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A Study of Tirzepatide (LY3298176) Versus Semaglutide Once Weekly as Add-on Therapy to Metformin in Participants With Type 2 Diabetes

Phase 3
Completed
Conditions
Type 2 Diabetes
Interventions
Registration Number
NCT03987919
Lead Sponsor
Eli Lilly and Company
Brief Summary

The reason for this study is to compare the effect of the study drug tirzepatide to semaglutide on blood sugar levels in participants with type 2 diabetes. The study will last approximately 47 weeks and may include about 12 visits.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1879
Inclusion Criteria
  • Have been diagnosed with type 2 diabetes mellitus (T2DM)
  • Have HbA1c between ≥7.0% and ≤10.5%
  • Be on stable treatment with unchanged dose of metformin >1500 mg/day for at least 3 months prior to screening
  • Be of stable weight (±5%) for at least 3 months before screening
  • Have a body mass index (BMI) ≥25 kilograms per meter squared (kg/m²) at screening
Exclusion Criteria
  • Have type 1 diabetes mellitus
  • Have had chronic or acute pancreatitis any time prior to study entry
  • Have proliferative diabetic retinopathy or diabetic maculopathy or nonproliferative diabetic retinopathy requiring acute treatment
  • Have disorders associated with slowed emptying of the stomach, or have had any stomach surgeries for the purpose of weight loss
  • Have acute or chronic hepatitis, signs and symptoms of any other liver disease, or blood alanine transaminase (ALT) enzyme level >3.0 times the upper limit of normal (ULN) for the reference range, as determined by the central laboratory. Participants with nonalcoholic fatty liver disease (NAFLD) are eligible for participation in this trial only if there ALT level is ≤3.0 the ULN for the reference range
  • Have an estimated glomerular filtration rate <45 milliliters/minute/1.73 m² (or lower than the country specific threshold for using the protocol required dose of metformin per local label)
  • Have had a heart attack, stroke, or hospitalization for congestive heart failure in the past 2 months
  • Have a personal or family history of medullary thyroid carcinoma or personal history of multiple endocrine neoplasia syndrome type 2
  • Have been taking any other diabetes medicines other than metformin during the last 3 months
  • Have been taking weight loss drugs, including over-the-counter medications during the last 3 months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
5 mg TirzepatideTirzepatide5 milligrams (mg) tirzepatide administered subcutaneously (SC) once a week.
10 mg TirzepatideTirzepatide10 mg tirzepatide administered SC once a week.
1 mg SemaglutideSemaglutide1 mg semaglutide administered SC once a week.
15 mg TirzepatideTirzepatide15 mg tirzepatide administered SC once a week.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Hemoglobin A1c (HbA1c) (10 mg and 15 mg)Baseline, Week 40

HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Pooled Country + Treatment + Time + Treatment\*Time (Type III sum of squares).

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in HbA1c (5 mg)Baseline, Week 40

HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Pooled Country + Treatment + Time + Treatment\*Time (Type III sum of squares).

Percentage of Participants Achieving an HbA1c Target Value of <7%Week 40

Hemoglobin A1c (HbA1c) is the glycosylated fraction of hemoglobin A. HbA1c is measured to identify average plasma glucose concentration over prolonged periods of time.

Change From Baseline in Fasting Serum Glucose (FSG)Baseline, Week 40

Fasting serum glucose (FSG) is a test to determine sugar levels in serum sample after an overnight fast. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Treatment + Time + Treatment\*Time (Type III sum of squares).

Change From Baseline in Body WeightBaseline, Week 40

Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Treatment + Time + Treatment\*Time (Type III sum of squares).

Mean Change From Baseline in Daily Average 7-Point Self-Monitored Blood Glucose (SMBG) ValuesBaseline, Week 40

The self-monitored plasma glucose (SMBG) data were collected at the following 7 time points: Morning Premeal - Fasting, Morning 2-hour Postmeal, Midday Premeal, Midday 2-hour Postmeal, Evening Premeal, Evening 2-hour Postmeal and Bedtime. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Treatment + Time + Treatment\*Time (Type III sum of squares).

Percentage of Participants Who Achieved Weight Loss ≥5%Week 40

Percentage of Participants who Achieved Weight Loss ≥5%.

