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A Research Study on How Semaglutide Works in People With Fatty Liver Disease and Liver Damage

Investigation of Efficacy and Safety of Semaglutide s.c. Once-weekly Versus Placebo in Subjects With Non-alcoholic Steatohepatitis and Compensated Liver Cirrhosis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03987451
Enrollment
71
Registered
2019-06-17
Start date
2019-06-18
Completion date
2021-06-10
Last updated
2024-05-29

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

Conditions

Non-alcoholic Steatohepatitis

Brief summary

Semaglutide is a medicine studied in patients with non-alcoholic steatohepatitis (NASH), as it may improve liver damage. Participants will either get semaglutide or placebo (a dummy medicine) - which treatment participants get is decided by chance. The study will last for about 61 weeks in total. Participants will have 10 clinic visits and 3 phone calls with the study doctor or staff during the study. Some of the clinic visits may be spread over more days. Participants will need to inject themselves with medicine under the skin. Participants will have to do this once a week for 48 weeks. The study includes magnetic resonance imaging (MRI) scans of the liver, 1 or 2 liver tissue samples, ultrasound scans of the stomach and a possible examination of the food pipe. For some tests participants may need to remove some items of clothing. Participants will stop in the study if the doctor thinks that there are any risks for their health. The information collected from participants during the study may help them and other patients with NASH in the future. Women cannot take part if pregnant, breast-feeding or planning to become pregnant during the study period.

Interventions

DRUGSemaglutide

Semaglutide given subcutaneously (s.c., under the skin) once-weekly for 48 weeks

DRUGPlacebo (semaglutide)

Semaglutide placebo s.c. given once-weekly for 48 weeks

Sponsors

Novo Nordisk A/S
Lead SponsorINDUSTRY

Study design

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

Masking description

Sponsor staff involved in the clinical trial is masked according to company standard procedures.

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

* Male or female, aged 18-75 years (both inclusive) at the time of signing informed consent. * Histologic evidence of NASH and fibrosis stage 4 according to the NASH CRN classification based on central pathologist evaluation of a liver biopsy obtained within 360 days prior to screening. In subjects who have never had a liver biopsy showing NASH and F4, liver stiffness above 14 kPa by FibroScan® at screening must be documented before subjects can have a trial-related liver biopsy * A histological NAFLD activity score (NAS) equal to or above 3 with a score of 1 or more in lobular inflammation and hepatocyte ballooning based on central pathologist evaluation * Body mass index equal to or above 27 kg/m\^2

Exclusion criteria

* Presence or history of hepatic decompensation (e.g. ascites, variceal bleeding, hepatic encephalopathy or spontaneous bacterial peritonitis) or liver transplantation * Presence or history of gastroesophageal varices within the past 360 days prior to screening. For subjects with no known history of gastroesophageal varices and with a Fibroscan® equal to or above 20 kPa and thrombocytes equal to or below 150,000, a esophagogastroduodenoscopy must be performed to evaluate presence of gastroesophageal varices * Presence or history of hepatocellular carcinoma * Treatment with vitamin E (at doses equal to or above 800 IU/day) or pioglitazone which has not been at a stable dose in the opinion of the investigator in the period from 90 days prior to screening * Treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the period from 90 days prior to screening * Treatment with other glucose lowering agent(s) (apart from what is listed in the exclusion criterion above) or weight loss medication not stable in the opinion of the investigator in the period from 28 days prior to screening

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With At Least One Stage of Liver Fibrosis Improvement With No Worsening of Non-Alcoholic Steatohepatitis (NASH) After 48 WeeksWeek 48NASH resolution defined by NASH clinical research network (CRN) as lobular inflammation of 0 or 1; hepatocellular ballooning reduced to 0; both criteria were necessary conditions. Hepatocellular ballooning ranges from 0-2; lobular inflammation ranges from 0-3, higher scores indicating more severe hepatocellular ballooning/lobular inflammation. Worsening of NASH defined by NASH CRN as increase of at least 1 stage of either lobular inflammation, hepatocyte ballooning or steatosis. Worsening of fibrosis defined by increase in fibrosis at least 1 stage of Kleiner fibrosis classification: fibrosis stages range from 0-4, higher scores indicating greater fibrosis (0=None, 4=Cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Secondary

