Efficacy and Safety of Oral Semaglutide Versus Liraglutide and Versus Placebo in Subjects With Type 2 Diabetes Mellitus
PIONEER 4
3 other identifiers
interventional
711
13 countries
108
Brief Summary
This trial is conducted globally. The aim of this trial is to investigate efficacy and safety of oral Semaglutide versus Liraglutide and versus Placebo in Subjects with Type 2 Diabetes Mellitus.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for phase_3 diabetes
Started Aug 2016
Typical duration for phase_3 diabetes
108 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
August 8, 2016
CompletedStudy Start
First participant enrolled
August 10, 2016
CompletedFirst Posted
Study publicly available on registry
August 11, 2016
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 19, 2017
CompletedStudy Completion
Last participant's last visit for all outcomes
March 30, 2018
CompletedResults Posted
Study results publicly available
November 7, 2019
CompletedJuly 20, 2022
July 1, 2022
1 year
August 8, 2016
October 15, 2019
July 11, 2022
Conditions
Outcome Measures
Primary Outcomes (1)
Change in HbA1c (Week 26)
Change from baseline (week 0) in glycosylated haemoglobin (HbA1c) was evaluated at week 26. The endpoint was evaluated based on the data from the in-trial observation period, which was the time period from when a participant was randomised until the final scheduled visit, including any period after initiation of rescue medication and/or premature discontinuation of trial product. The endpoint was also evaluated based on the data from the on-treatment without rescue medication observation period, which was the time period when a participant was on treatment with trial product, excluding any period after initiation of rescue medication and/or premature trial product discontinuation.
Week 0, week 26
Secondary Outcomes (39)
Change in Body Weight (Week 26)
Week 0, week 26
Change in HbA1c (Week 52)
Week 0, week 52
Change in Body Weight (Week 52)
Week 0, week 52
Change in Body Weight (%)
Week 0, Week 26, Week 52
Change in Fasting Plasma Glucose
Week 0, week 26, week 52
- +34 more secondary outcomes
Study Arms (3)
Oral Semaglutide
EXPERIMENTALLiraglutide
ACTIVE COMPARATORPlacebo
PLACEBO COMPARATORInterventions
Eligibility Criteria
You may qualify if:
- 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, age above or equal to 18 years at the time of signing informed consent. For Japan only: Male or female, age at least 20 years at the time of signing informed consent
- Diagnosed with type 2 diabetes mellitus for at least 90 days prior to day of screening.
- HbA1c (glycosylated haemoglobin) of 7.0-9.5 % (53-80.3 mmol/mol) (both inclusive)
- Stable daily dose of metformin (above or equal to 1500 mg or maximum tolerated dose as documented in the subject medical record) alone or in combination with a stable daily dose of a SGLT-2 (sodium-glucose co-transporter-2) inhibitor for at least 90 days prior to day of screening (fixed-dose combinations are allowed)
You may not qualify if:
- 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).For certain specific countries: Additional specific requirements apply
- Any disorder, which in the investigator's opinion might jeopardise subject's safety or compliance with the protocol
- Family or personal history of Multiple Endocrine Neoplasia Type 2 (MEN 2) or Medullary Thyroid Carcinoma (MTC)
- History of pancreatitis (acute or chronic)
- History of major surgical procedures involving the stomach and potentially affecting absorption of trial product (e.g. subtotal and total gastrectomy, sleeve gastrectomy, gastric bypass surgery)
- Any of the following: myocardial infarction (MI), stroke or hospitalisation 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 (NYHA) Class IV
- Planned coronary, carotid or peripheral artery revascularisation known on the day of screening
- Subjects with ALT (alanine aminotransferase) above 2.5 × upper normal limit (UNL)
- Renal impairment defined as estimated Glomerular Filtration Rate (eGFR) below 60 mL/min/1.73 m\^2 as per Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI)
