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Trial · Interventional

CompletedPhase 3Results postedRegistry data

Efficacy and Safety of Semaglutide Once-weekly Versus Placebo as add-on to SGLT-2i in Subjects With Type 2 Diabetes Mellitus

Short name SUSTAIN 9

NCTNCT03086330 (opens ClinicalTrials.gov in a new tab)Other idNN9535-4269Other id2016-000904-27Other idU1111-1180-1213Other idJapicCTI-173542

Overview

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

United States, Austria, Canada, Japan, Norway, Puerto Rico, Russia

Start
15 Mar 2017
Primary completion
4 Jul 2018
Completion
6 Aug 2018
First posted
22 Mar 2017
Last update posted
2 Jul 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
201720182019
  1. Ph 3

    SUSTAIN 9

    NCT03086330

    15 Mar 2017 to 6 Aug 2018

Registry summary

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

This trial is conducted in Asia, Europe and North America. The aim of the trial is to compare the effect of semaglutide s.c. 1.0 mg once-weekly versus placebo as add-on to sodium glucose co-transporter-2 inhibitor (SGLT-2i) monotherapy or in combination with either metformin or sulfonylurea on glycaemic control after 30 weeks of treatment in subjects with type 2 diabetes. Subjects will remain on their pre-trial medication.

Interventions

  • SemaglutideDrug
  • PlaceboDrug

Arms2

  • Experimental

    Semaglutide

  • Placebo comparator

    Placebo

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) in HbA1c was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period, which started at the date of first dose of trial product and ended at the first date of any of the following: 1) the last dose of trial product + 7 days or 2) initiation of rescue medication.

Secondary outcomes(20)
  1. Change in Body Weight (kg)

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in body weight was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  2. Change in Fasting Plasma Glucose (FPG)

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in FPG was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

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

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in mean of the SMPG, 7-point profile was evaluated at week 30. Mean 7-point profile (the area under the profile) was calculated using the trapezoidal method and divided by the measurement time. Results are based on the 'on-treatment without rescue medication' observation period. Participants measured their plasma glucose at 7 different time points: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after start of dinner and at bedtime.

  4. Change in Self-measured Plasma Glucose (SMPG), 7-point Profile: Mean Post Prandial Increment (Over All Meals)

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in mean post prandial increment (over all meals) in the SMPG, 7-point profile was evaluated at week 30. The mean increment over all meals was derived as the mean of all available meal increments. Results are based on the 'on-treatment without rescue medication' observation period.

  5. Change in Fasting Blood Lipid, Total Cholesterol

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in total cholesterol (measured in mmol/L and presented as ratio to baseline) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  6. Change in Fasting Blood Lipid, Low-density Lipoprotein (LDL) Cholesterol

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in LDL (measured in mmol/L and presented as ratio to baseline) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  7. Change in Fasting Blood Lipid, High-density Lipoprotein (HDL) Cholesterol

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in HDL (measured in mmol/L and presented as ratio to baseline) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  8. Change in Fasting Blood Lipid, Triglycerides

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in triglycerides (measured in mmol/L and presented as ratio to baseline) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  9. Change in Body Weight (%)

    Time frame · Week 0, week 30

    Registry description

    Percent (%) change from baseline (week 0) in body weight (measured in kilogram (kg)) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  10. Change in Body Mass Index

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in body mass index (BMI) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period. BMI was calculated as 'body weight in kg/(height in meters) x (height in meters)'.

  11. Change in Waist Circumference

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in waist circumference was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  12. Change in Systolic Blood Pressure

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in systolic blood pressure was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  13. Change in Diastolic Blood Pressure

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in diastolic blood pressure was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  14. Change in Scores for Selected Patient Reported Outcomes: Short-form Health Survey (SF-36v2TM): Total Scores (Physical Component and Mental Component) and Scores From the 8 Domains

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in patient reported outcome (PRO) questionnaire, SF-36v2TM was evaluated at week 30. The SF-36v2™ questionnaire was used to assess the overall health related quality of life of participants. This questionnaire contains 36 items and measures the individual overall health related quality of life on 8 domains: 1) Physical functioning, 2) Role functioning, 3) Bodily pain, 4) General health, 5) Vitality, 6) Social functioning, 7) Role emotional and 8) Mental health. Each item is scored on a scale from 1 to either 2, 3, 5, or 6; each item score is then converted to a scale of 0-100, representing the percentage of total possible score achieved and with higher scores indicating a higher health status; items on the same scale are then averaged to obtain the 8 scale scores. Physical component summary (PCS) includes domains 1-4 and mental component summary (MCS) includes domains 5-8. Higher PCS and MCS scores on a scale of 0-100 indicate a higher health status.

  15. Change in Scores for Selected Patient Reported Outcomes: Diabetes Treatment Satisfaction Questionnaire (DTSQ): Treatment Satisfaction Score (Sum of 6 of 8 Items) and the 8 Items Separately

    Time frame · Week 0, week 30

    Registry description

    Change from baseline (week 0) in PRO questionnaire, DTSQ was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period. The DTSQ measures satisfaction with diabetes treatment. The DTSQ consists of 8 items evaluating 6 aspects of treatment satisfaction and 2 perceived recent event rates of hyperglycemia/hypoglycemia. Each item is scored on a 7- point Likert scale ranging from 0 (very dissatisfied) to 6 (very satisfied). Items evaluating 6 aspects (items 3-8) of treatment satisfaction are summed to produce a total treatment satisfaction score; DTSQ status total scores range from 0-36, with higher scores indicating greater satisfaction; the perceived frequency of hyperglycemia/hypoglycemia items are scored separately, with lower scores indicating better perceived blood glucose control.