MeasureTime frameDescription
Change From Baseline in Liver Stiffness Measured by Magnetic Resonance Elastography (MRE)-Ratio to BaselineBaseline (week 0), Week 48Change in Liver Stiffness from baseline to week 48 is presented as ratio to baseline. Liver stiffness was measured in kilopascal using MRE. MRE is a technology that uses MRI imaging with low-frequency vibrations to create a visual map (elastogram) that shows stiffness of the liver. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With NASH Resolution After 48 WeeksWeek 48NASH resolution defined by NASH clinical research network as lobular inflammation of 0 or 1 and hepatocellular ballooning reduced to 0; both criteria were necessary conditions. Hepatocellular ballooning ranges from 0-2; lobular inflammation ranges from 0-3, with higher scores indicating more severe hepatocellular ballooning or lobular inflammation. Worsening of fibrosis defined by an increase in fibrosis at least one stage of Kleiner fibrosis classification: fibrosis stages range from 0-4, with higher scores indicating greater fibrosis (0=None, 4=Cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Fibrosis-4 Score-Ratio to BaselineBaseline (week 0), Week 48Change in fibrosis-4 score from baseline to week 48 is presented as ratio to baseline. Fibrosis-4 is the ratio of age in years and aminotransferase to platelet count. It is a non-invasive hepatic fibrosis index score combining standard biochemical values, platelets, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and age that was calculated using formula: Fibrosis-4 = (Age \[years\] x AST \[units per liter (U/L)\]) / (platelets \[10\^9 cells/L\] x (square root of ALT \[U/L\])). A Fibrosis-4 index of \< 1.45 indicated no or moderate fibrosis and an index of \> 3.25 indicated extensive fibrosis/cirrhosis. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Baseline (week 0), Week 48Percentage of participants who had worsened, improved or had no change in total NAS from baseline to week 48 or missing data is presented. Worsening was defined as an increase of at least 1 in the NAS; Improvement was defined as a decrease of at least 1 in the NAS; while no change corresponds to no change in NAS and missing refers to participants with missing outcomes for NAS from baseline to week 48. NAS was calculated as the sum of scores for steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocyte ballooning (0 to 2). Therefore, it is assessed on a scale of 0-8, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationBaseline (week 0), Week 48Percentage of participants who had improved, worsened, or had no change in fibrosis stage from baseline to week 48 or missing data is presented. The degree of fibrosis was described by the Kleiner fibrosis staging system, ranging from F0 (absence of fibrosis), F1 (portal/perisinusoidal fibrosis), F2 (perisinusoidal and portal/periportal fibrosis), F3 (septal or bridging fibrosis) through F4 (cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in Hepatocyte BallooningBaseline (week 0), Week 48Percentage of participants who had improved, worsened, or had no change in hepatocyte ballooning from baseline to week 48 or missing data is presented. Hepatocyte ballooning was assessed on a scale of 0-2, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in Lobular InflammationBaseline (week 0), Week 48Percentage of participants who had improved, worsened, or had no change in lobular inflammation from baseline to week 48 or missing data is presented. Lobular inflammation was assessed on a scale of 0-3, with higher scores indicating more severe lobular inflammation. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in SteatosisBaseline (week 0), Week 48Percentage of participants who had improved, worsened, or had no change in steatosis from baseline to week 48 or missing data is presented. Steatosis was assessed on a scale of 0-3, with higher scores indicating more severe steatosis. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreBaseline (week 0), Week 48Percentage of participants who had improved, worsened, or had no change in the activity component of the SAF score from baseline to week 48 or missing data is presented. SAF score was assessed on a scale of 0-4, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Change in The Ishak Fibrosis ScoreBaseline (week 0), Week 48Percentage of participants who had improved, worsened, or had no change in the Ishak fibrosis score from baseline to week 48 or missing data is presented. Ishak fibrosis score was assessed on a scale of 0-6, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Hepatic CollagenBaseline (week 0), Week 48Change in hepatic collagen from baseline to week 48 was analysed. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in Kleiner fibrosis classification. The degree of fibrosis was described by the Kleiner fibrosis staging system, ranging from F0 (absence of fibrosis), F1 (portal/perisinusoidal fibrosis), F2 (perisinusoidal and portal/periportal fibrosis), F3 (septal or bridging fibrosis) through F4 (cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in hepatocyte ballooning clinical research network (CRN) score. Hepatocyte ballooning was assessed on a scale of 0-2, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in Lobular Inflammation (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in lobular inflammation CRN score. Lobular inflammation was assessed on a scale of 0-3, with higher scores indicating more severe lobular inflammation. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in Steatosis (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in steatosis CRN score. Steatosis was assessed on a scale of 0-3, with higher scores indicating more severe steatosis. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in NAS (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in NAS. NAS was calculated as the sum of scores for steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocyte ballooning (0 to 2). Therefore, it is assessed on a scale of 0-8, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in SAF Activity Component Score (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in SAF score. SAF score was assessed on a scale of 0-4, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)Baseline (week 0), Week 48Improvement is defined as at least one stage decrease from baseline to week 48 in Ishak fibrosis score. Ishak fibrosis score was assessed on a scale of 0-6, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Body WeightBaseline (week 0), Week 48Change in body weight from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Relative Change From Baseline in Body WeightBaseline (week 0), Week 48Relative change in body weight (measured as kg) from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Waist CircumferenceBaseline (week 0), Week 48Change in waist circumference from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Body Mass Index (BMI)Baseline (week 0), Week 48Change in BMI from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Weight Loss of >= 5% of Baseline Body Weight at Week 48Week 48Percentage of participants with weight loss of greater than or equal to (≥) 5% of baseline body weight at 48 weeks is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Percentage of Participants With Weight Loss of >= 10% of Baseline Body Weight at Week 48Week 48Percentage of participants with weight loss of ≥ 10% of baseline body weight at 48 weeks is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Glycosylated Haemoglobin A1c (HbA1c)Baseline (week 0), Week 48Change in HbA1c from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Fasting Plasma Glucose (FPG)Baseline (week 0), Week 48Change in FPG from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Fasting C-peptide-Ratio to BaselineBaseline (week 0), Week 48Change in fasting C-peptide \[measured as nanomoles per litre (nmol/L)\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Systolic And Diastolic Blood PressureBaseline (week 0), Week 48Change in systolic and diastolic blood pressure from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Total Cholesterol-Ratio to BaselineBaseline (week 0), Week 48Change in total cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Low-Density Lipoprotein (LDL) Cholesterol-Ratio to BaselineBaseline (week 0), Week 48Change in LDL cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in High-Density Lipoprotein (HDL) Cholesterol-Ratio to BaselineBaseline (week 0), Week 48Change in HDL cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Very Low-Density Lipoprotein (VLDL) Cholesterol-Ratio to BaselineBaseline (week 0), Week 48Change in VLDL cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Triglycerides-Ratio to BaselineBaseline (week 0), Week 48Change in triglycerides (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Free Fatty Acids (FFA)-Ratio to BaselineBaseline (week 0), Week 48Change in free fatty acids (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in High-Sensitivity C-reactive Protein (hsCRP)-Ratio to BaselineBaseline (week 0), Week 48Change in hsCRP (measured as milligrams per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Alanine Aminotransferase (ALT)-Ratio to BaselineBaseline (week 0), Week 48Change in ALT (measured as units per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Aspartate Aminotransferase (AST)-Ratio to BaselineBaseline (week 0), Week 48Change in AST (measured as units per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Gamma-Glutamyl Transferase (GGT)-Ratio to BaselineBaseline (week 0), Week 48Change in GGT (measured as units per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Albumin-Ratio to BaselineBaseline (week 0), Week 48Change in albumin \[measured as grams per deciliter (g/dL)\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Changes From Baseline in Thrombocytes-Ratio to BaselineBaseline (week 0), Week 48Change in thrombocytes \[measured as 10\^9 cells per liter\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Liver Fat Content Measured by Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF)-Ratio to BaselineBaseline (week 0), Week 48Change in liver fat content (measured as percentage) from baseline to week 48 is presented as ratio to baseline. Liver fat content was assessed via MRI-PDFF technique and results were measured in percentage. MRI-PDFF utilized a gradient echo sequence with low flip angle to minimize T1 bias, corrected T2\* decay (due to iron overload) via modeling of the fat signal as a superposition of multiple frequency components from 5 different lipid types, and was applied in each of the 9 Couinaud segments. This technique improved fat quantification accuracy for the entire liver permitting quantification of small differences/changes following pharmacological intervention. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Direct Bilirubin-Ratio to BaselineBaseline (week 0), Week 48Change in direct bilirubin \[measured as micromoles per liter (umol/L)\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Change From Baseline in Total Bilirubin-Ratio to BaselineBaseline (week 0), Week 48Change in total bilirubin \[measured as umol/L\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.
Number of Treatment-Emergent Adverse Events (TEAEs)From baseline (week 0) to week 55An adverse event (AE) was any untoward medical occurrence in a clinical trial participant administered or using a medicinal product, whether or not considered related to the medicinal product or usage. All AEs reported here are TEAEs. TEAE is defined as an event that had onset date during the on-treatment period. Outcome measure was evaluated based on data from on-treatment period which started on the date of first administration of trial product and ended on the date of whatever comes first of: a) last dose of trial product + 49 days (7 half-lives of semaglutide), b) follow-up visit (week 55), or c) end of the in-trial period.
Number of Treatment-Emergent Hypoglycaemic EpisodesFrom baseline (week 0) to week 55Hypoglycaemic episode (blood glucose less than or equal to (\<=) 3.9 mmol/L \[70 milligrams per decilitre (mg/dL)\] Or greater than (\>) 3.9 mmol/L (70 mg/dL) occurring in conjunction with hypoglycaemic symptoms) is defined as treatment emergent if the onset of the episode occurs during the on-treatment period. Outcome measure was evaluated based on data from on-treatment period which started on the date of first administration of trial product and ended on the date of whatever comes first of: a) last dose of trial product + 49 days (7 half-lives of semaglutide), b) follow-up visit (week 55), or c) end of the in-trial period.
Change From Baseline in PulseBaseline (week 0), Week 48Change in pulse from baseline to week 48 is presented. Outcome measure was evaluated based on data from on-treatment period which started on the date of first administration of trial product and ended on the date of whatever comes first of: a) last dose of trial product + 49 days (7 half-lives of semaglutide), b) follow-up visit (week 55), or c) end of the in-trial period.
Change From Baseline in International Normalized Ratio (INR)-Ratio to BaselineBaseline (week 0), Week 48Change in INR from baseline to week 48 is presented as ratio to baseline. INR is the ratio of measured prothrombin time over normal prothrombin time and it evaluates the extrinsic coagulation pathway (vitamin K dependent clotting factors II; V, VII, IX and X). These clotting factors are synthesised in the liver, thus INR is used as a marker of liver synthesis function. The therapeutic INR range varies, most commonly an INR 2-3 goal, but ranging from 1.5-4.0. Bleeding complications are more likely to occur above an INR value of 4.0. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Countries