Diabetes Treatment Satisfaction as Measured by the Diabetes Treatment Satisfaction Questionnaire, Change Version (DTSQc) Hyperglycemia, Hypoglycemia and Total ScoreBaseline, Week 40

DTSQc, an 8-item questionnaire, assesses relative change in treatment satisfaction perceived frequency of hyperglycemia, and perceived frequency of hypoglycemia from baseline to week 40 or early termination. The questionnaire consists of 8 items, 6 of which (1 and 4 through 8) assess treatment satisfaction. Each item is rated on a 7-point Likert scale. The scores from the 6 treatment satisfaction items are summed to a Total Treatment Satisfaction Score, which ranges from -18 to 18 where the higher the score the greater the improvement in satisfaction with treatment. The lower the score the greater the deterioration in satisfaction with treatment. The hyperglycemia and hypoglycemia scores range from -3 to 3 where negative scores indicate fewer problems with blood glucose levels and positive scores indicate more problems than before. LS Mean was determined by ANCOVA with Baseline DTSQs + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Treatment (Type III sum of squares).

Rate of Hypoglycemia With Blood Glucose <54 Milligram/Deciliter (mg/dL) [<3.0 Millimole/Liter (mmol/L)] or Severe HypoglycemiaBaseline through Safety Follow-Up (Up to Week 44)

The hypoglycemia events were defined by participant reported events with blood glucose \<54mg/dL) (\<3.0 mmol/L\] or severe hypoglycemia. Severe hypoglycemia is defined as an episode with severe cognitive impairment requiring the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. These episodes may be associated with sufficient neuroglycopenia to induce seizure or coma. The rate of postbaseline hypoglycemia was estimated by negative binomial model: number of episodes = Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Treatment.

Percentage of Participants Achieving an HbA1c Target Value of <5.7%Week 40

Percentage of Participants Achieving an HbA1c Target Value of \<5.7%.

Trial Locations

Locations (120)

PharmQuest

🇺🇸

Greensboro, North Carolina, United States

Aventiv Research Inc

🇺🇸

Columbus, Ohio, United States

Biopharma Informatic, Inc.

🇺🇸

Houston, Texas, United States

Centro de Pesquisas em Diabetes

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Syed Research Consultants Llc

🇺🇸

Sheffield, Alabama, United States

Cahaba Research

🇺🇸

Birmingham, Alabama, United States

Artemis Institute for Clinical Research

🇺🇸

San Marcos, California, United States

Catalina Research Institute, LLC

🇺🇸

Montclair, California, United States

University Clinical Investigators, Inc.

🇺🇸

Tustin, California, United States

South Florida Clinical Research Institute

🇺🇸

Margate, Florida, United States

New Horizon Research Center

🇺🇸

Miami, Florida, United States

Suncoast Research Group

🇺🇸

Miami, Florida, United States

United Osteoporosis Center

🇺🇸

Gainesville, Georgia, United States

Sky Clinical Research Network

🇺🇸

Union City, Georgia, United States

Cotton O'Neil Clinic

🇺🇸

Topeka, Kansas, United States

Lillestol Research LLC

🇺🇸

Fargo, North Dakota, United States

Heritage Valley Medical Group, Inc.

🇺🇸

Beaver, Pennsylvania, United States

Intend Research, LLC

🇺🇸

Norman, Oklahoma, United States

Green & Seidner Family Practice Associates

🇺🇸

Lansdale, Pennsylvania, United States

Dallas Diabetes Research Center

🇺🇸

Dallas, Texas, United States

Carl R. Meisner Medical Clinic, PLLC

🇺🇸

Sugar Land, Texas, United States

CEDIC

🇦🇷

Caba, Ar-b, Argentina

Centro de Investigaciones Metabólicas (CINME)

🇦🇷

Caba, Buenos Aires, Argentina

Centro Médico Viamonte

🇦🇷

Caba, Buenos Aires, Argentina

Centro Medico Dr Laura Maffei Investigacion Clinica Aplicada

🇦🇷

Caba, Buenos Aires, Argentina

Instituto Centenario

🇦🇷

Ciudad Autonoma de Buenos Aire, Argentina

Paratus Clinical Research Central Coast

🇦🇺

Kanwal, Au-nsw, Australia

Adelaide Medical Solutions

🇦🇺

Woodville South, Australia

ISPEM - Instituto São José dos Campos em Pesquisas Médicas

🇧🇷

São José dos Campos, Br-sp, Brazil

CPCLIN

🇧🇷

São Paulo, SP, Brazil

Dr. Consulta Clínica Médica LTDA

🇧🇷

São Paulo, Brazil

Milestone Research Inc.

