HIV Infections, Non-Alcoholic Fatty Liver Disease
Conditions
Keywords
NAFLD, HIV, semaglutide
Brief summary
The purpose of this study was to evaluate the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis.
Detailed description
This study evaluated the effects of semaglutide on intra-hepatic triglyceride (IHTG) content in people living with HIV (PLWH), central adiposity, insulin resistance or pre-diabetes, and hepatic steatosis. All participants received semaglutide subcutaneously once weekly for 24 weeks, followed by 24 weeks of observation off of the study drug. IHTG was quantified by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) evaluations at two time points during the study. Participants attended several study visits through Week 48. Participants completed food diaries, adherence and strength assessments, and report on hypoglycemia, vision changes, physical activity, diet, quality of life, and acceptability of study drug. Blood was collected at all visits and stool samples at two visits. Participants remained on their non-study-provided antiretroviral therapy (ART) throughout the study.
Interventions
DRUGSemaglutide
Administered subcutaneously
Sponsors
The University of Texas Health Science Center, Houston
National Institute of Allergy and Infectious Diseases (NIAID)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* HIV-1 infection, documented by any licensed rapid HIV test or HIV enzyme or chemiluminescence immunoassay (E/CIA) test kit at any time prior to study entry and confirmed by a licensed Western blot or a second antibody test by a method other than the initial rapid HIV and/or E/CIA, or by HIV-1 antigen, plasma HIV-1 RNA viral load. * NOTE: The term licensed refers to a US Food and Drug Administration (FDA)-approved kit, which is required for all investigational new drug (IND) studies, or for sites located in countries other than the United States, a kit that has been certified or licensed by an oversight body within that country and validated internally. Non-US sites are encouraged to use US FDA-approved methods for IND studies. * WHO (World Health Organization) and CDC (Centers for Disease Control and Prevention) guidelines mandate that confirmation of the initial test result must use a test that is different from the one used for the initial assessment. A reactive initial rapid test should be confirmed by either another type of rapid assay or an E/CIA that is based on a different antigen preparation and/or different test principle (e.g., indirect versus competitive), or a Western blot or a plasma HIV-1 RNA viral load. * Two separate reports of HIV-1 RNA measurements \<50 copies/mL, and no HIV-1 RNA measurement \>500 copies/mL, during the 48 weeks prior to entry. One of the HIV-1 RNA values must be the screening visit value, and the other value obtained between 24 and 48 weeks prior to entry. * NOTE: All values must have been reported from a US laboratory that has a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent, or at any network-approved non-US laboratory that is Virology Quality Assurance (VQA) certified. * No change in antiretroviral therapy (ART) in the 24 weeks prior to entry. * NOTE A: Modifications of ART formulation (e.g., from standard formulation to fixed dose combination or single tablet regimen) will be permitted. * NOTE B: Within-class substitutions are not permitted. * No plan to change ART for the study duration. * Within 30 days prior to pre-entry, a minimum WC measurement of ≥95 cm for individuals assigned male sex at birth or ≥94 cm for individuals assigned female sex at birth. * NOTE: For transgender study participants, sites should use the parameter that matches sex assigned at birth. * At least one of the following drawn within 30 days prior to pre-entry by any US laboratory that has a CLIA certification or its equivalent, or at any network-approved non-US laboratory that operates in accordance with Good Clinical Laboratory Practices (GCLP) and participates in appropriate external quality assurance programs: * Fasting plasma glucose 100-125 mg/dL (refer to the study protocol for a definition of fasting). * HbA1c between ≥5.7 and \<6.5% * Homeostatic model assessment of insulin resistance (HOMA-IR) \>3.0 (Refer to calculator: https://www.mdcalc.com/homa-ir-homeostatic-model-assessment-insulin-resistance) * Documentation of negative hepatitis A virus (HAV) immunoglobulin M (IgM) or HAV vaccination prior to study entry. * NOTE: If documentation is not available prior to screening, this should be obtained through routine clinical care within 30 days prior to entry. * Hepatic fat content (i.e., IHTG) ≥5%, as determined by liver magnetic resonance imaging-proton density fat fraction (MRI-PDFF) within 14 days prior to entry (and between 1-30 days after screening). * NOTE: Refer to the study protocol for more details. * CD4+ T-cell count ≥200 