Long Term Comparative Effectiveness of Once Weekly Semaglutide Versus Standard of Care in a Real World Adult US Population With Type 2 Diabetes - a Randomized Pragmatic Trial

NCT ID: NCT03596450

Last Updated: 2024-07-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

1278 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-13

Study Completion Date

2023-06-09

Brief Summary

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The main purpose of this study is to compare the effects of semaglutide (Ozempic®) with the effects of other treatments for type 2 diabetes in a normal practice setting. The participant will be assigned by chance (like flipping a coin) to one of the following treatment groups: Group 1: semaglutide (Ozempic®) (by injection into skin) Group 2: standard of care antidiabetic medication (oral or injectable). The participant has an equal chance of being in either of the treatment groups. Neither the participant nor the study doctor or study staff will be able to pick which group the participant is in, but the participant will know which study drug the participant has been assigned to. The study doctor will provide the participant with a prescription for the study diabetes medication based on the treatment group the participant is assigned. The participation will last about 2 years.

Detailed Description

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Conditions

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Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Semaglutide

Participants will receive semaglutide subcutaneously (s.c.) in addition to metformin monotherapy as treatment intensification in the course of routine clinical practice. Participants will be followed for 2 years, regardless of changes in antidiabetic treatment over the course of the study.

Group Type EXPERIMENTAL

Semaglutide

Intervention Type DRUG

Participants will be prescribed commercially available semaglutide s.c. and will be instructed to initiate treatment with semaglutide s.c. according to the approved label. The study doctor will determine the intended maintenance dose of semaglutide, as well as changes to the maintenance dose thereafter.

Standard of care

Participants will receive standard of care in addition to metformin monotherapy as treatment intensification in the course of routine clinical practice. Participants will be followed for 2 years, regardless of changes in antidiabetic treatment over the course of the study.

Group Type ACTIVE_COMPARATOR

Standard of care

Intervention Type DRUG

Participants will receive standard of care, defined as commercially available oral or injectable antidiabetic medication other than semaglutide. Participants will be prescribed and instructed to initiate commercially available antidiabetic medication according to the approved label and, if relevant for the specific antidiabetic medication, adjusted at the discretion of the study doctor.

Interventions

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Semaglutide

Participants will be prescribed commercially available semaglutide s.c. and will be instructed to initiate treatment with semaglutide s.c. according to the approved label. The study doctor will determine the intended maintenance dose of semaglutide, as well as changes to the maintenance dose thereafter.

Intervention Type DRUG

Standard of care

Participants will receive standard of care, defined as commercially available oral or injectable antidiabetic medication other than semaglutide. Participants will be prescribed and instructed to initiate commercially available antidiabetic medication according to the approved label and, if relevant for the specific antidiabetic medication, adjusted at the discretion of the study doctor.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Informed consent obtained before any study-related activities. Study-related activities are any procedures that are carried out as part of the study.
* Male or female, age 18 years or older at the time of signing informed consent.
* Type 2 diabetes mellitus diagnosis.
* Treatment with either 1 or 2 oral antidiabetic medications.
* Current member of a commercial or Medicare health plan with pharmacy benefits.
* Recorded HbAlc value within the last 90 days prior to randomization.
* Further intensification with an additional antidiabetic oral or injectable medication is indicated to achieve glycemic target at the discretion of the study physician according to approved labelling.

Exclusion Criteria

* Previous randomization in this study
* Treatment with more than 2 oral antidiabetic medications, oral semaglutide, or any injectable medication in a period of 30 days before the day of eligibility assessment. Temporary/emergency use of any type of insulin is allowed, as is prior insulin treatment for gestational diabetes.
* Contraindications to semaglutide according to the Food and Drug Administration approved label.
* Female who is pregnant, breastfeeding or intends to become pregnant
* Participation in another clinical trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Novo Nordisk A/S

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Reporting Anchor and Disclosure (1452)

Role: STUDY_DIRECTOR

Novo Nordisk A/S

Locations

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American Clinical Trials

Buena Park, California, United States

Site Status

St. Jos Heritage Hlthcr_Fllrtn

Fullerton, California, United States

Site Status

SC Clinical Research, Inc.

Garden Grove, California, United States

Site Status

New Hope Consulting & Clinical Trials

Lancaster, California, United States

Site Status

OM Research LLC

Lancaster, California, United States

Site Status

Pacific Clinical Studies

Los Alamitos, California, United States

Site Status

Pacific Medical Center

Milpitas, California, United States

Site Status

Facey Medical Foundation

Mission Hills, California, United States

Site Status

Monterey Endocrine & Diabetes Institute, Inc

Monterey, California, United States

Site Status

Do-Eun Lee

Napa, California, United States

Site Status

Format Medical Research

Oxnard, California, United States

Site Status

Joselito C Cabaccan, MD

San Jose, California, United States

Site Status

Premier Medical Center, Inc.

Toluca Lake, California, United States

Site Status

Adnab Research/Prestige Care Physician

Torrance, California, United States

Site Status

Altura Centers For Health

Tulare, California, United States

Site Status

Tariq Javed, MD Inc.

Visalia, California, United States

Site Status

Endocrinology & Diabetes Specialists

Walnut Creek, California, United States

Site Status

University of Colorado Hospital

Denver, Colorado, United States

Site Status

Denver Endocrinology Diabetes and Thyroid Center

Englewood, Colorado, United States

Site Status

ProHealth Physicians/OptumCare

Bristol, Connecticut, United States

Site Status

Western Connecticut Health Network_Danbury

Danbury, Connecticut, United States

Site Status

Endocrine Associates of Connecticut

Hamden, Connecticut, United States

Site Status

Ismail Tarkhan MD

Milford, Connecticut, United States

Site Status

Steven L. Saunders MD LLC

Milford, Connecticut, United States

Site Status

The Kaufmann Clinic, Inc.

Atlanta, Georgia, United States

Site Status

Primary Care Research

Atlanta, Georgia, United States

Site Status

Southern Family Medical Center

Augusta, Georgia, United States

Site Status

River Birch Research Alliance, LLC

Blue Ridge, Georgia, United States

Site Status

Gwinnett Research Insti/Buford Family Pract Urgent Care Ctr

Buford, Georgia, United States

Site Status

Centricity Research

Columbus, Georgia, United States

Site Status

Medical Care of LaGrange

La Grange, Georgia, United States

Site Status

Beaver Ruin Primary Care

Lilburn, Georgia, United States

Site Status

Privia Medical Group of Georgia LLC

Locust Grove, Georgia, United States

Site Status

DC Research Works

Marietta, Georgia, United States

Site Status

Urban Family Practice Assoc

Marietta, Georgia, United States

Site Status

Atlanta Center for Clinical Research

Roswell, Georgia, United States

Site Status

Sandersville Family Practice

Sandersville, Georgia, United States

Site Status

Meridian Clin Res, LLC

Savannah, Georgia, United States

Site Status

Family Health Care Center

Statesboro, Georgia, United States

Site Status

Eagles Landing Diabetes/Endocrinology

Stockbridge, Georgia, United States

Site Status

Herman Clinical Research LLC

Suwanee, Georgia, United States

Site Status

Sugarloaf Medical, PC

Suwanee, Georgia, United States

Site Status

East Georgia Healthcare Center Inc

Swainsboro, Georgia, United States

Site Status

Coastal Care Medical Clinic

Waycross, Georgia, United States

Site Status

St. Vincent Research Institute

Anderson, Indiana, United States

Site Status

American Health Network of Indiana, LLC_Avon_0

Avon, Indiana, United States

Site Status

Adams County Family Physicians

Berne, Indiana, United States

Site Status

Deaconess Clinic, Inc.

Evansville, Indiana, United States

Site Status

Associated Surgeons & Physicians LLC

Fort Wayne, Indiana, United States

Site Status

American Health Network of IN LLC_Franklin

Franklin, Indiana, United States

Site Status

American Health Network of Indiana, LLC_Greenfield

Greenfield, Indiana, United States

Site Status

La Porte County Institute For Clinical Research

Michigan City, Indiana, United States

Site Status

Beacon Medical Group Swartz-Weikamp

Mishawaka, Indiana, United States

Site Status

American Health Network of IN LLC

Muncie, Indiana, United States

Site Status

American Health Network of Indiana, LLC

New Albany, Indiana, United States

Site Status

Reid Endocrinology Center

Richmond, Indiana, United States

Site Status

Regional Endorine and Diabetes Associates

Ashland, Kentucky, United States

Site Status

Tri State Primary Caregrayson Health Park

Ashland, Kentucky, United States

Site Status

St Elizabeth Physicians Heart

Covington, Kentucky, United States

Site Status

The Endocrine & Diabetes Center

Owensboro, Kentucky, United States

Site Status

Paris Family Physicians PLLC

Paris, Kentucky, United States

Site Status

Gaurang B. Shah, MD

Richmond, Kentucky, United States

Site Status

WCMP Family Medicine

Belfast, Maine, United States

Site Status

Tri-County Research, Inc.

Sterling Heights, Michigan, United States

Site Status

Diabetes & Endo Specialists Inc

Chesterfield, Missouri, United States

Site Status

University Of Missouri - Columbia

Columbia, Missouri, United States

Site Status

Jefferson City Medical Group, PC

Jefferson City, Missouri, United States

Site Status

Trinity Healthcare

Springfield, Missouri, United States

Site Status

Saint Louis University

St Louis, Missouri, United States

Site Status

South County Endocrinology and Obesity Medicine, LLC

St Louis, Missouri, United States

Site Status

Palm Research Center Inc-Vegas

Las Vegas, Nevada, United States

Site Status

Albany Medical College - Endo

Albany, New York, United States

Site Status

Prominis Medical Services PC

Brooklyn, New York, United States

Site Status

Northwell Health Div of Endo

Great Neck, New York, United States

Site Status

Advanced Internal Medicine Group

Great Neck, New York, United States

Site Status

NYC Research, Inc.

