Research Study to Compare Three Doses of Semaglutide Tablets Taken Once Daily in People With Type 2 Diabetes (PIONEER PLUS)
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT04707469 |
Recruitment Status :
Completed
First Posted : January 13, 2021
Last Update Posted : May 17, 2023
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Condition or disease | Intervention/treatment | Phase |
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Diabetes Mellitus, Type 2 | Drug: Oral semaglutide | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 1606 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Masking Description: | Sponsor staff involved in the clinical trial is masked according to company standard procedures. |
Primary Purpose: | Treatment |
Official Title: | Efficacy and Safety of Once-daily Oral Semaglutide 25 mg and 50 mg Compared With 14 mg in Subjects With Type 2 Diabetes |
Actual Study Start Date : | January 15, 2021 |
Actual Primary Completion Date : | December 8, 2022 |
Actual Study Completion Date : | March 6, 2023 |

Arm | Intervention/treatment |
---|---|
Experimental: Oral semaglutide 50 mg
Participants will receive once daily semaglutide tablets in a dose escalating manner for 68 weeks: 3 mg (week 1-4), 7 mg (week 5-8), 14 mg (week 9-12), 25 mg (week 13-16) and 50 mg (week 17-68).
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Drug: Oral semaglutide
Participants will receive once daily semaglutide tablets (oral administration) in a dose escalating manner for 68 weeks. |
Experimental: Oral semaglutide 25 mg
Participants will receive once daily semaglutide tablets in a dose escalating manner for 68 weeks: 3 mg (week 1-4), 7 mg (week 5-8), 14 mg (week 9-12) and 25 mg (week 13-68).
|
Drug: Oral semaglutide
Participants will receive once daily semaglutide tablets (oral administration) in a dose escalating manner for 68 weeks. |
Active Comparator: Oral semaglutide 14 mg
Participants will receive once daily semaglutide tablets in a dose escalating manner for 68 weeks: 3 mg (week 1-4), 7 mg (week 5-8) and 14 mg (week 9-68).
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Drug: Oral semaglutide
Participants will receive once daily semaglutide tablets (oral administration) in a dose escalating manner for 68 weeks. |
- Change in glycated haemoglobin (HbA1c) [ Time Frame: From baseline (week 0) to week 52 ]%-point
- Change in HbA1c [ Time Frame: From baseline (week 0) to week 68 ]%-point
- Change in body weight [ Time Frame: From baseline (week 0) to week 52 ]kg
- Change in body weight [ Time Frame: From baseline (week 0) to week 68 ]kg
- Change in fasting plasma glucose (FPG) [ Time Frame: From baseline (week 0) to week 52 ]Millimoles per liter (mmol/L).
- Change in FPG [ Time Frame: From baseline (week 0) to week 68 ]mmol/L
- Change in BMI [ Time Frame: From baseline (week 0) to week 52 ]Kilograms per meter square (kg/m^2)
- Change in BMI [ Time Frame: From baseline (week 0) to week 68 ]Kilograms per meter square (kg/m^2)
- Achievement of HbA1c below 7% (Yes/No) [ Time Frame: At week 52 ]Count of participants
- Achievement of HbA1c below 7% (Yes/No) [ Time Frame: At week 68 ]Count of participants
- Achievement of HbA1c equal to or below 6.5% (Yes/No) [ Time Frame: At week 52 ]Count of participants
- Achievement of HbA1c equal to or below 6.5% (Yes/No) [ Time Frame: At week 68 ]Count of participants
- Relative change in body weight [ Time Frame: From baseline (week 0) to week 52 ]Percentage (%)
- Relative change in body weight [ Time Frame: From baseline (week 0) to week 68 ]Percentage (%)
- Change in waist circumference [ Time Frame: From baseline (week 0) to week 52 ]centimeters (cm)
- Change in waist circumference [ Time Frame: From baseline (week 0) to week 68 ]cm
- Achievement of weight loss equal to or above 5% (Yes/No) [ Time Frame: At week 52 ]Count of participants
- Achievement of weight loss equal to or above 5% (Yes/No) [ Time Frame: At week 68 ]Count of participants
- Achievement of weight loss equal to or above 10% (Yes/No) [ Time Frame: At week 52 ]Count of participants
- Achievement of weight loss equal to or above 10% (Yes/No) [ Time Frame: At week 68 ]Count of participants
- Adverse events [ Time Frame: From baseline (week 0) to follow-up visit (week 73) ]Count of events
- Change in fasting lipid profiles: total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides [ Time Frame: From baseline (week 0) to week 52 ]mmol/L
- Change in fasting lipid profiles: total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides [ Time Frame: From baseline (week 0) to week 52 ]milligrams per deciliter (mg/dL)
- Change in fasting lipid profiles: total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides [ Time Frame: From baseline (week 0) to week 68 ]mmol/L
- Change in fasting lipid profiles: total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides [ Time Frame: From baseline (week 0) to week 68 ]mg/dL
- Change in pulse [ Time Frame: From baseline (week 0) to week 52 ]Beats per minute (beats/min)
- Change in pulse [ Time Frame: From baseline (week 0) to week 68 ]beats/min
- Change in systolic blood pressure [ Time Frame: Fron baseline (week 0) to week 52 ]millimeters of mercury (mmHg)
- Change in systolic blood pressure [ Time Frame: Fron baseline (week 0) to week 68 ]mmHg
- Change in diastolic blood pressure [ Time Frame: Fron baseline (week 0) to week 52 ]mmHg
- Change in diastolic blood pressure [ Time Frame: Fron baseline (week 0) to week 68 ]mmHg

