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CompletedNCT06489457SEMATUpdated Jul 8, 2024

The Effects of Semaglutide vs Testosterone Replacement Therapy on Functional Hypogonadism and Sperm Quality in Men With Type 2 Diabetes Mellitus and Obesity

A Phase 3 interventional study of Semaglutide and Testosterone Undecanoate in Type 2 Diabetes Mellitus, Obesity and Functional Hypogonadism, sponsored by University Medical Centre Ljubljana. Completed at 1 site in Slovenia. Open to male participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-07-08.

Sponsored by University Medical Centre Ljubljana · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Registered 3 years 8 months after the study started (first participant enrolled Sep 2020, registered Jun 2024).
Phase
Phase 3
Study type
Interventional
Enrollment
25
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
Male
01

Study summary

The goal of this study is to learn whether semaglutide (treatment for type 2 diabetes and obesity) can improve signs and symptoms of hypogonadism in men with type 2 diabetes, obesity and hypogonadism (a condition when levels of testosterone are decreased).

The main questions the study aims to answer are:

  • Does semaglutide improve the quality of sperm?
  • Does semaglutide improve symptoms of hypogonadism as well as testosterone replacement?

The researchers will compare semaglutide to testosterone replacement to see which drug better treats symptoms of hypogonadism.

  • The participants will receive testosterone replacement therapy (intramuscular injection every 10-12 weeks) or magnitude (subcutaneous injection once a week).
  • The treatment will last 24 weeks.
  • The participants will visit the clinic at the start and the end of the study.

At the visit, the researchers will measure body weight and take a few blood samples. The participants will also be asked to complete several questionnaires and collect a sperm sample.

The participants are free to terminate their participation in the study at any time without giving a reason.

Read the detailed description

Men aged 18 - 65 years with type 2 diabetes on oral antidiabetic treatment, body mass index above 30 kg/m2 and functional hypogonadism (total testosterone below 11 nmol/L and at least 2 symptoms of hypogonadism) are eligible to participate in the study. The participants are randomized to either testosterone undecanoate (100 mg intramuscular injection once per 10-12 weeks) or semaglutide (subcutaneous injection once weekly titrated to 1 mg in concordance with Summary of product characteristics (SmPC) for 24 weeks.

At the beginning of the study and after 24 weeks of treatment the researchers measured anthropometric (body weight, body composition), endocrine (total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone binding globulin (SHBG)) and metabolic parameters (HbA1c, 75-g oral glucose tolerance test (OGTT), insulin, c-peptide). The participants also gave sperm samples and completed self-reported hypogonadism symptom evaluation (Ageing male symptoms (AMS) score, International Index of erectile function 15 (IIEF-15)).

02

Conditions studied

  • Type 2 Diabetes Mellitus
  • Obesity
  • Functional Hypogonadism

Keywords

  • Functional Hypogonadism
  • Type 2 Diabetes
  • Obesity
  • Tesrosterone Replacement Therapy
  • Semaglutide
  • GLP-1 agonist
  • Semen
  • Sperm
03

In context

Diabetes Mellitus

10,925 studies on the registry are indexed under Diabetes Mellitus; 1,319 are open to participants now.

This study's enrollment of 25 is below the median of 80 across 8,367 interventional studies indexed under Diabetes Mellitus.

Browse Diabetes Mellitus studies →

Lead sponsor

University Medical Centre Ljubljana is the lead sponsor of 284 studies on the registry; 71 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • type 2 diabetes mellitus,
  • obesity (body mass index (BMI) higher or equal to 30 kg/m\^2),
  • functional hypogonadism (defined by total testosterone less than 11 nmol/L and 2 or more symptoms of sexual dysfunction)

Exclusion criteria

Exclusion criteria:

  • Insulin treatment,
  • glucagon-like peptide 1 (GLP-1) agonist treatment,
  • sodium-glucose cotransporter-2 (SGLT-2) inhibitor treatment,
  • other identified causes of hypogonadism,
  • hemochromatosis,
  • active malignant disease,
  • thrombophilia,
  • venous thrombosis within 6 months,
  • recent acute myocardial infarction or stroke,
  • prostate-specific antigen (PSA) higher than 3 ng/L,
  • severe lower urinary tract symptoms with an International Prostate Symptom Score above 19,
  • severe sleep apnea syndrome,
  • hematocrit higher than 0.5,
  • significant kidney or liver disease,
  • ongoing treatment with opioid analgesics, antipsychotics, glucocorticoids,
  • alcohol abuse,
  • severe ongoing mental illness,
  • personal history of pancreatitis or medullary thyroid carcinoma,
  • personal or family history of multiple endocrine neoplasia type 2.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
25 participants (actual)

Study arms

  • Experimental
    Semaglutide Treatment

    Drug: Semaglutide

  • Active comparator
    Testosterone Replacement Therapy

    Drug: Testosterone Undecanoate

Interventions

  • DrugSemaglutide

    Semaglutide subcutaneous injection once weekly titrated to 1 mg in concordance with Summary of product characteristics (SmPC) (0.25 mg once weekly in the first month, 0.5 mg once weekly in the second month and 1 mg once weekly from the third month onward)

