MedPath

Research Study to Compare Semaglutide Tablets With Empagliflozin or Metformin Tablets in People With Type 2 Diabetes

Phase 3
Withdrawn
Conditions
Diabetes Mellitus, Type 2
Interventions
Registration Number
NCT06083675
Lead Sponsor
Novo Nordisk A/S
Brief Summary

This study compares the medicines semaglutide with empagliflozin or metformin in people with newly diagnosed type 2 diabetes. This study will look mainly at how well participant's blood sugar and body weight are controlled when they are taking the study medicines. Participants will either get semaglutide tablets, empagliflozin tablets or metformin tablets. Which treatment participants will get is decided by chance. Currently, doses of 3 milligram (mg), 7 mg and 14 mg semaglutide tablets (Rybelsus) can be prescribed in some countries. 25 mg and 50 mg semaglutide tablets are new doses. 10 mg and 25 mg empagliflozin tablets (Jardiance) can be prescribed in some countries. 500 mg metformin tablets (STADA) can be prescribed in some countries. Participants will get 1 to 4 tablets per day for 104 weeks. The study will last for about 2 years and 7 weeks (111 weeks). Participants should not have been treated for weight management 90 days before screening or never been treated with any medicine for type 2 diabetes (except diabetes during pregnancy) before screening. Women cannot take part if pregnant, breast-feeding or plan to get pregnant during the study period.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Male or female.
  • Age ≥18 and <60 years at the time of signing the informed consent.
  • Diagnosed with type 2 diabetes mellitus within 24 months from the day of screening.
  • HbA1c of 7.0-10.0% (53-86 millimoles per mole [mmol/mol])
  • Body mass index ≥25.0 kilogram per square meter (kg/m^2)
Exclusion Criteria
  • Treatment with any medication for the indication of diabetes. Prior insulin treatment for gestational diabetes is allowed.
  • Treatment with any medication for the indication of weight management 90 days prior to screening.
  • Renal impairment measured as estimated glomerular filtration rate (eGFR) <60 milliliters per minute per 1.73 meter sqaure (mL/min/1.73 m^2) at screening.
  • Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within 90 days before screening or in the period between screening and randomisation. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
  • C-peptide <1.5 nanograms per milliliter (ng/mL) at screening.
  • Positive insulinoma associated-protein 2 (IA-2) antibodies ≥7.5 Units/mL or anti-glutamic acid decarboxylase (anti-GAD) antibodies greater than (>) 5.0 international units per milliliter (IU/mL).
  • Impaired liver function, defined as Alanine aminotransferase (ALT) ≥2.5 times or Bilirubin >1.5 times upper normal limit at screening.
  • History of major surgical procedures involving the stomach potentially affecting absorption of trial products (example subtotal or total gastrectomy, sleeve gastrectomy, gastric bypass surgery) or current presence of gastrointestinal implant.
  • Presence of clinically significant gastrointestinal disorders affecting absorption of drugs and/or nutrients, as judged by the investigator.
  • Any contraindications for empagliflozin or metformin according to local labelling at the investigator's discretion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Semaglutide 25 mgSemaglutideParticipants will receive 25 mg oral semaglutide once daily in maintenance period after dose escalation period.
Semaglutide 50 mgSemaglutideParticipants will receive 50 mg oral semaglutide once daily in maintenance period after dose escalation period.
Metformin 2000 mgMetforminParticipants will receive metformin 1000 mg orally twice daily (total 2000 mg) in maintenance period after dose escalation period.
Empagliflozin 25 mgEmpagliflozinParticipants will 25 mg empagliflozin oral once daily in maintenance period after dose escalation period.
Primary Outcome Measures
NameTimeMethod
Change in glycated haemoglobin (HbA1c)From randomisation (week 0) to week 52

Measured in Percentage (%)-points.

Secondary Outcome Measures
NameTimeMethod
Change in FPGFrom randomisation (week 0) to week 104

Measured in mmol/L.

Change in 7 point SMPG mean profileFrom randomisation (week 0) to week 104

Measured in mmol/L.

Change in 7-point SMPG mean post prandial incrementsFrom randomisation (week 0) to week 104

Measured in mmol/L

Relative change in body weightFrom randomisation (week 0) to week 104

Measured in Percentage.

