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Binge Eating Liraglutide Intervention

Liraglutide 3.0mg/d for the Treatment of Binge Eating Disorder

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03279731
Acronym
BELIEVE
Enrollment
36
Registered
2017-09-12
Start date
2017-09-29
Completion date
2019-10-01
Last updated
2020-11-24

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

Conditions

Binge-Eating Disorder

Keywords

eating disorder, pharmacotherapy

Brief summary

The study is a 17-week, single-center, double-blind, parallel-group, randomized placebo controlled trial that will test the efficacy of liraglutide 3.0 mg/d as compared to placebo in reducing the number of binge episodes per week, achieving remission from binge episodes, and in changes in body weight, global BED symptom improvement, cognitive restraint of food intake, dietary disinhibition, perceived hunger, quality of life, and depressed mood at treatment end.

Detailed description

All applicants will be initially screened by phone and/or electronically to determine whether they potentially meet eligibility criteria. Those who appear to meet eligibility criteria and remain interested in the trial will be scheduled for an in-person interview. The in-person interview will be conducted by a psychologist or Masters' level staff member, who will obtain informed consent and evaluate subjects' behavioral eligibility (i.e., willingness and appropriateness to participate) using structured and semi-structured clinical interviews including: an examination of the applicants' BED symptoms, their mood, suicidality, and other general psychopathology. Participants will also be asked to complete questionnaires assessing eating behavior, demographic characteristics, frequency of specific eating behaviors related to loss of control, risk of substance dependence with the consumption of high fat/sugar foods, alexithymia, night eating syndrome, sleep patterns and quality, and attitudes towards food cravings. Subjects who remain interested and pass this portion of the assessment will proceed to meet with the study physician or nurse practitioner, who will obtain a medical history and conduct a physical examination to determine medical eligibility. Subjects will also have an electrocardiogram (EKG), fasting blood test, and a urine pregnancy test (for females of child bearing age) to confirm eligibility. Upon successful completion of the screening visit, subjects will be asked to eat as they normally would for 2 weeks. Once per week over these two weeks they will receive a brief survey through REDcap to assess their binge eating episodes for eligibility. Subjects who continue to meet eligibility criteria assessed at the screening visit and during the run-in period will be scheduled for a randomization visit at the Center within 3 weeks of their screening. Subjects will be randomly assigned to the two interventions in equal numbers (i.e., 1:1 ratio). The subject's weight, blood pressure, and pulse will then be measured. Following randomization, all subjects will have a medical visit with the study physician or nurse practitioner who will instruct them in the use of liraglutide 3.0 (as described later) and provide the first month's supply of medication. After randomization, subjects will return at week 1 to assess rate of response. Subjects will return for study visits every two weeks thereafter, at weeks 3, 5, 7, 9, 11, 13, 15, and 17. These study visits include a brief medical visit (10-15 minutes) with a physician or nurse practitioner to monitor their response to the medication or any changes in health. Vitals and weight will be taken. Additionally, binge episodes, mood, suicidality, and symptom improvement will be assessed by the psychologist or Masters' level trained study staff. Participants will be asked also to complete questionnaires assessing quality of life, obsessions related to food, and food cravings prior to each treatment visit for the secondary outcomes: In summary, study visits will consist of the medical visit, completion of written surveys, review of structured interviews with the study staff and review of medication adverse events. These visits are expected to last about 30-40 minutes. The study assessments at week 17 will consist of the previously listed procedures and measures in addition to the questionnaires and blood tests conducted at baseline.

Interventions

subcutaneous injection, pre-filled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg (6 mg/mL, 3 mL). Matching the recommended dosage and administration guidelines of the FDA-approved labeling for the use of liraglutide (Saxenda), the medication will be initiated at 0.6 mg daily for 1 week, and then increased by 0.6 mg/day in weekly intervals until a dose of 3.0 mg/day is achieved.

DRUGPlacebo

subcutaneous injection, pre-filled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg (6 mg/mL, 3 mL). It is designed to be identical to the pen used for liraglutide (Saxenda). Placebo product inactive ingredients: disodium phosphate dihydrate, 1.42 mg; propylene glycol, 14 mg; phenol, 5.5 mg; and water for injection

Sponsors

Novo Nordisk A/S
CollaboratorINDUSTRY
Kelly Allison
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Masking description

Novo Nordisk's Clinical Services (CS) will label, package, and ship the labelled study drugs to the Penn's Investigational Drug Service (IDS). Dr. Rockwell from Penn's IDS service will generate the randomization code using a 1:1 randomization scheme of liraglutide and placebo. The first subject to meet the treatment criteria will be assigned the first number in the sequence; each subsequent subject to meet treatment criteria will be assigned the next number in the sequence. Unblinding of the treatment codes will occur after all data have been verified and deemed clean by the data managers and statistician, and right before analysis of the data occurs. The code for a particular subject may be broken in a medical emergency if knowing the identity of the treatment allocation would influence the treatment of the subject or if demanded by the subject. Whenever a code is broken, the staff-member breaking the code will record the time, date and reason.