cells/mm\^3 within 30 days prior to pre-entry (may be from standard of care) at any US laboratory that has a CLIA certification or its equivalent, or at any network-approved non-US laboratory that is Immunology Quality Assurance (IQA) certified. * The following laboratory values obtained within 30 days prior to pre-entry by any US laboratory that has a CLIA certification or its equivalent, or at any network-approved non-US laboratory that operates in accordance with GCLP and participates in appropriate external quality assurance programs: * Absolute neutrophil count (ANC) \>750 cells/mm\^3 * Hemoglobin \>10 g/dL for individuals assigned male at birth and \>9 g/dL for individuals assigned female at birth * Creatinine clearance (CrCl) ≥50 mL/min, as calculated by the CKD-Epi equation. * NOTE: Please refer to A5371 protocol-specific web page (PSWP) for the website link to calculate CrCl using the CKD-Epi calculator. * NOTE: Calculations will be done without using cystatin C. Please refer to the A5371 Manual of Operating Procedures (MOPS) for further details. * Aspartate aminotransferase (AST) (SGOT) ≤3 x ULN on at least two measurements, with at least one within 30 days prior to pre-entry. Participants must also have no evidence of AST \>3 x ULN within the 3 months prior to entry, from routine clinical monitoring, if available. If no additional monitoring is available in the 3 months prior to entry, additional testing should be obtained within the screening interval (2-4 weeks apart) to ensure stability. * Alanine aminotransferase (ALT) (SGPT) ≤3 x ULN on at least two measurements, with at least one within 30 days prior to pre-entry. Participants must also have no evidence of ALT \>3 x ULN within the 3 months prior to entry, from routine clinical monitoring, if available. If no additional monitoring is available in the 3 months prior to entry, additional testing should be obtained within the screening interval (2-4 weeks apart) to ensure stability. * Fasting triglyceride level ≤500 mg/dL. * NOTE A: See the study protocol for a definition of fasting. * NOTE B: If level is \>500 mg/dL, level may be rechecked within the screening window. * For individuals taking daily medications with anti-inflammatory properties, including but not limited to, statins and chronic corticosteroids (inhaled corticosteroids exempt), the doses must be stable as determined by the site investigator for ≥3 months prior to study entry, and the individual should have no active plans to change dosing during the study period. * For individuals taking daily lipid-lowering medications (such as statins, fibrates, niacin, fish oil), the doses must be stable as determined by the site investigator for ≥3 months prior to study entry, and the individual should have no active plans to change dosing during the study period. * NOTE: Lipid-lowering equivalents for niacin and fish oil are ≥1 g and ≥3 g daily, respectively. * Ability and willingness of participant to provide informed consent * Willingness and ability to use auto-inject pen weekly for 24 weeks. * Willingness and ability to undergo MRI scans. * NOTE: Anxiolytics will not be provided through the study but may be provided at site expense. * For persons able to become pregnant, a negative serum or urine pregnancy test (urine test must have a sensitivity of \<25 mIU/mL) both 1) at screening (within 30 days prior to pre-entry MRI) and 2) within 3 days before or at entry (prior to registration into study) by any US clinic or laboratory that has a CLIA certification or its equivalent, or is using a point of care (POC)/ CLIA-waived test, or at any network-approved non-US laboratory or clinic that operates in accordance with Good Clinical Laboratory Practices (GCLP) and participates in appropriate external quality assurance programs. * NOTE: Individuals able to become pregnant are defined as individuals who have reached menarche and who have not been post-menopausal for at least 24 consecutive months (i.e., have had menses within the preceding 24 months), and have not undergone surgical sterilization such as hysterectomy, bilateral oophorectomy, tubal ligation, or salpingectomy. * If participating in sexual activity that could lead to the participant becoming pregnant, the participant must agree to use contraception while on study drug (24 weeks) and for 2 months following the last dose of study drug. At least one of the following must be used: * Intrauterine device (IUD) * Hormone-based contraceptive * Partner sterilization (i.e., vasectomy) and is the sole partner for the participant. * NOTE: Participant self-report of partner sterilization is acceptable. * For individuals taking Vitamin E (any dose), the dose must be stable as determined by the site investigator for more than 1 year prior to entry. * Willingness to be contacted by telephone or e-mail by study staff throughout the study.
