MedPath

Long Term Comparative Effectiveness of Once Weekly Semaglutide Versus Standard of Care in a Real World Adult US Population With Type 2 Diabetes - a Randomized Pragmatic Trial

Phase 4
Completed
Conditions
Diabetes Mellitus, Type 2
Interventions
Drug: Standard of care
Registration Number
NCT03596450
Lead Sponsor
Novo Nordisk A/S
Brief Summary

The main purpose of this study is to compare the effects of semaglutide (Ozempic®) with the effects of other treatments for type 2 diabetes in a normal practice setting. The participant will be assigned by chance (like flipping a coin) to one of the following treatment groups: Group 1: semaglutide (Ozempic®) (by injection into skin) Group 2: standard of care antidiabetic medication (oral or injectable). The participant has an equal chance of being in either of the treatment groups. Neither the participant nor the study doctor or study staff will be able to pick which group the participant is in, but the participant will know which study drug the participant has been assigned to. The study doctor will provide the participant with a prescription for the study diabetes medication based on the treatment group the participant is assigned. The participation will last about 2 years.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1278
Inclusion Criteria
  • Informed consent obtained before any study-related activities. Study-related activities are any procedures that are carried out as part of the study.
  • Male or female, age 18 years or older at the time of signing informed consent.
  • Type 2 diabetes mellitus diagnosis.
  • Treatment with either 1 or 2 oral antidiabetic medications.
  • Current member of a commercial or Medicare health plan with pharmacy benefits.
  • Recorded HbAlc value within the last 90 days prior to randomization.
  • Further intensification with an additional antidiabetic oral or injectable medication is indicated to achieve glycemic target at the discretion of the study physician according to approved labelling.
Exclusion Criteria
  • Previous randomization in this study
  • Treatment with more than 2 oral antidiabetic medications, oral semaglutide, or any injectable medication in a period of 30 days before the day of eligibility assessment. Temporary/emergency use of any type of insulin is allowed, as is prior insulin treatment for gestational diabetes.
  • Contraindications to semaglutide according to the Food and Drug Administration approved label.
  • Female who is pregnant, breastfeeding or intends to become pregnant
  • Participation in another clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard of careStandard of careParticipants will receive standard of care in addition to metformin monotherapy as treatment intensification in the course of routine clinical practice. Participants will be followed for 2 years, regardless of changes in antidiabetic treatment over the course of the study.
SemaglutideSemaglutideParticipants will receive semaglutide subcutaneously (s.c.) in addition to metformin monotherapy as treatment intensification in the course of routine clinical practice. Participants will be followed for 2 years, regardless of changes in antidiabetic treatment over the course of the study.
Primary Outcome Measures
NameTimeMethod
Number of Participants With Glycosylated Haemoglobin (HbA1c) Less Than 7.0 Percentage (%) (53 Millimoles Per Mole [mmol/Mol]) at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c less than 7.0 % (53 mmol/mol) at year 1 is presented. Yes: number of participants who achieved HbA1c less than 7.0 % at year 1; No: number of participants who did not achieve HbA1c less than 7.0 % at year 1.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Glycosylated Haemoglobin (HbA1c) Less Than 7.0% (53 Millimoles Per Mole [mmol/Mol]) at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c less than 7.0 % (53 mmol/mol) at year 2 is presented. Yes: number of participants who achieved HbA1c less than 7.0 % at year 2; No: number of participants who did not achieve HbA1c less than 7.0 % at year 2.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) or At Least 1% Point Improvement in HbA1c Compared to Baseline at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) or at least 1% point improvement in HbA1c compared to baseline at year 1 is presented. Yes: number of participants who achieved HbA1c less than 7.0% or at least 1% point improvement in HbA1c compared to baseline at year 1; No: number of participants who did not achieve HbA1c less than 7.0% or at least 1% point improvement in HbA1c compared to baseline at year 1

Number of Participants With HbA1c Target Attainment Per Healthcare Effectiveness Data and Information Set (HEDIS) Criteria at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c target attainment per HEDIS criteria (less than 8.0% if age ≥ 65 years or with defined comorbidities, otherwise less than 7.0%) at year 1 is presented. Yes: Number of participants who achieved HbA1c target attainment per HEDIS criteria at year 1; No: Number of participants who did not achieve HbA1c target attainment per HEDIS criteria at year 1

Change in Diastolic Blood Pressure (DBP) From Baseline to Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change in DBP from baseline to year 1 is presented.

