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Safety and Efficacy of Bimagrumab and Semaglutide in Adults Who Are Overweight or Obese

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05616013
Recruitment Status : Active, not recruiting
First Posted : November 14, 2022
Last Update Posted : February 1, 2024
Sponsor:
Collaborator:
Versanis Bio, Inc.
Information provided by (Responsible Party):
Eli Lilly and Company

Brief Summary:
A phase 2 study to assess the efficacy of bimagrumab alone or in addition to semaglutide to assess efficacy and safety in overweight or obese men and women

Condition or disease Intervention/treatment Phase
Obesity Obese Overweight or Obesity Biological: Bimagrumab Drug: Semaglutide Other: Bimagrumab Placebo Phase 2

Detailed Description:
This study investigates if bimagrumab in addition to semaglutide is able to preserve/increase muscle mass in the presence of weight and/or fat mass loss.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 507 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Intervention Model Description: The study is designed to have three periods. The 48-week core treatment period has 9 treatment arms, with combinations of 3 semaglutide doses (none, 1.0 mg and 2.4 mg) and 3 bimagrumab doses (0, 10 and 30 mg/kg). The core treatment period is then followed by an open-label 24-week treatment extension period during which participants originally assigned to either placebo or bimagrumab 10 mg/kg will switch to bimagrumab 30 mg/kg. All other treatment assignments will remain the same. The extension period is then followed by a 32-week post-treatment period, during which all study treatments will be withdrawn from all arms.
Masking: Double (Participant, Investigator)
Masking Description:

In regards to bimagrumab and placebo-bimagrumab, the participants, Investigator and Sponsor will be blinded.

Due to semaglutide being pre-filled, packaged and labeled by manufacturer, it is not possible to blind semaglutide.

Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Placebo-Controlled Multi-Center Study of Intravenous Bimagrumab, Alone or in Addition to Open Label Subcutaneous Semaglutide, to Investigate the Efficacy and Safety in Overweight or Obese Men and Women
Actual Study Start Date : November 16, 2022
Estimated Primary Completion Date : May 20, 2024
Estimated Study Completion Date : June 17, 2025

Resource links provided by the National Library of Medicine

Drug Information available for: Semaglutide

Arm Intervention/treatment
Placebo Comparator: Placebo to bimagrumab 30 mg/kg + no semaglutide
Participants will receive i.v. placebo at baseline and at Weeks 4, 16, 28 and 40 during the core treatment period and will switch during the extension period to receive bimagrumab 30 mg/kg at Weeks 52 and 64.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Other: Bimagrumab Placebo
Placebo

Placebo + semaglutide 1.0 mg
Participants will receive i.v. placebo at baseline and at Weeks 4, 16, 28, 40, 52 and 64, and s.c. semaglutide 1.0 mg weekly per the dose escalation schedule.
Drug: Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Other Names:
  • Wegovy
  • Ozempic

Other: Bimagrumab Placebo
Placebo

Placebo + semaglutide 2.4 mg
Participants will receive i.v. placebo at baseline and at Weeks 4, 16, 28 and 40, 52 and 64, and s.c. semaglutide 2.4 mg weekly per the dose escalation schedule.
Drug: Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Other Names:
  • Wegovy
  • Ozempic

Other: Bimagrumab Placebo
Placebo

Experimental: Bimagrumab 10 mg/kg to bimagrumab 30 mg/kg + no semaglutide
Participants will receive i.v. bimagrumab 10 mg/kg at baseline and at Weeks 4, 16, 28 and 40 during the core treatment period and will switch during the extension period to receive bimagrumab 30 mg/kg at Weeks 52 and 64.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Bimagrumab 10 mg/kg + semaglutide 1.0 mg
Participants will receive i.v. bimagrumab 10 mg/kg at baseline and at Weeks 4, 16, 28, 40, 52 and 64, and s.c. semaglutide 1.0 mg weekly per the dose escalation schedule.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Drug: Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Other Names:
  • Wegovy
  • Ozempic

Bimagrumab 10 mg/kg + semaglutide 2.4 mg
Participants will receive i.v. bimagrumab 10 mg/kg at baseline and at Weeks 4, 16, 28, 40, 52 and 64, and s.c. semaglutide 2.4 mg weekly per the dose escalation schedule.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Drug: Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Other Names:
  • Wegovy
  • Ozempic

Experimental: Bimagrumab 30 mg/kg + no semaglutide
Participants will receive i.v. bimagrumab 30 mg/kg at baseline and at Weeks 4, 16, 28, 40, 52 and 64.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Bimagrumab 30 mg/kg + semaglutide 1.0 mg
Participants will receive i.v. bimagrumab 30 mg/kg at baseline, and at Weeks 4, 16, 28, 40, 52 and 64, and s.c. semaglutide 1.0 mg weekly per the dose escalation schedule.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Drug: Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Other Names:
  • Wegovy
  • Ozempic

