Phase 3 · Semaglutide

SOUL trial results

Semaglutide Cardiovascular Outcomes Trial in Patients With Type 2 Diabetes

Number of Participants From Randomization to First Occurrence of a Major Adverse Cardiovascular Event (MACE), a Composite Endpoint Consisting of: Cardiovascular (CV) Death/Non-fatal Myocardial Infarction/Non-fatal Stroke (Participants), From randomisation (week 0) up to week 265. Oral Semaglutide: 579; Placebo: 668.

Participants
9,651
Status
completed
Completed
2024-08-23
Sponsor
Novo Nordisk A/S

As posted on ClinicalTrials.gov (NCT03914326), updated at source Dec 11, 2025. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.

Primary outcome

What SOUL measured first

Number of Participants From Randomization to First Occurrence of a Major Adverse Cardiovascular Event (MACE), a Composite Endpoint Consisting of: Cardiovascular (CV) Death/Non-fatal Myocardial Infarction/Non-fatal StrokeParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
579668
Side effects by arm

Side effects in SOUL

Percent of participants affected, From Week 0 up to Week 265. The most common events the registry lists.

EventOral SemaglutidePlacebo
Any serious event47.9%50.3%
Diabetic retinopathy19.5%19.3%
COVID-1915.7%16.1%
Nausea7.1%1.3%
Secondary outcomes

What else it measured

Number of Participants From Randomization to First Occurrence of CV Death;Renal Death;Onset of Persistent≥50% Reduction in eGFR(CKD-EPI);Onset of Persistent eGFR(CKD-EPI)<15 mL/Min/1.73m^2;Initiation of Chronic Renal Replacement TherapyParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
403435
Number of Participants From Randomization to Time of Occurrence of CV DeathParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
301320
Number of Participants From Randomization to First Occurrence of Major Adverse Limb Events (MALE), a Composite Endpoint Consisting of: Acute Limb Ischemia Hospitalisation/Chronic Limb Ischemia HospitalisationParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
7199
Number of Participants From Randomisation to First Occurrence of an Expanded MACE Composite Endpoint Consisting of: CV Death/Non-fatal Myocardial Infarction/ Non-fatal Stroke/Coronary Revascularisation/Unstable Angina Pectoris Requiring HospitalisationParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
670777
Number of Participants From Randomisation to First Occurrence of a Composite Endpoint Consisting of : All-cause Death/ Non-fatal MI/ Non-fatal StrokeParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
779902
Number of Participants From Randomisation to First Occurrence of a Composite Heart Failure Endpoint Consisting of: CV Death/Heart Failure Requiring Hospitalisation/Urgent Heart Failure VisitParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
405443
Number of Participants From Randomization to First Occurrence of CKD Endpoint:Renal Death;Onset of Persistent≥50% Reduction in eGFR (CKD-EPI);Onset of Persistent eGFR(CKD-EPI)<15 mL/Min/1.73 m^2;Initiation of Chronic Renal Replacement TherapyParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
112129
Number of Participants From Randomisation to Time to Occurrence of All-cause DeathParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
528577
Number of Participants From Randomisation to First Occurrence of Non-fatal Myocardial Infarction (MI)Participants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
191253
Number of Participants From Randomisation to First Occurrence of Non-fatal StrokeParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
144161
Number of Participants From Randomisation to First Occurrence of Heart Failure Requiring Hospitalisation or Urgent Heart Failure VisitParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
146167
Number of Participants From Randomisation to First Occurrence of Coronary RevascularisationParticipants · From randomisation (week 0) up to week 265 · count of participants
Oral Semaglutiden=4,825Placebon=4,825
200263
The trial

How SOUL was run

The researchers are doing this study to look whether the type 2 diabetes medicine, semaglutide, has a positive effect on heart disease. Participants will either get semaglutide tablets or placebo tablets ("dummy" medicine) - which treatment is decided by chance. Participants must take one tablet with water every morning on an empty stomach and not eat or drink anything for at least 30 minutes. The study will last for about 3.5-5 years. Participants will have up to 25 clinic visits and 1 phone call with the study doctor. Women cannot be in the study if pregnant, breast-feeding or if they plan to become pregnant during the study period.

  • Oral semaglutide: One tablet daily for 3.5 to 5 years
  • Placebo: One tablet daily for 3.5 to 5 years
Who could join the trial

Inclusion Criteria: * Male or female, age equal to or above 50 years at the time of signing informed consent * Diagnosed with type 2 diabetes mellitus * HbA1c 6.5% - 10.0% (47 - 86 mmol/mol) (both inclusive) (latest available and no more than 30 days old local laboratory assessment based on medical records or point of care measurement) * At least one of the below conditions (a-d): a) Coronary heart disease defined as at least one of the following: i. Prior myocardial infarction ii. Prior coronary revascularisation procedure iii. 50% or above stenosis in coronary artery documented by cardiac catheterisation, computerized tomography coronary angiography iv. Coronary heart disease with ischaemia documented by stress test with any imaging modality b) Cerebrovascular disease defined as at least one of the following: i. Prior stroke ii. Prior carotid artery revascularisation procedure iii.50% or above stenosis in carotid artery documented by X-ray angiography, magnetic resonance angiography, computerized tomography angiography or Doppler ultrasound c) Symptomatic peripheral artery disease (PAD) defined as at least one of the following: i. Intermittent claudication with an Ankle-brachial index (ABI) below 0.85 at rest ii. Intermittent claudication with a 50% or above stenosis in peripheral artery (excluding carotid) documented by X-ray angiography, magnetic resonance angiography, computerized tomography angiography or Doppler ultrasound iii. Prior peripheral artery (excluding carotid) revascularization procedure iv. Lower extremity amputation at or above ankle due to atherosclerotic disease (excluding e.g. trauma or osteomyelitis) d) Chronic kidney disease defined as: i. eGFR below 60 mL/min/1.73 m\^2 (based on medical records using latest available and no more than 6 months old assessment) Exclusion Criteria: * Any of the following: myocardial infarction, stroke, hospitalisation for unstable angina pectoris or transient ischaemic attack within the past 60 days prior to the day of screening * Planned coronary, carotid or peripheral artery revascularisation known on the day of screening * Heart failure presently classified as being in New York Heart Association Class IV * Treatment with any glucagon-like peptide-1 receptor agonist within 30 days before screening

Published papers

Papers from SOUL

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.