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A Research Study to Compare a New Medicine Oral Semaglutide to a Dummy Medicine in Children and Teenagers With Type 2 Diabetes

Phase 3
Active, not recruiting
Conditions
Diabetes Mellitus, Type 2
Interventions
Drug: Placebo (semaglutide)
Registration Number
NCT04596631
Lead Sponsor
Novo Nordisk A/S
Brief Summary

This study compares 2 medicines for type 2 diabetes: semaglutide (new medicine) and a dummy medicine (placebo). Semaglutide will be tested to see how well it works compared to the dummy medicine. The study will also test if semaglutide is safe in children and teenagers. Participants will either get semaglutide or the dummy medicine - which one is decided by chance. Participants will take 1 tablet of the study medicine every morning on an empty stomach. They have to wait 30 minutes before they eat, drink or take any other medication by mouth. The study will last for about 1 year and 3 months (66 weeks). Participants will have 12 clinic visits and 8 phone calls with the study doctor. At all 12 clinic visits, participants will have blood samples taken. Participants will also be asked some questions.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
132
Inclusion Criteria
  • Informed consent from parent(s) or legally acceptable representative (LAR) and child assent from the subject 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, aged 10 to below 18 years at the day of randomisation
  • HbA1c 6.5%-11.0% (47-97 mmol/mol) (both inclusive)
  • Diagnosed with type 2 diabetes mellitus according to the American Diabetes Association criteria and treated with:
  • stable metformin dose (stable metformin dose is defined as at least 1000 mg daily or the maximum tolerated dose for 56 days or longer prior to screening) or
  • stable metformin dose and a stable dose of basal insulin (stable dose of basal insulin is defined as basal insulin treatment equal to or more than 30 days prior to screening, compared to the dose at screening, dose adjustments of ± 25% are allowed) or
  • stable dose of basal insulin
Exclusion Criteria
  • Diagnosis of type 1 diabetes
  • Maturity onset diabetes of the young (MODY)
  • Positive insulinoma associated-protein 2 (IA-2) antibodies or anti-glutamic acid decarboxylase (anti-GAD) antibodies.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo (semaglutide)Placebo (semaglutide)Participants will receive semaglutide placebo tablets once daily in addition to background treatment with metformin or basal insulin or both, in addition to diet and exercise.
Semaglutide - max. tolerated doseOral semaglutideParticipants will receive semaglutide tablets once daily in addition to background treatment with metformin or basal insulin or both, in addition to diet and exercise.
Primary Outcome Measures
NameTimeMethod
Change from baseline in glycosylated haemoglobin (HbA1c)Week 0, week 26

Percentage point

Secondary Outcome Measures
NameTimeMethod
Anti-semaglutide antibody titerUp to 57 weeks

Count of participants

Anti-semaglutide antibodies with in vitro neutralising effect to semaglutideWeek 0 to week 57

Count of participants

Height velocityAt week 52

cm/year

Change from baseline in pubertal assessment (Tanner staging)Week 0, week 52

Stage 1-5 where 5 is full sexual maturity

Change from baseline in pulse rateWeek 0, week 52

Beats/minute

Number of treatment-emergent severe or blood glucose confirmed symptomatic hypoglycaemic episodes during exposure to trial productWeek 0 - week 57

Count of episodes

Change from baseline in prolactinWeek 0, week 52

mIU/L

Time to rescue medication (to support the hypothetical estimand)Week 0 - week 52

Days

Treatment emergent severe or blood glucose confirmed symptomatic hypoglycaemia episodeFrom randomisation (week 0) to week 26

Count of participants

Treatment-emergent severe or blood glucose confirmed symptomatic hypoglycaemia episode during exposure to trial productWeek 0 - week 57

Count of participants

Change from baseline in amylaseWeek 0, week 52

U/L

Change from baseline in lipaseWeek 0, week 52

U/L

Change from baseline in insulin-like growth factor 1 (IGF-1)Week 0, week 52

ng/mL

Change from baseline in dehydroepiandrosterone sulfate (DHEAS)Week 0, week 52

μmol/L

Change from baseline in bone age assessment, X-rayWeek 0, week 52

Years

Change from baseline in luteinizing hormone (LH)Week 0, week 52

mIU/mL

HbA1c below 7.0% (53 mmol/mol) (yes/no), ADA target and ISPAD guidelines from 2018At week 52