Exclusion criteria
* Known active hepatitis C virus (HCV) infection, defined as a detectable HCV RNA within 24 weeks prior to study entry. * NOTE A: Individuals with HCV RNA below the limit of quantitation for \>24 weeks prior to study entry are eligible, i.e., individuals who have been treated for hepatitis C are eligible if they have completed therapy \>24 weeks prior to study entry, and/or individuals who spontaneously cleared hepatitis C virus are eligible as long as they have had undetectable HCV RNA for \>24 weeks. HCV RNA testing is not provided by the study. * NOTE B: If HCV antibody testing has not been performed in the 5 years prior to screening and the participant does not have history of cured HCV infection, HCV antibody testing should be repeated at screening. If screening HCV antibody is positive or reactive, the individual is not eligible and should be referred for clinical evaluation through routine care. * Active/chronic hepatitis B (HBV), defined as a positive hepatitis B surface antigen (HBsAg) at screening. * NOTE A: HBsAg testing is only required at screening if HBV laboratory results are not available within the last 5 years prior to screening and individual does not have documented immunity. * NOTE B: If HBsAg positive, individual is not eligible and should be referred for clinical evaluation through routine care. * Known active severe delayed gastric emptying, as determined by the site investigator. * Gain or loss of \>5% body weight within 12 weeks prior to study entry. * NOTE: Self-report recall is acceptable. * Any plans to change diet or exercise regimen significantly, except for the adoption of study provided suggestions for diet and exercise, within the study period. * NOTE: Significantly refers to intent to join a weight-loss program such as Weight Watchers, or start a specific diet (such as ketogenic or very low carbohydrate). * Known acute or chronic liver disease with cirrhosis or portal hypertension. * History of liver transplant. * Breastfeeding or plans to become pregnant. * Current diagnosis of diabetes mellitus or current use of diabetes medications, or a laboratory measurement of hemoglobin A1c ≥6.5% at screening. * NOTE: Stable use of metformin (i.e., for ≥12 weeks) for indication other than diabetes (e.g., polycystic ovarian syndrome or pre-diabetes/impaired fasting glucose) may be permitted with approval of the Clinical Management Committee (CMC). * Known retinopathy (excluding remote history of cotton wool spots). * Personal or family (first-degree relative) history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2). * Untreated, poorly controlled, or previously undiagnosed thyroid disease defined as the presence of abnormal thyroid-stimulating hormone (TSH) at screening with no clear explanation. * Unexplained hypercalcemia corrected for albumin that is \>10.5 mg/dL at screening. Please refer to the A5371 MOPS for the calculation. * Use of any immunomodulatory (including prednisone equivalent of ≥10 mg), HIV vaccine, investigational therapy, or TNF-α therapy within 3 months prior to study entry. * Use of human growth hormone, tesamorelin, supraphysiologic testosterone to achieve therapeutic blood levels, or any use of other anabolic steroids within 3 months prior to study entry or plans to start these while on study. * NOTE: Chronic, stable hormone replacement therapy ≥3 months prior to entry in men with diagnosed hypogonadism or transgender person on masculinizing hormonal therapy is permitted. * Use of estrogens or progesterones at supraphysiologic doses within 3 months prior to study entry. * NOTE: Stable doses used for contraception, post-menopausal hormone replacement or feminizing hormone therapy for transgender persons ≥3 months prior to entry is permitted. * Known allergy/sensitivity or any hypersensitivity to components of study drug or its formulation. * Current serious illness requiring systemic treatment and/or hospitalization. * NOTE: The individual can be rescreened when they complete therapy or are clinically stable as determined by the site investigator. * Use of GLP-1 agonists within 24 weeks prior to study entry. * Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements. * Excessive consumption of alcohol of ≥3 months within 90 days prior to screening, defined as: * Consuming ≥5 alcoholic drinks for men or consuming ≥4 alcoholic drinks for women during a single occasion (i.e., at the same time or within a couple of hours of each other), or * ≥3 drinks on 4 or more days of the week on average for men or ≥2 drinks on 4 or more days of the week on average for women. * NOTE: For transgender study participants, sites should use the parameter that matches sex