Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)

Introduction Incretin-based therapies exert antihyperglycaemic effects in patients with type 2 diabetes (T2D) in a blood glucose concentration-dependent fashion. The first-in-class oral glucagon-like peptide-1 receptor agonist semaglutide has potent effects on glycaemic and weight control, but littl...

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Main Authors: Kyu Yong Cho, Hiroki Yokoyama, Tatsuya Atsumi, Hiroshi Nomoto, Jun Takeuchi, So Nagai, Yoshio Kurihara, Shin Aoki, Akinobu Nakamura, Hideaki Miyoshi, Shinji Taneda, Ichiro Sakuma, Sho Furusawa, Aika Miya, Hiraku Kameda
Format: Article
Language:English
Published: BMJ Publishing Group 2022-05-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/5/e056885.full
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author Kyu Yong Cho
Hiroki Yokoyama
Tatsuya Atsumi
Hiroshi Nomoto
Jun Takeuchi
So Nagai
Yoshio Kurihara
Shin Aoki
Akinobu Nakamura
Hideaki Miyoshi
Shinji Taneda
Ichiro Sakuma
Sho Furusawa
Aika Miya
Hiraku Kameda
author_facet Kyu Yong Cho
Hiroki Yokoyama
Tatsuya Atsumi
Hiroshi Nomoto
Jun Takeuchi
So Nagai
Yoshio Kurihara
Shin Aoki
Akinobu Nakamura
Hideaki Miyoshi
Shinji Taneda
Ichiro Sakuma
Sho Furusawa
Aika Miya
Hiraku Kameda
author_sort Kyu Yong Cho
collection DOAJ
description Introduction Incretin-based therapies exert antihyperglycaemic effects in patients with type 2 diabetes (T2D) in a blood glucose concentration-dependent fashion. The first-in-class oral glucagon-like peptide-1 receptor agonist semaglutide has potent effects on glycaemic and weight control, but little evidence has been published for the superiority of semaglutide for glycaemic control in patients after switching from a dipeptidyl peptidase-4 (DPP-4) inhibitor. Therefore, we aim to verify the efficacy of oral semaglutide in patients with T2D being treated with a DPP-4 inhibitor.Methods and analysis This study is a multicentre, prospective, randomised, open-label, parallel-group trial. In total, 172 participants with T2D who have been treated with a DPP-4 inhibitor for more than 12 weeks and who have a glycated haemoglobin (HbA1c) level of 7.0%–9.9% will be randomised to continue using their existing DPP-4 inhibitor or switch to oral semaglutide for 24 weeks. Biochemical analyses and physical assessment will be performed, and adverse events will be recorded at baseline and at the end of the study. The primary endpoint will be the effect of oral semaglutide on the change in HbA1c. The secondary endpoints will be the mean changes in body weight, abdominal circumference, systolic and diastolic blood pressure (BP), pulse rate, the relationship between improvement of metabolic parameters including HbA1c and patient background characteristics, side effects and other laboratory parameters.Ethics and dissemination This will be the first study to compare the effects of switching from a DPP-4 inhibitor to oral semaglutide on glycaemic control in patients with T2D. The results will be disseminated in peer-reviewed journals and at scientific conferences. Hokkaido University Certified Review Board (CRB no.1180001) has approved the protocol (no. 020–013).Trial registration number UMIN000045270 in the University Hospital Medical Information Network; jRCT1011210032 in the Japan Registry of Clinical Trials.
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spelling doaj-art-c71ac11459cd403d8e49e781e78fd7242025-08-20T02:17:08ZengBMJ Publishing GroupBMJ Open2044-60552022-05-0112510.1136/bmjopen-2021-056885Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)Kyu Yong Cho0Hiroki Yokoyama1Tatsuya Atsumi2Hiroshi Nomoto3Jun Takeuchi4So Nagai5Yoshio Kurihara6Shin Aoki7Akinobu Nakamura8Hideaki Miyoshi9Shinji Taneda10Ichiro Sakuma11Sho Furusawa12Aika Miya13Hiraku Kameda14Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, JapanJiyugaoka Medical Clinic, Obihiro, Japan4 Department of Rheumatology, Endocrinology and Nephrology, Hokkaido University, Sapporo, JapanDepartment of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanSapporo Diabetes and Thyroid Clinic, Sapporo, JapanDivision of Diabetes and Endocrinology, Department of Medicine, NTT East Corporation, Sapporo, JapanKurihara Clinic, Sapporo, JapanAoki Clinic, Sapporo, JapanDepartment of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDiabetes Center, Manda Memorial Hospital, Sapporo, JapanCaress Sapporo Hokko Memorial Clinic, Sapporo, JapanDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, JapanDepartment of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanDepartment of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, JapanIntroduction Incretin-based therapies exert antihyperglycaemic effects in patients with type 2 diabetes (T2D) in a blood glucose concentration-dependent fashion. The first-in-class oral glucagon-like peptide-1 receptor agonist semaglutide has potent effects on glycaemic and weight control, but little evidence has been published for the superiority of semaglutide for glycaemic control in patients after switching from a dipeptidyl peptidase-4 (DPP-4) inhibitor. Therefore, we aim to verify the efficacy of oral semaglutide in patients with T2D being treated with a DPP-4 inhibitor.Methods and analysis This study is a multicentre, prospective, randomised, open-label, parallel-group trial. In total, 172 participants with T2D who have been treated with a DPP-4 inhibitor for more than 12 weeks and who have a glycated haemoglobin (HbA1c) level of 7.0%–9.9% will be randomised to continue using their existing DPP-4 inhibitor or switch to oral semaglutide for 24 weeks. Biochemical analyses and physical assessment will be performed, and adverse events will be recorded at baseline and at the end of the study. The primary endpoint will be the effect of oral semaglutide on the change in HbA1c. The secondary endpoints will be the mean changes in body weight, abdominal circumference, systolic and diastolic blood pressure (BP), pulse rate, the relationship between improvement of metabolic parameters including HbA1c and patient background characteristics, side effects and other laboratory parameters.Ethics and dissemination This will be the first study to compare the effects of switching from a DPP-4 inhibitor to oral semaglutide on glycaemic control in patients with T2D. The results will be disseminated in peer-reviewed journals and at scientific conferences. Hokkaido University Certified Review Board (CRB no.1180001) has approved the protocol (no. 020–013).Trial registration number UMIN000045270 in the University Hospital Medical Information Network; jRCT1011210032 in the Japan Registry of Clinical Trials.https://bmjopen.bmj.com/content/12/5/e056885.full
spellingShingle Kyu Yong Cho
Hiroki Yokoyama
Tatsuya Atsumi
Hiroshi Nomoto
Jun Takeuchi
So Nagai
Yoshio Kurihara
Shin Aoki
Akinobu Nakamura
Hideaki Miyoshi
Shinji Taneda
Ichiro Sakuma
Sho Furusawa
Aika Miya
Hiraku Kameda
Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)
BMJ Open
title Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)
title_full Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)
title_fullStr Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)
title_full_unstemmed Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)
title_short Effects of switching from a dipeptidyl peptidase-4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes: protocol for a multicentre, prospective, randomised, open-label, parallel-group comparison study (the SWITCH-SEMA 2 study)
title_sort effects of switching from a dipeptidyl peptidase 4 inhibitor to oral semaglutide on glucose metabolism in patients with type 2 diabetes protocol for a multicentre prospective randomised open label parallel group comparison study the switch sema 2 study
url https://bmjopen.bmj.com/content/12/5/e056885.full
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