Impact of Liraglutide 3.0 on Body Fat Distribution

October 20, 2021 updated by: Parag Joshi, University of Texas Southwestern Medical Center

Impact of Liraglutide 3.0 on Body Fat Distribution, Visceral Adiposity, and Cardiometabolic Risk Markers In Overweight and Obese Adults at High Risk for Cardiovascular Disease

This study is a clinical study to investigate the efficacy of liraglutide compared to placebo in reducing visceral adiposity measured by MRI in overweight or obese subjects at high risk for cardiovascular disease after 40 weeks on-treatment.

Study Overview

Detailed Description

Obesity has long been recognized as a risk factor for all-cause mortality and morbidity, including the development of cardiovascular and metabolic diseases such as coronary artery disease, hypertension, insulin resistance, diabetes, and dyslipidemia. Obesity has recently been formally defined as a chronic disease characterized by pathophysiological processes that result in increased adipose tissue mass and can result in increased morbidity and mortality. Although the health risks associated with obesity are clear, there is an emerging appreciation that obesity per se, as defined by simple anthropometric measures such as waist circumference or body mass index (BMI), is neither necessary nor sufficient to promote cardiometabolic disease and atherosclerotic cardiovascular disease (ASCVD) risk. As a result, BMI alone is an insufficient marker of risk and may not accurately identify individuals at elevated risk for ASCVD. There is a pressing need to more accurately phenotype obesity to identify individuals at elevated risk for ASCVD that may benefit from more intensive preventive and therapeutic strategies

Study Type

Interventional

Enrollment (Actual)

235

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Texas
      • Dallas, Texas, United States, 75390
        • University of Texas Southwestern Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

35 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age ≥ 35 years
  • Able to provide informed consent
  • BMI ≥ 30 kg/m2 or ≥ 27 kg/m2 with metabolic syndrome
  • Metabolic syndrome is defined as at least three of the following:3

    1. waist circumference > 102 cm (40 in) in men and 88 cm (35 in) in women
    2. triglycerides > 150 mg/dL or on treatment for hypertriglyceridemia
    3. HDL cholesterol < 40 mg/dL in men and < 50 mg/dL in women
    4. blood pressure > 130/85 mmHg or on treatment for hypertension
    5. fasting glucose > 100 mg/dL

Exclusion Criteria:

  • Treatment with Glucagon-like peptide-1 (GLP-1) receptor agonists (including liraglutide, exenatide or others as they become available), dipeptidyl peptidase 4 (DPP-4) inhibitors or insulin within the last 3 months.
  • Receipt of any anti-obesity drug or supplement within 1 month prior to screening for this trial.
  • Self-reported or clinically documented history of significant fluctuations (>5% change) in weight within 3 months prior to screening for this trial.
  • History of diabetes mellitus (type 1 or 2) or on treatment with anti-diabetes medication.
  • History of chronic pancreatitis or idiopathic acute pancreatitis (current or prior history).
  • History of gallbladder disease (cholelithiasis or cholecystitis).
  • Chronic kidney disease stage III or greater (eGFR<60 mL/min).
  • Obesity induced by other endocrinologic disorders (e.g. Cushing Syndrome).
  • Current or history of treatment with medications that may cause significant weight gain, within 1 month prior to screening for this trial, including systemic corticosteroids (except for a short course of treatment, i.e., 7- 10 days), tri-cyclic antidepressants, atypical antipsychotic and mood stabilizers (e.g., imipramine, amitryptiline, mirtazapine, paroxetine, phenelzine, chlorpromazine, thioridazine, clozapine, olanzapine, valproic acid and its derivatives, and lithium).
  • Diet attempts using herbal supplements or over-the-counter medications within 1 month prior to screening for this trial.
  • Current participation in an organized weight reduction program or within the last 1 month prior to screening for this trial.
  • Participation in a clinical trial within the last 3 months prior to screening for this trial.
  • Familial or personal history of multiple endocrine neoplasia type 2 or familial medullary thyroid carcinoma.
  • Personal history of non-familial medullary thyroid carcinoma.
  • History of Major Depressive Disorder within the last 2 years.
  • History of other severe psychiatric disorders, e.g., schizophrenia, bipolar disorder.
  • Any lifetime history of a suicide attempt.
  • A history of any suicidal behavior in the last month prior to randomization.
  • Surgery scheduled for the trial duration period, except for minor surgical procedures, at the discretion of the Investigator.
  • Known or suspected hypersensitivity to trial product(s) or related product(s).
  • Known or suspected abuse of alcohol or narcotics.
  • Language barrier, mental incapacity, unwillingness or inability to understand.
  • Females of childbearing potential who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods. These include abstinence and the following methods: diaphragm with spermicide, condom with spermicide (by male partner), intrauterine device, sponge, spermicide, Norplant®, Depo-Provera® or oral contraceptives.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Liraglutide 3.0 mg

