Semaglutide and Vascular Regeneration (SEMA-VR)
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ClinicalTrials.gov Identifier: NCT05870462 |
Recruitment Status :
Recruiting
First Posted : May 23, 2023
Last Update Posted : July 25, 2023
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SEMA-VR is a prospective, randomized, 6-month long, open-label study of semaglutide. Approximately 100 participants with type 2 diabetes and/or obesity will be randomized (1:1) to receive semaglutide at escalating doses (up to 1.0 mg/week) or usual care without semaglutide for 6 months.
The goal of this trial is to understand how semaglutide exerts cardio-protective effects in people with type 2 diabetes and/or obesity. The main question it aims to answer is:
• Does semaglutide treatment preserve or increase the number of vessel-repairing cells circulating in the blood?
Participants will:
- Be allocated to receive either semaglutide or usual care for 6 months
- Provide a blood sample at the baseline visit and another blood sample at the 6-month visit
Researchers will compare participants receiving semaglutide to those receiving usual care for any differences in the 6-month change in the number of vessel-repairing cells in the blood.
Condition or disease | Intervention/treatment | Phase |
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Atherosclerosis Cardiovascular Diseases Diabetes Mellitus, Type 2 Obesity | Drug: Semaglutide Pen Injector | Phase 4 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 100 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Basic Science |
Official Title: | Semaglutide and Vascular Regeneration in People With Diabetes and/or Obesity |
Actual Study Start Date : | April 29, 2023 |
Estimated Primary Completion Date : | December 2024 |
Estimated Study Completion Date : | December 2024 |
Arm | Intervention/treatment |
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Experimental: Semaglutide
Participants will receive once-weekly semaglutide subcutaneous injection [Ozempic] at escalating doses from 0.25 mg/week, 0.5 mg/week, to 1.0 mg/week.
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Drug: Semaglutide Pen Injector
Participants experiencing side effects (e.g. nausea, stomach pain, constipation, diarrhea, vomiting) at the maximum dose (1.0 mg/week) may be down-titrated to 0.50 mg/week. Participants who had been receiving a dipeptidyl peptidase 4 (DPP-4) inhibitor (sitagliptin, saxagliptin, linagliptin, alogliptin) will stop taking their DPP-4 inhibitor upon randomization to this arm. Other Names:
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No Intervention: Usual care
Participants will continue to receive other usual medications, rehabilitation, procedures, and interventions as recommended by their healthcare providers.
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- Changes in the mean frequency (%) of circulating ALDHhiSSClow primitive progenitor cells in individuals treated with semaglutide versus usual care for 6 months [ Time Frame: Baseline to 6 months post-randomization ]
- Changes in the mean frequency (%) of circulating ALDHhiSSCmid pro-vascular monocytes in individuals treated with semaglutide versus usual care for 6 months [ Time Frame: Baseline to 6 months post-randomization ]
- Changes in the frequency (%) of circulating ALDHhiSSCmid pro-inflammatory monocytes in individuals treated with semaglutide versus usual care for 6 months [ Time Frame: Baseline to 6 months post-randomization ]
- Changes in the frequency (%) of circulating ALDHhiSSChi pro-inflammatory granulocyte precursors in individuals treated with semaglutide versus usual care for 6 months [ Time Frame: Baseline to 6 months post-randomization ]
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.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
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Adults ≥ 18 years of age who meet one of the following Health Canada indications to receive subcutaneous semaglutide injections:
- Documented T2D with inadequate glycemic control
- Body mass index (BMI) ≥ 30 kg/m^2 (obesity)
- BMI ≥ 27 kg/m^2 (overweight) and at least one weight-related comorbidity, such as hypertension, dyslipidemia, or obstructive sleep apnea
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AND meet one of the following ASCVD criteria:
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History of ASCVD:
- Documented coronary artery disease
- Documented cerebrovascular or carotid disease
- Documented peripheral artery disease
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No ASCVD but has 2 or more of the following risk factors:
- Cigarette smoker or stopped smoking within 3 months of screening
- Persistent hypertension (defined as office blood pressure ≥ 140/90 mmHg) or currently on antihypertensive medications
- BMI ≥ 27 kg/m^2
- estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73m^2
- Treated or untreated dyslipidemia
- Triglyceride ≥ 2.0 mmol/L
- HDL-C ≤ 1.0 mmol/L for men or ≤ 1.3 mmol/L for women
- High sensitivity C-reactive protein (hsCRP) ≥ 2.0 mg/L
- Documented micro- or macro-albuminuria
- Self-identified South Asian ethnicity
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Exclusion Criteria:
- Female subjects who are pregnant, planning pregnancy, or breastfeeding
- HbA1c > 11.0 %
- Currently on a GLP-1RA or previously taken a GLP-1RA
- Personal or family history of medullary thyroid carcinoma
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- New York Heart Association class IV symptoms of heart failure
- Known history of severe liver disease (e.g. Child-Pugh Class B or C)
- White blood cell count ≥ 15 x 10^9/L
- Active infectious disease requiring antibiotic or anti-viral agents
- Known acquired immunodeficiency syndrome such as HIV
- On oral steroid therapy (e.g. prednisone or other corticosteroids) or other immunosuppressive agents (e.g. methotrexate)
- Any malignancy not considered cured (except basal cell carcinoma of the skin). A subject is considered cured if there has been no evidence of cancer recurrence for the 5 years prior to screening
- Any clinically significant or unstable medical condition that might limit one's ability to complete the study or comply with the requirements of the protocol, including: dermatologic disease, hematological disease, pulmonary disease, hepatic disease, gastrointestinal disease, genitourinary disease, endocrine disease, neurological disease, and psychiatric disease
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): NCT05870462
Contact: Brady Park, BMSc | 2262359725 | brady.park@mail.utoronto.ca |
Canada, Ontario | |
North York Diagnostic and Cardiac Centre | Recruiting |
North York, Ontario, Canada, M6B 1N6 | |
Contact: Subodh Verma, MD, PhD | |
Diagnostic Assessment Centre | Recruiting |
Scarborough, Ontario, Canada, M1S4N6 | |
Contact: Subodh Verma, MD, PhD |
Principal Investigator: | Subodh Verma, MD, PhD | Unity Health Toronto | |
Principal Investigator: | David A Hess, PhD | Robarts Research Institute, London, Ontario | |
Study Chair: | David Mazer, MD | Unity Health Toronto | |
Study Chair: | Hwee Teoh, PhD | Unity Health Toronto |
Other Publications:
Responsible Party: | Canadian Medical and Surgical Knowledge Translation Research Group |
ClinicalTrials.gov Identifier: | NCT05870462 |
Other Study ID Numbers: |
Pro00068765 |
First Posted: | May 23, 2023 Key Record Dates |
Last Update Posted: | July 25, 2023 |
Last Verified: | July 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Product Manufactured in and Exported from the U.S.: | Yes |
GLP-1 receptor agonists GLP-1 Semaglutide Vascular regeneration Inflammation Monocytes |
Granulocytes Hematopoietic progenitor cells Cardiovascular risk Type 2 diabetes Obesity |
Cardiovascular Diseases Atherosclerosis Obesity Diabetes Mellitus, Type 2 Diabetes Mellitus Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Overweight Overnutrition |
Nutrition Disorders Body Weight Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Semaglutide Glucagon-Like Peptide-1 Receptor Agonists Hypoglycemic Agents Physiological Effects of Drugs |