HbA1c less than or equal to (≤) 6.5% (Yes/No)At week 52

Measured as count of participants.

HbA1c less than (<) 7% (Yes/No)At week 52

Measured as count of participants.

Change in body weightFrom randomisation (week 0) to week 104

Measured in kg.

Change in 7 point self measured plasma glucose (SMPG) mean profileFrom randomisation (week 0) to week 52

Measured in mmol/L.

Change in 7-point self-measured plasma glucose (SMPG) mean post prandial incrementsFrom randomisation (week 0) to week 52

Measured in mmol/L.

Change in diastolic blood pressureFrom randomisation (week 0) to week 104

Measured in mmHg.

HbA1c ≤6.5% (Yes/No)At week 104

Measured as count of participants.

Change in waist circumferenceFrom randomisation (week 0) to week 104

Measured in cm.

HbA1c <7.0% and body weight reduction ≥5% (Yes/No)At week 104

Measured as count of participants.

Body weight reduction greater than equal to ( ≥) 5% (Yes/No)At week 52

Measured as count of participants.

Change in fasting plasma glucose (FPG)From randomisation (week 0) to week 52

Measured in millimoles per liter (mmol/L).

Body weight reduction ≥10% (Yes/No)At week 104

Measured as count of participants.

Body weight reduction ≥15% (Yes/No)At week 104

Measured as count of participants.

Change in systolic blood pressureFrom randomisation (week 0) to week 104

Measured in mmHg.

Change in High-sensitivity C-reactive protein (hsCRP)From randomisation (week 0) to week 52

Measured in milligrams per liter (mg/L).

Time to rescue medicationFrom randomisation (week 0) to week 104

Measured in days.

Change in HbA1cFrom randomisation (week 0) to week 104

Measured in %-points.

HbA1c <7.0% (Yes/No)At week 104

Measured as count of participants.

Body weight reduction ≥5% (Yes/No)At week 104

Measured as count of participants.

Change in hsCRPFrom randomisation (week 0) to week 104

Measured in mg/L.

Treatment emergent adverse eventsFrom randomisation (week 0) to follow-up visit (week 109)

Measured as count of events.

Number of severe (level 3) or clinically significant (level 2) hypoglycaemic episodesFrom randomisation (week 0) to follow-up visit (week 109)

Measured as count of episodes.

Change in Control of Eating Questionnaire (CoEQ) score - Craving Control domainFrom randomisation (week 0) to week 52

CoEQ is a 19-item multidimensional patient reported outcome (PRO) that assesses the experience of hunger, satiety, and severity and type of food cravings. CoEQ consists of 4 subscales that measure craving control (5 items), positive mood (4 items), craving for sweet (4 items), craving for savoury food (4 items), and 2 single items that address hunger and satiety. Each item is evaluated on a 0-10 (i.e., 11-point) numeric rating scale. The total score for each subscale is calculated as the sum of the item scores divided by the number of items in the subscale. Scores ranges are thus: Craving Control 0-50/5 = 0-10); Positive Mood (0-40/4 = 0-10); Craving Sweet (0-40/4 = 0-10); Craving Savoury food (0-40/4 = 0-10); single items that address hunger and satiety (0-10). For the craving control subscale, the subscale score is reversed so that a higher score represents a greater level of craving control.

Change in CoEQ score - Craving for Savory domainFrom randomisation (week 0) to week 104

CoEQ is a 19-item multidimensional PRO that assesses the experience of hunger, satiety, and severity and type of food cravings. CoEQ consists of 4 subscales that measure craving control (5 items), positive mood (4 items), craving for sweet (4 items), craving for savoury food (4 items), and 2 single items that address hunger and satiety. Each item is evaluated on a 0-10 (i.e., 11-point) numeric rating scale. The total score for each subscale is calculated as the sum of the item scores divided by the number of items in the subscale. Scores ranges are thus: Craving Control 0-50/5 = 0-10); Positive Mood (0-40/4 = 0-10); Craving Sweet (0-40/4 = 0-10); Craving Savoury food (0-40/4 = 0-10); single items that address hunger and satiety (0-10). For the craving savoury food subscale, higher score represents a greater level of craving.

