Phase 2 · Semaglutide

NCT03987451 trial results

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

Percentage of Participants With At Least One Stage of Liver Fibrosis Improvement With No Worsening of Non-Alcoholic Steatohepatitis (NASH) After 48 Weeks (Percentage of participants), Week 48. Semaglutide 2.4 mg: 10.6; Placebo: 29.2.

Participants
71
Status
completed
Completed
2021-06-10
Sponsor
Novo Nordisk A/S

As posted on ClinicalTrials.gov (NCT03987451), updated at source May 29, 2024. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What NCT03987451 measured first

Percentage of Participants With At Least One Stage of Liver Fibrosis Improvement With No Worsening of Non-Alcoholic Steatohepatitis (NASH) After 48 WeeksPercentage of participants · Week 48 · number
Semaglutide 2.4 mgn=47Placebon=24
10.629.2
Side effects by arm

Side effects in NCT03987451

Percent of participants affected, From week 0 to week 55. Results are based on the safety analysis set which included all participants who received at least one dose of randomised treatment.. The most common events the registry lists.

EventSemaglutide 2.4 mgPlacebo
Any serious event12.8%8.3%
Nausea44.7%16.7%
Diarrhoea19.1%8.3%
Vomiting17%0%
Urinary tract infection6.4%16.7%
Abdominal pain12.8%0%
Decreased appetite12.8%4.2%
Eructation12.8%0%
Back pain0%12.5%
Abdominal pain upper10.6%8.3%
Dyspepsia10.6%0%
Fatigue8.5%0%
Headache8.5%8.3%
Pruritus8.5%4.2%
Constipation6.4%8.3%
Diabetes mellitus inadequate control0%8.3%
Dizziness4.3%8.3%
Upper respiratory tract infection4.3%8.3%
Abdominal distension6.4%4.2%
Arthralgia6.4%4.2%
Dysphagia6.4%0%
Gastrooesophageal reflux disease6.4%4.2%
Insomnia6.4%0%
Nasopharyngitis6.4%0%
Secondary outcomes

What else it measured

Change From Baseline in Liver Fat Content Measured by Magnetic Resonance Imaging-Proton Density Fat Fraction (MRI-PDFF)-Ratio to BaselineRatio of liver fat content · Baseline (week 0), Week 48 · geometric mean
Semaglutide 2.4 mgn=38Placebon=18
0.62(63.38)1.01(34.46)
Change From Baseline in Liver Stiffness Measured by Magnetic Resonance Elastography (MRE)-Ratio to BaselineRatio of liver stiffness · Baseline (week 0), Week 48 · geometric mean
Semaglutide 2.4 mgn=35Placebon=21
0.87(22.24)0.98(28.51)
Percentage of Participants With NASH Resolution After 48 WeeksPercentage of participants · Week 48 · number
Semaglutide 2.4 mgn=47Placebon=24
34.020.8
Change From Baseline in Fibrosis-4 Score-Ratio to BaselineRatio of fibrosis-4 score · Baseline (week 0), Week 48 · geometric mean
Semaglutide 2.4 mgn=44Placebon=23
0.9(30.7)1.0(38.0)
Percentage of Participants With Change in Non-Alcoholic Fatty Liver Disease (NAFLD) Activity Score (NAS)Percentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement61.758.3
Worsening2.116.7
No change21.320.8
Missing14.94.2
Percentage of Participants With Change in The Fibrosis Stage According to The Kleiner Fibrosis ClassificationPercentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement12.833.3
Worsening0.00.0
No change72.362.5
Missing14.94.2
Percentage of Participants With Change in Hepatocyte BallooningPercentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement55.333.3
Worsening2.18.3
No change27.754.2
Missing14.94.2
Percentage of Participants With Change in Lobular InflammationPercentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement42.637.5
Worsening12.812.5
No change29.845.8
Missing14.94.2
Percentage of Participants With Change in SteatosisPercentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement44.733.3
Worsening2.116.7
No change38.345.8
Missing14.94.2
Percentage of Participants With Change in The Steatosis-Activity-Fibrosis (SAF) Activity Component ScorePercentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement57.450.0
Worsening8.512.5
No change19.133.3
Missing14.94.2
Percentage of Participants With Change in The Ishak Fibrosis ScorePercentage of participants · Baseline (week 0), Week 48 · number
MeasureSemaglutide 2.4 mgn=47Placebon=24
Improvement27.737.5
Worsening2.112.5
No change55.345.8
Missing14.94.2
Change From Baseline in Hepatic CollagenPercentage of hepatic collagen · Baseline (week 0), Week 48 · mean
Semaglutide 2.4 mgn=37Placebon=21
-1.7(7.9)-1.2(5.1)
The trial

How NCT03987451 was run

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

  • Semaglutide: Dose escalation to 2.4 mg of semaglutide once-weekly
  • Placebo: Semaglutide placebo once-weekly
Who could join the trial

Inclusion Criteria: * Male or female, aged 18-75 years (both inclusive) at the time of signing informed consent. * Histologic evidence of NASH and fibrosis stage 4 according to the NASH CRN classification based on central pathologist evaluation of a liver biopsy obtained within 360 days prior to screening. In subjects who have never had a liver biopsy showing NASH and F4, liver stiffness above 14 kPa by FibroScan® at screening must be documented before subjects can have a trial-related liver biopsy * A histological NAFLD activity score (NAS) equal to or above 3 with a score of 1 or more in lobular inflammation and hepatocyte ballooning based on central pathologist evaluation * Body mass index equal to or above 27 kg/m\^2 Exclusion Criteria: * Presence or history of hepatic decompensation (e.g. ascites, variceal bleeding, hepatic encephalopathy or spontaneous bacterial peritonitis) or liver transplantation * Presence or history of gastroesophageal varices within the past 360 days prior to screening. For subjects with no known history of gastroesophageal varices and with a Fibroscan® equal to or above 20 kPa and thrombocytes equal to or below 150,000, a esophagogastroduodenoscopy must be performed to evaluate presence of gastroesophageal varices * Presence or history of hepatocellular carcinoma * Treatment with vitamin E (at doses equal to or above 800 IU/day) or pioglitazone which has not been at a stable dose in the opinion of the investigator in the period from 90 days prior to screening * Treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the period from 90 days prior to screening * Treatment with other glucose lowering agent(s) (apart from what is listed in the exclusion criterion above) or weight loss medication not stable in the opinion of the investigator in the period from 28 days prior to screening

Published papers

Papers from NCT03987451

Trial averages do not predict what one person will experience. Results are shown as the registry posts them, without interpretation.

GLPcompare is an informational data platform, not a medical provider or pharmacy. Nothing here is medical advice, a diagnosis, or a recommendation to start, stop, or change any treatment. Data is aggregated from public sources and can be incomplete or out of date. Always confirm with a licensed clinician and the current FDA label.