  16. HbA1c Below 7.0% (53 mmol/Mol)

    Time frame · After 30 weeks

    Registry description

    Percentage of participants with HbA1c below 7.0% (53 mmol/mol) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  17. HbA1c Equal to or Below 6.5% (48 mmol/Mol)

    Time frame · After 30 weeks

    Registry description

    Percentage of participants with HbA1c equal to or below 6.5% (48 mmol/mol) was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  18. Weight Loss Equal to or Above 3%

    Time frame · After 30 weeks

    Registry description

    Percentage of participants with weight loss equal to or above 3% of their baseline (week 0) body weight was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  19. Weight Loss Equal to or Above 5%

    Time frame · After 30 weeks

    Registry description

    Percentage of participants with weight loss equal to or above 5% of their baseline (week 0) body weight was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

  20. Weight Loss Equal to or Above 10%

    Time frame · After 30 weeks

    Registry description

    Percentage of participants with weight loss equal to or above 10% of their baseline (week 0) body weight was evaluated at week 30. Results are based on the 'on-treatment without rescue medication' observation period.

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 HbA1c)Spread
Semaglutide 1.0 mg-1.60.8
Placebo-0.20.9
Secondary and other outcome results(7)
Secondary outcomeMean· Week 0, week 30

Change in Body Weight (kg)

GroupValue (Kg)Spread
Semaglutide 1.0 mg-4.74.3
Placebo-1.03.1
Secondary outcomeMean· Week 0, week 30

Change in Fasting Plasma Glucose (FPG)

GroupValue (mmol/L)Spread
Semaglutide 1.0 mg-2.262.05
Placebo0.072.07
Secondary outcomeMean· Week 0, week 30

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

GroupValue (mmol/L)Spread
Semaglutide 1.0 mg-2.61.9
Placebo-0.32.0
Secondary outcomeMean· Week 0, week 30

Change in Self-measured Plasma Glucose (SMPG), 7-point Profile: Mean Post Prandial Increment (Over All Meals)

GroupValue (mmol/L)Spread
Semaglutide 1.0 mg-1.22.0
Placebo0.02.2
Secondary outcomeGeometric mean· Week 0, week 30

Change in Fasting Blood Lipid, Total Cholesterol

GroupValue (Ratio)Spread
Semaglutide 1.0 mg0.9119.4
Placebo1.0218.9
Secondary outcomeGeometric mean· Week 0, week 30

Change in Fasting Blood Lipid, Low-density Lipoprotein (LDL) Cholesterol

GroupValue (Ratio)Spread
Semaglutide 1.0 mg0.9031.6
Placebo1.0427.7
Secondary outcomeGeometric mean· Week 0, week 30

Change in Fasting Blood Lipid, High-density Lipoprotein (HDL) Cholesterol

GroupValue (Ratio)Spread
Semaglutide 1.0 mg0.9915.8
Placebo1.0113.9

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Semaglutide 1.0 mgParticipants received semaglutide in a dose escalation manner for 30 weeks: 0.25 mg (weeks 1 to 4), 0.50 mg (weeks 5 to 8) and 1.0 mg (weeks 9 to 30). Semaglutide was taken once weekly as s.c. injections.0 / 1507 / 15049 / 150
PlaceboParticipants received matching placebo (for semaglutide) in a dose escalation manner for 30 weeks. Placebo was taken once weekly as s.c. injections. Dose escalation for placebo matched that for semaglutide with regards to volume.0 / 1516 / 15128 / 151

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

Studies1

Studies that cite this trial.

More studies

1 study on this page

Indexing hint: Randomized controlled trial · 2019

Corrected

Semaglutide once weekly as add-on to SGLT-2 inhibitor therapy in type 2 diabetes (SUSTAIN 9): a randomised, placebo-controlled trial.

Zinman et al. 2019The lancet. Diabetes & endocrinologycited by 286

PMID 30833170DOI 10.1016/s2213-8587(19)30066-xPUB-30833170

Full text at the publisher

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, above or equal to 18 years at the time of signing informed consent. For Japan only: Male or female, age equal to or above 20 years at the time of signing informed consent * Diagnosed with type 2 diabetes mellitus * HbA1c of 7.0-10.0% (53-86 mmol/mol) (both inclusive) * Stable dose of an SGLT-2 inhibitor as monotherapy or in combination (including fixed-dose drug combination) with a stable dose of metformin (equal to or above 1500 mg or maximum tolerated dose) or a SU for at least 90 days prior to the day of screening. All medications in compliance with current local label 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) * Any disorder which in the investigator's opinion might jeopardise subject's safety or compliance with the protocol * Treatment with any medication for the indication 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 * Subjects with alanine aminotransferase above 2.5 x upper normal limit * Family or personal history of multiple endocrine neoplasia type 2 or medullary thyroid carcinoma. Family is defined as a first degree relative * History or presence of pancreatitis (acute or chronic) * History of diabetic ketoacidosis * Any of the following: myocardial infarction, stroke, hospitalization for unstable angina or transient ischaemic attack within the past 180 days prior to the day of screening * Subjects presently classified as being in New York Heart Association Class IV * Planned coronary, carotid or peripheral artery revascularisation known on the day of screening * Renal impairment measured as estimated Glomerular Filtration Rate value of eGFR below 60 ml/min/1.73 m\^2 as defined by KDIGO 2012 classification using isotope dilution mass spectrometry for serum creatinine measured at screening * Proliferative retinopathy or maculopathy requiring acute treatment. Verified by fundus photography or dilated fundoscopy performed within the past 90 days prior to randomisation * Presence or history of malignant neoplasms within the past 5 years prior to the day of screening. Basal and squamous cell skin cancer and any carcinoma in-situ is allowed

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