Change in Impact of Weight on Quality of Life-Lite Clinical Trials (IWQOL-Lite-CT) score - Physical function domainFrom randomisation (week 0) to week 52

IWQOL-Lite-CT measures weight-related physical and psychosocial functioning. The measure consists of 20 items yielding 3 composite scores, and 1 total score. Higher scores indicate better levels of functioning. Composite scores (score range): Physical composite (0-100), Psychosocial composite (0 100), Physical Function composite (0-100). Total score range (0-100).

Change in American Heart Association (AHA) Life's Simple 7 summary scoreFrom randomisation (week 0) to week 52

The AHA recommends focusing on 7 cardiovascular health factors (smoking, BMI, physical activity, diet, total cholesterol, blood pressure, and fasting blood glucose) for early or primary prevention of cardiovascular disease. The 7 health factors are each categorized as ideal, intermediate, or poor. Scales range from 0 (minimum) to 14 (maximum). Higher score represents a greater level of health.

Change in CoEQ score - Craving Control domainFrom randomisation (week 0) to week 104

CoEQ is a 19-item multidimensional PRO that assesses the experience of hunger, satiety, and severity and type of food cravings. CoEQ consists of 4 subscales that measure craving control (5 items), positive mood (4 items), craving for sweet (4 items), craving for savoury food (4 items), and 2 single items that address hunger and satiety. Each item is evaluated on a 0-10 (i.e., 11-point) numeric rating scale. The total score for each subscale is calculated as the sum of the item scores divided by the number of items in the subscale. Scores ranges are thus: Craving Control 0-50/5 = 0-10); Positive Mood (0-40/4 = 0-10); Craving Sweet (0-40/4 = 0-10); Craving Savoury food (0-40/4 = 0-10); single items that address hunger and satiety (0-10). For the craving control subscale, the subscale score is reversed so that a higher score represents a greater level of craving control.

Change in IWQOL-Lite-CT score - Physical function domainFrom randomisation (week 0) to week 104

IWQOL-Lite-CT measures weight-related physical and psychosocial functioning. The measure consists of 20 items yielding 3 composite scores, and 1 total score. Higher scores indicate better levels of functioning. Composite scores (score range): Physical composite (0-100), Psychosocial composite (0 100), Physical Function composite (0-100). Total score range (0-100).

Change in AHA Life's Simple 7 summary scoreFrom randomisation (week 0) to week 104

The AHA recommends focusing on 7 cardiovascular health factors (smoking, BMI, physical activity, diet, total cholesterol, blood pressure, and fasting blood glucose) for early or primary prevention of cardiovascular disease. The 7 health factors are each categorized as ideal, intermediate, or poor. Scales range from 0 (minimum) to 14 (maximum). Higher score represents a greater level of health.

Trial Locations

Locations (100)

Songklanagarind Hospital

🇹🇭

Songkla, Thailand

General Hospital of Thessaloniki "G.Papanikolaou"

🇬🇷

Thessaloniki, Greece

ETG Siedlce

🇵🇱

Siedlce, Masovian, Poland

Etyka Ośrodek Badań Klinicznych Tomasz Pesta S.K.A.

🇵🇱

Olsztyn, Poland

Centrum Medyczne Oporow

🇵🇱

Wroclaw, Poland

Centrum Medyczne Intercor Sp. z o.o.

🇵🇱

Bydgoszcz, Poland

Srinagarind Hospital

🇹🇭

Khon Kaen, Thailand

Clinica Grivitei 224 S.R.L.

