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Efficacy and Safety of Lixisenatide Versus Placebo on Top of Basal Insulin and/or Oral Antidiabetic Treatment in Older Type 2 Diabetic Patients

Phase 3
Completed
Conditions
Type 2 Diabetes
Interventions
Drug: Placebo
Drug: Antidiabetic background therapy
Registration Number
NCT01798706
Lead Sponsor
Sanofi
Brief Summary

Primary objective:

- To evaluate the effect of lixisenatide versus placebo over a period of 24 weeks on glycemic control, as evaluated by glycosylated hemoglobin (HbA1c) reduction, in older type 2 diabetes participants (T2DM) who are inadequately controlled with their current anti-diabetic treatment regimen.

Main secondary objective:

- To assess the safety and tolerability of lixisenatide compared to placebo in older T2DM participants (including occurrence of documented (Plasma Glucose PG \< 60 mg/dL) symptomatic hypoglycemia and gastrointestinal side effects).

Other secondary objectives:

* To assess the effect of lixisenatide compared to placebo after 24-week treatment on:

* Fasting plasma glucose (FPG);

* During liquid standardized breakfast meal challenge test : 2 hour- Postprandial Plasma Glucose (PPG) and Plasma Glucose Excursion;

* 7-point Self-monitored plasma glucose (SMPG) profile;

* Body weight;

* Change in total daily dose of basal insulin (if taken);

* Percentage of participants requiring rescue therapy

* Safety and tolerability;

* To assess lixisenatide pharmacokinetic profile;

* To assess anti-lixisenatide antibody development.

Detailed Description

Approximately 31 weeks including 24 week treatment period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
350
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
LixisenatideLixisenatide (AVE0010)Lixisenatide 10 mcg once daily (QD) for 2 weeks, then at a maintenance dose of 20 mcg QD up to Week 24. If the maintenance dose of 20 mcg was not tolerated, dose could be reduced to 10 mcg.
LixisenatideAntidiabetic background therapyLixisenatide 10 mcg once daily (QD) for 2 weeks, then at a maintenance dose of 20 mcg QD up to Week 24. If the maintenance dose of 20 mcg was not tolerated, dose could be reduced to 10 mcg.
PlaceboPlaceboPlacebo (matched to lixisenatide) QD for 24 Weeks.
PlaceboAntidiabetic background therapyPlacebo (matched to lixisenatide) QD for 24 Weeks.
Primary Outcome Measures
NameTimeMethod
Absolute Change in HbA1c From Baseline to Week 24Baseline, Week 24

Change in HbA1c was calculated by subtracting baseline value from Week 24 value. Missing data was imputed using last on-treatment observation carried forward (LOCF). On-treatment period for this efficacy variable was defined as the time from the first dose of study drug up to 14 days after the last dose of study drug. Here, number of participants analyzed=participants with baseline and at least one post-baseline HbA1c assessment during on-treatment period.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Gastrointestinal DisordersUp to Day 171
Change in 2-Hour PPG From Baseline to Week 24Baseline, Week 24

The 2-hour PPG test measured blood glucose 2 hours after eating a liquid standardized breakfast meal. Change in PPG was calculated by subtracting baseline value from Week 24 value. Missing data was imputed using LOCF. The on-treatment period for this efficacy variable was the time from the first dose of study drug up to the day of last dose of study drug.

Change in Average 7-point SMPG Profiles From Baseline to Week 24Baseline, Week 24

Participants recorded a 7-point plasma glucose profile measured before and 2 hours after each meal and at bedtime three times in a week before baseline, before visit Week 12 and before visit week 26 and the average value across the profiles performed in the week a visit for the 7-time points was calculated. Change in average 7-point SMPG was calculated by subtracting baseline value from Week 24 value. Missing data was imputed using LOCF. The on-treatment period for this efficacy variable was defined as the time from the first dose of study drug up to the day of last dose of study drug.

Percentage of Participants Requiring Rescue Therapy During 24 Week Treatment PeriodBaseline up to Week 24

Routine fasting SMPG and central laboratory FPG (and HbA1c after Week 12) values were used to determine the requirement of rescue medication. If fasting SMPG value exceeded the specified limit for 3 consecutive days, the central laboratory FPG (and HbA1c after Week 12) were performed. Threshold values - from baseline to Week 8: fasting SMPG/FPG \>270 mg/dL (15.0 mmol/L), from Week 8 to Week 12: fasting SMPG/FPG \>240 mg/dL (13.3 mmol/L), and from Week 12 to Week 24: fasting SMPG/FPG \>200 mg/dL (11.1 mmol/L) or HbA1c \>9%.