Drug: Liraglutide Active Drug

Other Names:

  • Saxenda

Escalate the liraglutide (active) dose to 3.0 mg/day over a 4 week period following an initial dose of 0.6 mg/day and weekly dose escalation steps of 0.6 mg/day through subcutaneous injection.

Liraglutide is administered once daily by subcutaneous injections with the pen-injector, either in the abdomen, thigh or upper arm. Injections can be done at any time of day irrespective of meals. Subjects will be instructed to escalate the liraglutide dose to 3.0 mg/day over a 4 week period following an initial dose of 0.6 mg/day and weekly dose escalation steps of 0.6 mg/day.
Other Names:
  • Saxenda
Placebo Comparator: Placebo

Drug: Placebo (for Liraglutide at a concentration of 6.0 mg/mL) Placebo tablet manufactured to mimic Liraglutide at a concentration of 6.0 mg/mL

Other Names:

  • Placebo
  • Saline injection

Escalate the Placebo dose to 3.0 mg/day over a 4 week period following an initial dose of 0.6 mg/day and weekly dose escalation steps of 0.6 mg/day through subcutaneous injection.

Placebo is administered once daily by subcutaneous injections with the pen-injector, either in the abdomen, thigh or upper arm. Injections can be done at any time of day irrespective of meals. Subjects will be instructed to escalate the placebo dose to 3.0 mg/day over a 4 week period following an initial dose of 0.6 mg/day and weekly dose escalation steps of 0.6 mg/day.
Other Names:
  • Saline injection

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Relative Percent Reduction in Visceral Adipose Tissue Mass Measured by MRI
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in visceral adipose tissue mass measured by MRI after 40 weeks on treatment.

Positive numbers reflect the reduction in the value from baseline to study endpoint as a percent of the baseline.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Absolute Reduction in Visceral Adipose Tissue Volume
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in visceral adipose tissue mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Relative Percent Reduction in Body Weight
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in body weight after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Absolute Reduction in Body Weight
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in body weight after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Relative Percent Reduction in Waist Circumference
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in waist circumference after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Absolute Reduction in Waist Circumference
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in waist circumference after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Relative Percent Reduction in Total Body Adipose Tissue
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in total body adipose tissue (fat) mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Absolute Reduction in Total Body Adipose Tissue
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in total body adipose tissue mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Relative Percent Reduction in Abdominal Subcutaneous Adipose Tissue
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in abdominal subcutaneous adipose tissue mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Absolute Reduction in Abdominal Subcutaneous Adipose Tissue
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in abdominal subcutaneous adipose tissue mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Relative Percent Reduction in Lower Body Subcutaneous Adipose Tissue
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in lower body subcutaneous adipose tissue mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Absolute Reduction in Lower Body Subcutaneous Adipose Tissue
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in lower body subcutaneous adipose tissue mass measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Relative Percent Reduction in Liver Fat Percent
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in liver (hepatic) fat percentage measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint. Negative values reflect an increase in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Absolute Reduction in Liver Fat Percent
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in liver (hepatic) fat percentage measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint. Negative values reflect an increase in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower cardiovascular risk.

