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Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure and Obesity

Effect of Semaglutide 2.4 mg Once Weekly on Function and Symptoms in Subjects With Obesity-related Heart Failure With Preserved Ejection Fraction

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04788511
Acronym
STEP-HFpEF
Enrollment
529
Registered
2021-03-09
Start date
2021-03-16
Completion date
2023-04-18
Last updated
2025-12-05

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

Conditions

Obesity

Brief summary

This study will look at how the participants daily life is affected by their heart failure. The study will also look at the change in participants body weight from the start to the end of the study. This is to compare the effect on heart failure symptoms and on body weight in people taking semaglutide (a new medicine) to people taking dummy medicine. Participants will either get semaglutide or dummy medicine - which treatment participants get is decided by chance. Participants will need to take 1 injection once a week. The study medicine is injected with a thin needle in a skin fold in the stomach area, thigh or upper arm. During the study participants will have talks with the study staff about healthy lifestyle choices including healthy food and physical activity. The study will last for approximately 59 weeks. Participants will have 11 clinic visits and 1 phone call with the study doctor. Women: Women cannot take part if they are pregnant, breast-feeding or plan to become pregnant during the study period.

Interventions

DRUGSemaglutide

Semaglutide will be injected into a skin fold, in the stomach, thigh or upper arm once a week at the same day of the week (to the extent possible) throughout the trial. Dose gradually escalated from 0.25 mg until target dose. The study will last for approximately 59 weeks.

DRUGPlacebo (semaglutide)

Placebo will be injected into a skin fold, in the stomach, thigh or upper arm once a week at the same day of the week (to the extent possible) throughout the trial. The study will last for approximately 59 weeks.

Sponsors

Novo Nordisk A/S
Lead SponsorINDUSTRY

Study design

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

Masking description

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

Eligibility

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

Inclusion criteria

* Male or female, age above or equal to 18 years at the time of signing informed consent. * Body mass index (BMI) greater than or equal to 30.0 kg/m\^2 * New York Heart Association (NYHA) Class II-IV * Left ventricular ejection fraction (LVEF) greater than or equal to 45 percentage at screening

Exclusion criteria

* A self-reported change in body weight greater than 5 kg (11 lbs) within 90 days before screening irrespective of medical records * Haemoglobin A1c (HbA1c) greater than or equal to 6.5 percentage (48 mmol/mol) based on latest available value from medical records, no older than 3 months or if unavailable a local measurement at screening

Design outcomes

Primary

MeasureTime frameDescription
Change in Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS)From baseline (week 0) to end of treatment (week 52)The KCCQ is a standardized 23-item, self-administered instrument that quantifies heart failure symptoms (frequency, severity, and recent change), physical limitation, quality of life, and social limitation. The overall summary score and all domains have been independently demonstrated to be valid, reliable, and responsive to clinical change. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ. Scores are transformed to a range of 0-100, in which higher scores reflect better health status. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Change in Body WeightFrom baseline (week 0) to end of treatment (week 52)Change in body weight from baseline (week 0) to end of treatment (week 52) is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Secondary

