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Dose-finding of Semaglutide Administered Subcutaneously Once Daily Versus Placebo and Liraglutide in Subjects With Type 2 Diabetes

Dose-finding of Semaglutide Administered Subcutaneously Once Daily Versus Placebo and Liraglutide in Subjects With Type 2 Diabetes

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02461589
Enrollment
706
Registered
2015-06-03
Start date
2015-09-21
Completion date
2016-10-13
Last updated
2019-07-31

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes, Diabetes Mellitus, Type 2

Brief summary

This trial is conducted globally. The aim of this trial is to investigate dose-finding of semaglutide administered subcutaneously once daily versus placebo and liraglutide in subjects with type 2 diabetes

Interventions

DRUGsemaglutide

Administered subcutaneously ( s.c., under the skin) once daily. All subjects will follow a 4-week dose-escalation regimen except subjects who received semaglutide flexible dosing.

DRUGliraglutide

Administered subcutaneously ( s.c., under the skin) once daily. All subjects will follow a 4-week dose-escalation regimen.

DRUGplacebo

Administered subcutaneously ( s.c., under the skin) once daily.

Sponsors

Novo Nordisk A/S
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Male or female, age at least 18 years at the time of signing informed consent. * Subjects should be on stable diabetes treatment consisting of diet and exercise with or without metformin (at least 1500 mg daily or maximum tolerated dose documented in the patient medical record) for at least 90 days prior to screening * HbA1c (glycosylated haemoglobin): 53-86 mmol/mol (7.0-10.0%) (both inclusive) * BMI: 25.0 - 40.0 kg/m\^2 (both inclusive)

Exclusion criteria

* Simultaneous participation in any other clinical trial of an investigational medicinal product * Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using adequate contraceptive methods throughout the trial including the 7 weeks follow-up period (adequate contraceptive measures as required by local regulation or practice). Germany: Only highly effective methods of birth control are accepted (i.e. one that results in less than 1% per year failure rate when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intrauterine device), or sexual abstinence or vasectomised partner. United Kingdom: Adequate contraceptive measures are defined as established use of oral, injected or implanted hormonal methods of contraception, placement of an intrauterine device or intrauterine system, barrier methods of contraception (condom or occlusive cap with spermicidal foam/gel/film/cream/suppository), female sterilisation, male sterilisation (where partner is sole partner of subject), or true abstinence (when in line with preferred and usual lifestyle) * Treatment with any medication for the indication of diabetes or obesity other than stated in the inclusion criteria in a period of 90 days before screening (an exception is short-term insulin treatment for acute illnesses for a total of below or equal to 14 days) * Anticipated initiation or change in concomitant medications (for more than 14 consecutive days or on an frequent basis) known to affect weight or glucose metabolism (e.g. orlistat, thyroid hormones, corticosteroids) * History of pancreatitis (acute or chronic) * Screening calcitonin above or equal to 50 ng/L * Family or personal history of Multiple Endocrine Neoplasia Type 2 (MEN2) or Medullary Thyroid Carcinoma (MTC) * Severe to moderate renal impairment defined as GFR, estimated below 60 ml/min/1.73 m\^2 as per CKD-EPI (Chronic Kidney Disease Epidemiology) * Within the past 180 days before screening any of the following: Myocardial infarction, stroke or hospitalisation for unstable angina and/or transient ischemic attack * Currently planned coronary, carotid or peripheral artery revascularisation * Patients presently classified as being in New York Heart Association (NYHA) Class III or IV

Design outcomes

Primary

MeasureTime frameDescription
Change in HbA1c (Glycosylated Haemoglobin)Week 0, week 26Estimated mean change from baseline in HbA1c at week 26. The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.

Secondary

MeasureTime frameDescription
Change in Fasting Plasma Glucose (FPG)Week 0, Week 26Estimated mean change from baseline in FPG at week 26. The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.
Body Weight ChangeWeek 0, Week 26The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.
Change in Systolic and Diastolic Blood PressureWeek 0, Week 26The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.

