Phase 3 · Semaglutide

PIONEER 8 trial results

Efficacy and Safety of Oral Semaglutide Versus Placebo in Subjects With Type 2 Diabetes Mellitus Treated With Insulin. A 52-week, Randomised, Double-blind, Placebo-controlled Trial (PIONEER 8 - Insulin add-on)

Participants
731
Status
completed
Completed
2018-08-22
Sponsor
Novo Nordisk A/S

As posted on ClinicalTrials.gov (NCT03021187), updated at source Mar 2, 2020. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What PIONEER 8 measured first

Change in HbA1c (Week 26)Percentage of HbA1c · Week 0, week 26 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
In-trial-0.5(1.0)-1.0(1.1)-1.3(1.1)-0.1(0.9)
On-treatment without rescue medication-0.6(1.1)-1.1(1.0)-1.4(0.9)-0.1(0.8)
Side effects by arm

Side effects in PIONEER 8

Percent of participants affected, Week 0 to week 57 (52 weeks treatment period + 5 weeks follow-up period). Results are based on the safety analysis set (SAS), which comprised all randomised participants who received at least one.... The most common events the registry lists.

EventOral Semaglutide 3 mgOral Semaglutide 7 mgOral Semaglutide 14 mgPlacebo
Any serious event13.6%10.5%6.6%9.2%
Nausea11.4%16.6%22.7%7.1%
Nasopharyngitis14.7%11.6%9.9%14.7%
Diarrhoea8.7%12.2%14.4%6%
Decreased appetite4.3%9.9%12.7%1.1%
Vomiting6%7.7%9.4%3.8%
Constipation4.3%8.3%6.6%2.7%
Upper respiratory tract infection4.3%3.3%7.2%7.1%
Abdominal discomfort3.8%6.1%5.5%1.6%
Hypertension1.6%2.2%0.6%6%
Urinary tract infection3.3%2.8%5.5%3.8%
Secondary outcomes

What else it measured

Change in Body Weight (Week 26)Kg · Week 0, week 26 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
In trial-1.4(3.1)-2.6(5.2)-3.7(4.0)-0.5(2.5)
On-treatment without rescue medication-1.5(3.1)-3.0(3.7)-3.9(3.6)-0.5(2.4)
Change in HbA1c (Week 52)Percentage of HbA1c · Week 0, week 52 · mean
Oral Semaglutide 3 mgn=173Oral Semaglutide 7 mgn=169Oral Semaglutide 14 mgn=168Placebon=172
-0.6(1.0)-0.9(1.1)-1.2(1.0)-0.2(0.8)
Change in Body Weight (kg) (Week 52)Kg · Week 0, week 52 · mean
Oral Semaglutide 3 mgn=174Oral Semaglutide 7 mgn=171Oral Semaglutide 14 mgn=170Placebon=173
-0.9(3.9)-2.2(5.2)-3.8(5.8)0.5(3.2)
Change in Fasting Plasma Glucose (FPG)mmol/L · Week 0, week 26, week 52 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 26-0.45(3.35)-1.14(3.08)-1.36(2.72)0.51(2.84)
Week 52-0.81(3.21)-1.12(2.91)-1.60(2.65)-0.09(2.97)
Change in Self-measured Plasma Glucose (SMPG) Mean 7-point Profilemmol/L · Week 0, week 26, week 52 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 26-1.2(2.3)-1.8(2.4)-2.0(2.2)-0.3(2.7)
Week 52-1.6(2.5)-1.7(2.4)-2.0(2.1)-0.9(2.4)
Change in SMPG Mean Postprandial Increment Over All Mealsmmol/L · Week 0, week 26, week 52 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 26-0.3(2.3)-0.8(2.6)-1.2(2.5)-0.1(2.8)
Week 52-0.3(2.3)-0.7(2.3)-0.7(2.3)-0.3(2.4)
Change in Body Weight (Percentage)Percentage change · Week 0, week 26, week 52 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 26-1.73(3.34)-3.11(5.66)-4.30(4.57)-0.47(3.02)
Week 52-1.18(4.17)-2.54(5.77)-4.42(6.07)0.65(3.72)
Change in Body Mass Indexkg/m^2 · Week 0, week 26, week 52 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 26-0.5(1.1)-1.0(1.7)-1.4(1.5)-0.2(0.9)
Week 52-0.3(1.4)-0.8(1.8)-1.4(2.1)0.2(1.2)
Change in Waist Circumferencecm · Week 0, week 26, week 52 · mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 26-0.9(4.1)-2.3(5.1)-3.6(4.9)-0.6(3.6)
Week 52-0.8(4.8)-2.3(5.1)-4.0(6.8)0.3(4.1)
Change in Total Cholesterol - Ratio to BaselineRatio of total cholesterol · Week 0, week 26, week 52 · geometric mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 260.99(15.5)0.95(18.7)0.95(17.3)1.03(15.4)
Week 520.98(18.2)0.97(19.2)0.95(18.1)1.00(17.6)
Change in LDL Cholesterol - Ratio to BaselineRatio of LDL cholesterol · Week 0, week 26, week 52 · geometric mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 260.98(27.1)0.93(30.2)0.93(24.5)1.03(25.9)
Week 520.97(29.2)0.96(29.4)0.95(27.6)1.00(28.3)
Change in HDL Cholesterol - Ratio to BaselineRatio of HDL cholesterol · Week 0, week 26, week 52 · geometric mean
MeasureOral Semaglutide 3 mgn=184Oral Semaglutide 7 mgn=182Oral Semaglutide 14 mgn=181Placebon=184
Week 261.00(13.5)0.98(13.5)0.98(16.7)1.01(13.0)
Week 521.01(14.4)0.98(13.4)1.01(14.3)1.00(13.9)
The trial

