- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT05569772
Semaglutid zur Behandlung von Glukoseintoleranz bei Frauen mit früherem Schwangerschaftsdiabetes (SERENA)
Semaglutid zur Behandlung von Glukoseintoleranz bei Frauen mit früherem Schwangerschaftsdiabetes: eine doppelblinde RCT
Studienübersicht
Status
Intervention / Behandlung
Detaillierte Beschreibung
Patientenpopulation: Frauen mit kürzlich aufgetretenem Gestationsdiabetes (GDM) und anhaltender Glukoseintoleranz in der frühen Zeit nach der Geburt sind eine besonders hohe Risikogruppe, da etwa 50 % innerhalb von 5 Jahren nach der Entbindung einen Typ-2-Diabetes (T2DM) entwickeln. Semaglutid ist ein langwirksamer Glucagon-like-Peptid-1 (GLP-1)-Agonist mit mehreren vorteilhaften metabolischen Wirkungen, einschließlich blutzuckersenkender Wirkung, Gewichtsverlust und kardiovaskulärer Schutzwirkung. Wir gehen davon aus, dass bei Frauen mit früherem GDM und Glukoseintoleranz in der frühen postpartalen Phase die Behandlung mit Semaglutid das Risiko, T2DM zu entwickeln, im Vergleich zu Placebo langfristig verringert.
Intervention und Vergleich: Belgische multizentrische doppelblinde RCT mit 12 Zentren zum Vergleich von Semaglutid (einmal wöchentlich) mit Placebo bei Frauen mit kürzlich aufgetretenem GDM und Glukoseintoleranz [beeinträchtigter Nüchtern-Glykämie (IFG) und/oder beeinträchtigter Glukosetoleranz (IGT) ] 6-24 Wochen nach der Geburt. Die Teilnehmer werden vor dem Hintergrund von Lebensstilmaßnahmen 1/1 auf Semaglutid oder Placebo randomisiert. Semaglutide wird über einen Zeitraum von 8 Wochen auf 1 mg/Woche hochtitriert. Die Teilnehmer werden 3 Jahre lang nachbeobachtet. Die Teilnehmer erhalten 3 Monate nach Beendigung der Intervention einen oralen 75-g-Glukosetoleranztest (OGTT). Die Randomisierung wird nach BMI beim frühen postpartalen Besuch stratifiziert (
Ergebnisse: Der primäre Endpunkt ist die Entwicklung von T2DM, definiert durch OGTT und/oder HbA1c. Wichtige sekundäre Endpunkte sind die Notwendigkeit einer Rettungstherapie bei Diabetes, Regression zur Normoglykämie, Gewichtsverlust, Betazellfunktion, Insulinresistenz und das metabolische Syndrom. Um eine Aussagekraft von 80 % zu erreichen, planen wir eine Stichprobengröße von 206, um eine geschätzte Verringerung des Risikos, T2DM zu entwickeln, um 50 % zwischen beiden Gruppen zu erkennen, wobei wir von einem 30 %igen Verlust an Follow-up während der Studie ausgehen.
Studientyp
Einschreibung (Geschätzt)
Phase
- Phase 3
Kontakte und Standorte
Studienkontakt
- Name: Katrien Benhalima, MD PhD
- Telefonnummer: 32 16340614
- E-Mail: katrien.benhalima@uzleuven.be
Studienorte
-
-
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Aalst, Belgien
- Rekrutierung
- AZORG
-
Kontakt:
- Katrien Wierckx
-
Antwerp, Belgien
- Rekrutierung
- UZA
-
Kontakt:
- Niels Bochanen
-
Antwerp, Belgien
- Rekrutierung
- ZAS
-
Kontakt:
- Ann Verhaegen
-
Bruges, Belgien
- Rekrutierung
- AZ St Jan Brugge
-
Kontakt:
- Sara Vandewalle, MD
- Telefonnummer: 003250 45 23 3
- E-Mail: SARA.VANDEWALLE@azsintjan.be
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Brussels, Belgien
- Rekrutierung
- UZ Brussel
-
Kontakt:
- Nancy Van Wilder
-
Brussels, Belgien
- Rekrutierung
- Erasme
-
Kontakt:
- Maria Lytrivi
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Ieper, Belgien
- Rekrutierung
- Jan Yperman
-
Kontakt:
- An Nollet, MD
- Telefonnummer: 003257 35 72 70
- E-Mail: an.nollet@yperman.net
-
Kortrijk, Belgien
- Rekrutierung
- AZ Groeninge Kortrijk
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Kontakt:
- Gertjan Vereecke
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Leuven, Belgien
- Rekrutierung
- UZ Leuven
-
Kontakt:
- Katrien Benhalima
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Liège, Belgien
- Rekrutierung
- CHU de Liege
-
Kontakt:
- JC Philips
-
Mouscron, Belgien
- Rekrutierung
- Centre Hospitalier Mouscron
-
Kontakt:
- Philippe Oriot
-
Sint-Niklaas, Belgien
- Rekrutierung
- Vitaz
-
Kontakt:
- Peter Coremans
-
Turnhout, Belgien
- Rekrutierung
- AZ Turnhout
-
Kontakt:
- Joke Cuypers, MD
- Telefonnummer: 003214 44 44 32
- E-Mail: joke.cuypers@azturnhout.be
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Beschreibung
Einschlusskriterien:
- Vor allen Screening-Verfahren wurde die freiwillige schriftliche Einverständniserklärung des Teilnehmers eingeholt
- Anwendung hochwirksamer Methoden der Empfängnisverhütung
- Vorgeschichte von GDM (diagnostiziert mit den WHO-Kriterien 2013 in der 24.–32. Schwangerschaftswoche) und Glukoseintoleranz 6–24 Wochen nach der Geburt (basierend auf den ADA-Kriterien)
- Muss in der Lage sein, Niederländisch, Französisch oder Englisch zu verstehen und zu sprechen
Ausschlusskriterien:
- 1. Der Teilnehmer hat eine Vorgeschichte von Diabetes oder Autoantikörpern für Typ-1-Diabetes, Pankreatitis in der Vorgeschichte, familiäre oder persönliche Vorgeschichte von medullärem Schilddrüsenkarzinom oder multiplem endokrinem Neoplasie-Syndrom Typ 2, schwere psychiatrische Störung im vergangenen Jahr, Herzinsuffizienz NYHA-Klasse 4, Nierenerkrankung im Endstadium (eGFR
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Verhütung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Verdreifachen
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
|---|---|
|
Aktiver Komparator: Semaglutid