Countries

Austria, Canada, Czechia, Germany, Malaysia, Russia, Serbia, South Africa, United Kingdom, United States

Participant flow

Recruitment details

The trial was conducted at 139 sites in 10 countries as follows: Austria: 3 sites; Canada: 8 sites; Czech Republic: 9 sites; Germany: 7 sites; Malaysia: 5 sites; Russian Federation: 7 sites; Serbia: 9 sites; South Africa: 7 sites; United Kingdom: 13 sites; United States: 71 sites.

Pre-assignment details

Of the 706 subjects randomised in the trial, 705 were exposed to trial products and 1 randomised subject withdrew prior to exposure.

Participants by arm

ArmCount
Semaglutide 0.05 mg/Day
Participants received semaglutide 0.05 mg subcutaneous (sc) injection once daily for 26 weeks. Semaglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
64
Semaglutide 0.1 mg/Day
Participants received semaglutide 0.05 mg sc injection once daily for 4 weeks followed by semaglutide 0.1 mg once daily upto week 26. Semaglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
63
Semaglutide 0.2 mg/Day
Participants received semaglutide 0.05 mg sc injection once daily for 4 weeks followed by semaglutide 0.1 mg once daily for next 4 weeks and then semaglutide 0.2 mg once daily upto week 26. Semaglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
65
Semaglutide 0.3 mg/Day
Participants received semaglutide 0.05 mg sc injection once daily for 4 weeks followed by semaglutide 0.1 mg once daily for next 4 weeks followed by 0.2 mg once daily for next 4 weeks and then semaglutide 0.3 mg once daily upto week 26. Semaglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
63
Liraglutide 0.3 mg/Day
Participants received liraglutide 0.3 mg sc injection once daily for 26 weeks. Liraglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
64
Liraglutide 0.6 mg/Day
Participants received liraglutide 0.3 mg sc injection once daily for 4 weeks followed by liraglutide 0.6 mg once daily upto week 26. Liraglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
64
Liraglutide 1.2 mg/Day
Participants received liraglutide 0.3 mg sc injection once daily for 4 weeks followed by liraglutide 0.6 mg once daily for next 4 weeks and then liraglutide 1.2 mg once daily upto week 26. Liraglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
64
Liraglutide 1.8 mg/Day
Participants received liraglutide 0.3 mg sc injection once daily for 4 weeks followed by liraglutide 0.6 mg once daily for next 4 weeks followed by liraglutide 1.2 mg once daily for next 4 weeks and then liraglutide 1.8 mg once daily upto week 26. Liraglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
65
Placebo
Participants received placebo (the volume matched the volume used for the specific dose of semaglutide or liraglutide) sc injection once daily upto 26 weeks. Placebo injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals.
129
Semaglutide Flexible
Participants received semaglutide 0.05 mg sc injection once daily for 4 weeks followed by semaglutide 0.1 mg once daily for next 4 weeks followed by 0.2 mg once daily for next 4 weeks and then semaglutide 0.3 mg once daily upto week 26. Semaglutide injection was administered in the thigh, abdomen, or upper arm, preferably around the same time of the day irrespective of meals. Participants were allowed to follow a more flexible dose-escalation regimen based on gastrointestinal tolerability. Semaglutide dose levels could be reduced in participants with poor gastrointestinal tolerability depending on investigator's assessment.
64
Total705

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006FG007FG008FG009
Overall StudyDeath0000000100
Overall StudyLost to Follow-up0023113131
Overall StudyMissing follow-up information1100001000
Overall StudyUnclassified0000001002
Overall StudyWithdrawal by Subject5132121331
Overall StudyWithdrawal from trial before exposure0000000001

