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Trial · Interventional

CompletedPhase 3Results postedRegistry data

Efficacy and Safety of Semaglutide Once-weekly Versus Sitagliptin Once-daily as add-on to Metformin in Subjects With Type 2 Diabetes (SUSTAIN - CHINA MRCT)

Short name SUSTAIN

NCTNCT03061214 (opens ClinicalTrials.gov in a new tab)Other idNN9535-4114Other idU1111-1149-0432Other idCTR20161003

Overview

Status
Completed
Phase
Phase 3
Enrollment
868 participants (actual)
Sponsor
Novo Nordisk A/S · Industry
Design
Randomized · Double masking
Countries
7 countries

Brazil, China, Hong Kong, South Africa, South Korea, Taiwan, Ukraine

Start
28 Aug 2017
Primary completion
14 Mar 2019
Completion
15 Apr 2019
First posted
23 Feb 2017
Last update posted
2 Mar 2021
Conditions
Diabetes · Diabetes Mellitus, Type 2

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
2017201820192020
  1. Ph 3

    SUSTAIN

    NCT03061214

    28 Aug 2017 to 15 Apr 2019

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

This trial is conducted in Africa, Asia, Europe and South America. The aim of the trial is to compare the effect of once-weekly dosing of two dose levels of semaglutide versus sitagliptin 100 mg once-daily on glycaemic control after 30 weeks of treatment. Subjects will remain on their stable pre-trial metformin.

Interventions

  • Semaglutide 0.5 mgDrug
  • Semaglutide 1.0 mgDrug
  • Sitagliptin placeboDrug
  • SitagliptinDrug
  • Semaglutide placebo 0.5 mgDrug
  • Semaglutide placebo 1.0 mgDrug

Arms4

  • Experimental

    Semaglutide 0.5 mg OW + sitagliptin placebo OD

  • Experimental

    Semaglutide 1 mg OW + sitagliptin placebo OD

  • Active comparator

    Sitagliptin OD + semaglutide placebo 0.5 mg OW

  • Active comparator

    Sitagliptin OD + semaglutide placebo 1 mg OW

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Change in HbA1c

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) to week 30 in glycosylated haemoglobin (HbA1c) was evaluated. Results are based on the 'on-treatment without rescue medication' observation period and 'in trial' observation period. 'On-treatment without rescue medication' observation period: started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first. 'In-trial' observation period: started when a participant was randomised until the final scheduled visit, including any period after initiation of rescue medication or premature treatment discontinuation.

Secondary outcomes(20)
  1. Change in Body Weight

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) to week 30 in body weight was evaluated. Results are based on the 'on-treatment without rescue medication' observation period which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  2. Change in Fasting Plasma Glucose (FPG)

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) to week 30 in FPG was evaluated. Results are based on the 'on-treatment without rescue medication' observation period which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  3. Change in Self-measured Plasma Glucose (SMPG) - Mean 7-point Profile

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) to week 30 in SMPG mean 7-point profile was evaluated. SMPG was recorded at the following 7 time points: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after dinner and at bedtime. Mean 7-point profile was defined as the area under the profile, calculated using the trapezoidal method, divided by the measurement time. Results are based on the 'on-treatment without rescue medication' observation period which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  4. Change in Self-measured Plasma Glucose (SMPG) - Mean Postprandial Increment Over All Meals

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) to week 30 in SMPG mean postprandial increment over all meals was evaluated. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  5. Change in Fasting Insulin - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting insulin from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting insulin was measured in picomoles per liter (pmol/L). Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  6. Change in Fasting C-peptide - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting C-peptide from baseline (week 0) to week 30 is presented as ratio to baseline. C-peptide was measured in nanomoles per liter (nmol/L). Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  7. Change in Fasting Glucagon - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting glucagon from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting glucagon was measured in picogram per mililiter (pg/mL). Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  8. Change in Fasting Proinsulin - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting proinsulin from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting proinsulin was measured in picomole per liter (pmol/L). Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  9. Change in Fasting Proinsulin/Insulin Ratio - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting proinsulin/insulin ratio from baseline (week 0) to week 30 is presented as ratio to baseline. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  10. Change in Fasting HOMA-B (Beta-cell Function) - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting HOMA-B (homeostasis model assessment beta-cell function) from baseline (week 0) to week 30 is presented as ratio to baseline. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  11. Change in Fasting HOMA-IR (Insulin Resistence) - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting HOMA-IR (homeostasis model assessment insulin resistence) from baseline (week 0) to week 30 is presented as ratio to baseline. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  12. Change in Patient Reported Outcome Questionnaire: SF-36v2™ Score