Intervention model description

Single-center, double-blind, randomized placebo-controlled trial with parallel groups.

Eligibility

Sex/Gender
ALL
Age
21 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

1. BMI \> 30 kg/m2 or BMI ≥ 27 - 29.9 kg/m² in the presence of at least one weight-related comorbid condition, such as binge eating disorder, hypertension, or dyslipidemia. There is no upper BMI limit for this trial. 2. Age ≥ 21 years and ≤ 70 years 3. Meet full DSM 5 criteria for BED 1. Recurrent episodes of binge eating characterized by both consuming an abnormally large amount of food in a short period of time compared with what others might eat in the same amount of time under the same or similar circumstances and experiencing a loss of control over eating during the episode. 2. These episodes feature at least 3 of the following: i. consuming food more rapidly than normal; ii. eating until uncomfortably full; iii. consuming large amounts of food when not hungry; iv. consuming food alone due to embarrassment; v. feeling disgusted, depressed, or guilty after eating a large amount of food. c. Significant distress about the binge episodes is present. d. Binge episodes must occur, on average, at least once per week for 3 months. 4. All races and ethnicities are included 5. Eligible female subjects will be: * non-pregnant, evidenced by a negative urine dipstick pregnancy test * non-lactating * surgically sterile or postmenopausal, or they will agree to continue to use an accepted method of birth control during the study 6. Ability to provide informed consent before any trial-related activities 7. Subjects must: * have a primary care provider (PCP) who is responsible for providing routine care * have reliable telephone or Internet service to communicate with study staff * understand and be willing to comply with all study-related procedures and agree to participate in the study by giving written informed consent * plan to remain in the Philadelphia area for the next 6 months or more

Exclusion criteria

1. Pregnant or nursing, or plans to become pregnant in the next 6 months, or not using adequate contraceptive measures 2. Personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 3. Uncontrolled hypertension (systolic blood pressure ≥ 160 mm Hg or diastolic blood pressure ≥ 100 mm Hg) 4. Type 1 diabetes 5. Type 2 diabetes 6. A combination of fasting glucose ≥ 126 mg/dl, combined with an HbA1c \>6.5, will be used to indicate the presence of diabetes, an exclusion criterion 7. Recent history of cardiovascular disease (e.g., myocardial infarction or stroke within the past 6 months), congestive heart failure, or heart block greater than first degree 8. Clinically significant hepatic or renal disease 9. Thyroid disease, not controlled 10. History of malignancy (except for non-melanoma skin cancer) in past 5 years 11. The presence of current anorexia nervosa or bulimia nervosa 12. Current major depressive episode, active suicidal ideation, or lifetime history of suicide attempts. We will exclude participants who have a Patient Health Questionnaire-9 (PHQ-9) \[31\] score \> 15, or a score of \> 1 on the suicidal ideation item, as well as any risk of suicidality as measured by a score of 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS)\[32\]. 13. Psychiatric hospitalization within the past 6 months 14. Self-reported alcohol or substance abuse within the past 12 months, including at-risk drinking (current consumption of ≥ 14 alcoholic drinks per week) 15. Diagnosis current or past psychosis 16. Use in past 3 months of medications known to treat BED (such as lisdexamfetamine), induce significant weight loss (i.e., prescription weight loss medications), or induce weight gain (e.g., chronic use of oral steroids, second generation antipsychotics) 17. Currently receiving behavioral or pharmacological treatment for BED 18. Loss of ≥ 10 lb of body weight within the past 3 months 19. Known or suspected allergy to trial medication(s), excipients, or related products 20. Hypersensitivity to liraglutide or any product components 21. The receipt of any investigational drug within 6 months prior to this trial 22. Previous participation in this trial (e.g., randomized and failed to participate) 23. History of pancreatitis 24. History of gastrointestinal surgery (unless it was an adjustable gastric band that has been removed).

Design outcomes

Primary

MeasureTime frameDescription
Binge Episodesbaseline and 17 weeks (or last observation carried forward)Change in objective binge episodes per week from randomization (week 0) to study end (week 17)

Secondary

MeasureTime frameDescription
Remission From Binge-eating13 to 17 weeksthe percentage of participants (completers) who have achieved remission from binge-eating (no binge episodes between weeks 13 - 17)
Assessment of Improvement of Binge Eating Symptomsweek 17 (or last observation carried forward)week 17 rating on the interviewer-based Clinical Global Impression of Improvement (CGII) Scale for global assessment of BED symptoms The CGII includes the following rating scale: Compared to the patient's condition at baseline to the project \[prior to medication initiation\], this patient's condition is: 1 very much improved; 2 much improved; 3 improved; 4 no change; 5 worse; 6 much worse; 7 very much worse.
Change in Body Weightbaseline and 17 weeks (or last observation carried forward)changes in body weight

Countries

United States

Participant flow

Recruitment details

Participants were recruited at university based medical school clinic setting. The first participant was randomized on September 29, 2017; the last participant completed participation on September 6, 2019. Note: 9 participants were censored from the trial due to an error in medication/placebo assignment by the Investigational Drug Service. As such, these 9 participants were not considered in any of the analyses presented, leaving 13 in the liraglutide and 14 in the placebo group.