- Proliferative retinopathy or maculopathy requiring acute treatment. Verified by fundus photography or dilated fundoscopy performed within 90 days prior to randomisation
- History or presence of malignant neoplasms within the last 5 years (except basal and squamous cell skin cancer and carcinoma in situ)
- History of diabetic ketoacidosis
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Novo Nordisk A/Slead
Study Sites (108)
Novo Nordisk Investigational Site
Birmingham, Alabama, 35222, United States
Novo Nordisk Investigational Site
Los Alamitos, California, 90720, United States
Novo Nordisk Investigational Site
San Diego, California, 92111, United States
Novo Nordisk Investigational Site
Denver, Colorado, 80246, United States
Novo Nordisk Investigational Site
Hallandale, Florida, 33009, United States
Novo Nordisk Investigational Site
Jacksonville, Florida, 32256, United States
Novo Nordisk Investigational Site
Miami, Florida, 33155, United States
Novo Nordisk Investigational Site
Ocala, Florida, 34470, United States
Novo Nordisk Investigational Site
Orlando, Florida, 32801, United States
Novo Nordisk Investigational Site
Orlando, Florida, 32804, United States
Novo Nordisk Investigational Site
Ormond Beach, Florida, 32174-6302, United States
Novo Nordisk Investigational Site
St. Petersburg, Florida, 33713, United States
Novo Nordisk Investigational Site
West Palm Beach, Florida, 33401, United States
Novo Nordisk Investigational Site
Peoria, Illinois, 61603, United States
Novo Nordisk Investigational Site
Topeka, Kansas, 66606, United States
Novo Nordisk Investigational Site
Slidell, Louisiana, 70461-4231, United States
Novo Nordisk Investigational Site
Butte, Montana, 59701, United States
Novo Nordisk Investigational Site
Lebanon, New Hampshire, 03756, United States
Novo Nordisk Investigational Site
Teaneck, New Jersey, 07666, United States
Novo Nordisk Investigational Site
Albany, New York, 12203, United States
Novo Nordisk Investigational Site
Mineola, New York, 11501, United States
Novo Nordisk Investigational Site
Greensboro, North Carolina, 27408, United States
Novo Nordisk Investigational Site
Morganton, North Carolina, 28655, United States
Novo Nordisk Investigational Site
Wilmington, North Carolina, 28401, United States
Novo Nordisk Investigational Site
Dublin, Ohio, 43016, United States
Novo Nordisk Investigational Site
Maumee, Ohio, 43537, United States
Novo Nordisk Investigational Site
Norman, Oklahoma, 73069, United States
Novo Nordisk Investigational Site
McMurray, Pennsylvania, 15317, United States
Novo Nordisk Investigational Site
Summerville, South Carolina, 29485, United States
Novo Nordisk Investigational Site
Bristol, Tennessee, 37620-7352, United States
Novo Nordisk Investigational Site
Arlington, Texas, 76012-4637, United States
Novo Nordisk Investigational Site
Dallas, Texas, 75230, United States
Novo Nordisk Investigational Site
Dallas, Texas, 75390-9302, United States
Novo Nordisk Investigational Site
Houston, Texas, 77004-7000, United States
Novo Nordisk Investigational Site
North Richland Hills, Texas, 76180, United States
Novo Nordisk Investigational Site
San Antonio, Texas, 78229, United States
Novo Nordisk Investigational Site
San Antonio, Texas, 78249, United States
Novo Nordisk Investigational Site
Newport News, Virginia, 23606, United States
Novo Nordisk Investigational Site
Richmond, Virginia, 23219, United States
Novo Nordisk Investigational Site
Virginia Beach, Virginia, 23454, United States
Novo Nordisk Investigational Site
Karlovac, 47000, Croatia
Novo Nordisk Investigational Site
Osijek, 31 000, Croatia
Novo Nordisk Investigational Site
Slavonski Brod, 35 000, Croatia
Novo Nordisk Investigational Site
Zagreb, 10 000, Croatia
Novo Nordisk Investigational Site
Zagreb, 10000, Croatia
Novo Nordisk Investigational Site
Náchod, 54701, Czechia
Novo Nordisk Investigational Site
Pilsen, 304 60, Czechia
Novo Nordisk Investigational Site
Prague, 150 00, Czechia
Novo Nordisk Investigational Site