France, Germany, Spain, United Kingdom, United States

Participant flow

Recruitment details

The trial was conducted at 38 sites in 5 countries as follows (number of sites that screened subjects/ number of sites that randomised subjects): United States (24/19); United Kingdom (4/3); Germany (3/2); France (5/3); Spain (2/2).

Pre-assignment details

Participants were randomised in a 2:1 ratio to receive once-weekly either semaglutide or placebo subcutaneously as an adjunct to a reduced-calorie diet and increased physical activity.

Participants by arm

ArmCount
Semaglutide 2.4 mg
Participants were to receive once weekly subcutaneous (s.c.) injection of semaglutide for 48 weeks. Participants initially received 0.24 milligrams (mg) of semaglutide and the dose was then escalated once in 4 weeks until the target dose of 2.4 mg was reached: 0.24 mg (week 1 to week 4), 0.5 mg (week 5 to week 8), 1.0 mg (week 9 to week 12), 1.7 mg (week 13 to week 16), 2.4 mg (week 16 to week 48).
47
Placebo
Participants were to receive once weekly s.c. injection of placebo matched to semaglutide (0.24 mg, 0.5 mg, 1.0 mg, 1.7 mg or 2.4 mg) for 48 weeks.
24
Total71

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up10
Overall StudyWithdrawal by Subject11

Baseline characteristics

CharacteristicSemaglutide 2.4 mgPlaceboTotal
Age, Customized
65<= to <75 years
10 Participants6 Participants16 Participants
Age, Customized
<65 years
37 Participants18 Participants55 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
11 Participants4 Participants15 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
33 Participants19 Participants52 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants1 Participants4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
0 Participants2 Participants2 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
4 Participants1 Participants5 Participants
Race (NIH/OMB)
White
41 Participants21 Participants62 Participants
Sex: Female, Male
Female
31 Participants18 Participants49 Participants
Sex: Female, Male
Male
16 Participants6 Participants22 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 470 / 24
other
Total, other adverse events
38 / 4715 / 24
serious
Total, serious adverse events
6 / 472 / 24

Outcome results

Primary

Percentage of Participants With At Least One Stage of Liver Fibrosis Improvement With No Worsening of Non-Alcoholic Steatohepatitis (NASH) After 48 Weeks

NASH resolution defined by NASH clinical research network (CRN) as lobular inflammation of 0 or 1; hepatocellular ballooning reduced to 0; both criteria were necessary conditions. Hepatocellular ballooning ranges from 0-2; lobular inflammation ranges from 0-3, higher scores indicating more severe hepatocellular ballooning/lobular inflammation. Worsening of NASH defined by NASH CRN as increase of at least 1 stage of either lobular inflammation, hepatocyte ballooning or steatosis. Worsening of fibrosis defined by increase in fibrosis at least 1 stage of Kleiner fibrosis classification: fibrosis stages range from 0-4, higher scores indicating greater fibrosis (0=None, 4=Cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Week 48

