To determine non inferiority of two doses of BI 10773 (10 mg/daily and 25 mg/daily) compared to placebo with respect to first occurrence of any of the adjudicated components of the primary composite Major Adverse Cardiovascular Event endpoint (…
ID
Source
Brief title
Condition
- Glucose metabolism disorders (incl diabetes mellitus)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
- Time to the first occurence of any of the following adjudicated components of
the primary composite endpoint: cardiovascular death (including fatal stroke
and fatal MI), non-fatal myocardial infaction (exluding silent MI), and
non-fatal stroke.
Secondary outcome
Key secondary:
* The composite of the following adjudicated events: cardiovascular death
(including fatal stroke and fatal MI), non-fatal myocardial infaction (exluding
silent MI), and non-fatal stroke, and hospitalization for unstable angina
pectoris
Secondary:
* The occurence of and time to each of the following events:
- Silent myocardial infarction (see appendix 10.4 of the protocol)
- Heart failure requiring hospitalization
- New onset albuminuria (ACR>=30mg/g)
- New onsed macroalbuminuria (ACR>=300mg/g)
- Composite microvascular outcome (see section 5.2.1 of the protocol)
Background summary
Diabetes Mellitus type 2 is a disease which is characterized by increased blood
glucose levels. It is a condition that eventually causes damage in many organs
and tissues, resulting in a marked decrease of life expectancy and quality of
life. Therefore, treatment to maintain the blood glucose levels within normal
ranges remains important, certainly also for patients with an increased
cardiovascular risk.
There is no cure for Diabetes Mellitus type 2, but it can be treated by a diet,
excercise, several oral medications and insulin. Not all medications are well
tolerated and many compounds cause side-effects. BI 10773 is a SGLT-2 inhibitor
that decreases the reabsorption of glucose by the kidneys, resulting in
excretion of this glucose by the urine. Previous studies have shown that this
results in decreased plasmaglucose and HbA1c levels.
Study objective
To determine non inferiority of two doses of BI 10773 (10 mg/daily and 25
mg/daily) compared to placebo with respect to first occurrence of any of the
adjudicated components of the primary composite Major Adverse Cardiovascular
Event endpoint (cardiovascular death, non fatal stroke, nonfatal myocardial
infarction) in patients with type 2 diabetes mellitus increased cardiovascular
risk.
Study design
About 7000 patients with Diabetes Melllitus type 2 will participate in this
study worldwide. Of them, 1/3 will receive treatment with 10 mg BI 10773 daily,
1/3 will receive treatment with 25 mg BI 10773 daily, and 1/3 will receive
placebo for the duration of the study. The treatment will be add-on to the
stable background treatment, or as primary treatment for drug-naive patients.
The treatment period is preceded by a 2-week placebo run-in period, and
concluded with a follow-up visit 4 weeks after study medication termination
(may be done by phone).
This is a randomized, double-blind, placebo controlled study.
Intervention
At visit 2, the 2-week once-daily placebo run-in period starts.
At visit 3, patients are randomized to either once daily BI 10773 10 mg, once
daily BI 10773 25 mg, or once daily placebo (ratio 1:1:1).
Study burden and risks
Assuming a treatment period of 8years, this would at most be the following :
- Physical examination (visits 2, 8, 10, continuation visits and final visit)
- Vital signs (all visits)
- Height (visit 1), weight and waist (visits 1, 3, 8 and 10, once yearly after
week 52, and final visit)
- ECG (visits 3, 8, 10, continuation visits and final visit)
- Diet and exercise couselling (visits 1-10, continuation visits and final
visit)
- Urine sample (visits 1,2, 3, 6, 8, 10, continuation visits, final visit and
follow-up)
- Blood sample (all visits except visits 5 and 7)
- HBGM test (starting from visit 2, during run-in and follow up at least once
daily, otherwise at least once per week)
Comeniusstraat 6
ALKMAAR 1817 MS
NL
Comeniusstraat 6
ALKMAAR 1817 MS
NL
Listed location countries
Age
Inclusion criteria
(see paragraph 3.3.2 of the protocol for the complete list)
1.Diagnosis of type 2 diabetes mellitus prior to informed consent
2.Male and female patients on diet and exercise regimen who are drug-naïve or pre-treated with any background therapy. Antidiabetic therapy has to be unchanged for 12 weeks prior to randomization. If insulin is part of the background therapy, the insulin prescribed dose should not be changed within the 12 weeks prior to randomisation by more than 10% daily from the baseline value at randomisation
3.HbA1c of >=7.0% and <=10% at Visit 1 (screening) for patients on background therapy or HbA1c of >=7.0% and <=9.0% At Visit 1 (screening) for drug-naïve patients.
4.Age >= 18 years
5.BMI <= 45 kg/m2 (Body Mass Index) at Visit 1
7.Signed and dated written informed consent by date of Visit 1 in accordance with GCP and local legislation
8.High cardiovascular risk (see protocol paragraph 3.3.2 for definition)
Exclusion criteria
1. Uncontrolled hyperglycaemia with a glucose level >240 mg/dl (>13.3 mmol/L) after an overnight fast during placebo run-in and confirmed by a second measurement (not on the same day)
2. Indication of liver disease, defined by serum levels of either ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3 x upper limit of normal (ULN) as determined during screening and/or run in phase.
3. Planned cardiac surgery or angioplasty within 3 months.
4. Impaired renal function, defined as GFR<30 ml/min (severe renal impairment, MDRD formula) as determined during screening and/or run in phase.
5. Bariatric surgery within the past two years and other gastrointestinal surgeries that induce chronic malabsorption.
6. Blood dyscrasias or any disorders causing haemolysis or unstable Red Blood Cell (e.g. malaria, babesiosis, haemolytic anaemia)
7. Medical history of cancer (except for basal cell carcinoma) and/or treatment for cancer within the last 5 years.
8. Contraindications to background therapy according to the local label.
9. Treatment with anti-obesity drugs (e.g., sibutramine, orlistat) 3 months prior to informed consent or any other treatment at the time of screening (i.e., surgery, aggressive diet regimen, etc.) leading to unstable body weight
10. Current treatment with systemic steroids at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent or any other uncontrolled endocrine disorder except T2DM
11. Pre-menopausal women (last menstruation * 1 year prior to informed consent) who:
- are nursing or pregnant or
- are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the study and do not agree to submit to periodic pregnancy testing during participation in the trial. Acceptable methods of birth control include tubal ligation, transdermal patch, intra uterine devices/systems (IUDs/IUSs), oral, implantable or injectable contraceptives, sexual abstinence (if allowed by local Authorities), double barrier method and vasectomised partner.
12. Alcohol or drug abuse within the 3 months prior to informed consent that would interfere with trial participation or any ongoing condition leading to a decreased compliance to study procedures or study drug intake
13. Participation in another trial with Intake of an investigational drug in another trial within 30 days prior to intake of study medication in this trial, or participating in another trial (involving an investigational drug and/or follow-up) after discontinuing medication in this trial.
14. Any other clinical condition that would jeopardize patients safety while participating in this clinical trial
15. Acute coronary syndrome, stroke or TIA within 2 months prior to informed consent
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2009-016178-33-NL |
ClinicalTrials.gov | NCT01131676 |
CCMO | NL32194.072.10 |