Bochum, 44791, Germany
Novo Nordisk Investigational Site
Duisburg, 47051, Germany
Novo Nordisk Investigational Site
Falkensee, 14612, Germany
Novo Nordisk Investigational Site
Hamburg, 22607, Germany
Novo Nordisk Investigational Site
Ludwigshafen, 67059, Germany
Novo Nordisk Investigational Site
Oldenburg I. Holst, 23758, Germany
Novo Nordisk Investigational Site
Saint Ingbert-Oberwürzbach, 66386, Germany
Novo Nordisk Investigational Site
Villingen-Schwenningen, 78048, Germany
Novo Nordisk Investigational Site
Budapest, 1032, Hungary
Novo Nordisk Investigational Site
Budapest, 1042, Hungary
Novo Nordisk Investigational Site
Gyula, 5700, Hungary
Novo Nordisk Investigational Site
Kalocsa, 6300, Hungary
Novo Nordisk Investigational Site
Nagykanizsa, 8800, Hungary
Novo Nordisk Investigational Site
Szeged, H-6725, Hungary
Novo Nordisk Investigational Site
Székesfehérvár, 8000, Hungary
Novo Nordisk Investigational Site
Szigetvár, 7900, Hungary
Novo Nordisk Investigational Site
Szolnok, 5004, Hungary
Novo Nordisk Investigational Site
Tatabánya, 2800, Hungary
Novo Nordisk Investigational Site
Bunkyo-ku, Tokyo, 113-8655, Japan
Novo Nordisk Investigational Site
Kumamoto-shi,Kumamoto, 862 0976, Japan
Novo Nordisk Investigational Site
Mito-shi, Ibaraki, 310-0826, Japan
Novo Nordisk Investigational Site
Okawa-shi, Fukuoka, 831-0016, Japan
Novo Nordisk Investigational Site
Sapporo-shi, Hokkaido, 060-0001, Japan
Novo Nordisk Investigational Site
Shimotsuke-shi, Tochigi, 329-0433, Japan
Novo Nordisk Investigational Site
Suita-shi, Osaka, 564-0051, Japan
Novo Nordisk Investigational Site
Tochigi, 323-0022, Japan
Novo Nordisk Investigational Site
Yamato-shi, Kanagawa, 242-0004, Japan
Novo Nordisk Investigational Site
Ogre, LV-5001, Latvia
Novo Nordisk Investigational Site
Riga, LV-1002, Latvia
Novo Nordisk Investigational Site
Riga, LV-1011, Latvia
Novo Nordisk Investigational Site
Riga, LV-1038, Latvia
Novo Nordisk Investigational Site
Bialystok, 15-445, Poland
Novo Nordisk Investigational Site
Bydgoszcz, 85-822, Poland
Novo Nordisk Investigational Site
Gdansk, 80-214, Poland
Novo Nordisk Investigational Site
Gniewkowo, 88-140, Poland
Novo Nordisk Investigational Site
Krakow, 30-363, Poland
Novo Nordisk Investigational Site
Poznan, 60-589, Poland
Novo Nordisk Investigational Site
Szczecin, 70-506, Poland
Novo Nordisk Investigational Site
Warsaw, 02-507, Poland
Novo Nordisk Investigational Site
Wroclaw, 52-416, Poland
Novo Nordisk Investigational Site
Toa Baja, 00949, Puerto Rico
Novo Nordisk Investigational Site
Bardejov, 08501, Slovakia
Novo Nordisk Investigational Site
Bratislava, 851 01, Slovakia
Novo Nordisk Investigational Site
Košice, 040 01, Slovakia
Novo Nordisk Investigational Site
Nitra, 949 01, Slovakia
Novo Nordisk Investigational Site
Rožňava, 04801, Slovakia
Novo Nordisk Investigational Site
Vrútky, 038 61, Slovakia
Novo Nordisk Investigational Site
Benoni, Gauteng, 1501, South Africa
Novo Nordisk Investigational Site
Johannesburg, Gauteng, 2193, South Africa
Novo Nordisk Investigational Site
Durban, KwaZulu-Natal, 4092, South Africa
Novo Nordisk Investigational Site
Durban, KwaZulu-Natal, 4450, South Africa
Novo Nordisk Investigational Site
Cape Town, Western Cape, 7500, South Africa
Novo Nordisk Investigational Site
Kyiv, 04114, Ukraine
Novo Nordisk Investigational Site
Odesa, 65059, Ukraine
Novo Nordisk Investigational Site
Vinnytsia, 21010, Ukraine
Novo Nordisk Investigational Site
Ajman, 21499, United Arab Emirates
Novo Nordisk Investigational Site
Al Mafraq, 2951, United Arab Emirates
Novo Nordisk Investigational Site
Dubai, 4545, United Arab Emirates
Novo Nordisk Investigational Site
Rahba City, 34555, United Arab Emirates
Novo Nordisk Investigational Site
Umm Al Quwain City, 24, United Arab Emirates
Related Publications (7)
Pratley R, Amod A, Hoff ST, Kadowaki T, Lingvay I, Nauck M, Pedersen KB, Saugstrup T, Meier JJ; PIONEER 4 investigators. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. Lancet. 2019 Jul 6;394(10192):39-50. doi: 10.1016/S0140-6736(19)31271-1. Epub 2019 Jun 8.