Population: Full analysis set (FAS) included all randomised participants.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With At Least One Stage of Liver Fibrosis Improvement With No Worsening of Non-Alcoholic Steatohepatitis (NASH) After 48 Weeks10.6 Percentage of participants
PlaceboPercentage of Participants With At Least One Stage of Liver Fibrosis Improvement With No Worsening of Non-Alcoholic Steatohepatitis (NASH) After 48 Weeks29.2 Percentage of participants
Comparison: The common odds ratio between semaglutide and placebo adjusting for baseline diabetes was estimated along with exact 95% confidence interval based on conditioning on the marginal 2×2 tables.p-value: 0.086795% CI: [0.06, 1.24]Cochran-Mantel-Haenszel
Secondary

Change From Baseline in Alanine Aminotransferase (ALT)-Ratio to Baseline

Change in ALT (measured as units per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Alanine Aminotransferase (ALT)-Ratio to Baseline0.7 Ratio of ALTGeometric Coefficient of Variation 58.1
PlaceboChange From Baseline in Alanine Aminotransferase (ALT)-Ratio to Baseline1.0 Ratio of ALTGeometric Coefficient of Variation 32.2
Secondary

Change From Baseline in Albumin-Ratio to Baseline

Change in albumin \[measured as grams per deciliter (g/dL)\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Albumin-Ratio to Baseline1.0 Ratio of albuminGeometric Coefficient of Variation 6.1
PlaceboChange From Baseline in Albumin-Ratio to Baseline1.0 Ratio of albuminGeometric Coefficient of Variation 5.9
Secondary

Change From Baseline in Aspartate Aminotransferase (AST)-Ratio to Baseline

Change in AST (measured as units per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Aspartate Aminotransferase (AST)-Ratio to Baseline0.7 Ratio of ASTGeometric Coefficient of Variation 47.8
PlaceboChange From Baseline in Aspartate Aminotransferase (AST)-Ratio to Baseline1.0 Ratio of ASTGeometric Coefficient of Variation 29
Secondary

Change From Baseline in Body Mass Index (BMI)

Change in BMI from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Body Mass Index (BMI)-3.1 Kilograms per meter squareStandard Deviation 2.8
PlaceboChange From Baseline in Body Mass Index (BMI)-0.2 Kilograms per meter squareStandard Deviation 1.8
Secondary

Change From Baseline in Body Weight

Change in body weight from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Body Weight-8.6 KilogramsStandard Deviation 7.8
PlaceboChange From Baseline in Body Weight-0.8 KilogramsStandard Deviation 5
Secondary

Change From Baseline in Direct Bilirubin-Ratio to Baseline

Change in direct bilirubin \[measured as micromoles per liter (umol/L)\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Direct Bilirubin-Ratio to Baseline1.1 Ratio of direct bilirubinGeometric Coefficient of Variation 33.7
PlaceboChange From Baseline in Direct Bilirubin-Ratio to Baseline1.0 Ratio of direct bilirubinGeometric Coefficient of Variation 24.8
Secondary

Change From Baseline in Fasting C-peptide-Ratio to Baseline

Change in fasting C-peptide \[measured as nanomoles per litre (nmol/L)\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants with type 2 diabetes who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Fasting C-peptide-Ratio to Baseline0.95 Ratio of fasting C-peptideGeometric Coefficient of Variation 47.08
PlaceboChange From Baseline in Fasting C-peptide-Ratio to Baseline1.00 Ratio of fasting C-peptideGeometric Coefficient of Variation 45.73
Secondary

Change From Baseline in Fasting Plasma Glucose (FPG)

Change in FPG from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants with type 2 diabetes who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Fasting Plasma Glucose (FPG)-2.20 millimoles per liter (mmol/L)Standard Deviation 2.52
PlaceboChange From Baseline in Fasting Plasma Glucose (FPG)0.23 millimoles per liter (mmol/L)Standard Deviation 2.94
Secondary

Change From Baseline in Fibrosis-4 Score-Ratio to Baseline

Change in fibrosis-4 score from baseline to week 48 is presented as ratio to baseline. Fibrosis-4 is the ratio of age in years and aminotransferase to platelet count. It is a non-invasive hepatic fibrosis index score combining standard biochemical values, platelets, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and age that was calculated using formula: Fibrosis-4 = (Age \[years\] x AST \[units per liter (U/L)\]) / (platelets \[10\^9 cells/L\] x (square root of ALT \[U/L\])). A Fibrosis-4 index of \< 1.45 indicated no or moderate fibrosis and an index of \> 3.25 indicated extensive fibrosis/cirrhosis. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Fibrosis-4 Score-Ratio to Baseline0.9 Ratio of fibrosis-4 scoreGeometric Coefficient of Variation 30.7
PlaceboChange From Baseline in Fibrosis-4 Score-Ratio to Baseline1.0 Ratio of fibrosis-4 scoreGeometric Coefficient of Variation 38
Secondary

Change From Baseline in Free Fatty Acids (FFA)-Ratio to Baseline

Change in free fatty acids (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Free Fatty Acids (FFA)-Ratio to Baseline1.07 Ratio of FFAGeometric Coefficient of Variation 75.99
PlaceboChange From Baseline in Free Fatty Acids (FFA)-Ratio to Baseline1.43 Ratio of FFAGeometric Coefficient of Variation 77.7
Secondary

Change From Baseline in Gamma-Glutamyl Transferase (GGT)-Ratio to Baseline

Change in GGT (measured as units per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Gamma-Glutamyl Transferase (GGT)-Ratio to Baseline0.7 Ratio of GGTGeometric Coefficient of Variation 40.9
PlaceboChange From Baseline in Gamma-Glutamyl Transferase (GGT)-Ratio to Baseline1.0 Ratio of GGTGeometric Coefficient of Variation 24.4
Secondary