assigned at birth. * Known chronic pancreatitis or more than one episode of pancreatitis ever in the past. * Inability to keep study product at 36°F to 46°F (2°C to 8°C) prior to first use, or to maintain the study product at a controlled room temperature between 59°F and 86°F (15°C to 30°C) following first use. * Intent to use any medication likely to cause significant changes in weight during the study period. * NOTE: Refer to the study protocol for a list of medications in this category. * Use of stavudine within 12 months prior to study entry. * Prior bariatric surgery (e.g., lap band, gastric sleeve, or Roux-en-Y bypass surgery) or major gastric surgery or plans to undergo weight reduction surgery while on study. * Individuals with any metal, implantable devices (e.g., pacemakers, prosthetics), or shrapnel, per standard MRI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change (Absolute) in IHTG (%) | Measured at pre-entry and Week 24 | The absolute change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of IHTG (%) | Measured at Week 24 | Intra-hepatic triglyceride content (%) at Week 24 (\<5% vs. \>=5%). All participants were \>=5% at pre-entry. |
| Occurrence of Premature Discontinuation of Study Treatment | Measured through Week 24 | Premature study treatment discontinuation prior to the Week 24 visit. |
| Occurrence of Grade ≥3 Adverse Event That is Related to Study Treatment | Measured through Week 24 | Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Adverse events are graded on a scale from 1-5: 1=mild, 2=moderate, 3=severe, 4=life-threatening, 5=death. |
| Change (Absolute) in Body Mass Index (BMI) | Measured at Week 0 and Week 24 | The absolute change in body mass index from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Body Weight | Measured at Week 0 and Week 24 | The absolute change in body weight from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Minimum Waist Circumference (WC) | Measured at Week 0 and Week 24 | The absolute change in minimum WC from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Insulin Resistance (HOMA-IR) | Measured at Week 0 and Week 24 | The absolute change in HOMA-IR from the study entry (Week 0) visit to the Week 24 visit. HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a method used to estimate how well your body responds to insulin. HOMA-IR is caluclated with the following formula: (fasting glucose in mmol/L x fasting insulin in mIU/mL)/22.5 A higher HOMA-IR score indicates a greater likelihood of insulin resistance. |
| Change (Percent) in IHTG (%) | Measured at pre-entry and Week 24 | The percentage change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit. The percentage change is defined as IHTC % at week 24 minus IHTC % at pre-entry, then divided by IHTC % at pre-entry, then multiplied by 100. |
| Change (Absolute) in Fasting Glucose | Measured at Week 0 and Week 24 | The absolute change in fasting glucose from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Fasting Total Cholesterol | Measured at Week 0 and Week 24 | The absolute change in fasting total cholesterol from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Fasting LDL Cholesterol | Measured at Week 0 and Week 24 | The absolute change in fasting LDL cholesterol from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Fasting HDL Cholesterol | Measured at Week 0 and Week 24 | The absolute change in fasting HDL cholesterol from the study entry (Week 0) visit to the Week 24 visit. |
| Change (Absolute) in Fasting Triglycerides | Measured at Week 0 and Week 24 | The absolute change in fasting triglycerides from the study entry (Week 0) visit to the Week 24 visit. |
| Presence of Metabolic Syndrome | Measured at Weeks 0, 12 and 24 | Metabolic syndrome is defined as having ≥3 of the following: increased minimum WC (\>=40 inches for male sex at birth; \>=35 inches for female sex at birth), increased fasting triglyceride level (\>150 mg/dL or taking lipid-lowering medication), reduced fasting HDL cholesterol (\<40 mg/dL for male sex at birth; \<50 mg/dL for female sex at birth), increased blood pressure (\>=135/85 mmHg or taking BP medication), and increased fasting glucose (\>100 mg/dL or taking glucose-lowering medication). |
| Change (Absolute) in Hemoglobin A1C (HbA1c) | Measured at Week 0 and Week 24 | The absolute change in HbA1c from the study entry (Week 0) visit to the Week 24 visit. |
Countries
Brazil, United States
Participant flow
Recruitment details
The first participant was enrolled in February 2021. Study enrollment was completed in September 2022 with the enrollment of the last participant. Participants were enrolled from 9 sites in the United States and Brazil.
