LivingGLP1
parallel randomized trial

PIONEER 8

Efficacy and Safety of Oral Semaglutide Versus Placebo in Subjects With Type 2 Diabetes Mellitus Treated With Insulin. A 52-week, Randomised, Double-blind, Placebo-controlled Trial (PIONEER 8 - Insulin add-on)

Design

Randomized
731
Start year
2017
Treatment
52 weeks, follow-up 57 weeks
Countries
multinational
Sponsor
Novo Nordisk A/S (industry)
Eligibility
adults with type 2 diabetes on basal, premixed or basal bolus insulin with or without metformin

Conduct and analysis

Blinding
double blind
Sequence generation
not reported
Allocation concealment
not reported
Outcome adjudication
not reported
Primary estimand
treatment policy
Analysis population
full analysis
Missing data
pattern mixture model; MMRM for trial product estimand

Arms

ArmTreatmentBackgroundRandomizedAnalyzedCompleted treatment
A1Semaglutide 3 mg oral once daily (original tablet)
Oral semaglutide 3 mg
insulin with or without metformin; lifestyle: not reported184184
A2Semaglutide 7 mg oral once daily (original tablet)
Oral semaglutide 7 mg
insulin with or without metformin; lifestyle: not reported182182
A3Semaglutide 14 mg oral once daily (original tablet)
Oral semaglutide 14 mg
insulin with or without metformin; lifestyle: not reported181181
A4Placebo
Placebo
insulin with or without metformin; lifestyle: not reported184184

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
Placebo
A4
Whole trial
ALL
agemean (years)61606160
agesd (years)9101010
asiann66666665
blackn15101113
bmi: 25 to less than 30n217
bmi: 30 to less than 35n199
bmi: 35 or moren176
bmi: less than 25n139
diabetes duration: 10 or moren517
diabetes duration: 5 to less than 10n145
diabetes duration: less than 5n69
femalen82799679
hba1cmean (percent)8.28.28.28.2
hba1csd (percent)0.70.70.70.7
hispanicn18243025
other race american indian alaska nativen1010
other race native hawaiian pacific islandern0000
other race not applicablen121088
other race othern1110
whiten89959498