DTSQc, Total Treatment Satisfaction Score Measured at Year 2At year 2

DTSQc total treatment satisfaction score measured at year 2 is presented. The DTSQc provides a measure of how satisfied participants are with their current diabetes treatment compared with previous treatment. It consists of 8 questions, which are to be answered on a Likert scale from -3 to +3 (-3 = much less satisfied now to +3 = much more satisfied now), with 0 (midpoint), representing no change. Six questions are summed to produce a total treatment satisfaction score. The remaining two questions concern perceived frequency of hyperglycemia and perceived frequency of hypoglycemia, respectively. The DTSQc total treatment satisfaction score ranges from -18 to +18, with higher scores associated with greater treatment satisfaction.

Change in HbA1c (Percentage-point [%-Point]) From Baseline to Year 1Baseline (less than or equal to 90 days prior to randomization at week 0), year 1

Change in HbA1c from baseline to year 1 is presented in %-point.

Number of Participants Who Attained Individualized HbA1c Target at Year 1 (Yes/No)At year 1

Number of participants who attained individualized HbA1c target at year 1 is presented. Study physicians set and documented an individualized HbA1c target for participants prior to randomization based on their clinical judgement and knowledge of the participant. Yes: number of participants who achieved individualized HbA1c target attained at year 1; No: number of participants who did not achieve individualized HbA1c target attained at year 1

Change in Body Weight (in Pounds) From Baseline to Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change in body weight (in pounds) from baseline to year 1 is presented.

Time to First Treatment Intensification (Add-on) or Change (Switch) After Randomization During 2 YearsWeek 0 to year 2

Time to first treatment intensification (add-on) or change (switch) after randomization during 2 years is presented.

Diabetes Treatment Satisfaction Questionnaire, Change Version (DTSQc), Total Treatment Satisfaction Score Measured at Year 1At year 1

DTSQc total treatment satisfaction score measured at year 1 is presented. The DTSQc provides a measure of how satisfied participants are with their current diabetes treatment compared with previous treatment. It consists of 8 questions, which are to be answered on a Likert scale from -3 to +3 (-3 = much less satisfied now to +3 = much more satisfied now), with 0 (midpoint), representing no change. Six questions are summed to produce a total treatment satisfaction score. The remaining two questions concern perceived frequency of hyperglycemia and perceived frequency of hypoglycemia, respectively. The DTSQc total treatment satisfaction score ranges from -18 to +18, with higher scores associated with greater treatment satisfaction.

Change in HbA1c (Percentage-point [%-Point]) From Baseline to Year 2Baseline (less than or equal to 90 days prior to randomization at week 0), year 2

Change in HbA1c from baseline to year 2 is presented in percentage-point.

Time to First Study Drug Discontinuation During 2 YearsWeek 0 to year 2

Time to first study drug discontinuation during 2 years is presented. First study drug discontinuation=date of the first time a patient is not taking study drug as defined.

Change From Baseline in SF-12 v2, PCS-12 Score at Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change from baseline in SF-12 v2, PCS-12 score at year 2 is presented. The SF-12 v2 is a 12-item generic health-related quality of life measure that assesses physical and mental functioning. The items were scored using the scoring software. It contains two summary scores: Physical Component Summary (PCS) Score and Mental Component Summary (MCS) Score. The scores are norm-scored such that the scores range from 0-100 with a mean of 50 and standard deviation of 10. A higher score is associated with better quality of life and a lower score, poorer quality of life.

Change From Baseline in WPAI-GH Activity Impairment Score at Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change from baseline in WPAI-GH activity impairment score at year 2 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work/reduced on-the-job effectiveness), Work productivity loss (overall work impairment/absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

All Cause Healthcare Resource Utilization (HCRU): Mean Number of Inpatient Admissions Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause healthcare resource utilization - mean number of inpatient admissions per participant from baseline to year 2 is presented.

Diabetes Related HCRU: Number of Participants With Diabetes Related Inpatient Admission (Yes/No) From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabeted related HCRU - number of participants with diabetes related inpatient admission from baseline to year 2 is presented. Yes: number of participants who experienced diabetes related inpatient admission; no: number of participants who did not experience diabetes related inpatient admission.

Diabetes Related HCRU: Number of Participants With Diabetes Related Outpatient Encounter (Yes/No) From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabeted related HCRU - number of participants with diabeted related outpatient encounter from baseline to year 2 is presented. Physician outpatient office visit is defined by a medical claim with outpatient place of service and an evaluation and management code. Yes: number of participants who experienced diabeted related outpatient encounter; no: number of participants who did not experience diabeted related outpatient encounter.

Number of Participants With HbA1c Less Than 8.0% (64 mmol/Mol) at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 1 is presented. Yes: number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 1; No: number of participants who did not achieve HbA1c less than 8.0% (64 mmol/mol) at year 1.

Percentage Change in Body Weight From Baseline to Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Percentage change in body weight from baseline to year 2 is presented.