Change From Baseline in Glycosylated Haemoglobin A1c (HbA1c)

Change in HbA1c from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants with type 2 diabetes who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Glycosylated Haemoglobin A1c (HbA1c)-1.4 Percentage of HbA1CStandard Deviation 1.1
PlaceboChange From Baseline in Glycosylated Haemoglobin A1c (HbA1c)0.2 Percentage of HbA1CStandard Deviation 1.1
Secondary

Change From Baseline in Hepatic Collagen

Change in hepatic collagen from baseline to week 48 was analysed. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Hepatic Collagen-1.7 Percentage of hepatic collagenStandard Deviation 7.9
PlaceboChange From Baseline in Hepatic Collagen-1.2 Percentage of hepatic collagenStandard Deviation 5.1
Secondary

Change From Baseline in High-Density Lipoprotein (HDL) Cholesterol-Ratio to Baseline

Change in HDL cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in High-Density Lipoprotein (HDL) Cholesterol-Ratio to Baseline1.07 Ratio of HDL cholesterolGeometric Coefficient of Variation 12.83
PlaceboChange From Baseline in High-Density Lipoprotein (HDL) Cholesterol-Ratio to Baseline0.99 Ratio of HDL cholesterolGeometric Coefficient of Variation 16.3
Secondary

Change From Baseline in High-Sensitivity C-reactive Protein (hsCRP)-Ratio to Baseline

Change in hsCRP (measured as milligrams per liter) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in High-Sensitivity C-reactive Protein (hsCRP)-Ratio to Baseline0.63 Ratio of hsCRPGeometric Coefficient of Variation 107.66
PlaceboChange From Baseline in High-Sensitivity C-reactive Protein (hsCRP)-Ratio to Baseline1.13 Ratio of hsCRPGeometric Coefficient of Variation 70.38
Secondary

Change From Baseline in International Normalized Ratio (INR)-Ratio to Baseline

Change in INR from baseline to week 48 is presented as ratio to baseline. INR is the ratio of measured prothrombin time over normal prothrombin time and it evaluates the extrinsic coagulation pathway (vitamin K dependent clotting factors II; V, VII, IX and X). These clotting factors are synthesised in the liver, thus INR is used as a marker of liver synthesis function. The therapeutic INR range varies, most commonly an INR 2-3 goal, but ranging from 1.5-4.0. Bleeding complications are more likely to occur above an INR value of 4.0. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in International Normalized Ratio (INR)-Ratio to Baseline1.02 Ratio of INRGeometric Coefficient of Variation 5.59
PlaceboChange From Baseline in International Normalized Ratio (INR)-Ratio to Baseline1.01 Ratio of INRGeometric Coefficient of Variation 25.07
Secondary

Change From Baseline in Liver Fat Content Measured by Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF)-Ratio to Baseline

Change in liver fat content (measured as percentage) from baseline to week 48 is presented as ratio to baseline. Liver fat content was assessed via MRI-PDFF technique and results were measured in percentage. MRI-PDFF utilized a gradient echo sequence with low flip angle to minimize T1 bias, corrected T2\* decay (due to iron overload) via modeling of the fat signal as a superposition of multiple frequency components from 5 different lipid types, and was applied in each of the 9 Couinaud segments. This technique improved fat quantification accuracy for the entire liver permitting quantification of small differences/changes following pharmacological intervention. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Liver Fat Content Measured by Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF)-Ratio to Baseline0.62 Ratio of liver fat contentGeometric Coefficient of Variation 63.38
PlaceboChange From Baseline in Liver Fat Content Measured by Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF)-Ratio to Baseline1.01 Ratio of liver fat contentGeometric Coefficient of Variation 34.46
Secondary

Change From Baseline in Liver Stiffness Measured by Magnetic Resonance Elastography (MRE)-Ratio to Baseline

Change in Liver Stiffness from baseline to week 48 is presented as ratio to baseline. Liver stiffness was measured in kilopascal using MRE. MRE is a technology that uses MRI imaging with low-frequency vibrations to create a visual map (elastogram) that shows stiffness of the liver. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Liver Stiffness Measured by Magnetic Resonance Elastography (MRE)-Ratio to Baseline0.87 Ratio of liver stiffnessGeometric Coefficient of Variation 22.24
PlaceboChange From Baseline in Liver Stiffness Measured by Magnetic Resonance Elastography (MRE)-Ratio to Baseline0.98 Ratio of liver stiffnessGeometric Coefficient of Variation 28.51
Secondary

Change From Baseline in Low-Density Lipoprotein (LDL) Cholesterol-Ratio to Baseline

Change in LDL cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Low-Density Lipoprotein (LDL) Cholesterol-Ratio to Baseline0.99 Ratio of LDL cholesterolGeometric Coefficient of Variation 17.88
PlaceboChange From Baseline in Low-Density Lipoprotein (LDL) Cholesterol-Ratio to Baseline1.02 Ratio of LDL cholesterolGeometric Coefficient of Variation 30.07
Secondary

Change From Baseline in Pulse

Change in pulse from baseline to week 48 is presented. Outcome measure was evaluated based on data from on-treatment period which started on the date of first administration of trial product and ended on the date of whatever comes first of: a) last dose of trial product + 49 days (7 half-lives of semaglutide), b) follow-up visit (week 55), or c) end of the in-trial period.

