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Clinical trial

Lifestyle modification and liraglutide (MODEL)

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Last updated:31st Jul 2016
Identifier: NCT02911818

This is a 52 week, single center, open-labeled, randomized controlled trial.

A total of 150 subjects with obesity, who are free of types 1 and 2 diabetes, as well as contraindications to weight loss, will be randomly assigned to one of three treatment groups: 1) lifestyle counseling, as currently recommended by the Centers for Medicare and Medicaid Services (CMS) (i.e., CMS-Alone); 2) CMS lifestyle counseling plus liraglutide (i.e., CMS-Liraglutide); or 3) CMS-Liraglutide plus a portion-controlled diet (i.e., Multi-Component Intervention).

Subjects in all three groups will have 14 brief (15 minute) lifestyle counseling visits the first 24 weeks, followed by monthly visits in weeks 25-52. This is the schedule and duration of counseling visits recommended by CMS. Counseling sessions will be delivered by a physician, nurse practitioner or registered dietitian (RD) working in consultation with the former providers.

Subjects in all three groups also will have brief physician visits at weeks 1, 4, 8, 16, 24, 36, and 52 (total of 7 visits). These visits are needed for subjects in both liraglutide groups to monitor their response to the medication. These visits are included for subjects in CMS-Alone to match the intensity of medical care provided the two other groups.

The primary outcome is % reduction in initial body weight, as measured from randomization to week 52. Secondary outcomes include the proportion of participants who at week 52 lose >5%, >10%, and >15% of initial weight, as well as % reduction in weight at week 24 and the proportion of participants who meet the three categorical weight losses at this time. The secondary efficacy measures include changes (from randomization to week 52) in cardiovascular disease (CVD) risk factors, glycemic control, mood, quality of life, eating behavior, appetite, sleep, and satisfaction with weight loss.

Safety endpoints will include physical examination, adverse events (AEs), standard laboratory tests, and mental health assessed by the Columbia Suicidality Severity Rating Scale (C-SSRS) and Patient Health Questionnaire (PHQ-9).

Statistical Analysis. Using a sample size equation for longitudinal clustered samples, a randomization sample of 50 subjects in CMS-Alone, 50 in CMS-Liraglutide, and 50 in the Multi-Component Intervention provides >80% power to detect the two primary contrasts to be statistically significant. This estimate allows for 20% attrition during the 52-week trial, resulting in approximately 40 treatment completers per group. The ITT longitudinal statistical design will further improve power by allowing the inclusion of available data for non-completers and the adjustment of possible variance reducing baseline covariates.


Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Combining Lifestyle Modification and Liraglutide to Improve Weight Loss and Health Outcomes
 

Arms Assigned Interventions
Active Comparator: CMS-Alone
Lifestyle counseling, as currently recommended by the CMS.
Behavioral: CMS-recommended lifestyle counseling
21 brief (15 minute) lifestyle counseling visits provided by a physician, nurse practitioner, or registered dietitian.
Active Comparator: CMS-Liraglutide
CMS lifestyle counselling plus liraglutide.
Behavioral: CMS-recommended lifestyle counseling
21 brief (15 minute) lifestyle counseling visits provided by a physician, nurse practitioner, or registered dietitian.
Drug: Liraglutide 3.0mg
Liraglutide is a once-daily self-administered, subcutaneous (beneath the skin) injection.
Other Name: Saxenda
Active Comparator: Multi-Component Intervention
CMS-Liraglutide plus a 1000-1200 kcal/day portion-controlled diet.
Behavioral: CMS-recommended lifestyle counseling
21 brief (15 minute) lifestyle counseling visits provided by a physician, nurse practitioner, or registered dietitian.
Drug: Liraglutide 3.0mg
Liraglutide is a once-daily self-administered, subcutaneous (beneath the skin) injection.
Other Name: Saxenda
Other: Portion-Controlled Diet
A 1000-1200 kcal/day portion-controlled diet.
Category Value
Date last updated at source 2016-09-20
Study type(s) Randomised clinical trial
Expected enrolment 150
Study start date 2016-08-01
Estimated primary completion date 2018-01-01

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