Count of participants

Change from baseline in insulin-like growth factor binding protein 3 (IGFBP 3)Week 0, week 52

ng/mL

Change from baseline in calcitoninWeek 0, week 52

pmol/L

Change from baseline in FPGWeek 0, week 52

mmol/L

Relative change from baseline in body weightWeek 0, week 52

Percentage

HbA1c equal to or below 6.5% (48 mmol/mol) (yes/no), American Association of Clinical Endocrinologists (AACE) targetAt week 26

Count of participants

Number of treatment-emergent severe or blood glucose confirmed symptomatic hypoglycaemic episodesFrom randomisation (week 0) to week 26

Count of episodes

Change from baseline in fasting plasma glucose (FPG)Week 0, week 26

mmol/L

Change from baseline in body mass index (BMI) standard deviation score (SDS)Week 0, week 26

SDS

Change from baseline in body weightWeek 0, week 52

kg

Change from baseline in systolic blood pressureWeek 0, week 52

mmHg

Change from baseline in estradiol (for girls)Week 0, week 52

pmol/L

Change from baseline in testosterone (for boys)Week 0, week 52

nmol/L

Change from baseline in glycosylated haemoglobin (HbA1c)Week 0, week 52

Percentage point

Change from baseline in waist circumferenceWeek 0, week 52

cm

Change from baseline in BMI SDSWeek 0, week 52

SDS

BMI percentile (age and gender adjusted)Week 0, week 52

Percent

Change from baseline in diastolic blood pressureWeek 0, week 52

mmHg

HbA1c below 7.0% (53 mmol/mol) (yes/no), American Diabetes Association (ADA) target and International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines from 2018At week 26

Count of participants

HbA1c equal to or below 6.5% (48 mmol/mol) (yes/no), AACE targetat week 26At week 52

Count of participants

Number of treatment-emergent adverse events (TEAEs) during exposure to trial productWeek 0 - week 57

Count of events

Change from baseline in thyroid stimulating hormone (TSH/thyrotropin)Week 0, week 52

mIU/L

Time to additional anti-diabetic medication (to support the treatment policy estimand)Week 0 - week 52

Days

Change from baseline in follicle stimulating hormone (FSH)Week 0, week 52

mIU/mL

Apparent clearance (CL/F)Week 0 - week 52

L/h

SNAC plasma concentrationsWeek 0 - week 52

ng/mL

Anti-semaglutide antibodies cross reacting with endogenous GLP-1Week 0 to week 57

Count of participants

Change from pre-dose to post-dose (25 and 40 min) in lactateAt week 26

mmol/L

Average concentration (Cavg)Week 0 - week 52

nmol/L

Anti-semaglutide antibody statusWeek 0 - week 57

Count of participants

Cross reacting antibodies with in vitro neutralising effect to endogenous GLP-1Week 0 to week 57

Count of participants

Change from baseline in height SDSWeek 0, week 26

SDS

Trial Locations

Locations (61)

Soroka MC - Pediatric Endocrinology

🇮🇱

Beer Sheva, Israel

Rambam MC - Department of Pediatrics A

🇮🇱

Haifa, Israel

Taipei Mackay Memorial Hospital

🇨🇳

Taipei, Taiwan

Children's Hospital Los Angeles - Endocrinology

🇺🇸

Los Angeles, California, United States

Nemours Chld Clnc Jacksonville

🇺🇸

Jacksonville, Florida, United States

University of South Florida Diabetes Center

🇺🇸

Tampa, Florida, United States

Children's Healthcare Atlanta

🇺🇸

Atlanta, Georgia, United States

Indiana Uni School of Med-Ped

🇺🇸

Indianapolis, Indiana, United States

University Of Louisville Research Foundation

🇺🇸

Louisville, Kentucky, United States

Barry J. Reiner, MD LLC

🇺🇸

Baltimore, Maryland, United States

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Soroka MC - Pediatric Endocrinology
🇮🇱Beer Sheva, Israel

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