MeasureTime frameDescription
Change in C-Reactive Protein (CRP): Ratio to BaselineFrom baseline (week -2) to end of treatment (week 52)Change in high sensitivity C-reactive protein measured in ratio of C-reactive protein to baseline (week -2) at end of treatment (week 52) is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Percentage of Participants Achieving 10 Percent (%) Weight Loss (Yes/No)From baseline (week 0) to end of treatment (week 52)Percentage of participants who achieved 10% weight loss (yes/no) from baseline (week 0) to end of treatment (week 52) is presented. In the reported data, 'Yes' infers percentage of participants who have achieved 10% weight loss whereas 'No' infers percentage of participants who have not achieved 10% weight loss. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Percentage of Participants Achieving 15% Weight Loss (Yes/No)From baseline (week 0) to end of treatment (week 52)Percentage of participants who achieved 15% weight loss (yes/no) from baseline (week 0) to end of treatment (week 52) is presented. In the reported data, 'Yes' infers percentage of participants who have achieved 15% weight loss whereas 'No' infers percentage of participants who have not achieved 15% weight loss. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Percentage of Participants Achieving 20% Weight Loss (Yes/No)From baseline (week 0) to end of treatment (week 52)Percentage of participants who achieved 20% weight loss (yes/no) from baseline (week 0) to end of treatment (week 52) is presented. In the reported data, 'Yes' infers percentage of participants who have achieved 20% weight loss whereas 'No' infers percentage of participants who have not achieved 20% weight loss The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Percentage of Participants Improving 5 Points or More in KCCQ Clinical Summary Score (Yes/No)From baseline (week 0) to end of treatment (week 52)Percentage of participants improving 5 points or more in KCCQ-CSS from baseline to end of treatment is presented. The KCCQ is standardized 23-item, self-administered instrument that quantifies heart failure symptoms(frequency, severity, and recent change), physical limitation, quality of life, and social limitation. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ. Scores are transformed to range of 0-100, in which higher scores reflect better health status. In the reported data, 'Yes' infers percentage of participants who have improved 5 points or more in score whereas 'No' infers percentage of participants who have not improved 5 points or more in score. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Change in Six-minute Walking Distance (6MWD)From baseline (week 0) to end of treatment (week 52)Observed mean change from baseline (week 0) in 6 minutes walking distance (6MWD) test to end of treatment (week 52) is presented. The 6MWD is a common test of functional exercise capacity that assesses the distance a participant can walk in 6 minutes. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Change in KCCQ Overall Summary Score (KCCQ-OSS)From baseline (week 0) to end of treatment (week 52)The KCCQ is a standardized 23-item, self-administered instrument that quantifies heart failure symptoms (frequency, severity, and recent change), physical limitation, quality of life, and social limitation. The overall summary score and all domains have been independently demonstrated to be valid, reliable, and responsive to clinical change. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ while KCCQ-OSS includes the symptom, physical limitation, quality of life, and social limitation domains. Scores are transformed to a range of 0-100, in which higher scores reflect better health status. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Percentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in KCCQ-CSS (PGI-S)From baseline (week 0) to end of treatment (week 52)The patient global impression of status (PGI-S) for KCCQ was used to rate participants' symptoms of heart failure using 4-category ordinal scale (no symptoms, mild, moderate, severe). KCCQ is standardized 23-item, self-administered instrument that quantifies heart failure symptoms (frequency, severity, and recent change), physical limitation, quality of life, and social limitation. OSS and all domains have been independently demonstrated to be valid, reliable, and responsive to clinical change. KCCQ-CSS includes symptom and physical limitation domains of the KCCQ. Scores are transformed to range of 0-100, in which higher scores reflect better health status. Outcome measure was evaluated based on data from in-trial period. In-trial period was defined as uninterrupted time interval from date of randomization to date of last contact with trial site. The threshold was defined as mean change in KCCQ-CSS in those participants with one-category improvement in PGI-S from baseline to week 52.
Percentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in 6MWD (PGI-S)From baseline (week 0) to end of treatment (week 52)Observed mean change from baseline in 6 minutes walking distance (6MWD) test using PGI-S is evaluated for this outcome measure. The 6MWD is a common test of functional exercise capacity that assesses the distance a participant can walk in 6 minutes. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site. The threshold was defined as the mean change in 6MWD in those participants with an one-category improvement in PGI-S from baseline to week 52.
Change in Systolic Blood Pressure (SBP)From baseline (week -2) to end of treatment (week 52)Observed mean change in systolic blood pressure from baseline (week -2) to end of treatment (week 52) is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Change in Waist CircumferenceFrom baseline (week 0) to end of treatment (visit 52)Change waist circumference from baseline (week 0) to end of the treatment (visit 52) presented. Waist circumference is defined as the abdominal circumference located midway between the lower rib margin and the iliac crest. Measurement must be obtained in standing position with a non-stretchable measuring tape and to the nearest cm or inch. The tape should touch the skin but not compress soft tissue and twists in the tape should be avoided. The participant should be asked to breathe normally. The same measuring tape should be used throughout the trial. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
Percentage of Participants Improving 10 Points or More in KCCQ Clinical Summary Score (Yes/No)From baseline (week 0) to end of treatment (week 52)Percentage of participants improving 10 points or more in KCCQ-CSS from baseline to end of treatment is presented. The KCCQ is standardized 23-item, self-administered instrument that quantifies heart failure symptoms(frequency, severity, and recent change), physical limitation, quality of life, and social limitation. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ. Scores are transformed to range of 0-100, in which higher scores reflect better health status. In reported data, 'Yes' infers percentage of participants who have improved 5 points or more in score whereas 'No' infers percentage of participants who have not improved 10 points or more in score. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.
The Hierarchical Composite Endpoint: Percentage of Wins of Participant PairsFrom baseline (week 0) to end of study (week 57)The hierarchical composite outcome measure from baseline (week 0) to end of study (week 57) consists of the components: time to all-cause death, number of heart failure events requiring hospitalization or urgent heart failure visit, time to first heart failure event requiring hospitalization or urgent heart failure visit, difference at least 15 in KCCQ CSS change from baseline to 52 weeks, difference at least 10 in KCCQ CSS change from baseline to 52 weeks, difference at least 5 in KCCQ CSS change from baseline to 52 weeks and difference at least 30 meters in six-minute walking distance change from baseline to 52 weeks. It was analyzed by the win-ratio approach using all participants pairs across treatment groups. Overall summary of wins in each treatment group is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as uninterrupted time interval from date of randomization to date of last contact with trial site.

