A Research Study to Find Out How Semaglutide Works in the Kidneys Compared to Placebo, in People With Type 2 Diabetes and Chronic Kidney Disease (the REMODEL Trial) (REMODEL)
Primary Purpose
Diabetes Mellitus, Type 2, Chronic Kidney Disease
Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Semaglutide
Placebo (Semaglutide)
Sponsored by
About this trial
This is an interventional treatment trial for Diabetes Mellitus, Type 2
Eligibility Criteria
Inclusion Criteria:
- Male or female.
- Age above or equal to 18 years at the time of signing informed consent.
- Diagnosed with T2D (type 2 diabetes) greater than or equal to 180 days prior to the day of screening.
- HbA1c (glycated haemoglobin) below or equal to 9.0 percent (below or equal to 75 mmol/mol).
Depending on biopsy/non-biopsy population:
- For subjects in the non-biopsy population: Serum creatinine-based eGFR greater than or equal to 30 and below or equal to 75 mL/min/1.73 m^2(CKD-EPI).
- For subjects in the biopsy sub-population: Serum creatinine-based eGFR greater than or equal to 40 and below or equal to 75 mL/min/1.73 m^2(CKD-EPI).
- UACR ( Urinary albumin-to-creatinine ratio ) greater than or equal to 20 and below 5000 mg/g.
- Treatment with maximum labelled or tolerated dose of a renin-angiotensin-aldosterone system (RAAS) blocking agent including an angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB)) unless such treatment is contraindicated or not tolerated.Treatment dose must be stable for at least 28 days prior to screening.
Exclusion Criteria:
- Use of any glucagon-like peptide 1 receptor agonist (GLP-1 RA) within 30 days prior to screening.
- A prior solid organ transplant or awaiting solid organ transplant.
- Myocardial infarction, stroke, hospitalisation for unstable angina pectoris or transient ischaemic attack within 180 days prior to the day of screening.
- Presence or history of malignant neoplasms (other than basal or squamous cell skin cancer, in situ carcinomas of the cervix, or in situ prostate cancer) within 5 years prior to the day of screening.
- Congenital or hereditary kidney diseases including polycystic kidney disease, autoimmune kidney diseases including glomerulonephritis or congenital urinary tract malformations.
- Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days prior to screening or in the period between screening and Visit 2. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
- Treatment with systemic anti-inflammatory or immunosuppressant drugs within 90 days prior to screening. Stable treatment with acetylsalicylic acid for prevention of cardiovascular events and occasional use of propionic acid derivatives drugs (e.g. ibuprofen) is allowed.
- Any contraindication for MRI according to standard checklist used in clinical routine, including claustrophobia or metallic foreign bodies, metallic implants, internal electrical devices, or permanent makeup/tattoos that cannot be declared MR compatible.
- Combination use of an ACE (angiotensin-converting enzyme) inhibitor and an ARB (angiotensin II receptor blockers).
Sites / Locations
- Novo Nordisk Investigational Site
- Novo Nordisk Investigational Site
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational Site
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational Site
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
- Novo Nordisk Investigational SiteRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Semaglutide 1.0 mg OW
Placebo (Semaglutide) 1.0 mg OW
Arm Description
Once-weekly (OW) Semaglutide administered subcutaneously (s.c., under the skin).
Once-weekly (OW) placebo (Semaglutide) administered subcutaneously (s.c., under the skin).
Outcomes
Primary Outcome Measures
Change in kidney oxygenation (cortex), BOLD (blood oxygenation-level dependent) MRI ( magnetic resonance imaging )
ratio
Change in kidney oxygenation (medulla), BOLD MRI(R2)
ratio
Change in global kidney perfusion (MRI)
ratio
Change in kidney inflammation (cortex), T1 mapping (MRI)
ratio
Change in kidney inflammation (medulla), T1 mapping (MRI)
ratio
Secondary Outcome Measures
Change in gene expression assessed by single nucleus RNA sequencing (kidney biopsy)
log2 fold-change
Change in glomerular basement membrane width (kidney biopsy)
nm
Change in ADC (apparent diffusion coefficient) (cortex) (MRI)
ratio
Change in ADC (medulla) (MRI)
ratio
Change in mean RARI (renal artery resistive index ) (MRI)
ratio
Change in mean arterial flow (MRI)
ratio
Change in natriuresis (urinary sodium excretion) (urinalysis)
mmol/l
Change in albumin excretion rate (urinalysis)
mg/24 hours
Change in kidney function (creatinine clearance) (urinalysis
ml/min/1.73 m^2
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04865770
Brief Title
A Research Study to Find Out How Semaglutide Works in the Kidneys Compared to Placebo, in People With Type 2 Diabetes and Chronic Kidney Disease (the REMODEL Trial)
Acronym
REMODEL
Official Title
Renal Mode of Action of Semaglutide in Patients With Type 2 Diabetes and Chronic Kidney Disease
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 28, 2021 (Actual)
Primary Completion Date
October 7, 2024 (Anticipated)
Study Completion Date
November 18, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novo Nordisk A/S
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
We are doing this study to learn more about how semaglutide may help fight chronic kidney disease in people with type 2 diabetes. We are doing this by looking into how semaglutide works in the kidneys.
