Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial

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Standard

Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS) : a multicentre, randomised, phase 3b trial. / Aroda, Vanita R.; Aberle, Jens; Bardtrum, Lars; Christiansen, Erik; Knop, Filip K.; Gabery, Sanaz; Pedersen, Sue D.; Buse, John B.

In: The Lancet, Vol. 402, No. 10403, 2023, p. 693-704.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Aroda, VR, Aberle, J, Bardtrum, L, Christiansen, E, Knop, FK, Gabery, S, Pedersen, SD & Buse, JB 2023, 'Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial', The Lancet, vol. 402, no. 10403, pp. 693-704. https://doi.org/10.1016/S0140-6736(23)01127-3

APA

Aroda, V. R., Aberle, J., Bardtrum, L., Christiansen, E., Knop, F. K., Gabery, S., Pedersen, S. D., & Buse, J. B. (2023). Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial. The Lancet, 402(10403), 693-704. https://doi.org/10.1016/S0140-6736(23)01127-3

Vancouver

Aroda VR, Aberle J, Bardtrum L, Christiansen E, Knop FK, Gabery S et al. Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial. The Lancet. 2023;402(10403):693-704. https://doi.org/10.1016/S0140-6736(23)01127-3

Author

Aroda, Vanita R. ; Aberle, Jens ; Bardtrum, Lars ; Christiansen, Erik ; Knop, Filip K. ; Gabery, Sanaz ; Pedersen, Sue D. ; Buse, John B. / Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS) : a multicentre, randomised, phase 3b trial. In: The Lancet. 2023 ; Vol. 402, No. 10403. pp. 693-704.

Bibtex

@article{7f60f8d1ea494ee5b30e2299a4aafa0a,
title = "Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial",
abstract = "Background: Once-daily oral semaglutide is an effective type 2 diabetes treatment. We aimed to investigate a new formulation of oral semaglutide at higher investigational doses versus the approved 14 mg dose in adults with inadequately controlled type 2 diabetes. Methods: This global, multicentre, randomised, double-blind, phase 3b trial, carried out at 177 sites in 14 countries, enrolled adults with type 2 diabetes, glycated haemoglobin (HbA1c) 8·0−10·5% (64−91 mmol/mol), a BMI of 25·0 kg/m2 or greater, receiving stable daily doses of one to three oral glucose-lowering drugs. Participants were randomly assigned (1:1:1), by means of an interactive web response system, to once-daily oral semaglutide 14 mg, 25 mg, or 50 mg for 68 weeks. Investigators, site personnel, trial participants, and trial sponsor staff were masked to dose assignment throughout the trial. The primary endpoint was change in HbA1c from baseline to week 52, evaluated with a treatment policy estimand in the intention-to-treat population. Safety was assessed in all participants who received at least one dose of trial drug. This trial is registered with ClinicalTrials.gov, NCT04707469, and the European Clinical Trials register, EudraCT 2020-000299-39, and is complete. Findings: Between Jan 15 and Sept 29, 2021, of 2294 people screened, 1606 (n=936 [58·3%] male; n=670 [41·7%] female; mean [SD] age 58·2 [10·8] years) received oral semaglutide 14 mg (n=536), 25 mg (n=535), or 50 mg (n=535). At baseline, mean (SD) HbA1c was 9·0% (0·8; 74·4 mmol/L [SD 8·3]) and mean bodyweight was 96·4 kg (21·6). Mean changes (SE) in HbA1c at week 52 were −1·5 percentage points (SE 0·05) with oral semaglutide 14 mg, −1·8 percentage points (0·06) with 25 mg (estimated treatment difference [ETD] −0·27, 95% CI −0·42 to −0·12; p=0·0006), and −2·0 percentage points (0·06) with 50 mg (ETD −0·53, −0·68 to −0·38; p<0·0001). Adverse events were reported by 404 (76%) participants in the oral semaglutide 14 mg group, 422 (79%) in the 25 mg group, and 428 (80%) in the 50 mg group. Gastrointestinal disorders, which were mostly mild to moderate, occurred more frequently with oral semaglutide 25 mg and 50 mg than with 14 mg. Ten deaths occurred during the trial; none were judged to be treatment related. Interpretation: Oral semaglutide 25 mg and 50 mg were superior to 14 mg in reducing HbA1c and bodyweight in adults with inadequately controlled type 2 diabetes. No new safety concerns were identified. Funding: Novo Nordisk.",
author = "Aroda, {Vanita R.} and Jens Aberle and Lars Bardtrum and Erik Christiansen and Knop, {Filip K.} and Sanaz Gabery and Pedersen, {Sue D.} and Buse, {John B.}",
note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Ltd",
year = "2023",
doi = "10.1016/S0140-6736(23)01127-3",
language = "English",
volume = "402",
pages = "693--704",
journal = "The Lancet",
issn = "0140-6736",
publisher = "TheLancet Publishing Group",
number = "10403",

}

RIS

TY - JOUR

T1 - Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS)

T2 - a multicentre, randomised, phase 3b trial

AU - Aroda, Vanita R.

AU - Aberle, Jens

AU - Bardtrum, Lars

AU - Christiansen, Erik

AU - Knop, Filip K.

AU - Gabery, Sanaz

AU - Pedersen, Sue D.

AU - Buse, John B.