Baseline characteristics

CharacteristicSemaglutide 0.05 mg/DaySemaglutide 0.1 mg/DaySemaglutide 0.2 mg/DaySemaglutide 0.3 mg/DayLiraglutide 0.3 mg/DayLiraglutide 0.6 mg/DayLiraglutide 1.2 mg/DayLiraglutide 1.8 mg/DayPlaceboSemaglutide FlexibleTotal
Age, Continuous57.53 years
STANDARD_DEVIATION 9.8
57.51 years
STANDARD_DEVIATION 10
58.37 years
STANDARD_DEVIATION 9.58
54.76 years
STANDARD_DEVIATION 9.66
57.20 years
STANDARD_DEVIATION 10.78
59.45 years
STANDARD_DEVIATION 9.77
53.73 years
STANDARD_DEVIATION 11.35
55.82 years
STANDARD_DEVIATION 9.19
57.08 years
STANDARD_DEVIATION 9.25
54.81 years
STANDARD_DEVIATION 9.7
56.67 years
STANDARD_DEVIATION 9.94
Body weight93.44 kg
STANDARD_DEVIATION 18.27
92.40 kg
STANDARD_DEVIATION 17.2
98.07 kg
STANDARD_DEVIATION 17.92
94.82 kg
STANDARD_DEVIATION 17.84
92.25 kg
STANDARD_DEVIATION 17.48
92.68 kg
STANDARD_DEVIATION 16.46
96.67 kg
STANDARD_DEVIATION 18.28
93.40 kg
STANDARD_DEVIATION 19.34
93.98 kg
STANDARD_DEVIATION 17.75
95.29 kg
STANDARD_DEVIATION 15.43
94.28 kg
STANDARD_DEVIATION 17.61
Diastolic blood pressure80.06 mmHg
STANDARD_DEVIATION 8.9
79.71 mmHg
STANDARD_DEVIATION 8.56
80.48 mmHg
STANDARD_DEVIATION 8.87
81.41 mmHg
STANDARD_DEVIATION 8.05
81.83 mmHg
STANDARD_DEVIATION 6.98
81.28 mmHg
STANDARD_DEVIATION 6.9
82.98 mmHg
STANDARD_DEVIATION 6.94
80.66 mmHg
STANDARD_DEVIATION 7.62
80.98 mmHg
STANDARD_DEVIATION 8
81.89 mmHg
STANDARD_DEVIATION 8.4
81.11 mmHg
STANDARD_DEVIATION 7.96
Fasting plasma glucose9.26 mmol/L
STANDARD_DEVIATION 2.6
8.97 mmol/L
STANDARD_DEVIATION 2.22
9.20 mmol/L
STANDARD_DEVIATION 2.28
9.67 mmol/L
STANDARD_DEVIATION 2.56
9.32 mmol/L
STANDARD_DEVIATION 2.54
9.34 mmol/L
STANDARD_DEVIATION 2.33
9.91 mmol/L
STANDARD_DEVIATION 2.7
9.18 mmol/L
STANDARD_DEVIATION 2.45
9.67 mmol/L
STANDARD_DEVIATION 2.98
9.82 mmol/L
STANDARD_DEVIATION 2.66
9.45 mmol/L
STANDARD_DEVIATION 2.59
HbA1c (glycosylated haemoglobin)7.87 percentage of HbA1c
STANDARD_DEVIATION 0.71
7.91 percentage of HbA1c
STANDARD_DEVIATION 0.83
7.96 percentage of HbA1c
STANDARD_DEVIATION 0.82
8.23 percentage of HbA1c
STANDARD_DEVIATION 0.8
8.06 percentage of HbA1c
STANDARD_DEVIATION 0.86
8.12 percentage of HbA1c
STANDARD_DEVIATION 0.81
8.14 percentage of HbA1c
STANDARD_DEVIATION 0.87
8.07 percentage of HbA1c
STANDARD_DEVIATION 0.85
8.12 percentage of HbA1c
STANDARD_DEVIATION 0.87
8.10 percentage of HbA1c
STANDARD_DEVIATION 0.91
8.06 percentage of HbA1c
STANDARD_DEVIATION 0.84
Sex: Female, Male
Female
31 Participants28 Participants22 Participants31 Participants35 Participants32 Participants30 Participants32 Participants57 Participants28 Participants326 Participants
Sex: Female, Male
Male
33 Participants35 Participants43 Participants32 Participants29 Participants32 Participants34 Participants33 Participants72 Participants36 Participants379 Participants
Systolic blood pressure133.70 mmHg
STANDARD_DEVIATION 15.14
130.97 mmHg
STANDARD_DEVIATION 14.92
131.34 mmHg
STANDARD_DEVIATION 12.55
132.08 mmHg
STANDARD_DEVIATION 11.69
134.02 mmHg
STANDARD_DEVIATION 11.3
132.41 mmHg
STANDARD_DEVIATION 12.37
134.20 mmHg
STANDARD_DEVIATION 12.73
131.02 mmHg
STANDARD_DEVIATION 11.86
132.17 mmHg
STANDARD_DEVIATION 14.26
132.70 mmHg
STANDARD_DEVIATION 12.74
132.43 mmHg
STANDARD_DEVIATION 13.1