Participants will either get semaglutide or placebo (a 'dummy' medicine) - which treatment participants get is decided by chance.
Semaglutide is a medicine doctors can prescribe in some countries for the treatment of type 2 diabetes.
Participants will get the study medicine in a pen. Participants will use the pen to inject the medicine into the skin once a week.
The study will last for about 1 year. Participants will have 11 visits to the clinic, and 2 phone visits. Some of the visits could be in different locations.
Study staff will take blood samples at most of these visits. At 9 visits, participants will be asked to bring a sample of their first morning urine. At 4 of the visits participants will have to bring urine that they have collected over the last 24 hours.
The study includes magnetic resonance imaging (MRI) scans of participants' kidneys which is a test that shows a detailed picture of organs and other parts inside the body. The scan will last for 30 minutes, and is free of radiation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2, Chronic Kidney Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Sponsor staff involved in the clinical trial is masked according to company standard procedures.
Allocation
Randomized
Enrollment
105 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Semaglutide 1.0 mg OW
Arm Type
Experimental
Arm Description
Once-weekly (OW) Semaglutide administered subcutaneously (s.c., under the skin).
Arm Title
Placebo (Semaglutide) 1.0 mg OW
Arm Type
Placebo Comparator
Arm Description
Once-weekly (OW) placebo (Semaglutide) administered subcutaneously (s.c., under the skin).
Intervention Type
Drug
Intervention Name(s)
Semaglutide
Intervention Description
Semaglutide given subcutaneously (sc, under the skin) once weekly. Dose gradually increased over 8 weeks from 0.25 to 1.0 mg. The study will last for about 1 year.
Intervention Type
Drug
Intervention Name(s)
Placebo (Semaglutide)
Intervention Description
Placebo (Semaglutide) given subcutaneously (sc, under the skin) once weekly. Dose gradually increased over 8 weeks from 0.25 to 1.0 mg. The study will last for about 1 year.
Primary Outcome Measure Information:
Title
Change in kidney oxygenation (cortex), BOLD (blood oxygenation-level dependent) MRI ( magnetic resonance imaging )
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in kidney oxygenation (medulla), BOLD MRI(R2)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in global kidney perfusion (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in kidney inflammation (cortex), T1 mapping (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in kidney inflammation (medulla), T1 mapping (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Secondary Outcome Measure Information:
Title
Change in gene expression assessed by single nucleus RNA sequencing (kidney biopsy)
Description
log2 fold-change
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in glomerular basement membrane width (kidney biopsy)
Description
nm
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in ADC (apparent diffusion coefficient) (cortex) (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in ADC (medulla) (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52
Title
Change in mean RARI (renal artery resistive index ) (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in mean arterial flow (MRI)
Description
ratio
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in natriuresis (urinary sodium excretion) (urinalysis)
Description
mmol/l
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in albumin excretion rate (urinalysis)
Description
mg/24 hours
Time Frame
From baseline (week 0) to end of treatment (week 52)
Title
Change in kidney function (creatinine clearance) (urinalysis
Description
ml/min/1.73 m^2
Time Frame
From baseline (week 0) to end of treatment (week 52
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female.
Age above or equal to 18 years at the time of signing informed consent.
Diagnosed with T2D (type 2 diabetes) greater than or equal to 180 days prior to the day of screening.
HbA1c (glycated haemoglobin) below or equal to 9.0 percent (below or equal to 75 mmol/mol).
Depending on biopsy/non-biopsy population:
For subjects in the non-biopsy population: Serum creatinine-based eGFR greater than or equal to 30 and below or equal to 75 mL/min/1.73 m^2(CKD-EPI).
For subjects in the biopsy sub-population: Serum creatinine-based eGFR greater than or equal to 40 and below or equal to 75 mL/min/1.73 m^2(CKD-EPI).