Participants by arm
| Arm | Count |
|---|---|
| Semaglutide All participants received a dose of 0.25 mg of semaglutide weekly starting at study entry, followed by 0.5 mg weekly starting at Week 2, and then 1.0 mg weekly from Weeks 4 through 24.
Semaglutide: Administered subcutaneously | 51 |
| Total | 51 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Incarceration | 1 |
| Overall Study | Protocol Violation | 1 |
| Overall Study | Withdrawal by Subject | 2 |
Baseline characteristics
| Characteristic | Semaglutide |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 3 Participants |
| Age, Categorical Between 18 and 65 years | 48 Participants |
| Age, Continuous | 52 years |
| Ethnicity (NIH/OMB) Hispanic or Latino | 20 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 31 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Intra-Hepatic Triglyceride Content (IHTG) | 12.7 percent of IHTG content STANDARD_DEVIATION 6.05 |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 16 Participants |
| Race (NIH/OMB) More than one race | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 3 Participants |
| Race (NIH/OMB) White | 30 Participants |
| Region of Enrollment Brazil | 2 participants |
| Region of Enrollment United States | 49 participants |
| Sex: Female, Male Female | 18 Participants |
| Sex: Female, Male Male | 33 Participants |
| Sex/Gender, Customized Cisgender Female | 18 Participants |
| Sex/Gender, Customized Cisgender Male | 30 Participants |
| Sex/Gender, Customized Transgender Female | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 51 |
| other Total, other adverse events | 20 / 51 |
| serious Total, serious adverse events | 2 / 51 |
Outcome results
Primary
Change (Absolute) in IHTG (%)
The absolute change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit.
Time frame: Measured at pre-entry and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in IHTG (%) | -4.24 IHTG % |
Comparison: The study was powered to detect an absolute IHTG change of -5% assuming a null change of 0%, a standard deviation of absolute IHTG change of 9%, and 37 evaluable participants.p-value: <0.00195% CI: [-5.41, -3.06]Regression, Linear
Secondary
Change (Absolute) in Body Mass Index (BMI)
The absolute change in body mass index from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Body Mass Index (BMI) | -2.77 kg/m^2 |
p-value: <0.00195% CI: [-3.36, -2.17]Regression, Linear
Secondary
Change (Absolute) in Body Mass Index (BMI)
The absolute change in body mass index from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured from Week 0 to Week 12
Population: Per-protocol population (N=49)
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Body Mass Index (BMI) | -2.15 kg/m^2 |
p-value: <0.00195% CI: [-2.55, -1.75]Regression, Linear
Secondary
Change (Absolute) in Body Weight
The absolute change in body weight from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Body Weight | -6.16 kg |
p-value: <0.00195% CI: [-7.3, -5.03]Regression, Linear
Secondary
Change (Absolute) in Body Weight
The absolute change in body weight from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Body Weight | -7.80 kg |
p-value: <0.00195% CI: [-9.48, -6.13]Regression, Linear
Secondary
Change (Absolute) in Fasting Glucose
The absolute change in fasting glucose from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting Glucose | -9.90 mg/dl |
p-value: <0.00195% CI: [-14.7, -5.09]Regression, Linear
Secondary
Change (Absolute) in Fasting Glucose
The absolute change in fasting glucose from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting Glucose | -8.87 mg/dl |
p-value: <0.00195% CI: [-12.26, -5.48]Regression, Linear
Secondary
Change (Absolute) in Fasting HDL Cholesterol
The absolute change in fasting HDL cholesterol from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting HDL Cholesterol | 2.04 mg/dl |