🇷🇴

Braila, Romania

MHAT- Hristo Botev AD

🇧🇬

Vratsa, Bulgaria

CPCLIN - Centro de Pesquisas Clínicas

🇧🇷

São Paulo, Sao Paulo, Brazil

Diagnostic-Consultative Centre "Sveti Georgi" Eood

🇧🇬

Plovdiv, Bulgaria

Sparsh Hospital, Bhubaneshwar

🇮🇳

Bhubaneshwar, India

Hillcrest Family Health Center

🇺🇸

Waco, Texas, United States

Klinik Kesihatan Cheras Baru

🇲🇾

Kuala Lumpur, Malaysia

Medical Care and Research S. A de C.V

🇲🇽

Merida, Yucatan, Mexico

Dayanand Medical College & Hospital_Ludhiana

🇮🇳

Ludhiana, Punjab, India

''Aipsomcidemd - Dr. Lilyana Bodurova-Troharova" Eood

🇧🇬

Samokov, Bulgaria

Lifecare Hospital and Research Centre

🇮🇳

Bangalore, Karnataka, India

Diabetes, Thyroid and Endocrine Centre

🇮🇳

Jaipur, Rajasthan, India

Opca bolnica Karlovac

🇭🇷

Karlovac, Croatia

Swasthya Diabetes Care

🇮🇳

Ahmedabad, India

Ashirwad Hospital and Research Centre

🇮🇳

Thane, Maharashtra, India

Medanta Lucknow Hospital

🇮🇳

Lucknow, Uttar Pradesh, India

"Medical center Medishtit Velisia" OOD

🇧🇬

Stara Zagora, Bulgaria

Ramaiah Memorial Hospital

🇮🇳

Bangalore, Karnataka, India

TOTALL Diabetes Hormone Institute

🇮🇳

Indore, Madhya Pradesh, India

Seth GS Medical College & KEM Hospital

🇮🇳

Mumbai, Maharashtra, India

Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe, Wardha

🇮🇳

Wardha, Maharashtra, India

Iatriko Psychicou Private Clinic

🇬🇷

Athens, Greece

Govt Medical College

🇮🇳

Vadodara, Gujrat, India

Goa Medical College

🇮🇳

Goa, Maharashtra, India

K R Hospital

🇮🇳

Mysuru, Karnataka, India

Excel Endocrine Centre

🇮🇳

Kolhapur, Maharashtra, India

Gandhi Hospital & Medical college

🇮🇳

Hyderabad, Telengana, India

Yashoda hospital

🇮🇳

Hyderabad, Telengana, India

M.V.Hospital for Diabetes Pvt. Ltd.

🇮🇳

Chennai, Tamil Nadu, India

Núcleo de Pesquisa Clínica do Rio Grande do Sul Ltda.

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

Jawahar Lal Nehru Govt. Medical College

🇮🇳

Ajmer, Rajasthan, India

Siriraj Hospital

🇹🇭

Bangkok Noi, Bangkok, Thailand

Instituto de Ciências Farmacêuticas

🇧🇷

Goiânia, Goias, Brazil

Individual Practice For Specialized Outpatient Medical Care Doctor Miglena Rizova Ltd.

🇧🇬

Kyustendil, Bulgaria

"Aipsomcemd - Dr. Petya Georgieva" Eood

🇧🇬

Plovdiv, Bulgaria

Poliklinika SLAVONIJA OSIJEK

🇭🇷

Osijek, Osječko - Baranjska Županija, Croatia

Diagnostic Consulting Center 1 Velingrad EOOD

🇧🇬

Velingrad, Bulgaria

Iatriko Athinon (Athens Medical Canter)

🇬🇷

Athens, Greece

Iatriko Athinon 'Palaiou Falirou'

🇬🇷

Athens, Greece

Opca bolnica Pula

🇭🇷

Pula, Croatia

Specijalna bolnica Medico

🇭🇷

Rijeka, Croatia

University Hospital of Athens ATTIKON

🇬🇷

Haidari-Athens, Greece

University General Hospital of Ioannina,Internal Medicine

🇬🇷

Ioannina, Greece

"Laiko" General Hospital of Athens

🇬🇷

Athens, Greece

"Thermi" Private Hosital

🇬🇷

Thessaloniki, Greece

General Hospital of Thessaloniki 'G. Gennimatas

🇬🇷

Thessaloniki, Greece

EUROMEDICA Gen Clinic The/ki, Endocrin,Metabolism,Diabetes

🇬🇷

Thessaloniki, Greece

Belinus Bt.