Semaglutid SC einmal wöchentlich, Auftitration über 2 Monate auf 1 mg/Woche (0,25 mg einmal wöchentlich, nach 4 Wochen 0,5 mg einmal wöchentlich und nach 8 Wochen die Erhaltungsdosis von 1 mg einmal wöchentlich), Behandlungsdauer von max. 3 Jahre
|
Erhaltungsdosis von 1 mg s.c. einmal wöchentlich
Andere Namen:
|
|
Placebo-Komparator: Placebo
Placebo s.c. einmal wöchentlich, gleiches Dosissteigerungsschema, mit passenden Injektionen, Behandlungsdauer von max. 3 Jahre
|
Erhaltungsdosis von 1 mg s.c. einmal wöchentlich
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Development of T2DM
Zeitfenster: by 160 weeks
|
Defined by FPG, OGTT, and/or HbA1c according to the ADA criteria
|
by 160 weeks
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Need for glucose-lowering (rescue) therapy
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage need for rescue therapy for diabetes
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Frequency of prediabetes based on FPG, OGTT, and/or HbA1c
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage of prediabetes based on FPG, OGTT, and/or HbA1c
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Regression to normoglycaemia
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage regression to normoglycaemia, based on fasting glycaemia, oral glucose tolerance test and/or HbA1c (ADA criteria)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Change in body weight
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Change in body weight (kg)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
BMI
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Mean BMI (Kg/m2)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Waist circumference
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Mean waist circumference (cm)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Waist-to-hip ratio
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Waist/hip circumference ratio
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Proportion of participants achieving ≥5% weight loss
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage weight loss ≥5%
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Proportion of participants achieving ≥10% weight loss
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage weight loss ≥10%
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Proportion of participants achieving ≥15% weight loss
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage weight loss ≥15%
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Body fat percentage assessed by bioelectrical impedance analysis (Bodystat 1500®)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage body fat measured by bioelectrical impedance analysis
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
β-cell function, assessed by HOMA-B
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Beta-cell function measured by the HOMA-B index
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Insulinogenic index divided by HOMA-IR
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Beta-cell function measured by the by the insulinogenic index divided by HOMA-insulin resistance index
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Insulin secretion-sensitivity index-2
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Beta-cell function measured by theby the insulin-secretion sensitivity-2 index
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Stumvoll index
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Beta-cell function measured by the Stumvoll index
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Insulin sensitivity, assessed by the Matsuda index (reflecting whole body insulin sensitivity)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Whole body Insulin sensitivity measured by the insulin sensitivity index of Matsuda
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
1/HOMA-IR, reflecting primarily hepatic insulin sensitivity
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
The reciprocal of the homeostasis model assessment of insulin resistance (1/HOMA-IR)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Prevalence of the metabolic syndrome
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage of the metabolic syndrome based on the WHO criteria
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Blood pressure (blood pressure ≥140/90 mmHg)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage blood pressure ≥140/90mmHg
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Heart rate
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Mean heart rate
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Lipid profile, including low density lipoprotein-cholesterol (LDL-cholesterol, ≥100 mg/dL or ≥2,6 mmol/L)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage LDL cholesterol ≥100mg/dl or ≥2,6 mmol/L
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Lipid profile, including triglycerides (≥150 mg/dL or ≥1,7 mmol/L)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Percentage triglycerides ≥150mg/dl or ≥1,7 mmol/L
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Health-related quality of life assessed by SF-36
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Health-related quality of life assessed using the 36-Item Short Form Health Survey (SF-36).