Analyses this trial contributes to

Results

169 adjudicated result lines, grouped by outcome. Open an outcome to see its values.
HbA1c change (27 lines; O01)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change-0.6 percent1.1184hypothetical; full analysis; registry:outcomes
26A1 vs A4md-0.6 percent-0.7 to -0.4hypothetical; full analysis; registry:outcomes
26A1change-0.5 percent1.0184treatment policy; full analysis; registry:outcomes
26A1 vs A4md-0.5 percent-0.7 to -0.3treatment policy; full analysis; registry:outcomes
26A2 vs A4md-1.0 percent-1.2 to -0.8hypothetical; full analysis; registry:outcomes
26A2change-1.0 percent1.1182treatment policy; full analysis; registry:outcomes
26A2 vs A4md-0.9 percent-1.1 to -0.7treatment policy; full analysis; registry:outcomes
26A2change-1.1 percent1.0182hypothetical; full analysis; registry:outcomes
26A3change-1.4 percent0.9181hypothetical; full analysis; registry:outcomes
26A3change-1.3 percent1.1181treatment policy; full analysis; registry:outcomes
26A3 vs A4md-1.2 percent-1.4 to -1.0treatment policy; full analysis; registry:outcomes
26A3 vs A4md-1.4 percent-1.6 to -1.2hypothetical; full analysis; registry:outcomes
26A4change-0.1 percent0.8184hypothetical; full analysis; registry:outcomes
26A4change-0.1 percent0.9184treatment policy; full analysis; registry:outcomes
52A1change-0.6 percent1.0173not stated; full analysis; registry:outcomes
52A2change-0.9 percent1.1169not stated; full analysis; registry:outcomes
52A3change-1.2 percent1.0168not stated; full analysis; registry:outcomes
52A3change-1.5 percenthypothetical; other; race:asian; R0008864:Table 1
52A3 vs A4md-1.9 percent-2.2 to -1.5hypothetical; other; race:asian; R0008864:Table 1
52A3change-0.6 percenthypothetical; other; race:black; R0008864:Table 1
52A3 vs A4md-0.6 percent-1.7 to 0.4hypothetical; other; race:black; R0008864:Table 1
52A3change-1.1 percenthypothetical; other; race:white; R0008864:Table 1
52A3 vs A4md-0.9 percent-1.1 to -0.8hypothetical; other; race:white; R0008864:Table 1
52A4change-0.2 percent0.8172not stated; full analysis; registry:outcomes
52A4change0.3 percenthypothetical; other; race:asian; R0008864:Table 1
52A4change0.0 percenthypothetical; other; race:black; R0008864:Table 1
52A4change-0.1 percenthypothetical; other; race:white; R0008864:Table 1
Body weight change in kilograms (diabetes) (18 lines; O02)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1 vs A4md-0.9 kg-1.8 to -0.0treatment policy; full analysis; registry:outcomes
26A1change-1.5 kg3.1184hypothetical; full analysis; registry:outcomes
26A1 vs A4md-0.9 kg-1.6 to -0.2hypothetical; full analysis; registry:outcomes
26A1change-1.4 kg3.1184treatment policy; full analysis; registry:outcomes
26A2change-3.0 kg3.7182hypothetical; full analysis; registry:outcomes
26A2change-2.6 kg5.2182treatment policy; full analysis; registry:outcomes
26A2 vs A4md-2.0 kg-3.0 to -1.0treatment policy; full analysis; registry:outcomes
26A2 vs A4md-2.5 kg-3.2 to -1.8hypothetical; full analysis; registry:outcomes
26A3 vs A4md-3.3 kg-4.2 to -2.3treatment policy; full analysis; registry:outcomes
26A3change-3.9 kg3.6181hypothetical; full analysis; registry:outcomes
26A3 vs A4md-3.7 kg-4.4 to -3.0hypothetical; full analysis; registry:outcomes
26A3change-3.7 kg4.0181treatment policy; full analysis; registry:outcomes
26A4change-0.5 kg2.5184treatment policy; full analysis; registry:outcomes
26A4change-0.5 kg2.4184hypothetical; full analysis; registry:outcomes
52A1change-0.9 kg3.9174not stated; full analysis; registry:outcomes
52A2change-2.2 kg5.2171not stated; full analysis; registry:outcomes
52A3change-3.8 kg5.8170not stated; full analysis; registry:outcomes
52A4change0.5 kg3.2173not stated; full analysis; registry:outcomes
HbA1c below 7 percent (8 lines; O03)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1responders50 / 184not stated; full analysis; registry:outcomes
26A2responders74 / 182not stated; full analysis; registry:outcomes
26A3responders101 / 181not stated; full analysis; registry:outcomes
26A4responders12 / 184not stated; full analysis; registry:outcomes
52A1responders50 / 184not stated; full analysis; registry:outcomes
52A2responders67 / 182not stated; full analysis; registry:outcomes
52A3responders91 / 181not stated; full analysis; registry:outcomes
52A4responders16 / 184not stated; full analysis; registry:outcomes
Level 2 or 3 hypoglycemia (participants) (4 lines; O04)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events52 / 184not stated; safety; registry:outcomes
A2events47 / 181not stated; safety; registry:outcomes
