), week 52

Change From Baseline in Pulse (Week 68)

Change from baseline (week 0) in pulse at week 68 are presented. Results are based on the data from the on-treatment observation period, which was the time period when a participant was on trial treatment, including any period after initiation of rescue medication.

Time frame: Baseline (week 0), week 68