Percentage Change in Body Weight From Baseline to Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Percentage change in body weight from baseline to year 1 is presented.

Change in Systolic Blood Pressure (SBP) From Baseline to Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change in SBP from baseline to year 1 is presented.

Change From Baseline in SF-12 v2, Mental Component Summary (MCS-12) Score at Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change from baseline in SF-12 v2, MCS-12 score at year 1 is presented. The SF-12 v2 is a 12-item generic health-related quality of life measure that assesses physical and mental functioning. The items were scored using the scoring software. It contains two summary scores: PCS Score and MCS Score. The scores are norm-scored such that the scores range from 0-100 with a mean of 50 and standard deviation of 10. A higher score is associated with better quality of life and a lower score, poorer quality of life.

All Cause HCRU: Mean Number of Outpatient Encounters Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - mean number of outpatient encounters per participant from baseline to year 2 is presented. Physician outpatient office visit is defined by a medical claim with outpatient place of service and an evaluation and management code.

All Cause HCRU: Number of Participants With ER Encounter (Yes/No) From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - number of participants with ER encounter from baseline to year 2 is presented. Yes: number of participants who experienced ER Encounter; no: number of participants who did not experience ER Encounter.

Diabetes Related HCRU: Mean Number of Diabetes Related ER Encounters Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabetes related HCRU - mean number of diabetes related ER encounters per participant from baseline to year 2 is presented.

Diabetes Related HCRU: Number of Participants With Diabetes Related ER Encounter (Yes/No) From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabeted related HCRU - number of participants with diabeted related ER encounter from baseline to year 2 is presented. Yes: number of participants who experienced diabeted related ER encounter; no: number of participants who did not experience diabeted related ER encounter.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) or At Least 1% Point Improvement in HbA1c Compared to Baseline at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) or at least 1% point improvement in HbA1c compared to baseline at year 2 is presented. Yes: number of participants who achieved HbA1c less than 7.0% or at least 1% point improvement in HbA1c compared to baseline at year 2; No: number of participants who did not achieve HbA1c less than 7.0% or at least 1% point improvement in HbA1c compared to baseline at year 2.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) and No Further Antidiabetic Medication Intensification After Randomization at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) and no further antidiabetic medication intensification after randomization at year 2 is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) and no further antidiabetic medication intensification after randomization at year 2; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) and no further antidiabetic medication intensification after randomization at year 2.

Number of Participants With Reported Hypoglycemia Leading to Inpatient Admission or ER Encounter During Year 1 (Yes/No)Week 0 to year 1

Number of participants who reported hypoglycemia leading to inpatient admission or ER encounter during year 1 is presented. Yes: number of participants who reported hypoglycemia leading to inpatient admission or ER encounter during year 1; No: number of participants who did not report hypoglycemia leading to inpatient admission or ER encounter during year 1.

Percentage of Medication Possession Ratio (MPR) for Study Drug Medication Adherence for the First Year of the StudyWeek 0 to year 1

Percentage of MPR for study drug medication adherence for the first year of the study is presented. Medication adherence referred to a participant's conformance to the provider's recommendation with respect to timing, dosage, and frequency of medication taken during the prescribed length of time. The MPR was used to assess adherence. MPR was calculated as follows: MPR (%) = Sum of days supply for all prescription fills\*100/Total number of days in time period. MPR was capped at 100%. MPR was calculated from pharmacy claims data and irrespective of adherence to randomized treatment or changes to antidiabetic treatment.

Number of Hypoglycemic Episodes Leading to an Inpatient Admission or Emergency Room (ER) Encounter From Baseline to Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Number of hypoglycemic episodes leading to an inpatient admission or emergency room (ER) encounter from baseline to year 2 is presented.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) and No Further Antidiabetic Medication Intensification After Randomization at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) and no further antidiabetic medication intensification after randomization at year 1 is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) and no further antidiabetic medication intensification after randomization at year 1; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) and no further antidiabetic medication intensification after randomization at year 1.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) at Year 1 in Participants With HbA1c >9.0% at Baseline (Yes/No)At year 1

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) at year 1 in participants with HbA1c \>9.0% at baseline is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) at year 1 in participants with HbA1c \>9.0% at baseline; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) at year 1 in participants with HbA1c \>9.0% at baseline.

Change in Body Weight (in Pounds) From Baseline to Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change in body weight (in pounds) from baseline to year 2 is presented.

Change From Baseline in Short Form 12-Item Version 2 Survey (SF-12 v2), Physical Component Summary (PCS-12) Score at Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change from baseline in SF-12 v2, PCS-12 score at year 1 is presented. The SF-12 v2 is a 12-item generic health-related quality of life measure that assesses physical and mental functioning. The items were scored using the scoring software. It contains two summary scores: Physical Component Summary (PCS) Score and Mental Component Summary (MCS) Score. The scores are norm-scored such that the scores range from 0-100 with a mean of 50 and standard deviation of 10. A higher score is associated with better quality of life and a lower score, poorer quality of life.