Countries

Argentina, Australia, Canada, Czechia, Denmark, Germany, Hungary, Israel, Netherlands, Poland, Spain, United Kingdom, United States

Participant flow

Recruitment details

The trial was conducted at 83 sites in 13 countries, as follows: Argentina (6), Australia (5), Hungary (8), Czech Republic (5), Poland (6), Spain (3), Netherlands (6), Denmark (3), United States (16), Canada (4), Israel (5), Germany (7) and United Kingdom (9).

Participants by arm

ArmCount
Semaglutide 2.4 mg
Participants with obesity (BMI ≥30.0 kg/m\^2) related heart failure with preserved ejection fraction received semaglutide 2.4 mg once weekly by subcutaneous injection (in the abdomen, thigh or upper arm). Participants initially received 0.25 mg of semaglutide. The dose was then escalated every fourth week with increments of 0.25 mg for 16 weeks until the target dose of 2.4 mg was reached. The treatment period was 52 weeks.
263
Placebo
Participants with obesity (BMI ≥30.0 kg/m\^2) related heart failure with preserved ejection fraction received placebo once weekly by subcutaneous injection (in the abdomen, thigh or upper arm) for 52 weeks. The dose escalation and maintenance of placebo matched that of semaglutide.
266
Total529

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath34
Overall StudyLost to Follow-up27
Overall StudyWithdrawal by Subject21

Baseline characteristics

CharacteristicPlaceboTotalSemaglutide 2.4 mg
Age, Continuous68 years
STANDARD_DEVIATION 10
68 years
STANDARD_DEVIATION 10
69 years
STANDARD_DEVIATION 9
Ethnicity (NIH/OMB)
Hispanic or Latino
21 Participants36 Participants15 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
245 Participants493 Participants248 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
13 Participants21 Participants8 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
1 Participants1 Participants0 Participants
Race (NIH/OMB)
White
252 Participants507 Participants255 Participants
Sex: Female, Male
Female
148 Participants297 Participants149 Participants
Sex: Female, Male
Male
118 Participants232 Participants114 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
3 / 2634 / 266
other
Total, other adverse events
93 / 26357 / 266
serious
Total, serious adverse events
35 / 26371 / 266

Outcome results

Primary

Change in Body Weight

Change in body weight from baseline (week 0) to end of treatment (week 52) is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange in Body Weight-13.9 Percentage of body weightStandard Deviation 8.1
PlaceboChange in Body Weight-2.5 Percentage of body weightStandard Deviation 5.6
Comparison: The responses were analyzed using an analysis of covariance model with randomized treatment and stratification (BMI\<35.0 kg/m\^2, BMI\>=35.0 kg/m\^2) as factors and baseline body weight (kg) as covariate. The analysis was based on the in-trial period using the FAS population. Missing observations at week 52 were multiple (x1000) imputed from retrieved participants of the same randomized treatment arm.p-value: <0.000195% CI: [-11.9, -9.4]ANCOVA
Primary