🇭🇺

Debrecen, Hungary

Endolife Specialty Hospitals

🇮🇳

Guntur, Andhra Pradesh, India

Yalamanchi Hospitals and Research centres pvt ltd

🇮🇳

Vijaywada, Andhra Pradesh, India

Maulana Azad Medical College

🇮🇳

Delhi, New Delhi, India

BP Poddar Hospital

🇮🇳

Kolkata,, West Bengal, India

Klinik Kesihatan Kuang

🇲🇾

Rawang, Selangor, Malaysia

Klinik Kesihatan Greentown Ipoh

🇲🇾

Ipoh, Malaysia

FAICIC S. de R.L. de C.V.

🇲🇽

Veracruz, Mexico

Clinmedica Research sp. z o.o.

🇵🇱

Skierniewice, Lodzkie, Poland

Eme Red Hospitalaria

🇲🇽

Mérida, Yucatán, Mexico

Diab Serwis Popenda Spółka Jawna

🇵🇱

Chorzów, Poland

Sc Mediab Srl

🇷🇴

Tirgu Mures, Mures, Romania

Trialmed CRS

🇵🇱

Piotrków Trybunalski, Łódzkie, Poland

ENDOPRACTICA W.Beker, D.Mielczarek, P.Mielczarek, J.Struzik spółka cywilna

🇵🇱

Opole, Poland

NZOZ NEURO-KARD Ilkowski i Partnerzy Spółka Partnerska Lekarzy

🇵🇱

Poznań, Poland

Institutul National De Diabet Nutritie Si Boli Metabolice Prof.Dr.N.Paulescu Bucuresti- Ion Movila

🇷🇴

Bucharest, Bucurestii, Romania

SC Nutrilife SRL

🇷🇴

Bucharest, Romania

S.C. Dianutrilife Medica S.R.L.

🇷🇴

Ploiesti, Romania

Diabet Med SRL

🇷🇴

Bucuresti, Romania

Healthcare centre Zvezdara

🇷🇸

Belgrade, RS, Serbia

Rajavithi Hospital

🇹🇭

Bangkok, Thailand

Thammasat University Hospital

🇹🇭

Klong Luang, Pathum Thani, Thailand

Maharaj Nakorn Chiang Mai Hospital

🇹🇭

Chiang Mai, Thailand

Ramathibodi Hospital

🇹🇭

Bangkok, Thailand

CPQuali Pesquisa Clínica Ltda

🇧🇷

São Paulo, Sao Paulo, Brazil

Specijalna bolnica Krapinske Toplice - Endokrinologija

🇭🇷

Krapinske Toplice, Croatia

Navneeth Memorial Hospital

🇮🇳

Ahmedabad, Gujrat, India

All India Institute of Medical Sciences (AIIMS), Nagpur

🇮🇳

Maharashtra, India

Clinica Korall S.R.L. Satu Mare

🇷🇴

Satu-Mare, Romania

BSES MG hospital

🇮🇳

Mumbai, Maharashtra, India

Mahatma Gandhi Memorial Hospital, Sherpura

🇮🇳

Warangal, India

Hospital Miri

🇲🇾

Sarawak, Miri, Malaysia

Hospital Sultan Haji Ahmad Shah

🇲🇾

Temerloh,Pahang, Malaysia

NZOZ Vita-Diabetica Malgorzata Buraczyk

🇵🇱

Bialystok, Podlaskie Voivodeship, Poland

Healthcare centre Kragujevac

🇷🇸

Kragujevac, RS, Serbia

Osmania General Hospital

🇮🇳

Hyderabad, A.p., India

Lifepoint Multispecialty Hospital

🇮🇳

Pune, India

Hospital Melaka

🇲🇾

Melaka, Malaysia

Hospital Seri Manjung

🇲🇾

Seri Manjung, Malaysia

Healthcare centre Nis

🇷🇸

Nis, RS, Serbia

Aligarh Muslim University

🇮🇳

Aligarh, India

Klinik Kesihatan Bintulu

🇲🇾

Bintulu, Malaysia

JIPMER

🇮🇳

Puducherry, India

NZOZ Euromedica

🇵🇱

Grudziadz, Poland

Centra Medyczne Medyceusz Sp. z o.o.

🇵🇱

Łódź, Poland

ClinDiab Egészségügyi Szolgáltató és Kereskedelmi Kft.

🇭🇺

Budapest, Hungary

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