    Time frame · Week 0, week 30

    Registry description

    Short Form (SF)-36 is a 36-item patient-reported survey that measures patient's overall health-related quality of life (HRQoL). SF-36v2™ (acute version) questionnaire measured 8 domains of functional health \& well-being and 2 component summary scores (physical component summary-PCS and mental component summary-MCS). The 0-100 scale scores (where higher scores indicated a better HRQoL) from the SF-36 were converted to norm-based scores to enable a direct interpretation in relation to the distribution of the scores in the 2009 U.S. general population. In the metric of norm-based scores, 50 and 10 corresponds to the mean and standard deviation respectively of the 2009 U.S. general population. Change from baseline (week 0) in the domain scores and component summary (PCS and MCS) scores were evaluated at weeks 30. A positive change score indicates an improvement since baseline. Results are based on the data from the 'on-treatment without rescue medication' observation period.

  13. Change in Patient Reported Outcome Questionnaire: DTSQs Score

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in Diabetes Treatment Satisfaction Questionnaire (DTSQs) was evaluated at week 30. The DTSQs items are scored on a 7-point graded response scale ranging from 6 to 0. Higher scores indicate higher levels of treatment satisfaction for DTSQs items 3 -8. For items 1 and 2 a higher score indicates a higher patient perceived experience of high blood sugars and low blood sugars, respectively. Thus, lower scores indicate a perception of blood glucose levels being "none of the time" unacceptably high (item 1) or low (item 2). The domain score of total treatment satisfaction (total treatment satisfaction score) was computed by adding the six items scores 3-8. The score ranges 0-36. A higher treatment satisfaction score indicates a higher level of treatment satisfaction. Results are based on the 'on-treatment without rescue medication' observation period.

  14. Change in High-sensitivity CRP - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in high-sensitivity C-reactive protein (CRP) from baseline (week 0) to week 30 is presented as ratio to baseline. High-sensitivity CRP was measured in mg/L. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  15. Change in Waist Circumference

    Time frame · Week 0, week 30

    Registry description

    Change in waist circumference from baseline (week 0) to week 30 was measured. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  16. Change in BMI

    Time frame · Week 0, week 30

    Registry description

    Change in body mass index (BMI) from baseline (week 0) to week 30 was measured. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  17. Change in Fasting Total Cholesterol - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting total cholesterol from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting total cholesterol was measured in mmol/L. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  18. Change in Fasting LDL Cholesterol - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting low density lipoprotein (LDL) from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting LDL was measured in mmol/L. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  19. Change in Fasting VLDL Cholesterol - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting very low density lipoprotein (VLDL) from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting VLDL was measured in mmol/L. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

  20. Change in Fasting HDL Cholesterol - Ratio to Baseline

    Time frame · Week 0, week 30

    Registry description

    Change in fasting high density lipoprotein (HDL) from baseline (week 0) to week 30 is presented as ratio to baseline. Fasting HDL was measured in mmol/L. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose to either the day of last dose plus 7 days or first initiation of rescue medication, whichever came first.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeMean· Week 0, week 30

Change in HbA1c

GroupValue (Percentage of glycosylated haemoglobin)Spread
Semaglutide 0.5 mg-1.51.1
Semaglutide 1.0 mg-1.80.9
Sitagliptin-1.00.9
Secondary and other outcome results(7)
Secondary outcomeMean· Week 0, week 30

Change in Body Weight

GroupValue (Kilogram (kg))Spread
Semaglutide 0.5 mg-3.03.8
Semaglutide 1.0 mg-4.23.7
Sitagliptin-0.42.5
Secondary outcomeMean· Week 0, week 30

Change in Fasting Plasma Glucose (FPG)

GroupValue (Millimoles per liter (mmol/L))Spread
Semaglutide 0.5 mg-2.182.5
Semaglutide 1.0 mg-2.622.13
Sitagliptin-1.01.74
Secondary outcomeMean· Week 0, week 30

Change in Self-measured Plasma Glucose (SMPG) - Mean 7-point Profile

GroupValue (Millimoles per liter (mmol/L))Spread
Semaglutide 0.5 mg-2.52.4
Semaglutide 1.0 mg-3.32.2
Sitagliptin-1.62.0
Secondary outcomeMean· Week 0, week 30

Change in Self-measured Plasma Glucose (SMPG) - Mean Postprandial Increment Over All Meals

GroupValue (Millimoles per liter (mmol/L))Spread
Semaglutide 0.5 mg-1.02.2
Semaglutide 1.0 mg-1.22.1
Sitagliptin-0.72.2
Secondary outcomeGeometric mean· Week 0, week 30

Change in Fasting Insulin - Ratio to Baseline

GroupValue (Ratio of fasting insulin)Spread
Semaglutide 0.5 mg1.0646.6
Semaglutide 1.0 mg1.0351.2
Sitagliptin1.0141.6
Secondary outcomeGeometric mean· Week 0, week 30