Change From Baseline in SF-12 v2, MCS-12 Score at Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change from baseline in SF-12 v2, MCS-12 score at year 2 is presented. The SF-12 v2 is a 12-item generic health-related quality of life measure that assesses physical and mental functioning. The items were scored using the scoring software. It contains two summary scores: PCS Score and MCS Score. The scores are norm-scored such that the scores range from 0-100 with a mean of 50 and standard deviation of 10. A higher score is associated with better quality of life and a lower score, poorer quality of life.

Change From Baseline in WPAI-GH Absenteeism (Work Time Missed) Score at Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change from baseline in WPAI-GH Absenteeism (work time missed) score at year 2 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work/reduced on-the-job effectiveness), Work productivity loss (overall work impairment/absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

Change From Baseline in WPAI-GH Work Productivity Loss (Overall Work Impairment/Absenteeism Plus Presenteeism) Score at Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change from baseline in WPAI-GH work productivity loss (overall work impairment/absenteeism plus presenteeism) score at year 1 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work / reduced on-the-job effectiveness), Work productivity loss (overall work impairment / absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

Number of Participants With HbA1c Target Attainment Per Healthcare Effectiveness Data and Information Set (HEDIS) Criteria at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c target attainment per HEDIS criteria (less than 8.0% if age ≥ 65 years or with defined comorbidities, otherwise less than 7.0%) at year 2 is presented. Yes: Number of participants who achieved HbA1c target attainment per HEDIS criteria at year 2; No: Number of participants who did not achieve HbA1c target attainment per HEDIS criteria at year 2.

Change From Baseline in Work Productivity and Activity Impairment, General Health Questionnaire (WPAI-GH) Absenteeism (Work Time Missed) Score at Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change from baseline in WPAI-GH Absenteeism (work time missed) score at year 1 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work/reduced on-the-job effectiveness), Work productivity loss (overall work impairment/absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

Change From Baseline in WPAI-GH Presenteeism (Impairment at Work/Reduced On-the-job Effectiveness) Score at Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change from baseline in WPAI-GH Presenteeism (Impairment at Work/Reduced On-the-job Effectiveness) score at year 1 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work / reduced on-the-job effectiveness), Work productivity loss (overall work impairment / absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

Change From Baseline in WPAI-GH Presenteeism (Impairment at Work/Reduced On-the-job Effectiveness) Score at Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change from baseline in WPAI-GH Presenteeism (Impairment at Work/Reduced On-the-job Effectiveness) score at year 2 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work / reduced on-the-job effectiveness), Work productivity loss (overall work impairment / absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

All Cause HCRU: Mean Cumulative Length of Stay for Inpatient Admissions Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - mean cumulative length of stay for inpatient admissions per participant from baseline to year 2 is presented. Cumulative inpatient length of stay is the sum of the length of stay of all inpatient admissions a participant experiences from baseline to year 2.

Diabetes Related HCRU: Mean Number of Diabetes Related Inpatient Admissions Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabetes related HCRU - mean number of diabetes related inpatient admissions per participant from baseline to year 2 is presented.

Diabetes Related HCRU: Mean Cumulative Length of Stay for Diabetes Related Inpatient Admissions Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabetes related HCRU - mean cumulative length of stay for diabetes related inpatient admissions per participant from baseline to year 2 is presented. Cumulative inpatient length of stay is the sum of the length of stay of all diabetes related inpatient admissions a participant experiences from baseline to year 2.

Diabetes Related HCRU: Mean Number of Diabetes Related Outpatient Encounters Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabetes related HCRU - mean number of diabetes related outpatient encounters per participant from baseline to year 2 is presented. Physician outpatient office visit is defined by a medical claim with outpatient place of service and an evaluation and management code.

Number of Participants Who Attained Individualized HbA1c Target at Year 2 (Yes/No)At year 2

Number of participants who attained individualized HbA1c target at year 2 is presented. Study physicians set and documented an individualized HbA1c target for participants prior to randomization based on their clinical judgement and knowledge of the participant. Yes: number of participants who achieved individualized HbA1c target attained at year 2; No: number of participants who did not achieve individualized HbA1c target attained at year 2

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) at Year 2 in Participants With HbA1c >9.0% at Baseline (Yes/No)At year 2

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) at year 2 in participants with HbA1c \>9.0% at baseline is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) at year 2 in participants with HbA1c \>9.0% at baseline; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) at year 2 in participants with HbA1c \>9.0% at baseline.