PMID: 31186120RESULTAraki E, Terauchi Y, Watada H, Deenadayalan S, Christiansen E, Horio H, Kadowaki T. Efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes: A post hoc subgroup analysis of the PIONEER 1, 3, 4 and 8 trials. Diabetes Obes Metab. 2021 Dec;23(12):2785-2794. doi: 10.1111/dom.14536. Epub 2021 Sep 27.
PMID: 34472698RESULTAroda VR, Bauer R, Christiansen E, Haluzik M, Kallenbach K, Montanya E, Rosenstock J, Meier JJ. Efficacy and safety of oral semaglutide by subgroups of patient characteristics in the PIONEER phase 3 programme. Diabetes Obes Metab. 2022 Jul;24(7):1338-1350. doi: 10.1111/dom.14710. Epub 2022 May 9.
PMID: 35373893RESULTRen H, Berry S, Malkin SJP, Hunt B, Bain S. Early use of oral semaglutide in the UK: A cost-effectiveness analysis versus continuing metformin and SGLT-2 inhibitor therapy. BMJ Open. 2023 Sep 29;13(9):e070473. doi: 10.1136/bmjopen-2022-070473.
PMID: 37775297DERIVEDPratley RE, Crowley MJ, Gislum M, Hertz CL, Jensen TB, Khunti K, Mosenzon O, Buse JB. Oral Semaglutide Reduces HbA1c and Body Weight in Patients with Type 2 Diabetes Regardless of Background Glucose-Lowering Medication: PIONEER Subgroup Analyses. Diabetes Ther. 2021 Apr;12(4):1099-1116. doi: 10.1007/s13300-020-00994-9. Epub 2021 Mar 4.
PMID: 33660198DERIVEDThethi TK, Pratley R, Meier JJ. Efficacy, safety and cardiovascular outcomes of once-daily oral semaglutide in patients with type 2 diabetes: The PIONEER programme. Diabetes Obes Metab. 2020 Aug;22(8):1263-1277. doi: 10.1111/dom.14054. Epub 2020 May 13.
PMID: 32267058DERIVEDHusain M, Bain SC, Jeppesen OK, Lingvay I, Sorrig R, Treppendahl MB, Vilsboll T. Semaglutide (SUSTAIN and PIONEER) reduces cardiovascular events in type 2 diabetes across varying cardiovascular risk. Diabetes Obes Metab. 2020 Mar;22(3):442-451. doi: 10.1111/dom.13955. Epub 2020 Feb 5.
PMID: 31903692DERIVED
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Results Point of Contact
- Title
- Clinical Reporting Anchor and Disclosure (1452)
- Organization
- Novo Nordisk A/S
Study Officials
- STUDY DIRECTOR
Global Clinical Registry (GCR, 1452)
Novo Nordisk A/S
Publication Agreements
- PI is Sponsor Employee
- No
- Restriction Type
- OTHER
- Restrictive Agreement
- Yes
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, INVESTIGATOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
August 8, 2016
First Posted
August 11, 2016
Study Start
August 10, 2016
Primary Completion
August 19, 2017
Study Completion
March 30, 2018
Last Updated
July 20, 2022
Results First Posted
November 7, 2019
Record last verified: 2022-07