Pre-assignment details

Participants underwent a 2 week run in to assure that they continued to have binge episodes before being randomized to placebo or liraglutide 3.0 mg.

Participants by arm

ArmCount
Liraglutide (Saxenda) 6Mg/Ml Inj Pen 3Ml
Pre-filled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg via subcutaneous injection. Matching the recommended dosage and administration guidelines of the FDA-approved labeling for the use of liraglutide (Saxenda), the medication will be initiated at 0.6 mg daily for 1 week, and then increased by 0.6 mg/day in weekly intervals until a dose of 3.0 mg/day is achieved. Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. Liraglutide (Saxenda) 6Mg/Ml Inj Pen 3Ml: subcutaneous injection, pre-filled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg (6 mg/mL, 3 mL). Matching the recommended dosage and administration guidelines of the FDA-approved labeling for the use of liraglutide (Saxenda), the medication will be initiated at 0.6 mg daily for 1 week, and then increased by 0.6 mg/day in weekly intervals until a dose of 3.0 mg/day is achieved.
13
Placebo
Pre-filled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg of placebo via subcutaneous injection. The placebo will be initiated at 0.6 mg daily for 1 week, and then increased by 0.6 mg/day in weekly intervals until a dose of 3.0 mg/day is achieved.The inactive ingredients include: disodium phosphate dihydrate, 1.42 mg; propylene glycol, 14 mg; phenol, 5.5 mg; and water for injection. Placebo: subcutaneous injection, pre-filled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg (6 mg/mL, 3 mL). It is designed to be identical to the pen used for liraglutide (Saxenda). Placebo product inactive ingredients: disodium phosphate dihydrate, 1.42 mg; propylene glycol, 14 mg; phenol, 5.5 mg; and water for injection
14
Total27

Baseline characteristics

CharacteristicLiraglutide (Saxenda) 6Mg/Ml Inj Pen 3MlPlaceboTotal
Age, Continuous46.4 years
STANDARD_DEVIATION 7.9
42.1 years
STANDARD_DEVIATION 12.7
44.2 years
STANDARD_DEVIATION 10.6
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
13 Participants14 Participants27 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
objective binge episodes per week4.90 binge episodes/week
STANDARD_DEVIATION 0.69
2.80 binge episodes/week
STANDARD_DEVIATION 0.67
3.30 binge episodes/week
STANDARD_DEVIATION 2.13
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
5 Participants6 Participants11 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
8 Participants8 Participants16 Participants
Region of Enrollment
United States
13 participants14 participants27 participants
Sex/Gender, Customized
Female at birth
6 Participants11 Participants17 Participants
Sex/Gender, Customized
Male at birth
7 Participants3 Participants10 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 190 / 17
other
Total, other adverse events
17 / 1911 / 17
serious
Total, serious adverse events
2 / 191 / 17

Outcome results

Primary

Binge Episodes

Change in objective binge episodes per week from randomization (week 0) to study end (week 17)

Time frame: baseline and 17 weeks (or last observation carried forward)

ArmMeasureValue (MEAN)Dispersion
LiraglutideBinge Episodes-3.97 objective binge episodes per weekStandard Deviation 0.56
PlaceboBinge Episodes-2.50 objective binge episodes per weekStandard Deviation 0.053
Secondary

Assessment of Improvement of Binge Eating Symptoms

week 17 rating on the interviewer-based Clinical Global Impression of Improvement (CGII) Scale for global assessment of BED symptoms The CGII includes the following rating scale: Compared to the patient's condition at baseline to the project \[prior to medication initiation\], this patient's condition is: 1 very much improved; 2 much improved; 3 improved; 4 no change; 5 worse; 6 much worse; 7 very much worse.

Time frame: week 17 (or last observation carried forward)

ArmMeasureValue (MEAN)Dispersion
LiraglutideAssessment of Improvement of Binge Eating Symptoms1.52 units on a scaleStandard Deviation 0.27
PlaceboAssessment of Improvement of Binge Eating Symptoms1.93 units on a scaleStandard Deviation 0.26
Secondary

Change in Body Weight

changes in body weight

Time frame: baseline and 17 weeks (or last observation carried forward)

Population: Last Observation Carried Forward

ArmMeasureValue (MEAN)Dispersion
LiraglutideChange in Body Weight-4.7 kgStandard Deviation 0.83
PlaceboChange in Body Weight-0.94 kgStandard Deviation 0.73
Secondary

Remission From Binge-eating

the percentage of participants (completers) who have achieved remission from binge-eating (no binge episodes between weeks 13 - 17)

Time frame: 13 to 17 weeks

Population: Remission was calculated for completers who had data from weeks 13-17

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
LiraglutideRemission From Binge-eating3 Participants
PlaceboRemission From Binge-eating4 Participants

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