Change From Baseline in WPAI-GH Work Productivity Loss (Overall Work Impairment/Absenteeism Plus Presenteeism) Score at Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change from baseline in WPAI-GH work productivity loss (overall work impairment/absenteeism plus presenteeism) score at year 2 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work / reduced on-the-job effectiveness), Work productivity loss (overall work impairment / absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

Change From Baseline in WPAI-GH Activity Impairment Score at Year 1Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 1

Change from baseline in WPAI-GH activity impairment score at year 1 is presented. The WPAI-GH yields four types of scores: Absenteeism (work time missed), Presenteesism (impairment at work/reduced on-the-job effectiveness), Work productivity loss (overall work impairment/absenteeism plus presenteeism), and Activity Impairment. WPAI outcomes are expressed as impairment percentages (0-100), with higher numbers indicating greater impairment and less productivity, i.e., worse outcomes (percent work time missed due to health, percent impairment while working due to health, percent overall work impairment due to health, percent activity impairment due to health).

All Cause HCRU: Mean Number of Emergency Room (ER) Encounters Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - mean number of emergency room (ER) encounters per participant from baseline to year 2 is presented.

All Cause HCRU: Mean Number of Medication Visits Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - mean number of medication visits per participant from baseline to year 2 is presented.

All Cause HCRU: Number of Participants With Inpatient Admission (Yes/No) From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - number of participants with inpatient admission from baseline to year 2 is presented. Yes: number of participants who experienced inpatient admission; no: number of participants who did not experience inpatient admission.

All Cause HCRU: Number of Participants With Outpatient Encounter (Yes/No) From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

All cause HCRU - number of participants with outpatient encounter from baseline to year 2 is presented. Physician outpatient office visit is defined by a medical claim with outpatient place of service and an evaluation and management code. Yes: number of participants who experienced outpatient encounter; no: number of participants who did not experience outpatient encounter.

Diabetes Related HCRU: Mean Number of Diabetes Related Medication Visits Per Participant From Baseline to Year 2From baseline (less than or equal to 4 weeks prior to the randomization at week 0) to year 2

Diabetes related HCRU - mean number of diabetes related medication visits per participant from baseline to year 2 is presented.

Number of Participants With HbA1c Less Than 8.0% (64 mmol/Mol) at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 2 is presented. Yes: number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 2; No: number of participants who did not achieve HbA1c less than 8.0% (64 mmol/mol) at year 2.

Number of Participants With HbA1c Less Than 8.0% (64 mmol/Mol) at Year 2 in Participants With HbA1c >9.0% at Baseline (Yes/No)At year 2

Number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 2 in participants with HbA1c \>9.0% at baseline is presented. Yes: number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 2 in participants with HbA1c \>9.0% at baseline; No: number of participants who did not achieve HbA1c less than 8.0% (64 mmol/mol) at year 2 in participants with HbA1c \>9.0% at baseline.

Change in Diastolic Blood Pressure (DBP) From Baseline to Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change in DBP from baseline to year 2 is presented.

Number of Participants With Absolute HbA1c Reduction of ≥ 0.5% Without Experiencing Hypoglycemia Leading to Inpatient Admission or ER Encounter and a Body Weight Loss of ≥ 5% Versus Baseline at Year 1 (Yes/No)At year 1

Number of participants who achieved absolute HbA1c reduction of ≥ 0.5% without experiencing hypoglycemia leading to inpatient admission or ER encounter and a body weight loss of ≥ 5% versus baseline at year 1 is presented. Yes: number of participants who achieved absolute HbA1c reduction of ≥ 0.5% without experiencing hypoglycemia leading to inpatient admission or ER encounter and a body weight loss of ≥ 5% versus baseline at year 1; No: number of participants who did not achieve absolute HbA1c reduction of ≥ 0.5% without experiencing hypoglycemia leading to inpatient admission or ER encounter and a body weight loss of ≥ 5% versus baseline at year 1.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) Without Experiencing Hypoglycemia Leading to Inpatient Admission or ER Encounter and Body Weight Loss of ≥ 5% Versus Baseline at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and body weight loss of ≥ 5% versus baseline at year 2 is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and body weight loss of ≥ 5% versus baseline at year 2; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and body weight loss of ≥ 5% versus baseline at year 2.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) Without Experiencing Hypoglycemia Leading to Inpatient Admission or ER Encounter and No Body Weight Gain Versus Baseline at Year 2 (Yes/No)At year 2

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and no body weight gain versus baseline at year 2 is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and no body weight gain versus baseline at year 2; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and no body weight gain versus baseline at year 2.