Time frame: Baseline (week 0), Week 48

Population: Safety analysis set included all participants that received at least one dose of randomised treatment. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Pulse6 Beats per minuteStandard Deviation 11
PlaceboChange From Baseline in Pulse2 Beats per minuteStandard Deviation 14
Secondary

Change From Baseline in Systolic And Diastolic Blood Pressure

Change in systolic and diastolic blood pressure from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureGroupValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Systolic And Diastolic Blood PressureChange From Baseline in Systolic Blood Pressure-4.1 millimeter of mercuryStandard Deviation 17.6
Semaglutide 2.4 mgChange From Baseline in Systolic And Diastolic Blood PressureChange From Baseline in Diastolic Blood Pressure0.4 millimeter of mercuryStandard Deviation 11.7
PlaceboChange From Baseline in Systolic And Diastolic Blood PressureChange From Baseline in Systolic Blood Pressure0.1 millimeter of mercuryStandard Deviation 17.1
PlaceboChange From Baseline in Systolic And Diastolic Blood PressureChange From Baseline in Diastolic Blood Pressure-0.7 millimeter of mercuryStandard Deviation 8.4
Secondary

Change From Baseline in Total Bilirubin-Ratio to Baseline

Change in total bilirubin \[measured as umol/L\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Total Bilirubin-Ratio to Baseline1.0 Ratio of total bilirubinGeometric Coefficient of Variation 34.5
PlaceboChange From Baseline in Total Bilirubin-Ratio to Baseline0.9 Ratio of total bilirubinGeometric Coefficient of Variation 24.5
Secondary

Change From Baseline in Total Cholesterol-Ratio to Baseline

Change in total cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Total Cholesterol-Ratio to Baseline0.98 Ratio of total cholesterolGeometric Coefficient of Variation 11.86
PlaceboChange From Baseline in Total Cholesterol-Ratio to Baseline1.05 Ratio of total cholesterolGeometric Coefficient of Variation 17.61
Secondary

Change From Baseline in Triglycerides-Ratio to Baseline

Change in triglycerides (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Triglycerides-Ratio to Baseline0.90 Ratio of triglyceridesGeometric Coefficient of Variation 28.4
PlaceboChange From Baseline in Triglycerides-Ratio to Baseline1.09 Ratio of triglyceridesGeometric Coefficient of Variation 28.08
Secondary

Change From Baseline in Very Low-Density Lipoprotein (VLDL) Cholesterol-Ratio to Baseline

Change in VLDL cholesterol (measured as mmol/L) from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Very Low-Density Lipoprotein (VLDL) Cholesterol-Ratio to Baseline0.90 Ratio of VLDL cholesterolGeometric Coefficient of Variation 28.37
PlaceboChange From Baseline in Very Low-Density Lipoprotein (VLDL) Cholesterol-Ratio to Baseline1.09 Ratio of VLDL cholesterolGeometric Coefficient of Variation 28.09
Secondary

Change From Baseline in Waist Circumference

Change in waist circumference from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange From Baseline in Waist Circumference-6.3 centimetersStandard Deviation 7.7
PlaceboChange From Baseline in Waist Circumference0.4 centimetersStandard Deviation 6.8
Secondary

Changes From Baseline in Thrombocytes-Ratio to Baseline

Change in thrombocytes \[measured as 10\^9 cells per liter\] from baseline to week 48 is presented as ratio to baseline. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. Overall number of participants analysed = Number of participants who contributed to the analysis

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChanges From Baseline in Thrombocytes-Ratio to Baseline1.0 Ratio of thrombocytesGeometric Coefficient of Variation 16.1
PlaceboChanges From Baseline in Thrombocytes-Ratio to Baseline1.0 Ratio of thrombocytesGeometric Coefficient of Variation 14.7
Secondary

Number of Treatment-Emergent Adverse Events (TEAEs)

An adverse event (AE) was any untoward medical occurrence in a clinical trial participant administered or using a medicinal product, whether or not considered related to the medicinal product or usage. All AEs reported here are TEAEs. TEAE is defined as an event that had onset date during the on-treatment period. Outcome measure was evaluated based on data from on-treatment period which started on the date of first administration of trial product and ended on the date of whatever comes first of: a) last dose of trial product + 49 days (7 half-lives of semaglutide), b) follow-up visit (week 55), or c) end of the in-trial period.

Time frame: From baseline (week 0) to week 55

Population: Safety analysis set included all participants that received at least one dose of randomised treatment.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgNumber of Treatment-Emergent Adverse Events (TEAEs)290 Events
PlaceboNumber of Treatment-Emergent Adverse Events (TEAEs)85 Events
Secondary

Number of Treatment-Emergent Hypoglycaemic Episodes

Hypoglycaemic episode (blood glucose less than or equal to (\<=) 3.9 mmol/L \[70 milligrams per decilitre (mg/dL)\] Or greater than (\>) 3.9 mmol/L (70 mg/dL) occurring in conjunction with hypoglycaemic symptoms) is defined as treatment emergent if the onset of the episode occurs during the on-treatment period. Outcome measure was evaluated based on data from on-treatment period which started on the date of first administration of trial product and ended on the date of whatever comes first of: a) last dose of trial product + 49 days (7 half-lives of semaglutide), b) follow-up visit (week 55), or c) end of the in-trial period.

Time frame: From baseline (week 0) to week 55

Population: Safety analysis set included all participants that received at least one dose of randomised treatment. Overall number of participants analysed = Number of participants with type 2 diabetes who contributed to the analysis

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgNumber of Treatment-Emergent Hypoglycaemic Episodes34 Episodes
PlaceboNumber of Treatment-Emergent Hypoglycaemic Episodes15 Episodes
Secondary

Percentage of Participants With Change in Hepatocyte Ballooning

Percentage of participants who had improved, worsened, or had no change in hepatocyte ballooning from baseline to week 48 or missing data is presented. Hepatocyte ballooning was assessed on a scale of 0-2, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in Hepatocyte BallooningImprovement55.3 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Hepatocyte BallooningWorsening2.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Hepatocyte BallooningNo change27.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Hepatocyte BallooningMissing14.9 Percentage of participants
PlaceboPercentage of Participants With Change in Hepatocyte BallooningMissing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in Hepatocyte BallooningImprovement33.3 Percentage of participants
PlaceboPercentage of Participants With Change in Hepatocyte BallooningNo change54.2 Percentage of participants
PlaceboPercentage of Participants With Change in Hepatocyte BallooningWorsening8.3 Percentage of participants
Secondary