Bimagrumab 30 mg/kg + semaglutide 2.4 mg
Participants will receive i.v. bimagrumab 30 mg/kg at baseline and at Weeks 4, 16, 28, 40, 52 and 64, and s.c. semaglutide 2.4 mg per the dose escalation schedule.
Biological: Bimagrumab
Human monoclonal antibody to the activin receptor type II

Drug: Semaglutide
Glucagon-like peptide-1 (GLP-1) receptor agonist
Other Names:
  • Wegovy
  • Ozempic




Primary Outcome Measures :
  1. Change from baseline in body weight at 48 weeks [ Time Frame: At baseline and 48 weeks ]
    Change in total body weight will be measured from baseline to 48 weeks


Secondary Outcome Measures :
  1. Change from baseline in waist circumference (cm) at 48 weeks [ Time Frame: At baseline and 48 weeks ]
    Waist circumference will be measured in standing position with a non-stretchable measuring tape and to the nearest 0.1 centimeter (cm).

  2. Change from baseline at 48 weeks in total body fat mass in kilograms (kg) [ Time Frame: At baseline and 48 weeks ]
    Fat mass will be obtained by dual-energy x-ray absorptiometry (DXA) Dual energy X-ray absorptiometry (DXA) will be used to assess changes in body composition.

  3. Change from baseline at 48 weeks in percent body fat [ Time Frame: At baseline and 48 weeks ]
    Percent body fat will be obtained by dual-energy x-ray absorptiometry (DXA) Dual energy X-ray absorptiometry (DXA) will be used to assess changes in body composition.

  4. Change from baseline at 48 weeks in visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and trunk fat mass by dual-energy x-ray absorptiometry (DXA) [ Time Frame: At baseline and 48 weeks ]
    Dual energy X-ray absorptiometry (DXA) will be used to assess changes in body composition.

  5. Proportion of participants at 48 weeks with change in waist circumference ≥ 5 cm [ Time Frame: At baseline and 48 weeks ]
    Waist circumference will be measured in standing position with a non-stretchable measuring tape and to the nearest 0.1 centimeter (cm).

  6. Proportion of participants at 48 weeks with change in Body weight ≥ 5%, ≥ 10% and ≥15% [ Time Frame: At baseline and 48 weeks ]
    Body weight will be measured in kilograms (kg) to the nearest 0.1 kg.

  7. Proportion of participants at 48 weeks with change in Fat mass ≥ 5% ≥ 10% ≥ 15% by Dual energy X-ray absorptiometry (DXA) [ Time Frame: At baseline and 48 weeks ]
    Dual energy X-ray absorptiometry (DXA) will be used to assess the changes in body composition.

  8. Proportion of participants at 48 weeks with change in Fat mass ≥ 10% with <5% decrease (or and increase) in lean mass by Dual energy X-ray absorptiometry (DXA) [ Time Frame: At baseline and 48 weeks ]
    Dual energy X-ray absorptiometry (DXA) will be used to assess changes in body composition.

  9. Percentage of weight loss due to fat mass or lean mass at 48 weeks by dual-energy x-ray absorptiometry (DXA) [ Time Frame: At baseline and 48 weeks ]
    Dual energy X-ray absorptiometry (DXA) will be used to assess changes in body composition.

  10. Change from baseline at 48 weeks in fat mass (kg and %) by bioelectrical impedance analysis (BIA) [ Time Frame: At baseline and 48 weeks ]
    Bioelectrical impedance analysis (BIA) is a widely used method for estimating body composition.

  11. Change from baseline at 48 weeks in lean mass (kg and %) and appendicular lean mass by dual-energy x-ray absorptiometry (DXA) [ Time Frame: At baseline 48 weeks ]
    Dual-energy x-ray absorptiometry (DXA) will be used to assess changes in body composition.

  12. Change from baseline at 48 weeks in lean mass (kg) by bioelectrical impedance analysis (BIA) [ Time Frame: At baseline 48 weeks ]
    Bioelectrical impedance analysis (BIA) is a widely used method for estimating body composition.

  13. Safety and tolerability measurements throughout 48 weeks by TEAEs [safety labs, vital signs] [ Time Frame: Baseline and 48 weeks ]
    Incidence and severity of treatment emergent adverse events (TEAEs)

  14. Proportion of Participants with change from baseline in Body Mass Index (BMI) categories at 48 weeks [ Time Frame: At baseline and 48 weeks ]

    BMI categories:

    i. Healthy weight: 18.5 kg/m2 to 24.9 kg/m2 ii. Overweight: 25 kg/m2 to 29.9 kg/m2 iii. Obesity class 1: 30 kg/m2 to 34.9 kg/m2 iv. Obesity class II: 35 kg/m2 to 39.9 kg/m2 v. Obesity class III: ≥ 40 kg/m2


  15. Proportion of Participants with change from baseline in waist-to-height ratio (WHtR ratio) categories at 48 weeks [ Time Frame: At baseline and 48 weeks ]
    WHtR ratio categories: <0.5; 0.5-0.59; ≥0.6

  16. Change from baseline in HbA1c (mmol/mol) at 48 weeks [ Time Frame: At baseline and 48 weeks ]
    To assess treatment effects on glucose metabolism and HbA1c.