Percentage of Medication Possession Ratio (MPR) for Study Drug Medication Adherence For The Two Years of The StudyWeek 0 to year 2

Percentage of MPR for study drug medication adherence for the two years of the study is presented. Medication adherence referred to a participant's conformance to the provider's recommendation with respect to timing, dosage, and frequency of medication taken during the prescribed length of time. The MPR was used to assess adherence. MPR was calculated as follows: MPR (%) = Sum of days supply for all prescription fills\*100/Total number of days in time period. MPR was capped at 100%. MPR was calculated from pharmacy claims data and irrespective of adherence to randomized treatment or changes to antidiabetic treatment.

Number of Participants With HbA1c Less Than 8.0% (64 mmol/Mol) at Year 1 in Participants With HbA1c >9.0% at Baseline (Yes/No)At year 1

Number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 1 in participants with HbA1c \>9.0% at baseline is presented. Yes: number of participants who achieved HbA1c less than 8.0% (64 mmol/mol) at year 1 in participants with HbA1c \>9.0% at baseline; No: number of participants who did not achieve HbA1c less than 8.0% (64 mmol/mol) at year 1 in participants with HbA1c \>9.0% at baseline

Change in Systolic Blood Pressure (SBP) From Baseline to Year 2Baseline (less than or equal to 4 weeks prior to the randomization at week 0), year 2

Change in SBP from baseline to year 2 is presented.

Number of Participants With Reported Hypoglycemia Leading to Inpatient Admission or ER Encounter During Year 2 (Yes/No)Week 0 to year 2

Number of participants who reported hypoglycemia leading to inpatient admission or ER encounter during year 2 is presented. Yes: number of participants who reported hypoglycemia leading to inpatient admission or ER encounter during year 2; No: number of participants who did not report hypoglycemia leading to inpatient admission or ER encounter during year 2.

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) Without Experiencing Hypoglycemia Leading to Inpatient Admission or ER Encounter and Body Weight Loss of ≥ 5% Versus Baseline at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and body weight loss of ≥ 5% versus baseline at year 1 is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and body weight loss of ≥ 5% versus baseline at year 1; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and body weight loss of ≥ 5% versus baseline at year 1

Number of Participants With HbA1c Less Than 7.0% (53 mmol/Mol) Without Experiencing Hypoglycemia Leading to Inpatient Admission or ER Encounter and No Body Weight Gain Versus Baseline at Year 1 (Yes/No)At year 1

Number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and no body weight gain versus baseline at year 1 is presented. Yes: number of participants who achieved HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and no body weight gain versus baseline at year 1; No: number of participants who did not achieve HbA1c less than 7.0% (53 mmol/mol) without experiencing hypoglycemia leading to inpatient admission or ER encounter and no body weight gain versus baseline at year 1.

Number of Participants With Absolute HbA1c Reduction of ≥ 0.5% Without Experiencing Hypoglycemia Leading to Inpatient Admission or ER Encounter and a Body Weight Loss of ≥ 5% Versus Baseline at Year 2 (Yes/No)At year 2

Number of participants who achieved absolute HbA1c reduction of ≥ 0.5% without experiencing hypoglycemia leading to inpatient admission or ER encounter and a body weight loss of ≥ 5% versus baseline at year 2 is presented. Yes: number of participants who achieved absolute HbA1c reduction of ≥ 0.5% without experiencing hypoglycemia leading to inpatient admission or ER encounter and a body weight loss of ≥ 5% versus baseline at year 2; No: number of participants who did not achieve absolute HbA1c reduction of ≥ 0.5% without experiencing hypoglycemia leading to inpatient admission or ER encounter and a body weight loss of ≥ 5% versus baseline at year 2.

Trial Locations

Locations (121)

Primary Care Research

🇺🇸

Atlanta, Georgia, United States

Palm Research Center Inc-Vegas

🇺🇸

Las Vegas, Nevada, United States

SC Clinical Research, Inc.

🇺🇸

Garden Grove, California, United States

New Hope Consulting & Clinical Trials

🇺🇸

Lancaster, California, United States

Centricity Research

🇺🇸

Columbus, Ohio, United States

Meridian Clin Res, LLC

🇺🇸

Savannah, Georgia, United States

Urban Family Practice Assoc

🇺🇸

Marietta, Georgia, United States

American Health Network of Indiana, LLC_Greenfield

🇺🇸

Greenfield, Indiana, United States

Adams County Family Physicians

🇺🇸

Berne, Indiana, United States

Gwinnett Research Insti/Buford Family Pract Urgent Care Ctr

🇺🇸

Buford, Georgia, United States

Sandersville Family Practice

🇺🇸

Sandersville, Georgia, United States

WCMP Family Medicine

🇺🇸

Belfast, Maine, United States

Beaver Ruin Primary Care

🇺🇸

Lilburn, Georgia, United States

Southern Family Medical Center

🇺🇸

Augusta, Georgia, United States

DC Research Works

🇺🇸

Marietta, Georgia, United States

St. Jos Heritage Hlthcr_Fllrtn

🇺🇸

Fullerton, California, United States

Do-Eun Lee

🇺🇸

Napa, California, United States

Preferred Primary Care Physicians_Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