Percentage of Participants With Change in Lobular Inflammation

Percentage of participants who had improved, worsened, or had no change in lobular inflammation from baseline to week 48 or missing data is presented. Lobular inflammation was assessed on a scale of 0-3, with higher scores indicating more severe lobular inflammation. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in Lobular InflammationImprovement42.6 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Lobular InflammationWorsening12.8 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Lobular InflammationNo change29.8 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Lobular InflammationMissing14.9 Percentage of participants
PlaceboPercentage of Participants With Change in Lobular InflammationMissing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in Lobular InflammationImprovement37.5 Percentage of participants
PlaceboPercentage of Participants With Change in Lobular InflammationNo change45.8 Percentage of participants
PlaceboPercentage of Participants With Change in Lobular InflammationWorsening12.5 Percentage of participants
Secondary

Percentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)

Percentage of participants who had worsened, improved or had no change in total NAS from baseline to week 48 or missing data is presented. Worsening was defined as an increase of at least 1 in the NAS; Improvement was defined as a decrease of at least 1 in the NAS; while no change corresponds to no change in NAS and missing refers to participants with missing outcomes for NAS from baseline to week 48. NAS was calculated as the sum of scores for steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocyte ballooning (0 to 2). Therefore, it is assessed on a scale of 0-8, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Missing14.9 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Worsening2.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Improvement61.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)No change21.3 Percentage of participants
PlaceboPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Improvement58.3 Percentage of participants
PlaceboPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Missing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)No change20.8 Percentage of participants
PlaceboPercentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Worsening16.7 Percentage of participants
Secondary

Percentage of Participants With Change in Steatosis

Percentage of participants who had improved, worsened, or had no change in steatosis from baseline to week 48 or missing data is presented. Steatosis was assessed on a scale of 0-3, with higher scores indicating more severe steatosis. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in SteatosisImprovement44.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in SteatosisWorsening2.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in SteatosisNo change38.3 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in SteatosisMissing14.9 Percentage of participants
PlaceboPercentage of Participants With Change in SteatosisMissing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in SteatosisImprovement33.3 Percentage of participants
PlaceboPercentage of Participants With Change in SteatosisNo change45.8 Percentage of participants
PlaceboPercentage of Participants With Change in SteatosisWorsening16.7 Percentage of participants
Secondary

Percentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis Classification

Percentage of participants who had improved, worsened, or had no change in fibrosis stage from baseline to week 48 or missing data is presented. The degree of fibrosis was described by the Kleiner fibrosis staging system, ranging from F0 (absence of fibrosis), F1 (portal/perisinusoidal fibrosis), F2 (perisinusoidal and portal/periportal fibrosis), F3 (septal or bridging fibrosis) through F4 (cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationImprovement12.8 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationWorsening0.0 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationNo change72.3 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationMissing14.9 Percentage of participants
PlaceboPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationMissing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationImprovement33.3 Percentage of participants
PlaceboPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationNo change62.5 Percentage of participants
PlaceboPercentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationWorsening0.0 Percentage of participants
Secondary

Percentage of Participants With Change in The Ishak Fibrosis Score

Percentage of participants who had improved, worsened, or had no change in the Ishak fibrosis score from baseline to week 48 or missing data is presented. Ishak fibrosis score was assessed on a scale of 0-6, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in The Ishak Fibrosis ScoreImprovement27.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Ishak Fibrosis ScoreNo change55.3 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Ishak Fibrosis ScoreWorsening2.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Ishak Fibrosis ScoreMissing14.9 Percentage of participants
PlaceboPercentage of Participants With Change in The Ishak Fibrosis ScoreMissing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in The Ishak Fibrosis ScoreImprovement37.5 Percentage of participants
PlaceboPercentage of Participants With Change in The Ishak Fibrosis ScoreWorsening12.5 Percentage of participants
PlaceboPercentage of Participants With Change in The Ishak Fibrosis ScoreNo change45.8 Percentage of participants
Secondary

Percentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component Score

Percentage of participants who had improved, worsened, or had no change in the activity component of the SAF score from baseline to week 48 or missing data is presented. SAF score was assessed on a scale of 0-4, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreWorsening8.5 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreNo change19.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreMissing14.9 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreImprovement57.4 Percentage of participants
PlaceboPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreImprovement50.0 Percentage of participants
PlaceboPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreWorsening12.5 Percentage of participants
PlaceboPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreMissing4.2 Percentage of participants
PlaceboPercentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScoreNo change33.3 Percentage of participants
Secondary

Percentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in Kleiner fibrosis classification. The degree of fibrosis was described by the Kleiner fibrosis staging system, ranging from F0 (absence of fibrosis), F1 (portal/perisinusoidal fibrosis), F2 (perisinusoidal and portal/periportal fibrosis), F3 (septal or bridging fibrosis) through F4 (cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in Kleiner fibrosis classification; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)Yes12.8 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)No72.3 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)Missing14.9 Percentage of participants
PlaceboPercentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)Yes33.3 Percentage of participants
PlaceboPercentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)No62.5 Percentage of participants
PlaceboPercentage of Participants With Improvement in Fibrosis Stage According to The Kleiner Fibrosis Classification (Yes/No)Missing4.2 Percentage of participants
Secondary

Percentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in hepatocyte ballooning clinical research network (CRN) score. Hepatocyte ballooning was assessed on a scale of 0-2, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in hepatocyte ballooning; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)Yes55.3 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)No29.8 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)Missing14.9 Percentage of participants
PlaceboPercentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)Missing4.2 Percentage of participants
PlaceboPercentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)Yes33.3 Percentage of participants
PlaceboPercentage of Participants With Improvement in Hepatocyte Ballooning (Yes/No)No62.5 Percentage of participants
Secondary

Percentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in Ishak fibrosis score. Ishak fibrosis score was assessed on a scale of 0-6, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in Ishak fibrosis score; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)No57.4 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)Yes27.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)Missing14.9 Percentage of participants
PlaceboPercentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)No58.3 Percentage of participants
PlaceboPercentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)Yes37.5 Percentage of participants
PlaceboPercentage of Participants With Improvement in Ishak Fibrosis Score (Yes/No)Missing4.2 Percentage of participants
Secondary

