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REDEFINE 3: A Research Study to See the Effects of CagriSema in People Living With Diseases in the Heart and Blood Vessels

Phase 3
Active, not recruiting
Conditions
Cardiovascular Disease
Interventions
Registration Number
NCT05669755
Lead Sponsor
Novo Nordisk A/S
Brief Summary

This study will look at the effects of CagriSema on cardiovascular events (for example heart attack and stroke) in people living with cardiovascular disease. Participants will either get CagriSema or a dummy medicine (also called "placebo") which has no effect on the body. Which treatment participants will get will be decided by chance. Participant's chance of getting CagriSema or placebo is the same. Participants will inject the study medicine once a week. The study medicine will be injected briefly with a thin needle, typically in the stomach, thighs or upper arms. The study will last for up to 4.5 years.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
7000
Inclusion Criteria
  • Male or female

  • Age above or equal to 55 years at the time of signing informed consent

  • Body mass index (BMI) greater than or equal to (>=) 25.0 kilograms per meter square (kg/m^2)

  • Established CVD as evidenced by at least one of the following:

    1. Prior myocardial infarction

    2. Prior stroke (ischemic or haemorrhagic stroke)

    3. Symptomatic peripheral arterial disease (PAD) defined as at least one of the following:

      1. Intermittent claudication with an ankle-brachial index (ABI) less than (<) 0.85 at rest
      2. Intermittent claudication with a >= 50% stenosis in a lower extremity peripheral artery documented by X-ray angiography, magnetic resonance (MR) angiography, computed tomography (CT) angiography or Doppler ultrasound
      3. Prior revascularization procedure of a lower extremity peripheral artery
      4. Lower extremity amputation at or above ankle due to atherosclerotic disease (excluding e.g., trauma or osteomyelitis)

For participants with T2D at screening the following inclusion criteria also apply:

  • Diagnosed with type 2 diabetes mellitus (T2D) >= 180 days before screening

  • HbA1c 6.5%-10% (48-86 millimoles per mole [mmol/mol]) (both inclusive), as measured by central laboratory at screening

  • Treatment with either:

    1. Lifestyle intervention alone
    2. 1-3 marketed oral antidiabetic drugs (OADs) (metformin, α-glucosidase inhibitors (AGI), glinides, sodium-glucose co-transporter 2 inhibitor (SGLT2i), dipeptidyl peptidase 4 (DPP4)-inhibitors, thiazolidinediones, or sulphonylureas (SU) as a single agent or in combination) according to local label
    3. Basal insulin alone or in combination with up to two marketed OADs, all according to local label
Exclusion Criteria
  • Myocardial infarction, stroke, hospitalization for unstable angina pectoris or transient ischaemic attack within 60 days before screening
  • Planned coronary, carotid or peripheral artery revascularisation known on the day of screening
  • Heart failure classified as being in New York Heart Association (NYHA) Class IV at screening
  • Treatment with any glucagon-like peptide-1 (GLP-1) receptor agonist (RA) or a medication with GLP-1 activity within 90 days before screening
  • End stage renal disease defined as estimated glomerular filtration rate (eGFR) < 15 millileters per minutes per 1.73^2 (mL/min/1.73 m^2), as measured by the central laboratory at screening
  • Chronic or intermittent haemodialysis or peritoneal dialysis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CagriSemaCagrilintideParticipants will receive cagrilintide and semaglutide subcutaneously (s.c.) once-weekly after a dose escalation period of 16 weeks during the maintenance period of 219 weeks.
CagriSemaSemaglutideParticipants will receive cagrilintide and semaglutide subcutaneously (s.c.) once-weekly after a dose escalation period of 16 weeks during the maintenance period of 219 weeks.
PlaceboPlaceboParticipants will receive placebo matched to cagrilintide and placebo matched to semaglutide s.c. once weekly for 235 weeks.
Primary Outcome Measures
NameTimeMethod
Time to first occurrence of major adverse cardiovascular event (MACE), a composite endpoint consisting of: cardiovascular (CV) death, non-fatal myocardial infarction, non-fatal strokeFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Secondary Outcome Measures
NameTimeMethod
Change in diastolic blood pressure (DBP)From baseline (week 0) to 120 weeks

Measured in mmHg.

Relative change in lipids: Total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol, triglycerides and free fatty acidsFrom baseline (week 0) to 120 weeks

Measured in percentage.

Change in glycated haemoglobin (HbA1c)From baseline (week 0) to 120 weeks

Measured in percentage-points.

Change from baseline in Interleukin 1 beta (IL-1β)From baseline (week 0) to 120 weeks

Measured in pg/mL.

