NOT_YET_RECRUITING
Semaglutide for Metabolic Intervention and Adipose Loss to Treat Atrial Fibrillation
The goal of the study is to learn how a weight loss medication called semaglutide, which is used to treat obesity, in addition to standard AF treatment might affect AF, atrial fibrillation severity, and whether it changes the risk of atrial fibrillation recurring after standard AF treatments.
Conditions:
🦠 Overweight or Obesity 🦠 Atrial Fibrillation
🗓️ Study Start (Actual) July 2024
🗓️ Primary Completion (Estimated) December 2027
✅ Study Completion (Estimated) June 2028
👥 Enrollment (Estimated) 200
🔬 Study Type INTERVENTIONAL
📊 Phase PHASE3
Locations:
📍 Phoenix, Arizona, United States
📍 Chicago, Illinois, United States

📋 Eligibility Criteria

Description

    Inclusion Criteria:

    • 1. Age 18-75 years
    • 2. BMI greater than or equal to 30 kg/m2
    • 3. Paroxysmal AF or persistent AF, in whom catheter ablation (CA) for AF is expected within 1 year (A group) or in whom catheter ablation is NOT expected within 1 year (M group)
    • 4. Ability to provide informed consent before any trial-related activities.
    • 5. Patients with type 2 diabetes mellitus (T2DM) will be included:
    • 1. If HbA1c (glycated hemoglobin) is less than or equal to 10 %
    • 2. If the subject is taking basal insulin only or oral hypoglycemic agents or a combination of those.
    • 3. Patients on SGLT2-inhibitors and TZDs (Thiazolidinedione) will be included if they have been on a stable dose of these medications for at least 6 months
    • 4. The following protocol will be adopted to adjust insulin secretagogues (sulfonylureas or meglitinides) and insulin during the study (adapted from the Look Ahead Study).
    • Patients will be asked to check their blood glucose (BG) 4 x day (before meals and at bed time) during the dose escalation and dose stabilization phases (weeks 0 to 20) and recommendation of dose adjustments will be immediately sent to their treating physician according to the dose adjustment scale below:
    • * 2 blood sugars \<100 mg/dl- reduce meds \[insulin secretagogues (sulfonylureas or meglitinides) and basal insulin\] by 0-50 %
    • * 3 blood sugars 80-100 mg/dl- reduce meds \[insulin secretagogues (sulfonylureas or meglitinides) and basal insulin\] by 25-75%
    • * 3 blood sugars \<80 mg/dl \> 2 x week or severe hypoglycemia or symptomatic hypoglycemia- reduce meds \[insulin secretagogues (sulfonylureas or meglitinides) and basal insulin\] by 50-100 %
    • Randomization to treatment (active and placebo) will be stratified to balance patients with T2DM across the study arms. After completion of the trial a prespecified subgroup analysis of the patients enrolled affected by T2DM will be performed.
    • For women of child-bearing potential, use of appropriate contraception will be required.
    • In patients that are prescribed amiodarone, standard care practices will be implemented to evaluate for liver and thyroid side effects with baseline liver and thyroid function tests via blood draw and evaluation every 6 months.

    Exclusion Criteria:

    • 1. Current use of GLP-1 RA (glucagon-like peptide receptor agonists) or DPP4 (Dipeptidyl peptidase-4)-inhibitors or use within the last 90 days prior to screening
    • 2. Current antiobesity medication use or use within the last 90 days prior to screening
    • 3. A self-reported change in body weight of \> 5 kg (11 lb.) within 30 days before screening
    • 4. History of bariatric surgery
    • 5. History of type I diabetes mellitus
    • 6. Current use of prandial insulin
    • 7. Hospitalization for unstable angina, or TIA (Transient ischemic attack) \< 30 days prior to screening
    • 8. Pulmonary embolism \< 90 days before screening
    • 9. MI (myocardial infarction), stroke, etc. \< 90 months prior to screening
    • 10. Uncontrolled thyroid disease: TSH (Thyroid-stimulating hormone) \> 10.0 mIU/L (Milli-international Units Per Liter) or \< 0.4 mIU/L (Milli-international Units Per Liter) at screening
    • 11. Active malignancy
    • 12. Active enrollment in another investigational study that includes any kind of intervention
    • 13. The receipt of any investigational drug within 90 days prior to this trial.
    • 14. Inability to comply with study procedures
    • 15. Acute pancreatitis \< 180 days before screening
    • 16. History or presence of chronic pancreatitis
    • 17. CKD (Chronic Kidney Disease) stage 4 (GFR \<30 ml/min)
    • 18. A personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
    • 19. A prior serious hypersensitivity reaction to semaglutide or to any of the excipients in WEGOVY
    • 20. Chronic inflammatory conditions requiring immunosuppression and/or on glucocorticoids
    • 21. Previous participation in this trial (received at least one dose of study drug or placebo)
    • 22. Pregnant, breast-feeding or planning pregnancy
Ages Eligible for Study: 18 Years to 75 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: No

🗓️ Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

  • First Submitted 24 April 2024
  • First Submitted that Met QC Criteria 11 July 2024
  • First Posted 15 July 2024

Study Record Updates

  • Last Update Submitted that Met QC Criteria 11 July 2024
  • Last Update Posted 15 July 2024
  • Last Verified June 2024