p-value: 0.05395% CI: [-0.02, 4.11]Regression, Linear
Secondary
Change (Absolute) in Fasting HDL Cholesterol
The absolute change in fasting HDL cholesterol from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting HDL Cholesterol | -0.78 mg/dl |
p-value: 0.4395% CI: [-2.76, 1.2]Regression, Linear
Secondary
Change (Absolute) in Fasting LDL Cholesterol
The absolute change in fasting LDL cholesterol from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting LDL Cholesterol | -6.91 mg/dl |
p-value: 0.05195% CI: [-13.85, 0.03]Regression, Linear
Secondary
Change (Absolute) in Fasting LDL Cholesterol
The absolute change in fasting LDL cholesterol from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting LDL Cholesterol | -1.04 mg/dl |
p-value: 0.7395% CI: [-7.14, 5.05]Regression, Linear
Secondary
Change (Absolute) in Fasting Total Cholesterol
The absolute change in fasting total cholesterol from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting Total Cholesterol | -3.98 mg/dl |
p-value: 0.2595% CI: [-10.84, 2.89]Regression, Linear
Secondary
Change (Absolute) in Fasting Total Cholesterol
The absolute change in fasting total cholesterol from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting Total Cholesterol | -11.93 mg/dl |
p-value: 0.00495% CI: [-19.79, -4.08]Regression, Linear
Secondary
Change (Absolute) in Fasting Triglycerides
The absolute change in fasting triglycerides from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting Triglycerides | -26.78 mg/dl |
p-value: 0.00795% CI: [-46.04, -7.53]Regression, Linear
Secondary
Change (Absolute) in Fasting Triglycerides
The absolute change in fasting triglycerides from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Fasting Triglycerides | -18.65 mg/dl |
p-value: 0.01495% CI: [-33.29, -4.01]Regression, Linear
Secondary
Change (Absolute) in Hemoglobin A1C (HbA1c)
The absolute change in HbA1c from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Hemoglobin A1C (HbA1c) | -0.25 HbA1c % |
p-value: <0.00195% CI: [-0.32, -0.17]Regression, Linear
Secondary
Change (Absolute) in Insulin Resistance (HOMA-IR)
The absolute change in HOMA-IR from the study entry (Week 0) visit to the Week 24 visit. HOMA-IR (Homeostatic Model Assessment of Insulin Resistance) is a method used to estimate how well your body responds to insulin. HOMA-IR is caluclated with the following formula: (fasting glucose in mmol/L x fasting insulin in mIU/mL)/22.5 A higher HOMA-IR score indicates a greater likelihood of insulin resistance.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Insulin Resistance (HOMA-IR) | -1.46 uU/ml*mmol/l/22.5 |
p-value: 0.09295% CI: [-3.17, 0.25]Regression, Linear
Secondary
Change (Absolute) in Insulin Resistance (HOMA-IR)
The absolute change in HOMA-IR from the study entry (Week 0) visit to the Week 12 visit. HOMA-IR (Homeostatic Model Assessment of Insulin Resistanc) is a method used to estimate how well your body responds to insulin. HOMA-IR is caluclated with the following formula: (fasting glucose in mmol/L x fasting insulin in mIU/mL)/22.5 A higher HOMA-IR score indicates a greater likelihood of insulin resistance.
Time frame: Measured at Week 0 and Week 12
Population: Outcomes not available because fasting insulin data was not collected at Week 12.
Secondary
Change (Absolute) in Minimum Waist Circumference (WC)
The absolute change in minimum WC from the study entry (Week 0) visit to the Week 24 visit.
Time frame: Measured at Week 0 and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Minimum Waist Circumference (WC) | -6.66 cm |
p-value: <0.00195% CI: [-8.54, -4.78]Regression, Linear
Secondary
Change (Absolute) in Minimum Waist Circumference (WC)
The absolute change in minimum WC from the study entry (Week 0) visit to the Week 12 visit.