Change in Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS)

The KCCQ is a standardized 23-item, self-administered instrument that quantifies heart failure symptoms (frequency, severity, and recent change), physical limitation, quality of life, and social limitation. The overall summary score and all domains have been independently demonstrated to be valid, reliable, and responsive to clinical change. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ. Scores are transformed to a range of 0-100, in which higher scores reflect better health status. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange in Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS)16.8 Score on a scaleStandard Deviation 17.9
PlaceboChange in Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS)10.3 Score on a scaleStandard Deviation 17.3
Comparison: The responses at week 52 were analyzed using an analysis of covariance model with randomized treatment and stratification (BMI\<35.0 kg/m\^2, BMI\>=35.0 kg/m\^2) as factors and baseline KCCQ-CSS as covariate. The analysis was based on the in-trial period using the FAS population. Missing observations at week 52 were multiple (x1000) imputed from retrieved participants of the same randomized treatment arm.p-value: <0.000195% CI: [4.8, 10.9]ANCOVA
Secondary

Change in C-Reactive Protein (CRP): Ratio to Baseline

Change in high sensitivity C-reactive protein measured in ratio of C-reactive protein to baseline (week -2) at end of treatment (week 52) is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week -2) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
Semaglutide 2.4 mgChange in C-Reactive Protein (CRP): Ratio to Baseline0.55 Ratio of C-reactive proteinGeometric Coefficient of Variation 121.5
PlaceboChange in C-Reactive Protein (CRP): Ratio to Baseline0.92 Ratio of C-reactive proteinGeometric Coefficient of Variation 105.3
Secondary

Change in KCCQ Overall Summary Score (KCCQ-OSS)

The KCCQ is a standardized 23-item, self-administered instrument that quantifies heart failure symptoms (frequency, severity, and recent change), physical limitation, quality of life, and social limitation. The overall summary score and all domains have been independently demonstrated to be valid, reliable, and responsive to clinical change. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ while KCCQ-OSS includes the symptom, physical limitation, quality of life, and social limitation domains. Scores are transformed to a range of 0-100, in which higher scores reflect better health status. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange in KCCQ Overall Summary Score (KCCQ-OSS)16.8 Score on a scaleStandard Deviation 18.3
PlaceboChange in KCCQ Overall Summary Score (KCCQ-OSS)10.9 Score on a scaleStandard Deviation 17.5
Secondary

Change in Six-minute Walking Distance (6MWD)

Observed mean change from baseline (week 0) in 6 minutes walking distance (6MWD) test to end of treatment (week 52) is presented. The 6MWD is a common test of functional exercise capacity that assesses the distance a participant can walk in 6 minutes. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange in Six-minute Walking Distance (6MWD)23.5 MetersStandard Deviation 59.2
PlaceboChange in Six-minute Walking Distance (6MWD)5.8 MetersStandard Deviation 62.7
Secondary

Change in Systolic Blood Pressure (SBP)

Observed mean change in systolic blood pressure from baseline (week -2) to end of treatment (week 52) is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week -2) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange in Systolic Blood Pressure (SBP)-6.4 millimetre of mercury (mmHg)Standard Deviation 19
PlaceboChange in Systolic Blood Pressure (SBP)-1.1 millimetre of mercury (mmHg)Standard Deviation 17.5
Secondary

Change in Waist Circumference

Change waist circumference from baseline (week 0) to end of the treatment (visit 52) presented. Waist circumference is defined as the abdominal circumference located midway between the lower rib margin and the iliac crest. Measurement must be obtained in standing position with a non-stretchable measuring tape and to the nearest cm or inch. The tape should touch the skin but not compress soft tissue and twists in the tape should be avoided. The participant should be asked to breathe normally. The same measuring tape should be used throughout the trial. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (visit 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (MEAN)Dispersion
Semaglutide 2.4 mgChange in Waist Circumference-12.0 CentimeterStandard Deviation 8.5
PlaceboChange in Waist Circumference-2.8 CentimeterStandard Deviation 7.4
Secondary