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female, age above or equal to 18 years at the time of signing informed consent.
- Diagnosed with type 2 diabetes mellitus at least 180 days prior to the day of screening.
- HbA1c of 8.0-10.5% (64-91 mmol/mol) (both inclusive).
- BMI equal to or above 25 kg/m^2
- Stable daily dose(s) for 90 days prior to the day of screening of any of the following treatment regimens:
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No more than 3 of the following oral anti-diabetic drugs and at least 1 marked with a *:
- Metformin (equal to or above1500 mg or maximum tolerated or effective dose).
- Sulfonylureas (SU) (equal to or above half of the maximum approved dose according to local label or maximum tolerated or effective dose).
- Sodium/glucose cotransporter 2 (SGLT2) inhibitors (maximum tolerated dose).
- Dipeptidyl peptidase-4 (DPP-4) inhibitors (maximally indicated dose as per local label).
- Subjects, on treatment with stable dose of DPP-4 inhibitors at inclusion, must be willing to discontinue DPP-4 inhibitor treatment at randomisation (with no wash-out).
Exclusion Criteria:
- Treatment with any medication indicated for the treatment of diabetes or obesity other than stated in the inclusion criteria within the past 90 days prior to the day of screening. However, short term insulin treatment for a maximum of 14 days prior to the day of screening is allowed.
- Renal impairment measured as estimated glomerular filtration rate (eGFR) value of below 30 mL/min/1.73 m^2 according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation as defined by kidney disease improving global outcomes (KDIGO 2012) classification.
- Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days prior to screening or in the period between screening and randomisation. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04707469

Study Director: | Clinical Transparency (dept. 1452) | Novo Nordisk A/S |
Responsible Party: | Novo Nordisk A/S |
ClinicalTrials.gov Identifier: | NCT04707469 |
Other Study ID Numbers: |
NN9924-4635 U1111-1247-0210 ( Other Identifier: World Health Organization (WHO) ) 2020-000299-39 ( Registry Identifier: European Medicines Agency (EudraCT) ) |
First Posted: | January 13, 2021 Key Record Dates |
Last Update Posted: | May 17, 2023 |
Last Verified: | May 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | According to the Novo Nordisk disclosure commitment on novonordisk-trials.com |
URL: | http://novonordisk-trials.com |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |