ObesityPhase 3SMARTNCT04889183
SeMaglutide and Albuminuria Reduction Trial in Obese Individuals Without Diabetes
A Phase 3 study testing Semaglutide in people with Obesity and Albuminuria, run by University Medical Center Groningen at 13 sites in 4 countries.
Trial summary
Study to assess the effects of weekly subcutaneous administration of the GLP1-RA semaglutide 2.4mg on kidney function parameters in obese/overweight individuals at high risk of CKD progression. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Obesity, Albuminuria
- What is being tested?
- Semaglutide
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 125 participants
- Where
- 13 sitesin 4 countries
- Study dates
- 14 Mar 2022to 28 May 2024
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥ 18 years
- Body Mass index ≥ 27 kg/m2
- Albuminuria ≥ 30 mg/g and ≤ 3500 mg/g
- eGFR ≥ 25 ml/min/1.73m2
- Stable renal function prior to entry into the study defined as no more than 30% eGFR change in 3 months prior to enrolment
- Signed Informed Consent
Who cannot join
- Diagnosis with type 1 or type 2 Diabetes
- Hba1c ≥ 6.5% at screening
- Cardiovascular disease event in 3 months prior to enrollment
- Treatment with GLP-1 RA < 4 weeks prior to screening
- Uncontrolled thyroid disease TSH>6.0 mIU/L or <0.4 mIU/L at screening
- Acute pancreatitis < 180 days prior to screening
- History or presence of chronic pancreatitis
- Females of child-bearing potential who are pregnant, breast-feeding or have intention of becoming pregnant or are not using adequate contraceptive measures
Trial locations and contacts
13 sites in 4 countries.
13 sites in 4 countries
Netherlands5 sites
Dept Internal Medicine, division of Nephrology Hospital Group Twente
Almelo, 7609 PP
Rijnstate
Arnhem, Gelderland, 6815 AD
University Medical Center Groningen
Groningen, Provincie Groningen, 9713 GZ
Martini Ziekenhuis
Groningen, Provincie Groningen, 9728 NT
Isala
Zwolle, Overijssel, 8025 AB
Spain4 sites
Vall d'Hebron University Hospital
Barcelona, 08035
Hospital Universitari de Bellvitge
Barcelona, 08907
Hospital Da Costa Burela
Lugo, 27880
Hospital Clínico Universitario
Valencia, 46010
Canada2 sites
University of Calgary
Calgary, Alberta, 3230
Division of Nephrology University Health Network, University of Toronto
Toronto, Ontario, M5G 2C4
Germany2 sites
University Hospital Erlangen
Erlangen, 91054
University Hospital Wuerzburg
Würzburg, 97080
About this study
Study to assess the effects of weekly subcutaneous administration of the GLP1-RA semaglutide 2.4mg on kidney function parameters in obese/overweight individuals at high risk of CKD progression.
Read the detailed description
Glucagon Like Peptide 1 Receptor Agonist (GLP1-RA) therapies have been introduced as antidiabetic drugs. In addition, GLP1-RA therapies reduce body weight, in patients with and without diabetes, without inducing hypoglycemia. Moreover, GLP1-RA reduce albuminuria in patients with type 2 diabetes, and liraglutide and semaglutide have been shown to improve various risk markers of CKD progression in non-diabetic obese individuals. It is therefore likely that these agents delay progression of kidney function decline in high risk obese/overweight, non-diabetic individuals.
The main objective of the study is to assess the albuminuria lowering effects of semaglutide 2.4 mg s.c. once weekly (Semaglutide 3 mg/ml) compared to placebo in obese/overweight non-diabetic individuals with elevated albuminuria. This will be tested in a 24-week randomized placebo controlled double-blind two arm parallel clinical trial with a 4 week wash-out period after 24 weeks double blind treatment to assess off drug effects.
- Conditions
- Obesity, Albuminuria
- Being tested
- Semaglutide, Placebo
- Keywords
- SMART, Semaglutide, UMCG, Lambers Heerspink
- Medical subject headings
- Obesity, Albuminuria
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SemaglutideDrug
Patients will be treated for 24 weeks with semaglutide 3.0 mlg/ml s.c. once weekly. The starting dose of semaglutide will be 0.24 mg per week subcutaneous injection with increasing doses at 4, 8, 12, and 16 weeks to 0.5, 1,0, 1.7 and 2.4 mg.
PlaceboDrug
Patients will receive a matching placebo sc. once weekly during the treatment period of 24 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Semaglutide | Experimental | Patients will be treated with semaglutide 3 mg/ml s.c. once weekly for 24 weeks. The starting dose of semaglutide will be 0.24 mg subcutaneous injection with increasing doses at 4, 8, 12, and 16 weeks to 0.5, 1,0, 1.7 and 2.4 mg once weekly. Receives: Drug: Semaglutide |
| Placebo | Placebo comparator | Patients will receive a matching placebo s.c. once weekly. Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from baseline to week 24 in urinary albumin:creatinine ratio (UACR)
Measured in first morning void
Measured: Week 1 to week 24
Secondary outcomes (9)
estimated glomerular filtration rate (eGFR)
Change from baseline to week 24 in estimated glomerular filtration rate (eGFR)
Measured: Week 1 to week 24
Iohexol measured glomerular filtration rate (GFR)
Change from baseline to week 24 in Iohexol measured glomerular filtration rate (GFR)
Measured: Week 1 to week 24
urinary albumin:creatinine ratio (UACR) during wash-out
Change in urinary albumin:creatinine ratio (UACR) during wash-out
Measured: week 24 to 28
estimated glomerular filtration rate (eGFR) during wash-out
Change in estimated glomerular filtration rate (eGFR) during wash-out
Measured: week 24 to 28
body weight
Change from baseline to week 24 in body weight
Measured: Week 1 to week 24
hip circumference
Change from baseline to week 24 in hip circumference
Measured: Week 1 to week 24
systolic and diastolic blood pressure
Change from baseline to week 24 in systolic and diastolic blood pressure
Measured: Week 1 to week 24
extracellular fluid
Change from baseline to week 24 in extracellular fluid as measured by bio-impedance
Measured: Week 1 to week 24
high sensitivity C-reactive protein (CRP)
Change from baseline to week 24 in high sensitivity C-reactive protein (CRP)
Measured: Week 1 to week 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 May 2021
- Study start14 Mar 2022
- Primary completion28 May 2024
- Study completion28 May 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for ObesityStudies of the same condition, open and under way.
- More trials run by University Medical Center GroningenThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomized placebo controlled double-blind two arm parallel clinical trial
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 125 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Medical Center Groningen
- Sponsor type
- University, hospital or other
- Collaborators
- Novo Nordisk A/S
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04889183
- Sponsor's protocol ID
- 202100166
- Other IDs
- 2021-001247-27
- Acronym
- SMART
- Status last verified
- Nov 2024
- First submitted
- 6 May 2021
- Last updated
- 22 Apr 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Heerspink HJL, Soler M, Beernink JM, Jongs N, Cigarran S, Cruzado JM, Puchades MJ, Lopez-Martinez M, Apperloo E, Waanders F, Laverman GD, van der Aart-van der Beek A, van Beek AP, Verhave JC, Ahmed SB, Schmieder RE, Wanner C, Cherney DZI, Gorriz JL. Effects of Semaglutide on Body Composition and GFR: A Prespecified Analysis of the SMART Trial. Clin J Am Soc Nephrol. 2026 Jul 1;21(7):1149-1158. doi: 10.2215/CJN.0000001051. Epub 2026 Apr 30.
PubMed 42308057Apperloo EM, Gorriz JL, Soler MJ, Cigarran Guldris S, Cruzado JM, Puchades MJ, Lopez-Martinez M, Waanders F, Laverman GD, van der Aart-van der Beek A, Hoogenberg K, van Beek AP, Verhave J, Ahmed SB, Schmieder RE, Wanner C, Cherney DZI, Jongs N, Heerspink HJL. Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial. Nat Med. 2025 Jan;31(1):278-285. doi: 10.1038/s41591-024-03327-6. Epub 2024 Oct 25.
PubMed 39455729
Study at a glance
From the registry record, last updated by the sponsor on 22 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- SeMaglutide and Albuminuria Reduction Trial in Obese Individuals Without Diabetes
- ClinicalTrials.gov ID
- NCT04889183
- Acronym / sponsor ID
- SMART / 202100166
- Conditions
- Obesity, Albuminuria
- Keywords
- SMART, Semaglutide, UMCG, Lambers Heerspink
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 125 participants (actual)
- Lead sponsor
- University Medical Center GroningenUniversity, hospital or other
- Collaborators
- Novo Nordisk A/S
- Study start
- 14 Mar 2022 (actual)
- Primary completion
- 28 May 2024 (actual)
- Study completion
- 28 May 2024 (actual)
- First posted
- 17 May 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Study to assess the effects of weekly subcutaneous administration of the GLP1-RA semaglutide 2.4mg on kidney function parameters in obese/overweight individuals at high risk of CKD progression.
Detailed description
Glucagon Like Peptide 1 Receptor Agonist (GLP1-RA) therapies have been introduced as antidiabetic drugs. In addition, GLP1-RA therapies reduce body weight, in patients with and without diabetes, without inducing hypoglycemia. Moreover, GLP1-RA reduce albuminuria in patients with type 2 diabetes, and liraglutide and semaglutide have been shown to improve various risk markers of CKD progression in non-diabetic obese individuals. It is therefore likely that these agents delay progression of kidney function decline in high risk obese/overweight, non-diabetic individuals.
The main objective of the study is to assess the albuminuria lowering effects of semaglutide 2.4 mg s.c. once weekly (Semaglutide 3 mg/ml) compared to placebo in obese/overweight non-diabetic individuals with elevated albuminuria. This will be tested in a 24-week randomized placebo controlled double-blind two arm parallel clinical trial with a 4 week wash-out period after 24 weeks double blind treatment to assess off drug effects.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Randomized placebo controlled double-blind two arm parallel clinical trial
| Arm | Type | Receives |
|---|---|---|
| Semaglutide | Experimental | Drug: SemaglutidePatients will be treated with semaglutide 3 mg/ml s.c. once weekly for 24 weeks. The starting dose of semaglutide will be 0.24 mg subcutaneous injection with increasing doses at 4, 8, 12, and 16 weeks to 0.5, 1,0, 1.7 and 2.4 mg once weekly. |
| Placebo | Placebo comparator | Drug: PlaceboPatients will receive a matching placebo s.c. once weekly. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Age ≥ 18 years
- Body Mass index ≥ 27 kg/m2
- Albuminuria ≥ 30 mg/g and ≤ 3500 mg/g
- eGFR ≥ 25 ml/min/1.73m2
- Stable renal function prior to entry into the study defined as no more than 30% eGFR change in 3 months prior to enrolment
Key exclusion criteria (8 listed)
- Diagnosis with type 1 or type 2 Diabetes
- Hba1c ≥ 6.5% at screening
- Cardiovascular disease event in 3 months prior to enrollment
- Treatment with GLP-1 RA < 4 weeks prior to screening
- Uncontrolled thyroid disease TSH>6.0 mIU/L or <0.4 mIU/L at screening
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SemaglutidePatients will be treated for 24 weeks with semaglutide 3.0 mlg/ml s.c. once weekly. The starting dose of semaglutide will be 0.24 mg per week subcutaneous injection with increasing doses at 4, 8, 12, and 16 weeks to 0.5, 1,0, 1.7 and 2.4 mg. | Drug | Semaglutide |
| PlaceboPatients will receive a matching placebo sc. once weekly during the treatment period of 24 weeks. | Drug | Placebo |
Primary outcome
Change from baseline to week 24 in urinary albumin:creatinine ratio (UACR)
Time frame: Week 1 to week 24
Measured in first morning void
9 secondary outcomes
estimated glomerular filtration rate (eGFR)
Time frame: Week 1 to week 24
Iohexol measured glomerular filtration rate (GFR)
Time frame: Week 1 to week 24
urinary albumin:creatinine ratio (UACR) during wash-out
Time frame: week 24 to 28
estimated glomerular filtration rate (eGFR) during wash-out
Time frame: week 24 to 28
body weight
Time frame: Week 1 to week 24
hip circumference
Time frame: Week 1 to week 24
systolic and diastolic blood pressure
Time frame: Week 1 to week 24
extracellular fluid
Time frame: Week 1 to week 24
high sensitivity C-reactive protein (CRP)
Time frame: Week 1 to week 24
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Apr 2025.
- Derived from this study: PubMed 42308057Heerspink HJL, Soler M, Beernink JM, Jongs N, Cigarran S, Cruzado JM, Puchades MJ, Lopez-Martinez M, Apperloo E, Waanders F, Laverman GD, van der Aart-van der Beek A, van Beek AP, Verhave JC, Ahmed SB, Schmieder RE, Wanner C, Cherney DZI, Gorriz JL. Effects of Semaglutide on Body Composition and GFR: A Prespecified Analysis of the SMART Trial. Clin J Am Soc Nephrol. 2026 Jul 1;21(7):1149-1158. doi: 10.2215/CJN.0000001051. Epub 2026 Apr 30.
- Derived from this study: PubMed 39455729Apperloo EM, Gorriz JL, Soler MJ, Cigarran Guldris S, Cruzado JM, Puchades MJ, Lopez-Martinez M, Waanders F, Laverman GD, van der Aart-van der Beek A, Hoogenberg K, van Beek AP, Verhave J, Ahmed SB, Schmieder RE, Wanner C, Cherney DZI, Jongs N, Heerspink HJL. Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial. Nat Med. 2025 Jan;31(1):278-285. doi: 10.1038/s41591-024-03327-6. Epub 2024 Oct 25.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
13 sites in 4 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Semaglutide in people with Obesity and Albuminuria, run by University Medical Center Groningen at 13 sites in 4 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 13 sites in Netherlands, Spain, Canada, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from baseline to week 24 in urinary albumin:creatinine ratio (UACR) (time frame: Week 1 to week 24). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04889183, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Apr 2025.