title: A Phase 2, Randomized, Dose-Finding Study of the Novel Once-Weekly Human GLP-1 Analog, Semaglutide, Compared With Placebo and Open-Label Liraglutide in Patients With Type 2 Diabetes.
abstract: OBJECTIVE
  To investigate the dose-response relationship of semaglutide versus placebo and open-label liraglutide in terms of glycemic control in patients with type 2 diabetes.
  
  
  METHODS
  This was a 12-week, randomized, double-blind phase 2 trial. Patients (n = 415) were randomized to receive a subcutaneous injection of semaglutide once weekly without dose escalation (0.1-0.8 mg) or with dose escalation (E) (0.4 mg steps to 0.8 or 1.6 mg E over 1-2 weeks), open-label liraglutide once daily (1.2 or 1.8 mg), or placebo. The primary end point was change in HbA1c level from baseline. Secondary end points included change in body weight, safety, and tolerability.
  
  
  RESULTS
  Semaglutide dose-dependently reduced the level of HbA1c from baseline (8.1 ± 0.8%) to week 12 by up to -1.7%, and body weight by up to -4.8 kg (1.6 mg E, P < 0.001 vs. placebo). Up to 81% of patients achieved an HbA1c level of <7%. HbA1c level and weight reductions with semaglutide 1.6 mg E were greater than those with liraglutide 1.2 and 1.8 mg (based on unadjusted CIs), but adverse events (AEs) and withdrawals occurred more frequently. The incidence of nausea, vomiting, and withdrawal due to gastrointestinal AEs increased with the semaglutide dose; most events were mild to moderate, transient, and ameliorated by dose escalation. There were no major episodes of hypoglycemia and few cases of injection site reactions.
  
  
  CONCLUSIONS
  After 12 weeks, semaglutide dose-dependently reduced HbA1c level and weight in patients with type 2 diabetes. No unexpected safety or tolerability concerns were identified; gastrointestinal AEs typical of glucagon-like peptide 1 receptor agonists were mitigated by dose escalation. On this basis, weekly semaglutide doses of 0.5 and 1.0 mg with a 4-week dose escalation were selected for phase 3.
authors.affiliation: Diabetes Centre, Bad Lauterberg, Harz, Germany michael.nauck@rub.de.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Nauck
authors.affiliation: University of Glasgow, Glasgow, U.K.
authors.forename: John R
authors.initials: JR
authors.lastname: Petrie
authors.affiliation: University Magna Graecia, Catanzaro, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Sesti
authors.affiliation: Careggi Teaching Hospital, Florence, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
authors.affiliation: General Hospital, Narbonne, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Courrèges
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: Marie L
authors.initials: ML
authors.lastname: Lindegaard
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Jensen
authors.affiliation: Weill Cornell Medical College Qatar, Doha, Qatar.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Atkin
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D004763:Glucagon-Like Peptides / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives; D006442:Glycated Hemoglobin / Q000032:analysis / Q000187:drug effects; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007279:Injections, Subcutaneous; D000069450:Liraglutide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced; D000099194:Semaglutide
chemical_list: D001786:Blood Glucose; D004763:Glucagon-Like Peptides; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069450:Liraglutide; D000099194:Semaglutide