East Georgia Healthcare Center Inc

🇺🇸

Swainsboro, Georgia, United States

Paris Family Physicians PLLC

🇺🇸

Paris, Kentucky, United States

The Endocrine & Diabetes Center

🇺🇸

Owensboro, Kentucky, United States

Deaconess Clinic, Inc.

🇺🇸

Evansville, Indiana, United States

Reid Endocrinology Center

🇺🇸

Richmond, Indiana, United States

Pacific Clinical Studies

🇺🇸

Los Alamitos, California, United States

Sugarloaf Medical, PC

🇺🇸

Suwanee, Georgia, United States

St. Vincent Research Institute

🇺🇸

Anderson, Indiana, United States

Privia Medical Group of Georgia LLC

🇺🇸

Locust Grove, Georgia, United States

Eagles Landing Diabetes/Endocrinology

🇺🇸

Stockbridge, Georgia, United States

Medical Care of LaGrange

🇺🇸

LaGrange, Georgia, United States

American Health Network of IN LLC_Franklin

🇺🇸

Franklin, Indiana, United States

American Health Network of IN LLC

🇺🇸

Muncie, Indiana, United States

River Birch Research Alliance, LLC

🇺🇸

Blue Ridge, Georgia, United States

Associated Surgeons & Physicians LLC

🇺🇸

Fort Wayne, Indiana, United States

OnSite Clinical Solutions, LLC_Charlotte

🇺🇸

Charlotte, North Carolina, United States

Coastal Care Medical Clinic

🇺🇸

Waycross, Georgia, United States

The Kaufmann Clinic, Inc.