UACR ( Urinary albumin-to-creatinine ratio ) greater than or equal to 20 and below 5000 mg/g.
Treatment with maximum labelled or tolerated dose of a renin-angiotensin-aldosterone system (RAAS) blocking agent including an angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB)) unless such treatment is contraindicated or not tolerated.Treatment dose must be stable for at least 28 days prior to screening.
Exclusion Criteria:
Use of any glucagon-like peptide 1 receptor agonist (GLP-1 RA) within 30 days prior to screening.
A prior solid organ transplant or awaiting solid organ transplant.
Myocardial infarction, stroke, hospitalisation for unstable angina pectoris or transient ischaemic attack within 180 days prior to the day of screening.
Presence or history of malignant neoplasms (other than basal or squamous cell skin cancer, in situ carcinomas of the cervix, or in situ prostate cancer) within 5 years prior to the day of screening.
Congenital or hereditary kidney diseases including polycystic kidney disease, autoimmune kidney diseases including glomerulonephritis or congenital urinary tract malformations.
Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days prior to screening or in the period between screening and Visit 2. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
Treatment with systemic anti-inflammatory or immunosuppressant drugs within 90 days prior to screening. Stable treatment with acetylsalicylic acid for prevention of cardiovascular events and occasional use of propionic acid derivatives drugs (e.g. ibuprofen) is allowed.
Any contraindication for MRI according to standard checklist used in clinical routine, including claustrophobia or metallic foreign bodies, metallic implants, internal electrical devices, or permanent makeup/tattoos that cannot be declared MR compatible.
Combination use of an ACE (angiotensin-converting enzyme) inhibitor and an ARB (angiotensin II receptor blockers).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Novo Nordisk
Phone
(+1) 866-867-7178
Email
clinicaltrials@novonordisk.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Transparency (Dept.2834)
Organizational Affiliation
Novo Nordisk A/S
Official's Role
Study Director
Facility Information:
Facility Name
Novo Nordisk Investigational Site
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Individual Site Status
Withdrawn
Facility Name
Novo Nordisk Investigational Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90022
Country
United States
Individual Site Status
Suspended
Facility Name
Novo Nordisk Investigational Site
City
San Dimas
State/Province
California
ZIP/Postal Code
91773
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Orlando
State/Province
Florida
ZIP/Postal Code
32804
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77054
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Individual Site Status
Withdrawn
Facility Name
Novo Nordisk Investigational Site
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78233
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Seattle
State/Province
Washington
ZIP/Postal Code
98195
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2N2
Country
Canada
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Herlev
ZIP/Postal Code
2730
Country
Denmark
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
AMIENS cedex 1
ZIP/Postal Code
80054
Country
France
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Bois-Guillaume
ZIP/Postal Code
76230
Country
France
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Grenoble - Cédex 09
ZIP/Postal Code
38043
Country
France
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Reims
ZIP/Postal Code
51092
Country
France
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Toulouse
ZIP/Postal Code
31059
Country
France
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Milano
State/Province
MI
ZIP/Postal Code
20132
Country
Italy
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Bergamo
ZIP/Postal Code
24127
Country
Italy
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Padova
ZIP/Postal Code
35128
Country
Italy
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Roma
ZIP/Postal Code
00189
Country
Italy
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Bydgoszcz
ZIP/Postal Code
85-048
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Radom
ZIP/Postal Code
26-600
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Szczecin
ZIP/Postal Code
70-111
Country
Poland
Individual Site Status
Suspended
Facility Name
Novo Nordisk Investigational Site
City
Warszawa
ZIP/Postal Code
04-749
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Zabrze
ZIP/Postal Code
41-800
Country
Poland
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Durban
State/Province
KwaZulu-Natal
ZIP/Postal Code
4001
Country
South Africa
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Durban
State/Province
KwaZulu-Natal
ZIP/Postal Code
4092
Country
South Africa
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Cape Town
State/Province
Western Cape
ZIP/Postal Code
7925
Country
South Africa
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Hospitalet de Llobregat
ZIP/Postal Code
08907
Country
Spain
Individual Site Status
Recruiting
Facility Name
Novo Nordisk Investigational Site
City
Valencia
ZIP/Postal Code
46010
Country
Spain
Individual Site Status
Recruiting
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
According to the Novo Nordisk disclosure commitment on novonordisk-trials.com
IPD Sharing URL
http://novonordisk-trials.com
Learn more about this trial
A Research Study to Find Out How Semaglutide Works in the Kidneys Compared to Placebo, in People With Type 2 Diabetes and Chronic Kidney Disease (the REMODEL Trial)
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