LivingGLP1
parallel randomized trial

PIONEER 9

Dose-response, Safety and Efficacy of Oral Semaglutide Versus Placebo and Versus Liraglutide, All as Monotherapy in Japanese Subjects With Type 2 Diabetes

Design

Randomized
243
Start year
2017
Treatment
52 weeks, follow-up 57 weeks
Countries
Japan (16 sites)
Sponsor
Novo Nordisk A/S (industry)
Eligibility
Japanese adults 20 y or older; HbA1c 6.5 to 9.5 on one oral drug washed out, or 7.0 to 10.0 on diet and exercise

Conduct and analysis

Blinding
double blind
Sequence generation
not reported
Allocation concealment
not reported
Outcome adjudication
not reported
Primary estimand
hypothetical
Analysis population
full analysis
Missing data
MMRM

Arms

ArmTreatmentBackgroundRandomizedAnalyzedCompleted treatment
A1Semaglutide 3 mg oral once daily (original tablet)
Oral semaglutide 3 mg
none (monotherapy); lifestyle: not reported4949
A2Semaglutide 7 mg oral once daily (original tablet)
Oral semaglutide 7 mg
none (monotherapy); lifestyle: not reported4949
A3Semaglutide 14 mg oral once daily (original tablet)
Oral semaglutide 14 mg
none (monotherapy); lifestyle: not reported4848
A4Liraglutide 0.9 mg injection once daily
Liraglutide 0.9 mg
none (monotherapy); lifestyle: not reported4848
A5Placebo
Placebo
none (monotherapy); lifestyle: not reported4949

Baseline characteristics

As printed in the trial reports or registry, per arm or for the whole trial.
CharacteristicStatisticSemaglutide 3 mg oral once daily (original tablet)
A1
Semaglutide 7 mg oral once daily (original tablet)
A2
Semaglutide 14 mg oral once daily (original tablet)
A3
Liraglutide 0.9 mg injection once daily
A4
Placebo
A5
Whole trial
ALL
agemean (years)5860615959
agesd (years)9109109
asiann4949484849
blackn00000
bmimean (kg/m2)25.9
bmisd (kg/m2)4.3
diabetes durationmean (years)7.6
diabetes durationsd (years)5.6
egfrmean (mL/min/1.73 m2)97
egfrsd (mL/min/1.73 m2)12
femalen1313899
hba1cmean (percent)8.18.38.08.38.3
hba1csd (percent)0.81.00.90.81.1
hispanicn00000
weightmean (kg)71.1
weightsd (kg)13.3
whiten00000