🇺🇸

Atlanta, Georgia, United States

Beacon Medical Group Swartz-Weikamp

🇺🇸

Mishawaka, Indiana, United States

Franklin Family Practice

🇺🇸

Franklin, Ohio, United States

American Health Network of Indiana, LLC

🇺🇸

New Albany, Indiana, United States

Regional Endorine and Diabetes Associates

🇺🇸

Ashland, Kentucky, United States

Functional Endocrinology

🇺🇸

Mason, Ohio, United States

Privia Medical Group LLC

🇺🇸

Danville, Virginia, United States

Simcare Medical Research, LLC

🇺🇸

Sugar Land, Texas, United States

Primary Care Research South, Inc

🇺🇸

McMurray, Pennsylvania, United States

Prestige Clinical Research

🇺🇸

Franklin, Ohio, United States

PMG Research of Bristol

🇺🇸

Bristol, Tennessee, United States

St Elizabeth Physicians Heart

🇺🇸

Covington, Kentucky, United States

Saint Louis University

🇺🇸

Saint Louis, Missouri, United States

The Endocrinology Group

🇺🇸

Arlington, Virginia, United States

Trinity Healthcare

🇺🇸

Springfield, Missouri, United States

EDOC LLP

🇺🇸

Yonkers, New York, United States

Jefferson City Medical Group, PC

🇺🇸

Jefferson City, Missouri, United States

Central Ohio Clinical Research LLC

🇺🇸

Columbus, Ohio, United States

University Hospitals of Cleveland Case Medical Center

🇺🇸

Cleveland, Ohio, United States

OnSite Clinical Solutions, LLC_Charlotte_0

🇺🇸

Charlotte, North Carolina, United States

New Venture Medical Research

🇺🇸

Wadsworth, Ohio, United States

Northwell Health Div of Endo

🇺🇸

Great Neck, New York, United States

Lawson Family Medicine & Aesthetics

🇺🇸

Daleville, Virginia, United States

Medical Frontiers, LLC

🇺🇸

Carlisle, Ohio, United States

St. Vincent Hosp-Prevea Health

🇺🇸

Green Bay, Wisconsin, United States

Corporation Lane Research Center

🇺🇸

Virginia Beach, Virginia, United States

Chrysalis Clinical Research

🇺🇸

Saint George, Utah, United States

Christus Trinity Clinic Hill Country Landa

🇺🇸

New Braunfels, Texas, United States

Family Health Clinic

🇺🇸

Radford, Virginia, United States

Western University Medical Center at WU of Health Sciences

🇨🇦

London, Ontario, Canada

Swift Creek Family Care

🇺🇸

Colonial Heights, Virginia, United States

Family Care of Williamsburg

🇺🇸

Williamsburg, Virginia, United States

Family Medicine Healthcare

🇺🇸

Portsmouth, Virginia, United States

Chatham Family Medical Center

🇺🇸

Chatham, Virginia, United States

Ascension Medical Group- Germantown Clinic

🇺🇸

Milwaukee, Wisconsin, United States

Diabetes & Endo Specialists Inc

🇺🇸

Chesterfield, Missouri, United States

University Of Missouri - Columbia

🇺🇸

Columbia, Missouri, United States

Medical College of Wisconsin & Zablocki VAMC

🇺🇸

Milwaukee, Wisconsin, United States

University of Colorado Hospital

🇺🇸

Denver, Colorado, United States

NYU Grossman School of Med

🇺🇸

New York, New York, United States

Advanced Internal Medicine Group

🇺🇸

Great Neck, New York, United States

Format Medical Research

🇺🇸

Oxnard, California, United States

Endocrinology & Diabetes Specialists

🇺🇸

Walnut Creek, California, United States

Adnab Research/Prestige Care Physician

🇺🇸

Torrance, California, United States

La Porte County Institute For Clinical Research

🇺🇸

Michigan City, Indiana, United States

Tri-County Research, Inc.

🇺🇸

Sterling Heights, Michigan, United States

South County Endocrinology and Obesity Medicine, LLC

🇺🇸

Saint Louis, Missouri, United States

Valley Weight Loss Clinic

🇺🇸

Fargo, North Dakota, United States

American Clinical Trials

🇺🇸

Buena Park, California, United States

OM Research LLC

🇺🇸

Lancaster, California, United States

Pacific Medical Center

🇺🇸

Milpitas, California, United States

Facey Medical Foundation

🇺🇸

Mission Hills, California, United States

Monterey Endocrine & Diabetes Institute, Inc

🇺🇸

Monterey, California, United States

Joselito C Cabaccan, MD

🇺🇸

San Jose, California, United States

Premier Medical Center, Inc.

🇺🇸

Toluca Lake, California, United States

Altura Centers For Health

🇺🇸

Tulare, California, United States

Tariq Javed, MD Inc.

🇺🇸

Visalia, California, United States

Endocrine Associates of Connecticut

🇺🇸

Hamden, Connecticut, United States

Western Connecticut Health Network_Danbury

🇺🇸

Danbury, Connecticut, United States

Denver Endocrinology Diabetes and Thyroid Center

🇺🇸

Englewood, Colorado, United States

ProHealth Physicians/OptumCare

🇺🇸

Bristol, Connecticut, United States

Ismail Tarkhan MD

🇺🇸

Milford, Connecticut, United States

Steven L. Saunders MD LLC

🇺🇸

Milford, Connecticut, United States

Atlanta Center for Clinical Research

🇺🇸

Roswell, Georgia, United States

Herman Clinical Research LLC

🇺🇸

Suwanee, Georgia, United States

Family Health Care Center

🇺🇸

Statesboro, Georgia, United States

American Health Network of Indiana, LLC_Avon_0

🇺🇸

Avon, Indiana, United States

Gaurang B. Shah, MD

🇺🇸

Richmond, Kentucky, United States

Catherine LaRuffa, M.D., Inc.

🇺🇸

Blanchester, Ohio, United States

Prominis Medical Services PC

🇺🇸

Brooklyn, New York, United States

Albany Medical College - Endo

🇺🇸

Albany, New York, United States

NYC Research, Inc.

🇺🇸

New York, New York, United States

Diab & Endo Assoc of Stark Co

🇺🇸

Canton, Ohio, United States

Harleysville Medical Associates

🇺🇸

Harleysville, Pennsylvania, United States

Ascend Research Centers, Inc.

🇺🇸

McMinnville, Tennessee, United States

C. Lee Ginsburgh

🇺🇸

Newport News, Virginia, United States

Seven Corners Medical

🇺🇸

Falls Church, Virginia, United States

Hampton Family Practice

🇺🇸

Hampton, Virginia, United States

Hampton Roads Center for Clinical Research

🇺🇸

Suffolk, Virginia, United States

Endocrinology Consultants

🇺🇸

Virginia Beach, Virginia, United States

Piedmont Family Practice PLC

🇺🇸

Warrenton, Virginia, United States

Medical Associates of Central Virginia, Inc.

🇺🇸

Lynchburg, Virginia, United States

Tri State Primary Caregrayson Health Park

🇺🇸

Ashland, Kentucky, United States

Athens Medical Group

🇺🇸

Athens, Tennessee, United States

Murphy Research Center

🇺🇸

Humboldt, Tennessee, United States

Halifax Internal Medicine

🇺🇸

South Boston, Virginia, United States

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