Percentage of Participants Achieving 10 Percent (%) Weight Loss (Yes/No)

Percentage of participants who achieved 10% weight loss (yes/no) from baseline (week 0) to end of treatment (week 52) is presented. In the reported data, 'Yes' infers percentage of participants who have achieved 10% weight loss whereas 'No' infers percentage of participants who have not achieved 10% weight loss. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Achieving 10 Percent (%) Weight Loss (Yes/No)No34.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants Achieving 10 Percent (%) Weight Loss (Yes/No)Yes65.9 Percentage of participants
PlaceboPercentage of Participants Achieving 10 Percent (%) Weight Loss (Yes/No)No90.5 Percentage of participants
PlaceboPercentage of Participants Achieving 10 Percent (%) Weight Loss (Yes/No)Yes9.5 Percentage of participants
Secondary

Percentage of Participants Achieving 15% Weight Loss (Yes/No)

Percentage of participants who achieved 15% weight loss (yes/no) from baseline (week 0) to end of treatment (week 52) is presented. In the reported data, 'Yes' infers percentage of participants who have achieved 15% weight loss whereas 'No' infers percentage of participants who have not achieved 15% weight loss. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Achieving 15% Weight Loss (Yes/No)No56.1 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants Achieving 15% Weight Loss (Yes/No)Yes43.9 Percentage of participants
PlaceboPercentage of Participants Achieving 15% Weight Loss (Yes/No)No97.9 Percentage of participants
PlaceboPercentage of Participants Achieving 15% Weight Loss (Yes/No)Yes2.1 Percentage of participants
Secondary

Percentage of Participants Achieving 20% Weight Loss (Yes/No)

Percentage of participants who achieved 20% weight loss (yes/no) from baseline (week 0) to end of treatment (week 52) is presented. In the reported data, 'Yes' infers percentage of participants who have achieved 20% weight loss whereas 'No' infers percentage of participants who have not achieved 20% weight loss The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Achieving 20% Weight Loss (Yes/No)No76.4 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants Achieving 20% Weight Loss (Yes/No)Yes23.6 Percentage of participants
PlaceboPercentage of Participants Achieving 20% Weight Loss (Yes/No)No99.6 Percentage of participants
PlaceboPercentage of Participants Achieving 20% Weight Loss (Yes/No)Yes0.4 Percentage of participants
Secondary

Percentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in 6MWD (PGI-S)

Observed mean change from baseline in 6 minutes walking distance (6MWD) test using PGI-S is evaluated for this outcome measure. The 6MWD is a common test of functional exercise capacity that assesses the distance a participant can walk in 6 minutes. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site. The threshold was defined as the mean change in 6MWD in those participants with an one-category improvement in PGI-S from baseline to week 52.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in 6MWD (PGI-S)42.5 Percentage of Participants
PlaceboPercentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in 6MWD (PGI-S)28.0 Percentage of Participants
Secondary

Percentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in KCCQ-CSS (PGI-S)

The patient global impression of status (PGI-S) for KCCQ was used to rate participants' symptoms of heart failure using 4-category ordinal scale (no symptoms, mild, moderate, severe). KCCQ is standardized 23-item, self-administered instrument that quantifies heart failure symptoms (frequency, severity, and recent change), physical limitation, quality of life, and social limitation. OSS and all domains have been independently demonstrated to be valid, reliable, and responsive to clinical change. KCCQ-CSS includes symptom and physical limitation domains of the KCCQ. Scores are transformed to range of 0-100, in which higher scores reflect better health status. Outcome measure was evaluated based on data from in-trial period. In-trial period was defined as uninterrupted time interval from date of randomization to date of last contact with trial site. The threshold was defined as mean change in KCCQ-CSS in those participants with one-category improvement in PGI-S from baseline to week 52.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in KCCQ-CSS (PGI-S)43.2 Percentage of Participants
PlaceboPercentage of Participants Achieving Threshold for Clinically Meaningful Within-participants Change in KCCQ-CSS (PGI-S)32.5 Percentage of Participants
Secondary

