XW003 is an acylated human glucagon-like peptide 1 (GLP-1) analogue and is being developed for type 2 diabetes mellitus (T2DM) and obesity management.
The study treatment period for 4 groups in the study will be divided into the four Titration Treatment periods and one Core Treatment period. The overall duration of the study treatment for each group will be 26 weeks. The duration of Titration Treatment will be up to 14 weeks for the three groups of XW003 treatment but 4 weeks for Saxenda group. Approximately 250 participants who are adults with obesity, in the absence of type 2 or any other type of diabetes, are planned to be screened. Based on a 20% screening failure rate, a total of 200 participants are expected to be enrolled for the four groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
206
XW003 (from 0.2 mg to 1.2 mg, 1.8 mg, and 2.4 mg once weekly), should take place during the first 14 weeks after randomization as described: Dose Escalation Schedule of Investigational Product (XW003). All eligible participants assigned to the XW003 study groups should aim to reach the respective final target dose of XW003 at 1.2 mg, 1.8 mg, or 2.4 mg once weekly.
If a participant does not tolerate the recommended target dose of Saxenda group (e.g., 3.0 mg once daily), the participant may stay at the preceding highest tolerable dose (e.g., 2.4 mg once daily).
Paratus Clinical Research Brisbane
Brisbane, Queensland, Australia
Percentage change in participants body weight (%) from the Baseline
Analysis of covariance (ANCOVA), with treatment, baseline body weight, and stratification factor as covariate, will be used to determine the difference between one of the XW003 groups and Saxenda group.
Time frame: Week 26
Proportions of participants with body weight loss ≥5%, ≥10% and ≥15% of the Baseline
It is anticipated that XW003 can achieve considerable body weight loss and improve obesity-related markers in participants with obesity.
Time frame: Week 26
Absolute change in body weight (kg) of participants
Body weight should be measured at all site visits without shoes, on an empty bladder and only wearing light clothing.
Time frame: Week 26
Changes in waist circumference and hip circumference (cm) in participants
The waist circumference will be measured at the specified visits and is defined as the abdominal circumference located the midpoint between the lower rib margin and the iliac crest. The hip circumference is defined as the widest circumference around the buttocks.
Time frame: Week 26
Change in BMI in participants
Calculated by dividing the participant's body weight in kilograms by the participant's height in meters squared (kg/m2)
Time frame: Week 26
Change in fasting plasma glucose (FPG)
Calculated based on XW003 measured in blood.
Time frame: Week 26
Change in fasting serum insulin
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Calculated based on XW003 measured in blood.
Time frame: Week 26
Change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)
Change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)
Time frame: Week 26
Changes in fasting lipids (triglyceride, low-density lipoprotein [LDL], and high-density lipoprotein [HDL])
Lipids: triglyceride, low-density lipoprotein \[LDL\], and high-density lipoprotein \[HDL\].
Time frame: Week 26
Number and severity of treatment-emergent adverse events (TEAEs)
The most common treatment-emergent adverse events (TEAEs) were nausea, dyspepsia, constipation, vomiting, and loss of appetite, all of which deemed possibly related to XW003 injection and only occurred in the highest dose groups (0.6 mg and 1.0 mg). The severity of these TEAEs was mild or moderate.
Time frame: Week 26
Number and severity of new and ongoing gastrointestinal (GI) disorder (nausea, vomiting, diarrhea, and constipation) events by week
Analysis of the safety profile and tolerability of XW003 showed that the most common adverse events (AEs) of XW003 was gastrointestinal (GI) disorder, including nausea, bloating, loss of appetite, and weight loss.
Time frame: Week 26
Vital signs - participants' blood pressure change
After resting in a supine position for at least 5 minutes, the participant's systolic and diastolic blood pressure change.
Time frame: Week 26
Vital signs - participants' pulse rate change
After resting in a supine position for at least 5 minutes, the participant's pulse rate, and body temperature.
Time frame: Week 26
Vital signs - participants' ody temperature change
After resting in a supine position for at least 5 minutes, the participant's body temperature change.
Time frame: Week 26
Electrocardiograms (ECGs)
There was no XW003 injection related clinically significant effect 12-lead electrocardiography (ECG).
Time frame: Week 26
Haematology, biochemistry, coagulation, and calcitonin
Parameters to be tested are: * Haemoglobin (HGB) * Haematocrit (HCT) * Erythrocytes (RBC) * Platelets (PLAT) * Leucocytes (WBC) with differential * Urea * Creatinine (CREAT) * Total Bilirubin (BILI) and direct bilirubin (BILIDIR) * Urate * Albumin (ALB) * Alkaline phosphatase (ALP) * Creatine kinase (CK) * Alanine aminotransferase (ALT) * Aspartate aminotransferase (AST) * Gamma-glutamyl transferase (GGT) * Sodium (NA) * Potassium (K) * Calcium (CA) * Chloride (CL) * Phosphate (PHOS) * Bicarbonate (BICARB) * Amylase * Lipase * International Normalised Ratio (INR) * Activated partial thromboplastin time (APTT)
Time frame: Week 26
Injection site reactions (ISRs)
There were no hypoglycaemic episodes reported during the trial. Injection site reaction (ISRs) were reported in 1 participant in Cohort A2 (0.2/0.25 mg) and 2 participants in Cohort A6 (0.6 mg). The ISRs were mild in severity and recovered within 3 hours of dosing.
Time frame: Week 26
Physical examinations
It should include general appearance, thyroid gland, respiratory system, cardiovascular system, gastrointestinal system including mouth, musculoskeletal system, central and peripheral nervous system, skin, lymph node palpation, and head, ears, eyes, nose, throat and neck.
Time frame: Week 26
36-Item Short Form Survey (SF-36)
Physical and mental component summary scores and scores on the individual sub-domains, i.e., physical functioning, role functioning, bodily pain, general health, vitality, social functioning, role emotional and mental health
Time frame: Week 26