  17. Change from baseline at 48 weeks in Quality of Life Short Form 36 (SF-36) survey [ Time Frame: At baseline and 48 weeks ]
    Change from baseline at 48 weeks in Quality of Life Short Form 36 (SF-36) survey. To assess a subject's overall health related quality of life, as well as the physical functioning score. SF- 36 scores range from 0 (worst) to 100 (best)

  18. Change from Baseline at 48 weeks in Impact of Weight on Quality of Life-Lite for Clinical Trials (IWQOL-Lite) [ Time Frame: At baseline and 48 weeks ]
    Change from baseline in IWQOL-Lite CT. IWQOL-Lite CT is a 20-item modified survey instrument that is used to quantitatively assess an individual's perception of how their weight affects their day- to-day life, as well as the physical function score. Scores range from 0 (worst) to 100 (best)



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • A written informed consent must be obtained before any study-related assessments are performed.
  • Men and women between 18 and 80 years, inclusive; women of child-bearing potential (defined as those who are not post-menopausal or post-surgical sterilization) must meet both of the following criteria:

    • Two negative pregnancy tests (at screening and at randomization, prior to dosing)
    • Use of intrauterine device, from at least 3 months before the baseline visit through at least 4 months after the last dose of bimagrumab/placebo i.v., and an additional contraceptive (barrier) method from screening through at least 4 months after the last dose of bimagrumab/placebo i.v.
  • Body mass index (BMI) ≥ 30 or BMI ≥ 27 with one or more obesity-associated comorbidities (e.g., hypertension, insulin resistance, sleep apnea, or dyslipidemia)
  • Stable body weight (± 5 kg) within 90 days of screening, and body weight <150 kg
  • Have a history of at least one self-reported unsuccessful behavioral effort to lose body weight
  • Able to communicate well with the Investigator, comply with the study requirements and adhere to the diet and activity programs for the study duration

Key Exclusion Criteria:

  • History of, or known hypersensitivity to, monoclonal antibody drugs or a contraindication to semaglutide (Ozempic® or Wegovy®)
  • Use of other investigational drugs at the time of enrollment or within 30 days or 5 half-lives of enrollment, whichever is longer, or longer if required by local regulations
  • Treatment with any medication for the indication of obesity within the past 30 days before screening
  • Diagnosis of diabetes requiring current use of any antidiabetic drug or HbA1c ≥ 6.5% Note: Metabolic syndrome is not an exclusion, even if managed with an anti-diabetic drug such as metformin or an SGLT2 inhibitor. A diagnosis of prediabetes or impaired glucose tolerance managed exclusively with non-pharmacologic approaches (e.g., diet and exercise) is not an exclusion.
  • Any chronic infections likely to interfere with study conduct or interpretation such as hepatitis B (HBV), hepatitis C (HCV), or human immunodeficiency virus (HIV). History of hepatitis A or hepatitis C successfully treated is not exclusionary. Active COVID-19 infection.
  • Donation or loss of 400 mL or more of blood within 8 weeks prior to initial dosing, or longer if required by local regulation, or plasma donation (> 250 mL) within 14 days prior to the first dose
  • Any disorder, unwillingness, or inability not covered by any of the other exclusion criteria, which in the Investigator's opinion, might jeopardize the participant's safety or compliance with the protocol

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05616013


Locations
Show Show 26 study locations
Sponsors and Collaborators
Eli Lilly and Company
Versanis Bio, Inc.
Investigators
Layout table for investigator information
Study Chair: Kenneth Attie, MD Versanis Biotechnology
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Responsible Party: Eli Lilly and Company
ClinicalTrials.gov Identifier: NCT05616013    
Other Study ID Numbers: 18828
J4Z-MC-GIDA ( Other Identifier: Eli Lilly and Company )
VER201-PH2-031 ( Other Identifier: Versanis )
First Posted: November 14, 2022    Key Record Dates
Last Update Posted: February 1, 2024
Last Verified: January 2024

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Eli Lilly and Company:
bimagrumab
semaglutide
Additional relevant MeSH terms:
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Obesity
Overweight
Overnutrition
Nutrition Disorders
Body Weight
Semaglutide
Antibodies, Monoclonal
Antibodies, Blocking
Glucagon-Like Peptide-1 Receptor Agonists
Hypoglycemic Agents
Physiological Effects of Drugs
Immunologic Factors