🇨🇦

London, Ca-on, Canada

Bluewater Clinical Research Group Inc.

🇨🇦

Sarnia, Ca-on, Canada

Dr. Anil K. Gupta Medicine Professional Corporation

🇨🇦

Toronto, Ca-on, Canada

Manna Research

🇨🇦

Lévis, Ca-qc, Canada

Sheba Medical Center

🇮🇱

Ramat Gan, HaMerkaz, Israel

Clalit Health Services - Shuali Clinic

🇮🇱

Raanana, HaMerkaz, Israel

Diabetes Medical Center

🇮🇱

Tel Aviv, Il-ta, Israel

Clalit Health Services - Sakhnin Community Clinic

🇮🇱

Sakhnin, Israel

Hadassah Medical Center

🇮🇱

Jerusalem, Yerushalayim, Israel

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv Jaffa, Israel

Linn Medical Center

🇮🇱

Haifa, Ḥeifā, Israel

Centro de Estudios de Investigacion Metabolicos y Cardiovasculares

🇲🇽

Ciudad Madero, Tamaulipas, Mexico

Research and Cardiovascular Corp.

🇵🇷

Ponce, Puerto Rico

Paola Mansilla-Letelier, MD

🇵🇷

Guaynabo, Puerto Rico

Clinical Research Puerto Rico

🇵🇷

San Juan, Puerto Rico

Martha Gomez Cuellar M.D.

🇵🇷

San Juan, Puerto Rico

Staploe Medical Centre

🇬🇧

Ely, Gb-cam, United Kingdom

Oldfield Surgery

🇬🇧

Bath, Avon, United Kingdom

Oak Tree Surgery

🇬🇧

Liskeard, Gb-con, United Kingdom

Fowey River Practice

🇬🇧

Fowey, Gb-con, United Kingdom

Rame Medical Ltd

🇬🇧

Torpoint, Gb-con, United Kingdom

Queen Alexandra Hospital

🇬🇧

Portsmouth, Gb-ham, United Kingdom

Lister Hospital

🇬🇧

Stevenage, Gb-hrt, United Kingdom

Rowden Surgery

🇬🇧

cHIPPENHAM, Gb-wil, United Kingdom

University Hospital Coventry & Warwickshire

🇬🇧

Coventry, Warwickshire, United Kingdom

GenesisCare - Bundaberg

🇦🇺

Bundaberg, Queensland, Australia

Campbelltown Medical & Dental Centre

🇦🇺

Campbelltown, Au-nsw, Australia

Core Research Group

🇦🇺

Milton, Queensland, Australia

Eastern Clinical Research Unit

🇦🇺

Box Hill, Victoria, Australia

CIPADI

🇦🇷

Godoy Cruz, Mendoza, Argentina

Cent Priva Especiali Médicas Ambulatorias Inve Clin CEMAIC

🇦🇷

Cordoba, Argentina

PMG Research of Wilmington

🇺🇸

Wilmington, North Carolina, United States

South Broward Research

🇺🇸

Pembroke Pines, Florida, United States

Detweiler Family Medicine & Associates

🇺🇸

Lansdale, Pennsylvania, United States

Meir Medical Center

🇮🇱

Kfar Saba, HaMerkaz, Israel

Royal Brisbane and Womens Hospital

🇦🇺

Herston, Queensland, Australia

Olive Branch Family Medical Center

🇺🇸

Olive Branch, Mississippi, United States

CPQuali Pesquisa Clínica

🇧🇷

São Paulo, Br-sp, Brazil

National Research Institute - Huntington Park

🇺🇸

Panorama City, California, United States

Valley Clinical Trials, Inc.

