What PIONEER PLUS measured first
| Oral Semaglutide 14 mgn=497 | Oral Semaglutide 25 mgn=475 | Oral Semaglutide 50 mgn=492 |
|---|---|---|
| -1.5(1.3) | -1.9(1.3) | -2.1(1.4) |
Efficacy and Safety of Once-daily Oral Semaglutide 25 mg and 50 mg Compared With 14 mg in Subjects With Type 2 Diabetes
Change From Baseline in Glycated Haemoglobin (HbA1c) (Week 52) (Percentage point of HbA1c), Baseline (week 0), week 52. Oral Semaglutide 14 mg: -1.5; Oral Semaglutide 25 mg: -1.9; Oral Semaglutide 50 mg: -2.1.
As posted on ClinicalTrials.gov (NCT04707469), updated at source Dec 9, 2025. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.
| Oral Semaglutide 14 mgn=497 | Oral Semaglutide 25 mgn=475 | Oral Semaglutide 50 mgn=492 |
|---|---|---|
| -1.5(1.3) | -1.9(1.3) | -2.1(1.4) |
Percent of participants affected, Week 0 to week 73. The most common events the registry lists.
| Event | Oral Semaglutide 14 mg | Oral Semaglutide 25 mg | Oral Semaglutide 50 mg |
|---|---|---|---|
| Any serious event | 9.9% | 10.7% | 8.2% |
| Nausea | 18% | 27.2% | 27.3% |
| Vomiting | 9.7% | 17% | 18.2% |
| Diarrhoea | 12.4% | 12.9% | 14.2% |
| COVID-19 | 11.8% | 12% | 12.4% |
| Decreased appetite | 7.1% | 7.3% | 10.9% |
| Diabetic retinopathy | 7.7% | 4.9% | 6.6% |
| Constipation | 7.5% | 6.6% | 6.2% |
| Headache | 6.4% | 5.2% | 7.1% |
| Abdominal pain upper | 2.6% | 6% | 4.1% |
| Dyspepsia | 5.2% | 5.4% | 5.6% |
| Abdominal pain | 2.6% | 5.1% | 3.9% |
| Nasopharyngitis | 4.5% | 4.1% | 5.1% |
| Oral Semaglutide 14 mgn=503 | Oral Semaglutide 25 mgn=480 | Oral Semaglutide 50 mgn=495 |
|---|---|---|
| -4.4(5.2) | -7.1(6.8) | -8.3(7.5) |
| Oral Semaglutide 14 mgn=487 | Oral Semaglutide 25 mgn=469 | Oral Semaglutide 50 mgn=491 |
|---|---|---|
| -1.5(1.3) | -1.8(1.3) | -2.0(1.4) |
| Oral Semaglutide 14 mgn=333 | Oral Semaglutide 25 mgn=345 | Oral Semaglutide 50 mgn=339 |
|---|---|---|
| -0.4(1.2) | -0.8(1.1) | -1.0(1.2) |
| Oral Semaglutide 14 mgn=494 | Oral Semaglutide 25 mgn=460 | Oral Semaglutide 50 mgn=482 |
|---|---|---|
| -2.4(3.4) | -3.0(3.5) | -3.2(3.4) |
| Oral Semaglutide 14 mgn=485 | Oral Semaglutide 25 mgn=466 | Oral Semaglutide 50 mgn=485 |
|---|---|---|
| -2.4(3.4) | -3.0(3.7) | -3.2(3.4) |
| Oral Semaglutide 14 mgn=536 | Oral Semaglutide 25 mgn=535 | Oral Semaglutide 50 mgn=535 |
|---|---|---|
| 39 | 50.5 | 63 |
| Oral Semaglutide 14 mgn=536 | Oral Semaglutide 25 mgn=535 | Oral Semaglutide 50 mgn=535 |
|---|---|---|
| 39.2 | 49.9 | 58.9 |
| Oral Semaglutide 14 mgn=536 | Oral Semaglutide 25 mgn=535 | Oral Semaglutide 50 mgn=535 |
|---|---|---|
| 25.8 | 39.6 | 51.2 |
| Oral Semaglutide 14 mgn=536 | Oral Semaglutide 25 mgn=535 | Oral Semaglutide 50 mgn=535 |
|---|---|---|
| 23.6 | 35.8 | 46.2 |
| Oral Semaglutide 14 mgn=92 | Oral Semaglutide 25 mgn=54 | Oral Semaglutide 50 mgn=48 |
|---|---|---|
| NA(NA to NA) | NA(NA to NA) | NA(NA to NA) |
| Oral Semaglutide 14 mgn=495 | Oral Semaglutide 25 mgn=477 | Oral Semaglutide 50 mgn=495 |
|---|---|---|
| -4.5(5.5) | -7.1(7.4) | -8.2(8.1) |
| Oral Semaglutide 14 mgn=503 | Oral Semaglutide 25 mgn=480 | Oral Semaglutide 50 mgn=495 |
|---|---|---|
| -4.7(5.4) | -7.3(6.6) | -8.5(7.3) |
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®.
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.
Trial averages do not predict what one person will experience. Results are shown as the registry posts them, without interpretation.