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
EG007
affected / at risk
EG008
affected / at risk
EG009
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —— / —— / —— / —— / —— / —
other
Total, other adverse events
31 / 6434 / 6339 / 6542 / 6333 / 6427 / 6435 / 6435 / 650 / 12944 / 64
serious
Total, serious adverse events
7 / 643 / 632 / 652 / 631 / 642 / 642 / 647 / 650 / 1294 / 64

Outcome results

Primary

Change in HbA1c (Glycosylated Haemoglobin)

Estimated mean change from baseline in HbA1c at week 26. The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.

Time frame: Week 0, week 26

Population: Full analysis set

ArmMeasureValue (MEAN)Dispersion
Semaglutide 0.05 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-0.97 percentage of glycosylated haemoglobinStandard Deviation 0.85
Semaglutide 0.1 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-1.30 percentage of glycosylated haemoglobinStandard Deviation 1.03
Semaglutide 0.2 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-1.65 percentage of glycosylated haemoglobinStandard Deviation 0.79
Semaglutide 0.3 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-1.96 percentage of glycosylated haemoglobinStandard Deviation 0.95
Liraglutide 0.3 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-0.50 percentage of glycosylated haemoglobinStandard Deviation 0.93
Liraglutide 0.6 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-0.88 percentage of glycosylated haemoglobinStandard Deviation 0.9
Liraglutide 1.2 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-0.86 percentage of glycosylated haemoglobinStandard Deviation 0.92
Liraglutide 1.8 mg/DayChange in HbA1c (Glycosylated Haemoglobin)-1.32 percentage of glycosylated haemoglobinStandard Deviation 0.78
PlaceboChange in HbA1c (Glycosylated Haemoglobin)-0.05 percentage of glycosylated haemoglobinStandard Deviation 0.9
Semaglutide FlexibleChange in HbA1c (Glycosylated Haemoglobin)-1.72 percentage of glycosylated haemoglobinStandard Deviation 0.97
p-value: <0.000195% CI: [-1.3, -0.77]Mixed Models Analysis
p-value: <0.000195% CI: [-1.61, -1.08]Mixed Models Analysis
p-value: <0.000195% CI: [-1.95, -1.42]Mixed Models Analysis
p-value: <0.000195% CI: [-2.12, -1.6]Mixed Models Analysis
Secondary

Body Weight Change

The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.

Time frame: Week 0, Week 26

Population: Full analysis set

ArmMeasureValue (MEAN)Dispersion
Semaglutide 0.05 mg/DayBody Weight Change-2.75 kgStandard Deviation 2.82
Semaglutide 0.1 mg/DayBody Weight Change-4.36 kgStandard Deviation 4.24
Semaglutide 0.2 mg/DayBody Weight Change-6.70 kgStandard Deviation 4.57
Semaglutide 0.3 mg/DayBody Weight Change-8.23 kgStandard Deviation 5.34
Liraglutide 0.3 mg/DayBody Weight Change-1.48 kgStandard Deviation 3.06
Liraglutide 0.6 mg/DayBody Weight Change-1.81 kgStandard Deviation 3.06
Liraglutide 1.2 mg/DayBody Weight Change-1.78 kgStandard Deviation 3.41
Liraglutide 1.8 mg/DayBody Weight Change-3.68 kgStandard Deviation 4.26
PlaceboBody Weight Change-1.22 kgStandard Deviation 3.42
Semaglutide FlexibleBody Weight Change-6.60 kgStandard Deviation 4.98
Secondary

Change in Fasting Plasma Glucose (FPG)

Estimated mean change from baseline in FPG at week 26. The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.