Baseline, 40 weeks
Relative Percent Reduction in Total Body Lean Volume
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in total body lean volume (fat-free mass) measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Absolute Reduction in Total Body Lean Volume
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in total body lean volume (fat-free mass) measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Relative Percent Reduction in Total Thigh Muscle Volume
Time Frame: Baseline, 40 weeks

The effect on relative percent reduction from baseline in total thigh muscle volume measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Absolute Reduction in Total Thigh Muscle Volume
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in total thigh muscle volume measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

Baseline, 40 weeks
Relative Percent Reduction in Mean Anterior Thigh Muscle Fat Infiltration Percent
Time Frame: Baseline,40 weeks

The effect on relative percent reduction from baseline in mean anterior thigh muscle fat infiltration percent measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint. Negative values reflect an increase in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower risk for metabolic disease.

Baseline,40 weeks
Absolute Reduction in Mean Anterior Thigh Muscle Fat Infiltration Percent
Time Frame: Baseline,40 weeks

The effect on absolute reduction from baseline in mean anterior thigh muscle fat infiltration percent measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint. Negative values reflect an increase in the value from baseline to study endpoint.

Reduction in this variable is believed to be associated with lower risk for metabolic disease

Baseline,40 weeks
Change From Baseline in VAT/SAT Ratio
Time Frame: Baseline, 40 weeks

The effect on absolute reduction from baseline in Visceral adipose tissue/subcutaneous adipose tissue (VAT/SAT) ratio measured by MRI after 40 weeks on treatment versus placebo.

Positive numbers reflect the reduction in the value from baseline to study endpoint.

This is the ratio of visceral adipose tissue to subcutaneous adipose tissue and it is thought that lower values (relatively less visceral adipose tissue) are better.

Baseline, 40 weeks
Change From Baseline in Total Fat/Fat-free Mass Ratio
Time Frame: Baseline, 40 weeks

The effect on absolute change from baseline in total fat/fat-free mass ratio measured by MRI after 40 weeks on treatment versus placebo.

This is a ratio of fat to lean mass and it is believed that lower values (less fat relative to lean mass) is better.

Baseline, 40 weeks
Relative Percent Change in Fasting Blood Glucose
Time Frame: Baseline, 40 weeks

The relative percent change in fasting blood glucose from baseline to study end point as a percent of baseline by treatment group.

Negative values reflect a reduction. This is a blood based biomarker for diabetes in which normal levels are desirable (70-100 mg/dL).

Baseline, 40 weeks
Relative Percent Change in Insulin
Time Frame: Baseline, 40 weeks

The relative percent change in insulin from baseline to study end point as a percent of baseline by treatment group.

Positive values reflect an increase. Collection was impacted by coronavirus disease 2019 (COVID-19) and limitations to in person study visits, limiting complete collection of data for this measure.

This is a blood based biomarker in which lower fasting levels are desirable.

Baseline, 40 weeks
Relative Percent Change in HOMA-IR
Time Frame: Baseline, 40 weeks

The relative percent change in HOMA-IR from baseline to study end point as a percent of baseline by treatment group.

Positive values reflect an increase. Collection was impacted by coronavirus disease 2019 (COVID-19) and limitations to in person study visits, limiting complete collection of data for this measure.

The relative percent change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) from baseline to study end point by treatment group measures insulin resistance. Levels above 1.9 signal early insulin resistance, while levels above 2.9 signal significant insulin resistance. There will be optimal insulin sensitivity if HOMA-IR is less than 1.

Baseline, 40 weeks
Relative Percent Change in C-reactive Protein
Time Frame: Baseline, 40 weeks

The relative percent change in biomarker of inflammation: C-reactive protein (CRP) from baseline to study end point as a percent of baseline by treatment group.

Negative values reflect a decrease. Collection was impacted by coronavirus disease 2019 (COVID-19) and limitations to in person study visits, limiting complete collection of data for this measure.

This is a blood based test for which lower values are associated with less inflammation and lower risk for cardiovascular events.