🇺🇸

Northridge, California, United States

CMR of Greater New Haven

🇺🇸

Hamden, Connecticut, United States

Clinical Research of South Florida

🇺🇸

Coral Gables, Florida, United States

East Coast Institute for Research at The Jones Center

🇺🇸

Lake City, Florida, United States

Oviedo Medical Research

🇺🇸

Oviedo, Florida, United States

University of Iowa Hospital & Clinic

🇺🇸

Iowa City, Iowa, United States

Elite Clinical Trials

🇺🇸

Blackfoot, Idaho, United States

NECCR PrimaCare Research

🇺🇸

Fall River, Massachusetts, United States

ActivMed Practices and Research

🇺🇸

Methuen, Massachusetts, United States

Albany Medical College, Division of Community Endocrinology

🇺🇸

Albany, New York, United States

Clinvest Research LLC

🇺🇸

Springfield, Missouri, United States

Premier Research

🇺🇸

Trenton, New Jersey, United States

Diabetes & Endocrinology Consultants, PC

🇺🇸

Morehead City, North Carolina, United States

Capital Area Research, LLC

🇺🇸

Camp Hill, Pennsylvania, United States

Holston Medical Group

🇺🇸

Bristol, Tennessee, United States

Preferred Primary Care Physicians, Preferred Clinical Research-St. Clair

🇺🇸

Pittsburgh, Pennsylvania, United States

Consano Clinical Research, LLC

🇺🇸

Shavano Park, Texas, United States

Martin Diagnostic Clinic

🇺🇸

Tomball, Texas, United States

Burke Internal Medicine and Research

🇺🇸

Burke, Virginia, United States

The Vancouver Clinic

🇺🇸

Vancouver, Washington, United States

Capital Clinical Research Center

🇺🇸

Olympia, Washington, United States

CIPREC

🇦🇷

Ciudad Autonoma de Buenos Aire, Ar-b, Argentina

Investigaciones Medicas Imoba Srl

🇦🇷

Buenos Aires, Ar-c, Argentina

CEMEDIAB

🇦🇷

C.a.b.a., Ar-c, Argentina

Mautalen Salud e Investigacion-Centro de Osteopatías Médicas

🇦🇷

Ciudad Autonoma De Buenos Air, Buenos Aires, Argentina

Sanatorio Norte

🇦🇷

Santiago del Estero, Ar-g, Argentina

Paratus Clinical Research Western Sydney

🇦🇺

Blacktown, Au-nsw, Australia

Instituto de Investigaciones Clínicas Mar del Plata

🇦🇷

Mar del Plata, Provincia De Buenos Aires, Argentina

Holdsworth House Medical Practice

🇦🇺

Sydney, New South Wales, Australia

AusTrials

🇦🇺

Taringa, Queensland, Australia

GenesisCare - Wexford Medical Centre WA

🇦🇺

Murdoch, Western Australia, Australia

Barwon Health - The Geelong Hospital

🇦🇺

Geelong, Victoria, Australia

Manna Research - Burlington North

🇨🇦

Toronto, Ontario, Canada

CEDOES

🇧🇷

Vitória, Br-es, Brazil

CEPIC - Centro Paulista de Investigação Clínica

🇧🇷

São Paulo, Br-sp, Brazil

Rambam Health Care Campus

🇮🇱

Haifa, Ḥeifā, Israel

Hospital Universitario Dr. Jose Eleuterio Gonzalez

🇲🇽

Monterrey, N.l., Mexico

Royal Primary Care Chesterfield North west

🇬🇧

Chesterfield, Gb-dby, United Kingdom

Knowle House Surgery

🇬🇧

Plymouth, Gb-dev, United Kingdom

Wickersley Health Centre - Clifton Medical Centre

🇬🇧

Rotherham, United Kingdom

Oakenhurst Medical Practice

🇬🇧

Blackburn, Gb-lan, United Kingdom

Centro Especializado en Diabetes Obesidad y Enfermedades

🇲🇽

Mexico, D.f., Mexico

Instituto Jalisciense de Investigacion en Diabetes y Obesida

🇲🇽

Guadalajara, Jalisco, Mexico

Unidad de Investigaci�n Cl�nica Cardiometabolica de Occidente

🇲🇽

Guadalajara, Mx-jal, Mexico

Investigacion en Salud y Metabolismo S.C

🇲🇽

Chihuahua, Mexico

Diseno y Planeacion en Investigacion Medica

🇲🇽

Guadalajara, Jalisco, Mexico

Unidad Médica para la Salud Integral

🇲🇽

San Nicolás de los Garza, Nuevo León, Mexico

Leicester General Hospital

🇬🇧

Leicester, Leicestershire, United Kingdom

Cotton O'Neil Diabetes and Endocrinology Center

🇺🇸

Topeka, Kansas, United States

Thomas Jefferson University

🇺🇸

Philadelphia, Pennsylvania, United States

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