Change in Fasting C-peptide - Ratio to Baseline

GroupValue (Ratio of fasting C-peptide)Spread
Semaglutide 0.5 mg1.0830.3
Semaglutide 1.0 mg1.0532.4
Sitagliptin1.032.2
Secondary outcomeGeometric mean· Week 0, week 30

Change in Fasting Glucagon - Ratio to Baseline

GroupValue (Ratio of fasting glucagon)Spread
Semaglutide 0.5 mg0.8932.4
Semaglutide 1.0 mg0.8928.1
Sitagliptin0.9325.0

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Semaglutide 0.5 mgParticipants took subcutaneous (s.c., under the skin) injection of semaglutide, once weekly for 30 weeks: 0.25 mg for 0-4 weeks followed by 0.5 mg for 5-30 weeks. Participants also took sitagliptin placebo (0 mg) tablet orally, once daily for 30 weeks. Both semaglutide and sitagliptin placebo were taken any time of the day irrespective of meals. Participants continued taking their pre-trial metformin with the same dose and frequency throughout the trial.1 / 28718 / 287135 / 287
Semaglutide 1.0 mgParticipants took subcutaneous (s.c., under the skin) injection of semaglutide, once weekly for 30 weeks: 0.25 mg for 0-4 weeks followed by 0.5 mg for 5-8 weeks and then 1.0 mg for 9-30 weeks. Participants also took sitagliptin placebo (0 mg) tablet orally, once daily for 30 weeks. Both semaglutide and sitagliptin placebo were taken any time of the day irrespective of meals. Participants continued taking their pre-trial metformin with the same dose and frequency throughout the trial.1 / 29019 / 290139 / 290
SitagliptinParticipants were randomised to 2 different groups (Group 1: sitagliptin + semaglutide placebo 0.5 mg and Group 2: sitagliptin + semaglutide placebo 1.0 mg). Both groups were pooled together for data analysis. Participants took 100 mg sitagliptin tablets once-daily for 30 weeks. Participants also took semaglutide placebo injection with volume matched to different doses (0.25 mg/0.5 mg/1.0 mg) of semaglutide injection for 30 weeks. Both sitagliptin and semaglutide placebo were taken any time of the day irrespective of meals. Participants continued taking their pre-trial metformin with the same dose and frequency throughout the trial.0 / 29012 / 29089 / 290

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies2

Studies that cite this trial.

Studies with results

1 study on this page

Indexing hint: Randomized controlled trial · 2021

8 results

Efficacy and safety of once-weekly semaglutide versus once-daily sitagliptin as add-on to metformin in patients with type 2 diabetes in SUSTAIN China: A 30-week, double-blind, phase 3a, randomized trial.

Ji et al. 2021Diabetes, obesity & metabolismcited by 92

PMID 33074557PMC7839591DOI 10.1111/dom.14232PUB-33074557

Free to read · publisher termsCC BY-NC8 results

More studies

1 study on this page

PubMed tag: none · 2024

Efficacy and Safety of Once-Weekly Semaglutide Versus Once-Daily Sitagliptin as Metformin Add-on in a Korean Population with Type 2 Diabetes.

Lee et al. 2024Diabetes therapy : research, treatment and education of diabetes and related disorderscited by 7

PMID 38236431PMC10838861DOI 10.1007/s13300-023-01515-0PUB-38236431

Free to read · publisher termsCC BY-NC
Read at source

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
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 equal to or above 18 years at the time of signing informed consent - Subjects diagnosed with type 2 diabetes and on stable treatment in a period of 60 days prior to screening with metformin equal to or above 1500 mg (or maximum tolerated dose equal to or above 1000 mg). Stable is defined as unchanged medication and unchanged daily dose - HbA1c 7.0 - 10.5 % (53-91 mmol/mol) (both inclusive) Exclusion Criteria: - Female who is pregnant, breast-feeding or intends to become pregnant or is of childbearing potential not using an adequate contraceptive method throughout the trial including the 5 week follow-up period (adequate contraceptive measure as required by local regulation or practice) - Any disorder which, in the opinion of the investigator, might jeopardise subject's safety or compliance with the protocol - Treatment with glucose lowering agent(s) other than stated in the inclusion criteria in a period of 60 days before screening. An exception is short-term treatment (equal to or below 7 days in total) with insulin in connection with inter-current illness - History of chronic or idiopathic acute pancreatitis - Screening calcitonin value equal to or above 50 ng/L (pg/mL) - Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) - Impaired renal function defined as estimated glomerular filtration rate (eGFR) below 60 ml/min/1.73 m\^2 per modification of diet in renal disease (MDRD) formula (4 variable version) - Acute coronary or cerebrovascular event within 90 days before randomisation - Heart failure, New York Heart Association (NYHA) class IV

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