We're building a better ClinicalTrials.gov. Check it out and tell us what you think!
Try the New Site
We're building a modernized ClinicalTrials.gov! Visit Beta.ClinicalTrials.gov to try the new functionality.
Working…
ClinicalTrials.gov
ClinicalTrials.gov Menu

Research Study to Compare Three Doses of Semaglutide Tablets Taken Once Daily in People With Type 2 Diabetes (PIONEER PLUS)

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
Sponsor:
Information provided by (Responsible Party):
Novo Nordisk A/S

Brief Summary:
This study compares three doses of once daily semaglutide tablets in people with type 2 diabetes who were previously treated with other oral anti-diabetic medicines. Participants will be initiated on the lowest starting dose of 3 mg and gradually increased until they reach the final trial dose of 14 mg, 25 mg or 50 mg once daily semaglutide tablets. The final three doses will be randomized (i.e., decided by chance). Participants will be administered one tablet per day for 68 weeks. Women cannot take part if they are pregnant, breast-feeding or planning to become pregnant during the study period. Women who can get pregnant will be checked for pregnancy via urine tests. Once daily semaglutide tablets (3 mg, 7 mg and 14 mg) are approved for the treatment of type 2 diabetes in the US, in the EU and in some other countries, under the brand name Rybelsus®.

Condition or disease Intervention/treatment Phase
Diabetes Mellitus, Type 2 Drug: Oral semaglutide Phase 3

Layout table for study information
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

Resource links provided by the National Library of Medicine

Drug Information available for: Semaglutide

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).
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).
Drug: Oral semaglutide
Participants will receive once daily semaglutide tablets (oral administration) in a dose escalating manner for 68 weeks.




Primary Outcome Measures :
  1. Change in glycated haemoglobin (HbA1c) [ Time Frame: From baseline (week 0) to week 52 ]
    %-point

  2. Change in HbA1c [ Time Frame: From baseline (week 0) to week 68 ]
    %-point


Secondary Outcome Measures :
  1. Change in body weight [ Time Frame: From baseline (week 0) to week 52 ]
    kg

  2. Change in body weight [ Time Frame: From baseline (week 0) to week 68 ]
    kg

  3. Change in fasting plasma glucose (FPG) [ Time Frame: From baseline (week 0) to week 52 ]
    Millimoles per liter (mmol/L).

  4. Change in FPG [ Time Frame: From baseline (week 0) to week 68 ]
    mmol/L

  5. Change in BMI [ Time Frame: From baseline (week 0) to week 52 ]
    Kilograms per meter square (kg/m^2)

  6. Change in BMI [ Time Frame: From baseline (week 0) to week 68 ]
    Kilograms per meter square (kg/m^2)

  7. Achievement of HbA1c below 7% (Yes/No) [ Time Frame: At week 52 ]
    Count of participants

  8. Achievement of HbA1c below 7% (Yes/No) [ Time Frame: At week 68 ]
    Count of participants

  9. Achievement of HbA1c equal to or below 6.5% (Yes/No) [ Time Frame: At week 52 ]
    Count of participants

  10. Achievement of HbA1c equal to or below 6.5% (Yes/No) [ Time Frame: At week 68 ]
    Count of participants

  11. Relative change in body weight [ Time Frame: From baseline (week 0) to week 52 ]
    Percentage (%)

  12. Relative change in body weight [ Time Frame: From baseline (week 0) to week 68 ]
    Percentage (%)

  13. Change in waist circumference [ Time Frame: From baseline (week 0) to week 52 ]
    centimeters (cm)

  14. Change in waist circumference [ Time Frame: From baseline (week 0) to week 68 ]
    cm

  15. Achievement of weight loss equal to or above 5% (Yes/No) [ Time Frame: At week 52 ]
    Count of participants

  16. Achievement of weight loss equal to or above 5% (Yes/No) [ Time Frame: At week 68 ]
    Count of participants

  17. Achievement of weight loss equal to or above 10% (Yes/No) [ Time Frame: At week 52 ]
    Count of participants

  18. Achievement of weight loss equal to or above 10% (Yes/No) [ Time Frame: At week 68 ]
    Count of participants

  19. Adverse events [ Time Frame: From baseline (week 0) to follow-up visit (week 73) ]
    Count of events

  20. 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

  21. 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)

  22. 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

  23. 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

  24. Change in pulse [ Time Frame: From baseline (week 0) to week 52 ]
    Beats per minute (beats/min)

  25. Change in pulse [ Time Frame: From baseline (week 0) to week 68 ]
    beats/min

  26. Change in systolic blood pressure [ Time Frame: Fron baseline (week 0) to week 52 ]
    millimeters of mercury (mmHg)

  27. Change in systolic blood pressure [ Time Frame: Fron baseline (week 0) to week 68 ]
    mmHg

  28. Change in diastolic blood pressure [ Time Frame: Fron baseline (week 0) to week 52 ]
    mmHg

  29. Change in diastolic blood pressure [ Time Frame: Fron baseline (week 0) to week 68 ]
    mmHg



Information from the National Library of Medicine

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.


Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

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:
  • 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.

Information from the National Library of Medicine

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


Locations
Show Show 177 study locations
Sponsors and Collaborators
Novo Nordisk A/S
Investigators
Layout table for investigator information
Study Director: Clinical Transparency (dept. 1452) Novo Nordisk A/S
Layout table for additonal information
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

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
Layout table for MeSH terms
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases