Trial Outcomes & Findings for Treating PCOS With Semaglutide vs Active Lifestyle Intervention (NCT NCT03919929)

NCT ID: NCT03919929

Last Updated: 2025-11-25

Results Overview

Change from baseline in presence/severity of hepatic fat fraction will be measured with MRI, and calculated via the Dixon method as the proton density hepatic fat fraction, which ranges from 0-75%. A negative value means a decrease in liver fat, and a positive value means an increase in liver fat.

Recruitment status

COMPLETED

Study phase

PHASE2/PHASE3

Target enrollment

60 participants

Primary outcome timeframe

Baseline and 12 weeks

Results posted on

2025-11-25

Participant Flow

There were 5 participants who screen failed, and 4 participants who withdrew due to not tolerating the study medication.

Participant milestones

Participant milestones
Measure
Diet Intervention
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
GLP-1 Intervention
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Overall Study
STARTED
17
43
Overall Study
COMPLETED
17
34
Overall Study
NOT COMPLETED
0
9

Reasons for withdrawal

Reasons for withdrawal
Measure
Diet Intervention
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
GLP-1 Intervention
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Overall Study
Withdrawal by Subject
0
4
Overall Study
Screen Failure
0
5

Baseline Characteristics

Treating PCOS With Semaglutide vs Active Lifestyle Intervention

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
GLP-1 Intervention
n=38 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Total
n=55 Participants
Total of all reporting groups
Age, Continuous
14.44 years
STANDARD_DEVIATION 1.55 • n=45 Participants
15.65 years
STANDARD_DEVIATION 1.71 • n=12929 Participants
15.20 years
STANDARD_DEVIATION 1.64 • n=6349 Participants
Sex: Female, Male
Female
17 Participants
n=45 Participants
38 Participants
n=12929 Participants
55 Participants
n=6349 Participants
Sex: Female, Male
Male
0 Participants
n=45 Participants
0 Participants
n=12929 Participants
0 Participants
n=6349 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
9 Participants
n=45 Participants
18 Participants
n=12929 Participants
27 Participants
n=6349 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
8 Participants
n=45 Participants
20 Participants
n=12929 Participants
28 Participants
n=6349 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=45 Participants
0 Participants
n=12929 Participants
0 Participants
n=6349 Participants
Region of Enrollment
United States
17 participants
n=45 Participants
38 participants
n=12929 Participants
55 participants
n=6349 Participants

PRIMARY outcome

Timeframe: Baseline and 12 weeks

Change from baseline in presence/severity of hepatic fat fraction will be measured with MRI, and calculated via the Dixon method as the proton density hepatic fat fraction, which ranges from 0-75%. A negative value means a decrease in liver fat, and a positive value means an increase in liver fat.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Hepatic Fat Fraction
-1.84 Change in percentage of liver fat
Standard Deviation 4.39
-1.41 Change in percentage of liver fat
Standard Deviation 2.24

PRIMARY outcome

Timeframe: Baseline and 12 weeks

Change in weight will be calculated for each group (diet and semaglutide), and both the absolute and relative weight changes between the two groups will be reported.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Weight
-5.30 Change in weight (KG)
Standard Deviation 4.92
-1.66 Change in weight (KG)
Standard Deviation 2.81

SECONDARY outcome

Timeframe: Baseline and 12 weeks

Change from baseline of the rate of overnight de novo lipogenesis (DNL) will be measured utilizing stable isotope methods with deuterated water, and expressed as the rate of newly synthesized lipids in the serum triglyceride fraction. A negative value means a decrease in newly synthesized lipids after the 12 week intervention, and a positive value means an increase in newly synthesized lipids after the 12 week intervention. A lower value is better.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Rate of De Novo Lipogenesis (DNL)
-1.9 mg/dL
Standard Deviation 1.0
0.94 mg/dL
Standard Deviation 5.7

SECONDARY outcome

Timeframe: Baseline and 12 weeks

Participants will undergo a 75 gram oral glucose tolerance test, and the change from baseline in whole body insulin sensitivity will be expressed as Si, calculated via the oral minimal model.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Whole Body Insulin Sensitivity
0.000213 dl/kg/min per microU/ml
Standard Deviation 0.000423
0.0000629 dl/kg/min per microU/ml
Standard Deviation 0.000193

SECONDARY outcome

Timeframe: Baseline and 12 weeks

Change from baseline of adipose insulin sensitivity will be calculated as the percent suppression of free fatty acids, and the nadir of free fatty acids during the oral glucose tolerance test. Percent suppression of FFAs during the OGTT was calculated as fasting FFA minus the minimal FFA value divided by fasting FFA. This was calculated for baseline and after 12-weeks of intervention. The change was calculated by subtracting the final-baseline values. A higher absolute value means there was an improvement in adipose insulin sensitivity after 12-weeks of treatment.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Adipose Insulin Sensitivity
-1.431 percentage of change
Standard Deviation 9.97
0.44 percentage of change
Standard Deviation 12.06

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 12 weeks

This outcome evaluates mitochondrial function and excess tricarboxylic acid (TCA) cycle substrate cycling by measuring indirect carbon contributions to newly synthesized triglycerides and glucose using stable isotope-labeled glycerol. Participants receive orally administered \[U-13C3\]glycerol mixed in water, and plasma glucose and lipids are analyzed by 13C NMR spectroscopy. Indirect glycerol carbon contribution reflects the fraction of glycerol carbons that first enter the TCA cycle before incorporation into triglycerides and glucose. A decrease in the percentage of indirect contributions is beneficial, indicating decreased oxidative stress resulting from excess TCA cycling.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Percentage of Indirect Glycerol Carbon Contributions to Newly Synthesized Triglycerides and Glucose
3.08 percentage of indirect glycerol carbon c
Standard Deviation 5.24
-1.59 percentage of indirect glycerol carbon c
Standard Deviation 3.19

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 12 weeks

The Free Androgen Index (FAI) is a test for hyperandrogenism in women, using testosterone and sex hormone binding globulin (SHBG) as markers. The calculation is FAI = Total Testosterone (nmol/ L)) x 100 / Sex Hormone-Binding Globulin (SHBG) (nmol/ L). Typical values for the FAI in women are 7-10, and FAI is usually elevated in women with PCOS. The change in FAI will be calculated after 12 weeks of diet or semaglutide intervention. A negative value means an improvement as there was a decrease in androgen levels after 12 weeks of treatment.

Outcome measures

Outcome measures
Measure
GLP-1 Intervention
n=34 Participants
Participants will take a daily oral tablet of semaglutide for 4 months. Semaglutide 3mg and 7mg \[Rybelsus\]: Once daily oral tablet of semaglutide for 4 months
Diet Intervention
n=17 Participants
Weight loss with dietary intervention Weight loss diet: Prescribed weight loss diet to match weight loss in Drug arm
Change in Free Androgen Index
-2.45 unitless
Standard Deviation 3.27
-3.05 unitless
Standard Deviation 4.94

Adverse Events

Diet Intervention

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

GLP-1 Intervention

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Melanie Cree, MD, PhD

University of Colorado Anschutz Medical Campus

Phone: 720-777-5743

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place