Time frame: Measured at Week 0 and Week 12
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Absolute) in Minimum Waist Circumference (WC) | -5.53 cm |
p-value: <0.00195% CI: [-7.07, -3.99]Regression, Linear
Secondary
Change (Percent) in IHTG (%)
The percentage change in intra-hepatic triglyceride content (%), as quantfied by MRI-PDFF, from the pre-entry visit to the Week 24 visit. The percentage change is defined as IHTC % at week 24 minus IHTC % at pre-entry, then divided by IHTC % at pre-entry, then multiplied by 100.
Time frame: Measured at pre-entry and Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Semaglutide | Change (Percent) in IHTG (%) | -31.33 Relative change % |
p-value: <0.00195% CI: [-39.04, -23.62]Regression, Linear
Secondary
Level of IHTG (%)
Intra-hepatic triglyceride content (%) at Week 24 (\<5% vs. \>=5%). All participants were \>=5% at pre-entry.
Time frame: Measured at Week 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Semaglutide | Level of IHTG (%) | <5% IHTG | 14 participants |
| Semaglutide | Level of IHTG (%) | >=5% IHTG | 34 participants |
Secondary
Occurrence of Grade ≥3 Adverse Event That is Related to Study Treatment
Graded according to the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (DAIDS AE Grading Table), corrected Version 2.1, July 2017. Adverse events are graded on a scale from 1-5: 1=mild, 2=moderate, 3=severe, 4=life-threatening, 5=death.
Time frame: Measured through Week 24
Population: Analysis was done in the intent-to-treat population. These were all participants who were enrolled to the study.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Semaglutide | Occurrence of Grade ≥3 Adverse Event That is Related to Study Treatment | Yes | 2 Participants |
| Semaglutide | Occurrence of Grade ≥3 Adverse Event That is Related to Study Treatment | No | 49 Participants |
Secondary
Occurrence of Premature Discontinuation of Study Treatment
Premature study treatment discontinuation prior to the Week 24 visit.
Time frame: Measured through Week 24
Population: Analysis was done in the intent-to-treat population. These were all participants who were enrolled to the study.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Semaglutide | Occurrence of Premature Discontinuation of Study Treatment | Premature discontinuation | 3 participants |
| Semaglutide | Occurrence of Premature Discontinuation of Study Treatment | Completed study treatment | 48 participants |
Secondary
Presence of Metabolic Syndrome
Metabolic syndrome is defined as having ≥3 of the following: increased minimum WC (\>=40 inches for male sex at birth; \>=35 inches for female sex at birth), increased fasting triglyceride level (\>150 mg/dL or taking lipid-lowering medication), reduced fasting HDL cholesterol (\<40 mg/dL for male sex at birth; \<50 mg/dL for female sex at birth), increased blood pressure (\>=135/85 mmHg or taking BP medication), and increased fasting glucose (\>100 mg/dL or taking glucose-lowering medication).
Time frame: Measured at Weeks 0, 12 and 24
Population: Analysis was done in the per-protocol population. These were all participants who remained on study treatment until 28 days prior to the Week 24 MRI and who did not start prohibited medications known to cause changes in weight prior to the Week 24 MRI.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Semaglutide | Presence of Metabolic Syndrome | Baseline | Metabolic syndrome | 38 Participants |
| Semaglutide | Presence of Metabolic Syndrome | Baseline | No metabolic syndrome | 11 Participants |
| Semaglutide | Presence of Metabolic Syndrome | Week 12 | Metabolic syndrome | 25 Participants |
| Semaglutide | Presence of Metabolic Syndrome | Week 12 | No metabolic syndrome | 21 Participants |
| Semaglutide | Presence of Metabolic Syndrome | Week 24 | Metabolic syndrome | 28 Participants |
| Semaglutide | Presence of Metabolic Syndrome | Week 24 | No metabolic syndrome | 19 Participants |
Comparison: Comparison between Baseline and Week 12.p-value: 0.01695% CI: [0.55, 0.94]GEE model for repeated binary outcomes
Comparison: Comparison between Baseline and Week 24.p-value: 0.03395% CI: [0.58, 0.98]GEE model for repeated binary outcomes