How PIONEER 8 was run

This trial is conducted globally. The aim of the trial is to investigate the efficacy and safety of oral semaglutide versus placebo in subjects with Type 2 Diabetes Mellitus treated with insulin. All subjects should continue their pre-trial insulin therapy (basal, basal-bolus or premixed regimen including combinations of soluble insulins) throughout the trial. Subjects treated with metformin in addition to insulin treatment must continue their metformin treatment throughout the entire trial.

  • Semaglutide 3 mg
  • Semaglutide 3 mg + 7 mg
  • Semaglutide 3 mg + 7 mg + 14 mg
  • Placebo
Who could join the trial

Inclusion Criteria: - Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial. - Male or female, age above or equal to 18 years at the time of signing informed consent. For Japan only: Male or female, age above or equal to 20 years at the time of signing informed consent. - Diagnosed with type 2 diabetes mellitus 90 days or more prior to the day of screening. - HbA1c (glycosylated haemoglobin) of 7.0-9.5% (53-80 mmol/mol) (both inclusive). - Stable treatment with one of the following insulin regimens (minimum 10 IU/day) 90 or more days prior to the day of screening. Maximum 20% change in total daily dose is acceptable: (1) Basal insulin alone or (2) Basal and bolus insulin in any combination or (3) Premixed insulin including combinations of soluble insulins Exclusion Criteria: - Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using an adequate contraceptive method (adequate contraceptive measure as required by local regulation or practice). For Greece only: adequate contraceptive measures are defined as combined hormonal contraception (containing oestrogen and progesterone), which suppress ovulation (oral, intravaginal, percutaneous), progesterone-only hormonal contraception which suppress ovulation (oral, injectable, implantable), intrauterine device, hormone-releasing intrauterine system, bilateral tubal occlusion, partner with vasectomy, sexual abstinence. For Japan only: Adequate contraceptive measures are abstinence (not having sex), diaphragm, condom (by the partner), intrauterine device, sponge, spermicide or oral contraceptives. For Canada only: adequate contraceptive measures are defined as combined hormonal contraception (containing oestrogen and progesterone), which suppress ovulation (oral, intravaginal, percutaneous), progesterone-only hormonal contraception which suppress ovulation (oral, injectable, implantable), intrauterine device, hormone-releasing intrauterine system, bilateral tubal occlusion, partner with vasectomy, sexual abstinence - Any disorder, which in the investigator's opinion might jeopardise subject's safety or compliance with the protocol. - Family or personal history of Multiple Endocrine Neoplasia Type 2 (MEN 2) or Medullary Thyroid Carcinoma (MTC). - History of pancreatitis (acute or chronic). - History of major surgical procedures involving the stomach and potentially affecting absorption of trial product (e.g. subtotal and total gastrectomy, sleeve gastrectomy, gastric bypass surgery). - Any of the following: myocardial infarction (MI), stroke or hospitalisation for unstable angina or transient ischaemic attack within the past 180 days prior to the day of screening and randomisation. - Classified as being in New York Heart Association (NYHA) Class IV. - Planned coronary, carotid or peripheral...

Published papers

Papers from PIONEER 8

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

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