  • DrugTestosterone Undecanoate

    Testosterone Undecanoate intramuscular injection 1000 mg once per 10-12 weeks

06

What researchers measure

Primary outcomes

  1. Change in semen volume from baseline and between the treatment arms

    The semen volume will be measured and reported in mililiters (mL). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  2. Change in sperm concentration from baseline and between the treatment arms

    The sperm concentration will be measured and reported in number times 10\^6 per mililiter (10\^6/mL). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  3. Change in total motility of sperm from baseline and between the treatment arms

    The total motility will be assessed as total number of motile sperm and reported as number times 10\^6 per ejaculate (10\^6/ejaculate). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  4. Change in normal sperm forms from baseline and between the treatment arms

    The normal sperm forms will be assessed as total number of sperm with normal morphology and reported as number times 10\^6 per ejaculate (10\^6/ejaculate). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  5. Change in total number of sperm from baseline and between the treatment arms

    The total number of sperm will be measured and reported in number times 10\^6 per ejaculate (10\^6/ejaculate). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

Secondary outcomes

  1. Change in International index of erectile function 15 (IIEF-15) score from baseline and between the treatment arms

    IIEF-15 assesses male sexual function. It has 5 domains. Erectile function with scoring range from 30 (max) to 1 (min). Orgasmic function with scoring range from 10 (max) to 1 (min). Sexual desire with scoring range from 10 (max) to 2 (min). Intercourse satisfaction with scoring range from 15 (max) to 0 (min). Overall satisfaction with scoring range from 10 (max) to 2 (min). The subdomains combine to overall score with scoring range from 75 (max) to 6 (min). The higher score indicates the better sexual function.

    Time frame: Baseline and 24 weeks

  2. Change in Aging male symptoms (AMS) score from baseline and between the treatment arms

    The AMS score assesses male symptoms os hypogonadism. It has 3 subdomains. Psychological symptoms with scoring range from 25 (max) to 5 (min). Somatic with scoring range from 35 (max) to 7 (min). Sexual with scoring range from 25 (max) to 5 (min). The subdomains combine to overall score with scoring range from 85 (max) to 17 (min). The lower the score the less symptoms are present.

    Time frame: Baseline and 24 weeks

  3. Change in HbA1c from baseline and between the treatment arms

    The HbA1c will be measured and reported in % and milimoles per mole (mmol/mol). The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  4. Change in follicle-stimulating hormone (FSH) from baseline and between the treatment arms

    The FSH will be measured and reported in international units per liter (IU/L). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  5. Change in luteinizing hormone (LH) from baseline and between the treatment arms

    The LH will be measured and reported in international units per liter (IU/L). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  6. Change in estimated visceral adipose tissue from baseline and between the treatment arms

    Measured by dual-energy X-ray absorptiometry the estimated visceral adipose tissue will be reported in grams (g). The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  7. Change in percentage of body fat from baseline and between the treatment arms

    Measured by dual-energy X-ray absorptiometry the procentage of body fat will be reported in %. The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  8. Change in fasting serum low-density lipoproteins (LDL) cholesterol from baseline and between the treatment arms

    The LDL cholesterol will be measured and reported in milimoles per liter (mmol/L). The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  9. Change in fasting serum total cholesterol from baseline and between the treatment arms

    The total cholesterol will be measured and reported in milimoles per liter (mmol/L). The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  10. Change in fasting serum high-density lipoproteins (HDL) cholesterol from baseline and between the treatment arms

    The HDL cholesterol will be measured and reported in milimoles per liter (mmol/L). The higher the value the better the outcome.

    Time frame: Baseline and 24 weeks

  11. Change in fasting triglycerides from baseline and between the treatment arms

    Triglycerides will be measured and reported in milimoles per liter (mmol/L). The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

Other outcomes

  1. Change in body mass from baseline and between the treatment arms

    The body mass will be assessed and reported in kilograms (kg). The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  2. Change in body mass index (BMI) from baseline and between the treatment arms

    The BMI will be calculated from body mass and height using the following equation: BMI=body mass in kilograms (kg) divided by height in meters (m) squared, and reported in kg/m\^2. The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

  3. Change in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) score from baseline and between the treatment arms

    The HOMA-IR will be calculated using the following equation: HOMA-IR = (fasting plasma insulin×fasting plasma glucose)/22.5. The lower the value the better the outcome.

    Time frame: Baseline and 24 weeks

07

Study locations

1 site
  • University Medical Centre Ljubljana
    Ljubljana, 1000, Slovenia
08

References and documents

Individual participant data

Plan to share: No — We have not decided how and when IPD and the supporting information will be shared. The documents also need to be translated into English. It might take some time.

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 8, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06489457
Lead sponsor
University Medical Centre Ljubljana
Responsible party
Andrej Janez (Professor, PhD, MD, University Medical Centre Ljubljana) — Principal investigator
First posted
Jul 8, 2024
Start date
Sep 20, 2020
Primary completion
May 11, 2023
Completion
Jun 30, 2023
Last update
Jul 8, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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