N1 - Publisher Copyright: © 2023 Elsevier Ltd

PY - 2023

Y1 - 2023

N2 - Background: Once-daily oral semaglutide is an effective type 2 diabetes treatment. We aimed to investigate a new formulation of oral semaglutide at higher investigational doses versus the approved 14 mg dose in adults with inadequately controlled type 2 diabetes. Methods: This global, multicentre, randomised, double-blind, phase 3b trial, carried out at 177 sites in 14 countries, enrolled adults with type 2 diabetes, glycated haemoglobin (HbA1c) 8·0−10·5% (64−91 mmol/mol), a BMI of 25·0 kg/m2 or greater, receiving stable daily doses of one to three oral glucose-lowering drugs. Participants were randomly assigned (1:1:1), by means of an interactive web response system, to once-daily oral semaglutide 14 mg, 25 mg, or 50 mg for 68 weeks. Investigators, site personnel, trial participants, and trial sponsor staff were masked to dose assignment throughout the trial. The primary endpoint was change in HbA1c from baseline to week 52, evaluated with a treatment policy estimand in the intention-to-treat population. Safety was assessed in all participants who received at least one dose of trial drug. This trial is registered with ClinicalTrials.gov, NCT04707469, and the European Clinical Trials register, EudraCT 2020-000299-39, and is complete. Findings: Between Jan 15 and Sept 29, 2021, of 2294 people screened, 1606 (n=936 [58·3%] male; n=670 [41·7%] female; mean [SD] age 58·2 [10·8] years) received oral semaglutide 14 mg (n=536), 25 mg (n=535), or 50 mg (n=535). At baseline, mean (SD) HbA1c was 9·0% (0·8; 74·4 mmol/L [SD 8·3]) and mean bodyweight was 96·4 kg (21·6). Mean changes (SE) in HbA1c at week 52 were −1·5 percentage points (SE 0·05) with oral semaglutide 14 mg, −1·8 percentage points (0·06) with 25 mg (estimated treatment difference [ETD] −0·27, 95% CI −0·42 to −0·12; p=0·0006), and −2·0 percentage points (0·06) with 50 mg (ETD −0·53, −0·68 to −0·38; p<0·0001). Adverse events were reported by 404 (76%) participants in the oral semaglutide 14 mg group, 422 (79%) in the 25 mg group, and 428 (80%) in the 50 mg group. Gastrointestinal disorders, which were mostly mild to moderate, occurred more frequently with oral semaglutide 25 mg and 50 mg than with 14 mg. Ten deaths occurred during the trial; none were judged to be treatment related. Interpretation: Oral semaglutide 25 mg and 50 mg were superior to 14 mg in reducing HbA1c and bodyweight in adults with inadequately controlled type 2 diabetes. No new safety concerns were identified. Funding: Novo Nordisk.

AB - Background: Once-daily oral semaglutide is an effective type 2 diabetes treatment. We aimed to investigate a new formulation of oral semaglutide at higher investigational doses versus the approved 14 mg dose in adults with inadequately controlled type 2 diabetes. Methods: This global, multicentre, randomised, double-blind, phase 3b trial, carried out at 177 sites in 14 countries, enrolled adults with type 2 diabetes, glycated haemoglobin (HbA1c) 8·0−10·5% (64−91 mmol/mol), a BMI of 25·0 kg/m2 or greater, receiving stable daily doses of one to three oral glucose-lowering drugs. Participants were randomly assigned (1:1:1), by means of an interactive web response system, to once-daily oral semaglutide 14 mg, 25 mg, or 50 mg for 68 weeks. Investigators, site personnel, trial participants, and trial sponsor staff were masked to dose assignment throughout the trial. The primary endpoint was change in HbA1c from baseline to week 52, evaluated with a treatment policy estimand in the intention-to-treat population. Safety was assessed in all participants who received at least one dose of trial drug. This trial is registered with ClinicalTrials.gov, NCT04707469, and the European Clinical Trials register, EudraCT 2020-000299-39, and is complete. Findings: Between Jan 15 and Sept 29, 2021, of 2294 people screened, 1606 (n=936 [58·3%] male; n=670 [41·7%] female; mean [SD] age 58·2 [10·8] years) received oral semaglutide 14 mg (n=536), 25 mg (n=535), or 50 mg (n=535). At baseline, mean (SD) HbA1c was 9·0% (0·8; 74·4 mmol/L [SD 8·3]) and mean bodyweight was 96·4 kg (21·6). Mean changes (SE) in HbA1c at week 52 were −1·5 percentage points (SE 0·05) with oral semaglutide 14 mg, −1·8 percentage points (0·06) with 25 mg (estimated treatment difference [ETD] −0·27, 95% CI −0·42 to −0·12; p=0·0006), and −2·0 percentage points (0·06) with 50 mg (ETD −0·53, −0·68 to −0·38; p<0·0001). Adverse events were reported by 404 (76%) participants in the oral semaglutide 14 mg group, 422 (79%) in the 25 mg group, and 428 (80%) in the 50 mg group. Gastrointestinal disorders, which were mostly mild to moderate, occurred more frequently with oral semaglutide 25 mg and 50 mg than with 14 mg. Ten deaths occurred during the trial; none were judged to be treatment related. Interpretation: Oral semaglutide 25 mg and 50 mg were superior to 14 mg in reducing HbA1c and bodyweight in adults with inadequately controlled type 2 diabetes. No new safety concerns were identified. Funding: Novo Nordisk.

U2 - 10.1016/S0140-6736(23)01127-3

DO - 10.1016/S0140-6736(23)01127-3

M3 - Journal article

C2 - 37385279

AN - SCOPUS:85168601033

VL - 402

SP - 693

EP - 704

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 10403

ER -

ID: 366766295