Percentage of Participants Improving 10 Points or More in KCCQ Clinical Summary Score (Yes/No)

Percentage of participants improving 10 points or more in KCCQ-CSS from baseline to end of treatment is presented. The KCCQ is standardized 23-item, self-administered instrument that quantifies heart failure symptoms(frequency, severity, and recent change), physical limitation, quality of life, and social limitation. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ. Scores are transformed to range of 0-100, in which higher scores reflect better health status. In reported data, 'Yes' infers percentage of participants who have improved 5 points or more in score whereas 'No' infers percentage of participants who have not improved 10 points or more in score. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Improving 10 Points or More in KCCQ Clinical Summary Score (Yes/No)No36.6 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants Improving 10 Points or More in KCCQ Clinical Summary Score (Yes/No)Yes63.4 Percentage of participants
PlaceboPercentage of Participants Improving 10 Points or More in KCCQ Clinical Summary Score (Yes/No)No51.5 Percentage of participants
PlaceboPercentage of Participants Improving 10 Points or More in KCCQ Clinical Summary Score (Yes/No)Yes48.5 Percentage of participants
Secondary

Percentage of Participants Improving 5 Points or More in KCCQ Clinical Summary Score (Yes/No)

Percentage of participants improving 5 points or more in KCCQ-CSS from baseline to end of treatment is presented. The KCCQ is standardized 23-item, self-administered instrument that quantifies heart failure symptoms(frequency, severity, and recent change), physical limitation, quality of life, and social limitation. KCCQ-CSS includes the symptom and physical limitation domains of the KCCQ. Scores are transformed to range of 0-100, in which higher scores reflect better health status. In the reported data, 'Yes' infers percentage of participants who have improved 5 points or more in score whereas 'No' infers percentage of participants who have not improved 5 points or more in score. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as the uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of treatment (week 52)

Population: FAS included all the randomized participants for this trial. Here, Overall Number of Participants Analyzed signifies those participants who had an observed value at week 52.

ArmMeasureGroupValue (NUMBER)
Semaglutide 2.4 mgPercentage of Participants Improving 5 Points or More in KCCQ Clinical Summary Score (Yes/No)No24.7 Percentage of participants
Semaglutide 2.4 mgPercentage of Participants Improving 5 Points or More in KCCQ Clinical Summary Score (Yes/No)Yes75.3 Percentage of participants
PlaceboPercentage of Participants Improving 5 Points or More in KCCQ Clinical Summary Score (Yes/No)No36.3 Percentage of participants
PlaceboPercentage of Participants Improving 5 Points or More in KCCQ Clinical Summary Score (Yes/No)Yes63.7 Percentage of participants
Secondary

The Hierarchical Composite Endpoint: Percentage of Wins of Participant Pairs

The hierarchical composite outcome measure from baseline (week 0) to end of study (week 57) consists of the components: time to all-cause death, number of heart failure events requiring hospitalization or urgent heart failure visit, time to first heart failure event requiring hospitalization or urgent heart failure visit, difference at least 15 in KCCQ CSS change from baseline to 52 weeks, difference at least 10 in KCCQ CSS change from baseline to 52 weeks, difference at least 5 in KCCQ CSS change from baseline to 52 weeks and difference at least 30 meters in six-minute walking distance change from baseline to 52 weeks. It was analyzed by the win-ratio approach using all participants pairs across treatment groups. Overall summary of wins in each treatment group is presented. The outcome measure was evaluated based on the data from in-trial period. In-trial period was defined as uninterrupted time interval from date of randomization to date of last contact with trial site.

Time frame: From baseline (week 0) to end of study (week 57)

Population: FAS included all the randomized participants for this trial.

ArmMeasureValue (NUMBER)
Semaglutide 2.4 mgThe Hierarchical Composite Endpoint: Percentage of Wins of Participant Pairs60.1 Percentages of wins of participant pairs
PlaceboThe Hierarchical Composite Endpoint: Percentage of Wins of Participant Pairs34.9 Percentages of wins of participant pairs

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026