Efficacy and Safety of Oral Semaglutide Versus Placebo in Subjects With Type 2 Diabetes and Moderate Renal Impairment
Condition: Diabetes; Diabetes Mellitus, Type 2
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Intervention: semaglutide; placebo
Intervention description: Oral administration once daily.; Oral administration once daily.
Phase: Phase 3
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Enrollment: 324.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      This trial is conducted globally. The aim of this trial is to investigate efficacy and safety
      of oral semaglutide versus placebo in subjects with type 2 diabetes and moderate renal
      impairment.
    

Eligibility criteria:

        Inclusion Criteria:

          -  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

          -  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 mmol/mol) (both inclusive)

          -  Moderate renal impairment defined as estimated glomerular filtration rate of 30-59
             mL/min/1.73 m^2 as per Chronic Kidney Disease Epidemiology Collaboration formula

          -  Stable daily dose(s) within 90 days prior to the day of screening of any of the
             following treatment regimens:

          -  1-2 of the following oral anti-diabetic drugs:

          -  Metformin equal or above 1500 mg or maximum tolerated dose documented in the subject
             medical record),

          -  Sulfonylurea (equal or above half of the maximum approved dose according to local
             label or maximum tolerated dose as documented in subject medical record)

          -  Basal insulin alone (20% change in total daily dose of insulin glargine, insulin
             detemir, insulin degludec or NPH insulin) or

          -  Metformin (equal or above 1500 mg or maximum tolerated dose documented in the subject
             medical record) in combination with basal insulin (20% change in total daily dose of
             insulin glargine, insulin detemir, insulin degludec or NPH insulin)

        Exclusion Criteria:

          -  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 or Medullary Thyroid
             Carcinoma

          -  History of pancreatitis (acute or chronic)

          -  History of major surgical procedures involving the stomach potentially affecting
             absorption of trial product (e.g. subtotal and total gastrectomy, sleeve gastrectomy,
             gastric bypass surgery)

          -  Any of the following: myocardial infarction, stroke or hospitalisation for unstable
             angina or transient ischaemic attack within the past 180 days prior to the day of
             screening and randomisation

          -  Subjects presently classified as being in New York Heart Association Class IV

          -  Planned coronary, carotid or peripheral artery revascularisation known on the day of
             screening

          -  Subjects with alanine aminotransferase above 2.5 x upper normal limit

          -  Rapidly progressing renal disease (e.g. such as acute glomerulonephritis) as judged by
             the investigator or known nephrotic albuminuria (above 2200 mg/24 hours or above 2200
             mg/g)

          -  Use of systemic immunosuppressive treatment within 90 days prior to screening

          -  Treatment with any medication for the indication of diabetes or obesity other than
             stated in the inclusion criteria in a period of 90 days before the day of screening.
             An exception is short-term insulin treatment for acute illness for a total of below or
             equal to 14 days

          -  Known hypoglycaemic unawareness and/or recurrent severe hypoglycaemic episodes as
             judged by the investigator

          -  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)