New York, New York, United States

Site Status

NYU Grossman School of Med

New York, New York, United States

Site Status

EDOC LLP

Yonkers, New York, United States

Site Status

OnSite Clinical Solutions, LLC_Charlotte_0

Charlotte, North Carolina, United States

Site Status

OnSite Clinical Solutions, LLC_Charlotte

Charlotte, North Carolina, United States

Site Status

Valley Weight Loss Clinic

Fargo, North Dakota, United States

Site Status

Catherine LaRuffa, M.D., Inc.

Blanchester, Ohio, United States

Site Status

Diab & Endo Assoc of Stark Co

Canton, Ohio, United States

Site Status

Medical Frontiers, LLC

Carlisle, Ohio, United States

Site Status

University Hospitals of Cleveland Case Medical Center

Cleveland, Ohio, United States

Site Status

Central Ohio Clinical Research LLC

Columbus, Ohio, United States

Site Status

Centricity Research

Columbus, Ohio, United States

Site Status

Franklin Family Practice

Franklin, Ohio, United States

Site Status

Prestige Clinical Research

Franklin, Ohio, United States

Site Status

Functional Endocrinology

Mason, Ohio, United States

Site Status

New Venture Medical Research

Wadsworth, Ohio, United States

Site Status

Harleysville Medical Associates

Harleysville, Pennsylvania, United States

Site Status

Primary Care Research South, Inc

McMurray, Pennsylvania, United States

Site Status

Preferred Primary Care Physicians_Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

Athens Medical Group

Athens, Tennessee, United States

Site Status

PMG Research of Bristol

Bristol, Tennessee, United States

Site Status

Murphy Research Center

Humboldt, Tennessee, United States

Site Status

Ascend Research Centers, Inc.

McMinnville, Tennessee, United States

Site Status

Christus Trinity Clinic Hill Country Landa

New Braunfels, Texas, United States

Site Status

Simcare Medical Research, LLC

Sugar Land, Texas, United States

Site Status

Chrysalis Clinical Research

St. George, Utah, United States

Site Status

The Endocrinology Group

Arlington, Virginia, United States

Site Status

Chatham Family Medical Center

Chatham, Virginia, United States

Site Status

Swift Creek Family Care

Colonial Heights, Virginia, United States

Site Status

Lawson Family Medicine & Aesthetics

Daleville, Virginia, United States

Site Status

Privia Medical Group LLC

Danville, Virginia, United States

Site Status

Seven Corners Medical

Falls Church, Virginia, United States

Site Status

Hampton Family Practice

Hampton, Virginia, United States

Site Status

Medical Associates of Central Virginia, Inc.

Lynchburg, Virginia, United States

Site Status

C. Lee Ginsburgh

Newport News, Virginia, United States

Site Status

Family Medicine Healthcare

Portsmouth, Virginia, United States

Site Status

Family Health Clinic

Radford, Virginia, United States

Site Status

Halifax Internal Medicine

South Boston, Virginia, United States

Site Status

Hampton Roads Center for Clinical Research

Suffolk, Virginia, United States

Site Status

Endocrinology Consultants

Virginia Beach, Virginia, United States

Site Status

Corporation Lane Research Center

Virginia Beach, Virginia, United States

Site Status

Piedmont Family Practice PLC

Warrenton, Virginia, United States

Site Status

Family Care of Williamsburg

Williamsburg, Virginia, United States

Site Status

St. Vincent Hosp-Prevea Health

Green Bay, Wisconsin, United States

Site Status

Ascension Medical Group- Germantown Clinic

Milwaukee, Wisconsin, United States

Site Status

Medical College of Wisconsin & Zablocki VAMC

Milwaukee, Wisconsin, United States

Site Status

Western University Medical Center at WU of Health Sciences

London, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Buse JB, Nordahl Christensen H, Harty BJ, Cziraky MJ, Willey VJ, Skibsted S. Long-term comparative effectiveness of once-weekly semaglutide versus alternative treatments in a real-world US adult population with type 2 diabetes: a randomized pragmatic clinical trial. BMJ Open Diabetes Res Care. 2025 Oct 15;13(5):e005161. doi: 10.1136/bmjdrc-2025-005161.

Reference Type DERIVED
PMID: 41093600 (View on PubMed)

Buse JB, Nordahl Christensen H, Harty BJ, Mitchell J, Soule BP, Zacherle E, Cziraky M, Willey VJ. Study design and baseline profile for adults with type 2 diabetes in the once-weekly subcutaneous SEmaglutide randomized PRAgmatic (SEPRA) trial. BMJ Open Diabetes Res Care. 2023 May;11(3):e003206. doi: 10.1136/bmjdrc-2022-003206.

Reference Type DERIVED
PMID: 37137527 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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U1111-1207-6474

Identifier Type: OTHER

Identifier Source: secondary_id

NN9535-4416

Identifier Type: -

Identifier Source: org_study_id

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