Semaglutide's Efficacy in Achieving Weight Loss for Those With HIV

NCT ID: NCT04174755

Last Updated: 2024-12-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-22

Study Completion Date

2026-01-31

Brief Summary

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The prevalence of obesity is rising worldwide, both in low- and high-income countries, including people with HIV (PWH). Semaglutide's efficacy in achieving weight loss in obese PWH is still unexplored. The aim of this study is to assess the efficacy and safety of semaglutide in achieving greater weight loss compared to diet and excercise alone in obese PWH and to explore the effect of semaglutide on the immune function, markers of immune activation, viral reservoir, markers of glucose and lipid metabolism and gut microbiome.

Detailed Description

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A randomised, controlled, parallel-group, open-label study comparing treatment with the GLP-1 analogue semaglutide in combination with lifestyle interventions to lifestyle interventions alone in obese PWH.

The study will enroll HIV-1 infected patients ≥ 18 years with BMI ≥30kg/m2 or BMI ≥27kg/m2 and hypertension, dyslipidaemia or type 2 diabetes mellitus.

Primary objective: To assess the efficacy of semaglutide as an adjunct to diet and exercise in achieving greater weight loss in obese PWH as compared to diet and exercise alone.

Secondary objectives:

* To explore the effect of semaglutide on markers of immune function and HIV viral reservoirs in obese PWH.
* To explore the effect of semaglutide on markers of glucose and lipid metabolism in obese PWH.
* To explore the effect of semaglutide on markers of inflammation and gut microbial translocation in obese PWH.
* To assess the safety of semaglutide in obese PWH on stable ART.

Conditions

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Obesity HIV-1-infection

Keywords

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obesity HIV weight loss GLP-1 analogue immune activation viral reservoir gut microbiome

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 0.25/0.5/1 mg plus standard of care

Group Type EXPERIMENTAL

Semaglutide Injectable Product

Intervention Type DRUG

Semaglutide 0.25 mg subcutaneously once weekly for 4 weeks, then Semaglutide 0.5 mg subcutaneously once weekly for 4 weeks, then Semaglutide 1 mg subcutaneously once weekly for 20 weeks. Total treatment duration 28 weeks.

Standard of care

Intervention Type BEHAVIORAL

Diet and exercise advice for 40 weeks

Standard of care alone

Group Type OTHER

Standard of care

Intervention Type BEHAVIORAL

Diet and exercise advice for 40 weeks

Interventions

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Semaglutide Injectable Product

Semaglutide 0.25 mg subcutaneously once weekly for 4 weeks, then Semaglutide 0.5 mg subcutaneously once weekly for 4 weeks, then Semaglutide 1 mg subcutaneously once weekly for 20 weeks. Total treatment duration 28 weeks.

Intervention Type DRUG

Standard of care

Diet and exercise advice for 40 weeks

Intervention Type BEHAVIORAL

Other Intervention Names

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Ozempic Diet and exercise

Eligibility Criteria

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Inclusion Criteria

* Be over 18 years old
* Be HIV-1 antibody positive as determined by a positive 4th generation Ag/Ab ELISA assay
* Be stable on ART with a viral load suppressed \<40 copies/mL for a minimum of 2 years
* Have a CD4 count ≥200 cells/mm3 for a minimum of 1 year
* Have a BMI ≥30kg/m2 or have a BMI ≥27kg/m2 and hypertension, dyslipidaemia or type 2 diabetes mellitus
* Understand the study procedures, be able to comply with the study procedures, and voluntarily agree to participate by giving written informed consent for the trial

Exclusion Criteria

* Subjects unable to comply with the study protocol or unable to self-administer subcutaneous semaglutide
* History of obesity induced by other endocrine disorders: hypothyroidism, Cushing's syndrome, primary and secondary hypogonadism, hypothalamic disorders, polycystic ovary syndrome, insulinoma
* History of obesity induced by use of anti-psychotic medications known to be associated with weight gain (i.e. olanzapine, clozapine).
* Treatment with GLP-1 receptor agonists (including liraglutide, semaglutide or exenatide), dipeptidyl peptidase-4 (DPP-4) inhibitors or insulin within the last 3 months (including saxagliptin, linagliptin, sitagliptin)
* History of severe renal impairment, as defined by a baseline creatinine clearance \<30ml/min
* Individuals with a diagnosis of HIV-associated lipoatrophy/lipodystrophy, based on physician's assessment
* Individuals with severe hepatic impairment (Child Pugh score \>9)
* Subjects with active hepatitis B infection (defined as hepatitis B sAg positive) or hepatitis C (defined as hepatitis C Ab and RNA positive) co-infection
* Any active illness (including AIDS-defining illness) which in the opinion of the investigator precludes participation in the study
* History of cancer (apart from treated Kaposi's Sarcoma) and/or receiving chemotherapy or radiotherapy
* Active illicit intravenous drug use
* Subjects concurrently enrolled in another clinical trial of an investigational medicinal product.
* The investigator may decide that a subject cannot proceed in the study if there is any relevant other abnormal results in the screening assessments
* Subjects with any known or suspected hypersensitivity to semaglutide or any of the excipients of semaglutide
* Subjects on another medicinal product prescribed primarily for weight loss e.g. orlistat (see prohibited/cautioned concomitant medications/therapies section)
* For female subjects: pregnancy or breastfeeding at screening, planning future pregnancies or unwilling to take measures to avoid pregnancy for the duration of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Copenhagen

OTHER

Sponsor Role collaborator

Rush University Medical Center

OTHER

Sponsor Role collaborator

University College Dublin

OTHER

Sponsor Role lead

Responsible Party

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Patrick Mallon

Professor of Microbial Diseases

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Mater Misericordiae University Hospital

Dublin, , Ireland

Site Status RECRUITING

Countries

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Ireland

Central Contacts

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Stefano Savinelli, MD

Role: CONTACT

Phone: +3532215014

Email: [email protected]

Facility Contacts

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Aoife Cotter, PhD

Role: primary

References

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O'Sullivan L, Savinelli S, O'Hare S, Holden S, McHugh C, Mallon P, Doran P. An enhanced participant information leaflet and multimedia intervention to improve the quality of informed consent to a randomised clinical trial enrolling people living with HIV and obesity: a protocol for a Study Within A Trial (SWAT). Trials. 2022 Jan 17;23(1):50. doi: 10.1186/s13063-021-05979-y.

Reference Type DERIVED
PMID: 35039057 (View on PubMed)

Other Identifiers

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SWIFT Study

Identifier Type: -

Identifier Source: org_study_id