Scores range from 0 to 100, with higher scores indicating better health-related quality of life
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Health-related quality of life assessed by EQ-5D-5L
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Health-related quality of life assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Visual Analogue Scale (EQ VAS).
Scores range from 0 to 100, with higher scores indicating better perceived health status
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Symptoms of depression (CES-D)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Depressive symptoms assessed using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D).
Total scores range from 0 to 60, with higher scores indicating more depressive symptoms
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Symptoms of anxiety (short-form STAI)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Symptoms of anxiety assessed using the 6-item short-form State-Trait Anxiety Inventory (STAI).
Total scores range from 20 to 80 after score transformation, with higher scores indicating greater anxiety symptoms
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Treatment satisfaction assessed using a study-specific questionnaire based on the Diabetes Treatment Satisfaction Questionnaire
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Diabetes risk perception assessed using the Diabetes Risk Perception Questionnaire, a validated questionnaire that evaluates perceived risk of developing diabetes
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Sleep quality (Pittsburgh Sleep Quality Index)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Sleep quality assessed using the validated Pittsburgh Sleep Quality Index (PSQI)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Food security (short-form HFSSM)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Food security assessed using the short-form Household Food Security Survey Module (HFSSM).
Scores indicate the level of food security, with higher scores reflecting greater food insecurity
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Plasma metabolite concentrations
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Changes in and associations of metabolomic profiles, with cardiometabolic risk and treatment response.
Assessed using metabolomic profiling.
Blood samples will be collected at baseline and every 6 months during a 3.5-year follow-up period (study visits).
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Quality-adjusted life years (QALYs)
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Quality-adjusted life years (QALYs), calculated as the area under the curve of health-related quality of life utility values over time, where higher values indicate better health outcomes
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Incremental costs and incremental cost-effectiveness ratio (ICER) of semaglutide compared with placebo
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Incremental costs and incremental cost-effectiveness ratio (ICER) of semaglutide versus placebo
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
|
Incremental healthcare costs
Zeitfenster: Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Incremental healthcare costs associated with the intervention compared with control, calculated from collected healthcare resource utilization and unit cost data.
Currency (e.g., EUR per participant)
|
Assessed at 160 weeks (end of treatment) and at 172-184 weeks (3-6 months after discontinuation of study medication)
|
Mitarbeiter und Ermittler
Mitarbeiter
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Urogenitale Erkrankungen
- Erkrankungen des endokrinen Systems
- Weibliche Urogenitalerkrankungen und Schwangerschaftskomplikationen
- Stoffwechselerkrankungen
- Schwangerschaftskomplikationen
- Störungen des Glukosestoffwechsels
- Diabetes Mellitus
- Ernährungs- und Stoffwechselerkrankungen
- Schwangerschaftsdiabetes
- Diabetes mellitus, Typ 2
- Glucagon-ähnliche Peptid-1-Rezeptoragonisten
- Physiologische Wirkungen von Arzneimitteln
- Hypoglykämische Mittel
- Semaglutid
Andere Studien-ID-Nummern
- S66967
- 2022-502082-22-00 (Andere Kennung: EU CT number)
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
Beschreibung des IPD-Plans
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
Produkt, das in den USA hergestellt und aus den USA exportiert wird
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