Time frame: Week 0, Week 26

Population: Full analyses set. For Semaglutide flexible arm, data was available only for 63 subjects.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 0.05 mg/DayChange in Fasting Plasma Glucose (FPG)-2.09 mmol/LStandard Deviation 1.96
Semaglutide 0.1 mg/DayChange in Fasting Plasma Glucose (FPG)-2.08 mmol/LStandard Deviation 2.23
Semaglutide 0.2 mg/DayChange in Fasting Plasma Glucose (FPG)-2.64 mmol/LStandard Deviation 2.07
Semaglutide 0.3 mg/DayChange in Fasting Plasma Glucose (FPG)-3.53 mmol/LStandard Deviation 2.2
Liraglutide 0.3 mg/DayChange in Fasting Plasma Glucose (FPG)-1.33 mmol/LStandard Deviation 2.06
Liraglutide 0.6 mg/DayChange in Fasting Plasma Glucose (FPG)-1.56 mmol/LStandard Deviation 1.74
Liraglutide 1.2 mg/DayChange in Fasting Plasma Glucose (FPG)-1.51 mmol/LStandard Deviation 2.41
Liraglutide 1.8 mg/DayChange in Fasting Plasma Glucose (FPG)-1.92 mmol/LStandard Deviation 2.34
PlaceboChange in Fasting Plasma Glucose (FPG)-0.54 mmol/LStandard Deviation 2.45
Semaglutide FlexibleChange in Fasting Plasma Glucose (FPG)-3.40 mmol/LStandard Deviation 2.84
Secondary

Change in Systolic and Diastolic Blood Pressure

The data were analysed for the on-treatment until rescue medication observation period which includes observations recorded at or after date of first dose of trial product and not after the last dose of trial product plus the 7-day visit window or date of initiation of rescue therapy.

Time frame: Week 0, Week 26

Population: Full analysis set

ArmMeasureGroupValue (MEAN)Dispersion
Semaglutide 0.05 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-5.74 mmHgStandard Deviation 12.3
Semaglutide 0.05 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-0.60 mmHgStandard Deviation 8.78
Semaglutide 0.1 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-2.77 mmHgStandard Deviation 13.21
Semaglutide 0.1 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure0.66 mmHgStandard Deviation 8.26
Semaglutide 0.2 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-4.25 mmHgStandard Deviation 12.24
Semaglutide 0.2 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-1.62 mmHgStandard Deviation 9.38
Semaglutide 0.3 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-9.85 mmHgStandard Deviation 11.58
Semaglutide 0.3 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-4.02 mmHgStandard Deviation 8.56
Liraglutide 0.3 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-1.77 mmHgStandard Deviation 7.37
Liraglutide 0.3 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-3.77 mmHgStandard Deviation 9.79
Liraglutide 0.6 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-1.89 mmHgStandard Deviation 8.2
Liraglutide 0.6 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-3.20 mmHgStandard Deviation 10.89
Liraglutide 1.2 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-0.60 mmHgStandard Deviation 6.78
Liraglutide 1.2 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-4.69 mmHgStandard Deviation 12.73
Liraglutide 1.8 mg/DayChange in Systolic and Diastolic Blood PressureSystolicblood pressure-2.99 mmHgStandard Deviation 11.94
Liraglutide 1.8 mg/DayChange in Systolic and Diastolic Blood PressureDiastolic blood pressure0.63 mmHgStandard Deviation 8.13
PlaceboChange in Systolic and Diastolic Blood PressureSystolicblood pressure-2.34 mmHgStandard Deviation 11.4
PlaceboChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-0.61 mmHgStandard Deviation 8.5
Semaglutide FlexibleChange in Systolic and Diastolic Blood PressureSystolicblood pressure-6.62 mmHgStandard Deviation 14.02
Semaglutide FlexibleChange in Systolic and Diastolic Blood PressureDiastolic blood pressure-1.69 mmHgStandard Deviation 8.25

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026