Analyses this trial contributes to

Results

172 adjudicated result lines, grouped by outcome. Open an outcome to see its values.
HbA1c change (37 lines; O01)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1 vs A4md0.3 percent-0.0 to 0.6hypothetical; full analysis; registry:outcomes
26A1 vs A5md-1.1 percent-1.4 to -0.8hypothetical; full analysis; registry:outcomes
26A1change-1.2 percent33treatment policy; randomized; age:<65; R0016956:Figure 1A
26A1change-1.0 percent16treatment policy; randomized; age:>=65; R0016956:Figure 1A
26A1change-1.1 percent0.849treatment policy; full analysis; registry:outcomes
26A1 vs A4md0.2 percent-0.1 to 0.5treatment policy; full analysis; registry:outcomes
26A1 vs A5md-0.8 percent-1.1 to -0.5treatment policy; full analysis; registry:outcomes
26A1change-1.1 percent0.849hypothetical; full analysis; registry:outcomes
26A2change-1.6 percent0.849treatment policy; full analysis; registry:outcomes
26A2 vs A5md-1.2 percent-1.5 to -0.9treatment policy; full analysis; registry:outcomes
26A2change-1.5 percent34treatment policy; randomized; age:<65; R0016956:Figure 1A
26A2change-1.7 percent0.849hypothetical; full analysis; registry:outcomes
26A2 vs A4md-0.1 percent-0.4 to 0.2hypothetical; full analysis; registry:outcomes
26A2 vs A5md-1.5 percent-1.7 to -1.2hypothetical; full analysis; registry:outcomes
26A2change-1.6 percent15treatment policy; randomized; age:>=65; R0016956:Figure 1A
26A2 vs A4md-0.2 percent-0.5 to 0.1treatment policy; full analysis; registry:outcomes
26A3change-1.7 percent0.948treatment policy; full analysis; registry:outcomes
26A3change-1.7 percent0.848hypothetical; full analysis; registry:outcomes
26A3 vs A4md-0.3 percent-0.6 to -0.0hypothetical; full analysis; registry:outcomes
26A3 vs A5md-1.7 percent-2.0 to -1.4hypothetical; full analysis; registry:outcomes
26A3 vs A4md-0.4 percent-0.7 to -0.1treatment policy; full analysis; registry:outcomes
26A3 vs A5md-1.4 percent-1.7 to -1.1treatment policy; full analysis; registry:outcomes
26A3change-1.8 percent27treatment policy; randomized; age:<65; R0016956:Figure 1A
26A3change-1.8 percent21treatment policy; randomized; age:>=65; R0016956:Figure 1A
26A4change-1.3 percent33treatment policy; randomized; age:<65; R0016956:Figure 1A
26A4change-1.6 percent15treatment policy; randomized; age:>=65; R0016956:Figure 1A
26A4change-1.4 percent1.148treatment policy; full analysis; registry:outcomes
26A4change-1.4 percent1.148hypothetical; full analysis; registry:outcomes
26A5change-0.2 percent0.749hypothetical; full analysis; registry:outcomes
26A5change-0.4 percent1.049treatment policy; full analysis; registry:outcomes
26A5change-0.7 percent16treatment policy; randomized; age:>=65; R0016956:Figure 1A
26A5change-0.2 percent33treatment policy; randomized; age:<65; R0016956:Figure 1A
52A1change-1.0 percent0.938not stated; full analysis; registry:outcomes
52A2change-1.4 percent0.943not stated; full analysis; registry:outcomes
52A3change-1.5 percent0.841not stated; full analysis; registry:outcomes
52A4change-1.3 percent1.041not stated; full analysis; registry:outcomes
52A5change0.1 percent0.734not stated; full analysis; registry:outcomes
Body weight change in kilograms (diabetes) (20 lines; O02)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change-1.1 kg16treatment policy; randomized; age:>=65; R0016956:Figure 1B
26A1change-0.4 kg1.949not stated; full analysis; registry:outcomes
26A1change-0.3 kg33treatment policy; randomized; age:<65; R0016956:Figure 1B
26A2change-0.9 kg15treatment policy; randomized; age:>=65; R0016956:Figure 1B
26A2change-1.2 kg1.949not stated; full analysis; registry:outcomes
26A2change-1.2 kg34treatment policy; randomized; age:<65; R0016956:Figure 1B
26A3change-2.8 kg27treatment policy; randomized; age:<65; R0016956:Figure 1B
26A3change-1.8 kg21treatment policy; randomized; age:>=65; R0016956:Figure 1B
26A3change-2.4 kg3.048not stated; full analysis; registry:outcomes
26A4change0.1 kg1.648not stated; full analysis; registry:outcomes
26A4change0.2 kg33treatment policy; randomized; age:<65; R0016956:Figure 1B
26A4change-0.6 kg15treatment policy; randomized; age:>=65; R0016956:Figure 1B
26A5change-1.1 kg33treatment policy; randomized; age:<65; R0016956:Figure 1B
26A5change-1.1 kg1.649not stated; full analysis; registry:outcomes
26A5change-1.1 kg16treatment policy; randomized; age:>=65; R0016956:Figure 1B
52A1change0.0 kg2.449not stated; full analysis; registry:outcomes
52A2change-0.8 kg2.149not stated; full analysis; registry:outcomes
52A3change-2.9 kg3.948not stated; full analysis; registry:outcomes
52A4change0.5 kg2.048not stated; full analysis; registry:outcomes