Change in Pittsburgh Sleep Quality Index (PSQI)From baseline (week 0) to 120 weeks

The Pittsburgh Sleep Quality Index is a 19-item, self-rated questionnaire, assessed various aspects of sleep, sleep quality, and sleep disturbances. The PSQI is composed of 7 components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these 7 components yields 1 global score. An overall score ranges from 0 to 21, where lower scores denote a healthier sleep quality.

Time to occurrence of CV deathFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Time to first occurrence of a composite heart failure endpoint consisting of: CV death, heart failure, hospitalisation and urgent heart failure visitFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Time to first occurrence of an expanded MACE composite endpoint consisting of: CV death, non-fatal myocardial infarction, non-fatal stroke, coronary revascularisation and unstable angina requiring hospitalisationFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Time to first occurrence of a composite endpoint: Onset of persistent ≥40% reduction in eGFRcr (CKD-EPI), Onset of persistent eGFRcr (CKD-EPI) <15 mL/min/1.73 m2, Initiation of chronic kidney replacement therapy, Kidney death and CV deathFrom baseline (week -3) to end of study (up to 242 weeks or more)

CKD-EPI is Chronic Kidney Disease Epidemiology Collaboration. Measured in days.

Time to first occurrence of all-cause deathFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Time to first occurrence of a composite endpoint consisting of: all-cause death, non-fatal myocardial infarction and non-fatal strokeFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Change in waist circumferenceFrom baseline (week 0) to 120 weeks

Measured in centimeters (cm).

Change in systolic blood pressure (SBP)From baseline (week 0) to 120 weeks

Measured in millimeters of mercury (mmHg).

Number of severe hypoglycaemic episodes (level 3) (only for participants with type 2 diabetes mellitus [T2D] at screening)From baseline (week 0) to end of study (up to 242 weeks or more)

Measured as count of events.

Change in Short Form 36 v2.0 acute (SF-36v2)From baseline (week 0) to 120 weeks

SF-36v2.0 is a 36-item commonly used generic clinical outcome assessment (COA) instrument measuring health-related quality of life and general health status across disease areas. The SF-36v2.0 for adults with a 1 week recall period (i.e. acute version) measures the individual overall health-related quality of life in 8 health domains (physical functioning, role-physical, bodily pain, general health, social functioning, role emotional, vitality and mental health). Furthermore, it includes two aggregated scores: a physical component summary score and a mental component summary score. Range of score for domains and component summary scores : 1-100 (Higher scores indicated a better health state).

Change from baseline in tumour necrosis factor alpha (TNF-α)From baseline (week 0) to 120 weeks

Measured in picograms per milliliter (pg/mL)

Change from baseline in Interleukin 6 (IL-6)From baseline (week 0) to 120 weeks

Measured in pg/mL.

Time to first occurrence of myocardial infarction (fatal and non-fatal)From baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Time to first occurrence of stroke (fatal and non-fatal)From baseline (week 0) to end of study (up to 242 weeks or more)

Measured in days.

Relative change in body weightFrom baseline (week 0) to 120 weeks

Measured in percentage (%).

Number of treatment emergent serious adverse events (TESAEs)From baseline (week 0) to end of study (up to 242 weeks or more)

Measured in count of events.

Change from baseline in high-sensitivity C-reactive protein (hsCRP)From baseline (week 0) to 120 weeks

Measured in milligram per liter (mg/L)

Change in pain intensity rated by Numerical Rating Scale (NRS)From baseline (week 0) to 120 weeks

The NRS rates average pain intensity in the last 24 hours on a scale from 0 to 10, with 0 meaning 'No pain' and '10' meaning 'Pain as bad as you can imagine'.

Change in neuropathy status by baseline neuropathy group (painful neuropathy, painless neuropathy or no neuropathy)From baseline (week 0) to 120 weeks

Measured in percentage.

Number of event adjudication committee (EAC)-confirmed malignant neoplasmsFrom baseline (week 0) to end of study (up to 242 weeks or more)

Measured as count of events.

Trial Locations

Locations (556)

Univ of Alabama Birmingham

🇺🇸

Birmingham, Alabama, United States

Chambliss Clinical Trials LLC

🇺🇸

Montgomery, Alabama, United States

Honor Health

🇺🇸

Scottsdale, Arizona, United States

National Heart Institute Cal

🇺🇸

Beverly Hills, California, United States

Valley Clinical Trials

🇺🇸

Covina, California, United States

Scripps Wht Diab Inst La Jolla

🇺🇸

La Jolla, California, United States

First Valley Medical Group

🇺🇸

Lancaster, California, United States

Clinical Trials Research_Sacramento

🇺🇸

Lincoln, California, United States

Torrance Clin Res Inst, Inc.

🇺🇸

Lomita, California, United States

Pacific Clinical Studies

🇺🇸

Los Alamitos, California, United States

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Univ of Alabama Birmingham
🇺🇸Birmingham, Alabama, United States

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