Percentage of Participants With Improvement in Lobular Inflammation (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in lobular inflammation CRN score. Lobular inflammation was assessed on a scale of 0-3, with higher scores indicating more severe lobular inflammation. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in lobular inflammation; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in Lobular Inflammation (Yes/No)Missing14.9 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Lobular Inflammation (Yes/No)Yes42.6 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Lobular Inflammation (Yes/No)No42.6 Percentage of participants
PlaceboPercentage of Participants With Improvement in Lobular Inflammation (Yes/No)Yes37.5 Percentage of participants
PlaceboPercentage of Participants With Improvement in Lobular Inflammation (Yes/No)No58.3 Percentage of participants
PlaceboPercentage of Participants With Improvement in Lobular Inflammation (Yes/No)Missing4.2 Percentage of participants
Secondary

Percentage of Participants With Improvement in NAS (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in NAS. NAS was calculated as the sum of scores for steatosis (0 to 3), lobular inflammation (0 to 3), and hepatocyte ballooning (0 to 2). Therefore, it is assessed on a scale of 0-8, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in NAS; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in NAS (Yes/No)Yes61.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in NAS (Yes/No)No23.4 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in NAS (Yes/No)Missing14.9 Percentage of participants
PlaceboPercentage of Participants With Improvement in NAS (Yes/No)Yes58.3 Percentage of participants
PlaceboPercentage of Participants With Improvement in NAS (Yes/No)No37.5 Percentage of participants
PlaceboPercentage of Participants With Improvement in NAS (Yes/No)Missing4.2 Percentage of participants
Secondary

Percentage of Participants With Improvement in SAF Activity Component Score (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in SAF score. SAF score was assessed on a scale of 0-4, with higher scores indicating more severe disease. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in SAF score; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in SAF Activity Component Score (Yes/No)Yes57.4 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in SAF Activity Component Score (Yes/No)No27.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in SAF Activity Component Score (Yes/No)Missing14.9 Percentage of participants
PlaceboPercentage of Participants With Improvement in SAF Activity Component Score (Yes/No)Yes50.0 Percentage of participants
PlaceboPercentage of Participants With Improvement in SAF Activity Component Score (Yes/No)No45.8 Percentage of participants
PlaceboPercentage of Participants With Improvement in SAF Activity Component Score (Yes/No)Missing4.2 Percentage of participants
Secondary

Percentage of Participants With Improvement in Steatosis (Yes/No)

Improvement is defined as at least one stage decrease from baseline to week 48 in steatosis CRN score. Steatosis was assessed on a scale of 0-3, with higher scores indicating more severe steatosis. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants. In below table, 'Yes' infers percentage of participants who achieved at least one stage decrease from baseline to week 48 in steatosis; 'No' infers vice-versa; 'Missing' refers to percentage of participants with data missing due to different reasons (lost to follow-up, withdrawal).

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Improvement in Steatosis (Yes/No)Yes44.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Steatosis (Yes/No)No40.4 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants With Improvement in Steatosis (Yes/No)Missing14.9 Percentage of participants
PlaceboPercentage of Participants With Improvement in Steatosis (Yes/No)Yes33.3 Percentage of participants
PlaceboPercentage of Participants With Improvement in Steatosis (Yes/No)No62.5 Percentage of participants
PlaceboPercentage of Participants With Improvement in Steatosis (Yes/No)Missing4.2 Percentage of participants
Secondary

Percentage of Participants With NASH Resolution After 48 Weeks

NASH resolution defined by NASH clinical research network as lobular inflammation of 0 or 1 and hepatocellular ballooning reduced to 0; both criteria were necessary conditions. Hepatocellular ballooning ranges from 0-2; lobular inflammation ranges from 0-3, with higher scores indicating more severe hepatocellular ballooning or lobular inflammation. Worsening of fibrosis defined by an increase in fibrosis at least one stage of Kleiner fibrosis classification: fibrosis stages range from 0-4, with higher scores indicating greater fibrosis (0=None, 4=Cirrhosis). Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Week 48

Population: FAS included all randomised participants.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With NASH Resolution After 48 Weeks34.0 Percentage of participants
PlaceboPercentage of Participants With NASH Resolution After 48 Weeks20.8 Percentage of participants
Secondary

Percentage of Participants With Weight Loss of >= 10% of Baseline Body Weight at Week 48

Percentage of participants with weight loss of ≥ 10% of baseline body weight at 48 weeks is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Week 48

Population: FAS included all randomised participants.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Weight Loss of >= 10% of Baseline Body Weight at Week 4840.5 Percentage of participants
PlaceboPercentage of Participants With Weight Loss of >= 10% of Baseline Body Weight at Week 480 Percentage of participants
Secondary

Percentage of Participants With Weight Loss of >= 5% of Baseline Body Weight at Week 48

Percentage of participants with weight loss of greater than or equal to (≥) 5% of baseline body weight at 48 weeks is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Week 48

Population: FAS included all randomised participants.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants With Weight Loss of >= 5% of Baseline Body Weight at Week 4862.0 Percentage of participants
PlaceboPercentage of Participants With Weight Loss of >= 5% of Baseline Body Weight at Week 4825.4 Percentage of participants
Secondary

Relative Change From Baseline in Body Weight

Relative change in body weight (measured as kg) from baseline to week 48 is presented. Outcome measure was evaluated based on data from in-trial period which started on date of randomisation visit and ended on first of following dates (both inclusive):1) follow-up visit (week 55); 2) withdrawal of consent; 3) last contact with participant (for participants lost to follow-up); 4) death.

Time frame: Baseline (week 0), Week 48

Population: FAS included all randomised participants.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgRelative Change From Baseline in Body Weight-8.83 percent changeStandard Deviation 7.44
PlaceboRelative Change From Baseline in Body Weight-0.09 percent changeStandard Deviation 7.44

Source: ClinicalTrials.gov · Data processed: Feb 13, 2026