52A5change-1.0 kg1.749not stated; full analysis; registry:outcomes
HbA1c below 7 percent (10 lines; O03)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1responders24 / 49not stated; full analysis; registry:outcomes
26A2responders33 / 49not stated; full analysis; registry:outcomes
26A3responders35 / 48not stated; full analysis; registry:outcomes
26A4responders24 / 48not stated; full analysis; registry:outcomes
26A5responders6 / 49not stated; full analysis; registry:outcomes
52A1responders19 / 49not stated; full analysis; registry:outcomes
52A2responders29 / 49not stated; full analysis; registry:outcomes
52A3responders33 / 48not stated; full analysis; registry:outcomes
52A4responders20 / 48not stated; full analysis; registry:outcomes
52A5responders4 / 49not stated; full analysis; registry:outcomes
Level 2 or 3 hypoglycemia (participants) (5 lines; O04)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events0 / 49not stated; safety; registry:outcomes
A2events0 / 49not stated; safety; registry:outcomes
A3events0 / 48not stated; safety; registry:outcomes
A4events2 / 48not stated; safety; registry:outcomes
A5events0 / 49not stated; safety; registry:outcomes
Systolic blood pressure change (10 lines; O05)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change-3 mmHg1349not stated; safety; registry:outcomes
26A2change-5 mmHg1249not stated; safety; registry:outcomes
26A3change-2 mmHg1248not stated; safety; registry:outcomes
26A4change-1 mmHg1348not stated; safety; registry:outcomes
26A5change-4 mmHg1149not stated; safety; registry:outcomes
52A1change-0 mmHg1249not stated; safety; registry:outcomes
52A2change-1 mmHg1049not stated; safety; registry:outcomes
52A3change-1 mmHg1048not stated; safety; registry:outcomes
52A4change1 mmHg1548not stated; safety; registry:outcomes
52A5change-3 mmHg949not stated; safety; registry:outcomes
Percent body weight change (10 lines; O10)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1percent change-0.64 percent2.6549not stated; full analysis; registry:outcomes
26A2percent change-1.63 percent2.7849not stated; full analysis; registry:outcomes
26A3percent change-3.54 percent4.3348not stated; full analysis; registry:outcomes
26A4percent change0.08 percent2.2348not stated; full analysis; registry:outcomes
26A5percent change-1.58 percent2.2749not stated; full analysis; registry:outcomes
52A1percent change-0.03 percent3.2549not stated; full analysis; registry:outcomes
52A2percent change-1.23 percent3.0949not stated; full analysis; registry:outcomes
52A3percent change-4.42 percent5.9148not stated; full analysis; registry:outcomes
52A4percent change0.68 percent2.7348not stated; full analysis; registry:outcomes
52A5percent change-1.42 percent2.4749not stated; full analysis; registry:outcomes
Weight loss of 5 percent or more (10 lines; O11A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1responders1 / 49not stated; full analysis; registry:outcomes
26A2responders5 / 49not stated; full analysis; registry:outcomes
26A3responders16 / 48not stated; full analysis; registry:outcomes
26A4responders0 / 48not stated; full analysis; registry:outcomes
26A5responders3 / 49not stated; full analysis; registry:outcomes
52A1responders1 / 49not stated; full analysis; registry:outcomes
52A2responders5 / 49not stated; full analysis; registry:outcomes
52A3responders17 / 48not stated; full analysis; registry:outcomes
52A4responders2 / 48not stated; full analysis; registry:outcomes
52A5responders2 / 49not stated; full analysis; registry:outcomes
Weight loss of 10 percent or more (10 lines; O11B)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1responders0 / 49not stated; full analysis; registry:outcomes
26A2responders0 / 49not stated; full analysis; registry:outcomes
26A3responders3 / 48not stated; full analysis; registry:outcomes
26A4responders0 / 48not stated; full analysis; registry:outcomes
26A5responders0 / 49not stated; full analysis; registry:outcomes
52A1responders0 / 49not stated; full analysis; registry:outcomes
52A2responders1 / 49not stated; full analysis; registry:outcomes
52A3responders6 / 48not stated; full analysis; registry:outcomes
52A4responders0 / 48not stated; full analysis; registry:outcomes
52A5responders0 / 49not stated; full analysis; registry:outcomes
All cause mortality (5 lines; O20)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events0 / 49not stated; safety; registry:adverse_events
A2events0 / 49not stated; safety; registry:adverse_events
A3events0 / 48not stated; safety; registry:adverse_events
A4events0 / 48not stated; safety; registry:adverse_events