Baseline, 40 weeks
Relative Percent Change in Triglyceride/HDL-C Ratio
Time Frame: Baseline, 40 weeks

The relative percent change in triglyceride/HDL-C ratio from baseline to study end point as a percent of baseline by treatment group.

Negative values reflect a decrease. Collection was impacted by coronavirus disease 2019 (COVID-19) and limitations to in person study visits, limiting complete collection of data for this measure.

Lower ratio of triglycerides to HDL-cholesterol is associated with less insulin resistance and lower cardiovascular risk.

Baseline, 40 weeks
Relative Percent Change in Nt-proBNP
Time Frame: Baseline, 40 weeks

The relative percent change in N-terminal Pro Brain Natriuretic Peptides (Nt-proBNP) from baseline to study end point as a percent of baseline by treatment group.

Negative values reflect a decrease. Collection was impacted by coronavirus disease 2019 (COVID-19) and limitations to in person study visits, limiting complete collection of data for this measure.

NT-proBNP is a blood based biomarker. Lower levels are associated with lower risk for heart failure and cardiovascular events.

Baseline, 40 weeks
Absolute Change in Fasting Blood Glucose
Time Frame: Baseline,40 weeks
The change in fasting blood glucose from baseline to study end point by treatment group.
Baseline,40 weeks
Absolute Change in Insulin
Time Frame: Baseline, 40 weeks
The absolute change in insulin from baseline to study end point by treatment group. Collection was impacted by COVID-19 and changes to study visits.
Baseline, 40 weeks
Absolute Change in HOMA-IR
Time Frame: Baseline, 40 weeks
The absolute change in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) from baseline to study end point by treatment group measures insulin resistance. Levels above 1.9 signal early insulin resistance, while levels above 2.9 signal significant insulin resistance. There will be optimal insulin sensitivity if HOMA-IR is less than 1. Collection was impacted by COVID-19 and changes to study visits.
Baseline, 40 weeks
Absolute Change in CRP
Time Frame: Baseline, 40 weeks

The change in Markers of inflammation: C-reactive protein (CRP) from baseline to study end point by treatment group. Collection was impacted by COVID-19 and changes to study visits.

This is a blood based test for which lower values are associated with less inflammation and lower risk for cardiovascular events.

Baseline, 40 weeks
Absolute Change in Triglyceride/HDL-C Ratio
Time Frame: Baseline, 40 weeks

The change in triglyceride/HDL-C ratio from baseline to study end point by treatment group. Collection was impacted by COVID-19 and changes to study visits.

Lower ratio of triglycerides to HDL-cholesterol is associated with less insulin resistance and lower cardiovascular risk.

Baseline, 40 weeks
Absolute Change in Nt-proBNP
Time Frame: Baseline, 40 weeks

The change in N-terminal Pro Brain Natriuretic Peptides (Nt-proBNP) from baseline to study end point by treatment group. Collection was impacted by COVID-19 and changes to study visits.

NT-proBNP is a blood based biomarker. Lower levels are associated with lower risk for heart failure and cardiovascular events.

Baseline, 40 weeks
Change From Baseline in Heart Rate
Time Frame: Baseline, 40 weeks
The change in heart rate/pulse from baseline to study endpoint visit by treatment group.
Baseline, 40 weeks
Change From Baseline in Blood Pressure
Time Frame: Baseline, 40 weeks
The change in systolic blood pressure from baseline to study endpoint visit by treatment group.
Baseline, 40 weeks

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
On-treatment Time, Weeks
Time Frame: weeks
The mean duration of treatment during study follow-up.
weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Collaborators

Investigators

  • Principal Investigator: Parag Joshi, MD, University of Texas Southwestern Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2017

Primary Completion (Actual)

October 13, 2020

Study Completion (Actual)

October 13, 2020

Study Registration Dates

First Submitted

January 30, 2017

First Submitted That Met QC Criteria

January 30, 2017

First Posted (Estimate)

January 31, 2017

Study Record Updates

Last Update Posted (Actual)

November 19, 2021

Last Update Submitted That Met QC Criteria

October 20, 2021

Last Verified

October 1, 2021

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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