Design and baseline characteristics of the STRIDE trial: evaluating semaglutide in people with symptomatic peripheral artery disease and type 2 diabetes

🥉 Top 5% JournalOct 18, 2024European heart journal. Cardiovascular pharmacotherapy

Study design and starting traits of STRIDE trial testing semaglutide in people with artery disease and type 2 diabetes

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Abstract

A total of 792 participants with symptomatic peripheral artery disease (PAD) and type 2 diabetes (T2D) were enrolled in the STRIDE trial.

Participants had a median age of 68 years and a median duration of T2D of 12 years.
At baseline, the median maximum walking distance on a constant-load treadmill was 186 meters, indicating functional impairment.
Common risk factors included 25.6% current smokers, 87.9% with hypertension, and 42.7% with coronary heart disease.
The primary endpoint is the change in maximum walking distance, while secondary endpoints include quality of life and cardiometabolic assessments.

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BACKGROUND: People with lower extremity peripheral artery disease (PAD) suffer from a high burden of symptoms and significant functional impairment. There are few therapies that improve function and reduce symptoms in this population. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been shown to improve glycaemic control, reduce body weight, and reduce the risk of major adverse cardiovascular events in people with atherosclerotic cardiovascular disease and type 2 diabetes (T2D).

METHODS AND RESULTS: STRIDE (NCT04560998) is a randomized, placebo-controlled, double-blind phase 3b trial evaluating 1 mg once-weekly subcutaneous semaglutide (GLP-1 RA) vs. placebo, in people with symptomatic PAD (Fontaine IIa claudication) and T2D. Eligible participants were ≥18 years, had haemodynamically stable PAD, had no planned intervention, and were not receiving a GLP-1 RA. The primary endpoint is change in maximum walking distance on a constant-load treadmill (CLT). Secondary endpoints include quality of life and cardiometabolic assessments. A total of 792 participants were randomized in 20 countries. Participants' median age was 68 and median T2D duration 12 years. Risk factors included 25.6% current smokers, 87.9% with hypertension, and 42.7% with coronary heart disease. The mean BMI was 29.6 kg/m2 and the mean HbA1C was 7.3%. Participants exhibited baseline functional impairment with a median maximum walking distance of 186 m on a CLT.

CONCLUSION: STRIDE has enrolled participants with symptomatic PAD and T2D, frequent risk factors and comorbidities, and functional impairment. The trial will provide evidence for the functional outcomes with semaglutide in people with PAD and T2D.

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