A3events48 / 181not stated; safety; registry:outcomes
A4events54 / 184not stated; safety; registry:outcomes
Systolic blood pressure change (8 lines; O05)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change-1 mmHg12184not stated; safety; registry:outcomes
26A2change-3 mmHg17181not stated; safety; registry:outcomes
26A3change-5 mmHg14181not stated; safety; registry:outcomes
26A4change1 mmHg14184not stated; safety; registry:outcomes
52A1change-1 mmHg12184not stated; safety; registry:outcomes
52A2change-3 mmHg16181not stated; safety; registry:outcomes
52A3change-6 mmHg14181not stated; safety; registry:outcomes
52A4change0 mmHg14184not stated; safety; registry:outcomes
Percent body weight change (8 lines; O10)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1percent change-1.73 percent3.34184not stated; full analysis; registry:outcomes
26A2percent change-3.11 percent5.66182not stated; full analysis; registry:outcomes
26A3percent change-4.30 percent4.57181not stated; full analysis; registry:outcomes
26A4percent change-0.47 percent3.02184not stated; full analysis; registry:outcomes
52A1percent change-1.18 percent4.17184not stated; full analysis; registry:outcomes
52A2percent change-2.54 percent5.77182not stated; full analysis; registry:outcomes
52A3percent change-4.42 percent6.07181not stated; full analysis; registry:outcomes
52A4percent change0.65 percent3.72184not stated; full analysis; registry:outcomes
Weight loss of 5 percent or more (8 lines; O11A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1responders23 / 184not stated; full analysis; registry:outcomes
26A2responders53 / 182not stated; full analysis; registry:outcomes
26A3responders67 / 181not stated; full analysis; registry:outcomes
26A4responders5 / 184not stated; full analysis; registry:outcomes
52A1responders30 / 184not stated; full analysis; registry:outcomes
52A2responders48 / 182not stated; full analysis; registry:outcomes
52A3responders67 / 181not stated; full analysis; registry:outcomes
52A4responders9 / 184not stated; full analysis; registry:outcomes
Weight loss of 10 percent or more (8 lines; O11B)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1responders2 / 184not stated; full analysis; registry:outcomes
26A2responders12 / 182not stated; full analysis; registry:outcomes
26A3responders19 / 181not stated; full analysis; registry:outcomes
26A4responders1 / 184not stated; full analysis; registry:outcomes
52A1responders4 / 184not stated; full analysis; registry:outcomes
52A2responders17 / 182not stated; full analysis; registry:outcomes
52A3responders21 / 181not stated; full analysis; registry:outcomes
52A4responders1 / 184not stated; full analysis; registry:outcomes
Acute kidney injury (4 lines; O121)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events1 / 184not stated; safety; registry:adverse_events
A2events0 / 181not stated; safety; registry:adverse_events
A3events1 / 181not stated; safety; registry:adverse_events
A4events0 / 184not stated; safety; registry:adverse_events
All cause mortality (4 lines; O20)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events0 / 184not stated; safety; registry:adverse_events
A2events0 / 181not stated; safety; registry:adverse_events
A3events3 / 181not stated; safety; registry:adverse_events
A4events0 / 184not stated; safety; registry:adverse_events
SF-36 physical component summary change (8 lines; O24A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change0.94 points6.20184not stated; full analysis; registry:outcomes
26A2change0.75 points6.27182not stated; full analysis; registry:outcomes
26A3change-0.02 points4.81181not stated; full analysis; registry:outcomes
26A4change-0.05 points6.07184not stated; full analysis; registry:outcomes
52A1change0.26 points6.78184not stated; full analysis; registry:outcomes
52A2change0.12 points6.24182not stated; full analysis; registry:outcomes
52A3change-0.36 points6.09181not stated; full analysis; registry:outcomes
52A4change-0.41 points6.54184not stated; full analysis; registry:outcomes
Physical functioning (any instrument) (16 lines; O24B)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change1.88 points18.64184not stated; full analysis; registry:outcomes
26A1change0.53 points7.58184not stated; full analysis; registry:outcomes
26A2change-0.35 points16.28182not stated; full analysis; registry:outcomes
26A2change0.52 points6.61182not stated; full analysis; registry:outcomes
26A3change2.51 points15.94181not stated; full analysis; registry:outcomes
26A3change-0.07 points6.75181not stated; full analysis; registry:outcomes