A5events0 / 49not stated; safety; registry:adverse_events
SF-36 physical component summary change (10 lines; O24A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change-1.33 points4.5649hypothetical; full analysis; registry:outcomes
26A2change-0.38 points3.2849hypothetical; full analysis; registry:outcomes
26A3change0.93 points3.4948hypothetical; full analysis; registry:outcomes
26A4change-0.14 points3.2148hypothetical; full analysis; registry:outcomes
26A5change0.20 points4.1149hypothetical; full analysis; registry:outcomes
52A1change-1.28 points6.0349hypothetical; full analysis; registry:outcomes
52A2change-0.12 points4.3049hypothetical; full analysis; registry:outcomes
52A3change0.02 points4.0548hypothetical; full analysis; registry:outcomes
52A4change0.10 points3.4248hypothetical; full analysis; registry:outcomes
52A5change-0.10 points4.0349hypothetical; full analysis; registry:outcomes
Physical functioning (any instrument) (10 lines; O24B)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change-0.22 points2.5349hypothetical; full analysis; registry:outcomes
26A2change-0.09 points1.9349hypothetical; full analysis; registry:outcomes
26A3change0.04 points2.7148hypothetical; full analysis; registry:outcomes
26A4change0.09 points2.0148hypothetical; full analysis; registry:outcomes
26A5change-0.14 points2.6349hypothetical; full analysis; registry:outcomes
52A1change-0.31 points3.6349hypothetical; full analysis; registry:outcomes
52A2change0.30 points2.3749hypothetical; full analysis; registry:outcomes
52A3change-0.00 points3.4248hypothetical; full analysis; registry:outcomes
52A4change-0.09 points2.1148hypothetical; full analysis; registry:outcomes
52A5change-0.00 points2.9649hypothetical; full analysis; registry:outcomes
Health related quality of life total score (any instrument) (10 lines; O24C)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change6.67 points15.8149hypothetical; full analysis; registry:outcomes
26A2change7.98 points11.4749hypothetical; full analysis; registry:outcomes
26A3change11.22 points12.9948hypothetical; full analysis; registry:outcomes
26A4change9.77 points14.4648hypothetical; full analysis; registry:outcomes
26A5change4.18 points14.1349hypothetical; full analysis; registry:outcomes
52A1change6.97 points14.4749hypothetical; full analysis; registry:outcomes
52A2change5.52 points12.2949hypothetical; full analysis; registry:outcomes
52A3change8.02 points14.0948hypothetical; full analysis; registry:outcomes
52A4change7.12 points15.0948hypothetical; full analysis; registry:outcomes
52A5change0.57 points16.5349hypothetical; full analysis; registry:outcomes
Serious adverse events (5 lines; O25)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events2 / 49not stated; safety; registry:adverse_events
A2events3 / 49not stated; safety; registry:adverse_events
A3events0 / 48not stated; safety; registry:adverse_events
A4events0 / 48not stated; safety; registry:adverse_events
A5events3 / 49not stated; safety; registry:adverse_events
Nausea (5 lines; O27A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events2 / 49not stated; safety; registry:adverse_events
A2events5 / 49not stated; safety; registry:adverse_events
A3events4 / 48not stated; safety; registry:adverse_events
A4events0 / 48not stated; safety; registry:adverse_events
A5events1 / 49not stated; safety; registry:adverse_events
Diarrhea (5 lines; O27C)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events4 / 49not stated; safety; registry:adverse_events
A2events1 / 49not stated; safety; registry:adverse_events
A3events3 / 48not stated; safety; registry:adverse_events
A4events2 / 48not stated; safety; registry:adverse_events
A5events1 / 49not stated; safety; registry:adverse_events
Constipation (5 lines; O27D)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events5 / 49not stated; safety; registry:adverse_events
A2events6 / 49not stated; safety; registry:adverse_events
A3events6 / 48not stated; safety; registry:adverse_events
A4events9 / 48not stated; safety; registry:adverse_events
A5events3 / 49not stated; safety; registry:adverse_events
Thyroid cancer (any) (5 lines; O32B)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events0 / 49not stated; safety; Papillary thyroid cancer; registry:adverse_events
A2events1 / 49not stated; safety; Papillary thyroid cancer; registry:adverse_events
A3events0 / 48not stated; safety; Papillary thyroid cancer; registry:adverse_events
A4events0 / 48not stated; safety; Papillary thyroid cancer; registry:adverse_events
A5events0 / 49not stated; safety; Papillary thyroid cancer; registry:adverse_events