26A4change-1.70 points15.12184not stated; full analysis; registry:outcomes
26A4change-0.82 points7.25184not stated; full analysis; registry:outcomes
52A1change3.45 points19.79184not stated; full analysis; registry:outcomes
52A1change0.51 points8.27184not stated; full analysis; registry:outcomes
52A2change-0.59 points15.85182not stated; full analysis; registry:outcomes
52A2change-0.40 points6.69182not stated; full analysis; registry:outcomes
52A3change2.59 points16.02181not stated; full analysis; registry:outcomes
52A3change-0.32 points7.55181not stated; full analysis; registry:outcomes
52A4change-0.98 points17.33184not stated; full analysis; registry:outcomes
52A4change-0.77 points6.31184not stated; full analysis; registry:outcomes
Health related quality of life total score (any instrument) (8 lines; O24C)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
26A1change1.74 points13.37184not stated; full analysis; registry:outcomes
26A2change-0.45 points12.47182not stated; full analysis; registry:outcomes
26A3change3.41 points12.19181not stated; full analysis; registry:outcomes
26A4change-0.94 points10.40184not stated; full analysis; registry:outcomes
52A1change2.35 points14.50184not stated; full analysis; registry:outcomes
52A2change-0.79 points12.47182not stated; full analysis; registry:outcomes
52A3change4.35 points13.82181not stated; full analysis; registry:outcomes
52A4change-0.73 points13.50184not stated; full analysis; registry:outcomes
Serious adverse events (4 lines; O25)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events25 / 184not stated; safety; registry:adverse_events
A2events19 / 181not stated; safety; registry:adverse_events
A3events12 / 181not stated; safety; registry:adverse_events
A4events17 / 184not stated; safety; registry:adverse_events
Nausea (8 lines; O27A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events21 / 184not stated; safety; registry:adverse_events
A1events0 / 184not stated; safety; registry:adverse_events
A2events30 / 181not stated; safety; registry:adverse_events
A2events0 / 181not stated; safety; registry:adverse_events
A3events41 / 181not stated; safety; registry:adverse_events
A3events2 / 181not stated; safety; registry:adverse_events
A4events13 / 184not stated; safety; registry:adverse_events
A4events0 / 184not stated; safety; registry:adverse_events
Vomiting (8 lines; O27B)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events11 / 184not stated; safety; registry:adverse_events
A1events0 / 184not stated; safety; registry:adverse_events
A2events14 / 181not stated; safety; registry:adverse_events
A2events0 / 181not stated; safety; registry:adverse_events
A3events17 / 181not stated; safety; registry:adverse_events
A3events2 / 181not stated; safety; registry:adverse_events
A4events7 / 184not stated; safety; registry:adverse_events
A4events0 / 184not stated; safety; registry:adverse_events
Diarrhea (8 lines; O27C)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events16 / 184not stated; safety; registry:adverse_events
A1events0 / 184not stated; safety; registry:adverse_events
A2events22 / 181not stated; safety; registry:adverse_events
A2events0 / 181not stated; safety; registry:adverse_events
A3events26 / 181not stated; safety; registry:adverse_events
A3events1 / 181not stated; safety; registry:adverse_events
A4events11 / 184not stated; safety; registry:adverse_events
A4events0 / 184not stated; safety; registry:adverse_events
Constipation (4 lines; O27D)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events8 / 184not stated; safety; registry:adverse_events
A2events15 / 181not stated; safety; registry:adverse_events
A3events12 / 181not stated; safety; registry:adverse_events
A4events5 / 184not stated; safety; registry:adverse_events
Gallbladder and biliary disease (4 lines; O28)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events1 / 184not stated; safety; cholelithiasis; registry:adverse_events
A2events1 / 181not stated; safety; cholelithiasis; registry:adverse_events
A3events0 / 181not stated; safety; cholelithiasis; registry:adverse_events
A4events0 / 184not stated; safety; cholelithiasis; registry:adverse_events
Suicidal ideation or behavior (4 lines; O35A)
WeekArmStatisticEstimateSE or SD95% CIEvents / NDetail
A1events0 / 184not stated; safety; Depression suicidal; registry:adverse_events
A2events0 / 181not stated; safety; Depression suicidal; registry:adverse_events
A3events0 / 181not stated; safety; Depression suicidal; registry:adverse_events
A4events1 / 184not stated; safety; Depression suicidal; registry:adverse_events