Change in Plasma Glucose Excursions From Baseline to Week 24Baseline, Week 24

Plasma glucose excursion = 2-hour PPG minus plasma glucose 30 minutes prior to the liquid standardized breakfast meal test, before study drug administration. Change in plasma glucose excursions were calculated by subtracting baseline value from Week 24 value. Missing data was imputed using LOCF. The on-treatment period for this efficacy variable was the time from the first dose of study drug up to the day of last dose of study drug.

Change in FPG From Baseline to Week 24Baseline, Week 24

Change in FPG was calculated by subtracting baseline value from Week 24 value. Missing data was imputed using LOCF. The on-treatment period for this efficacy variable was the time from the first dose of study drug up to 1 day after the last dose of study drug.

Change in Total Daily Basal Insulin Dose From Baseline to Week 24 (in Participants Who Took Basal Insulin as Background Therapy)Baseline, Week 24

Change in basal insulin dose was calculated by subtracting baseline value from Week 24 value. Missing data was imputed using LOCF. The on-treatment period for this efficacy variable was the time from the first dose of study drug up to the day of last dose of study drug.

Change in Body Weight From Baseline to Week 24Baseline, Week 24

Change in body weight was calculated by subtracting baseline value from Week 24 value. Missing data was imputed using LOCF. On-treatment period for this efficacy variable was defined as the time from the first dose of study drug up to 3 days after the last dose of study drug.

Percentage of Participants With Symptomatic and Severe Symptomatic HypoglycemiaFirst dose of study drug up to 3 days after the last dose administration (maximum of 171 days)

Symptomatic hypoglycemia was an event with clinical symptoms that were considered to result from a hypoglycemic episode with an accompanying plasma glucose less than 60 mg/dL (3.3 mmol/L) or associated with prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration if no plasma glucose measurement was available. Severe symptomatic hypoglycemia was symptomatic hypoglycemia event in which the participant required the assistance of another person and was associated with either a plasma glucose level below 36 mg/dL (2.0 mmol/L) or prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration, if no plasma glucose measurement was available.

Percentage of Participants With HbA1c Reduction >0.5% at Week 24 and Did Not Experienced Documented (Plasma Glucose <60 mg/dL) Symptomatic HypoglycemiaWeek 24

The on-treatment period for HbA1c assessment was defined as the time from the first dose of study drug up to 14 days after the last dose of study drug. The on-treatment period for symptomatic hypoglycemia assessment was defined as the time from the first dose of study drug up to 1 day after the last dose of study drug.

Trial Locations

Locations (83)

Investigational Site Number 100002

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Plovdiv, Bulgaria

Investigational Site Number 840016

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Salisbury, North Carolina, United States

Investigational Site Number 276007

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Pohlheim, Germany

Investigational Site Number 124004

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Winnipeg, Canada

Investigational Site Number 100004

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Stara Zagora, Bulgaria

Investigational Site Number 840017

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Biloxi, Mississippi, United States

Investigational Site Number 124002

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Sherbrooke, Canada

Investigational Site Number 124003

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Hamilton, Canada

Investigational Site Number 036001

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Heidelberg, Australia

Investigational Site Number 036003

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Parkville, Australia

Investigational Site Number 840014

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Canal Fulton, Ohio, United States

Investigational Site Number 840009

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Omaha, Nebraska, United States

Investigational Site Number 840007

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Milwaukee, Wisconsin, United States

Investigational Site Number 840015

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Norwalk, California, United States

Investigational Site Number 616004

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Gdansk, Poland

Investigational Site Number 616002

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Ruda Slaska, Poland

Investigational Site Number 840004

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Rockville, Maryland, United States

Investigational Site Number 276004

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Essen, Germany

Investigational Site Number 036006

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Brookvale, Australia

Investigational Site Number 276006

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Pirna, Germany

Investigational Site Number 724004

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Santiago De Compostela, Spain

Investigational Site Number 578001

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Hønefoss, Norway

Investigational Site Number 616003

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Krakow, Poland

Investigational Site Number 752004

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Malmö, Sweden

Investigational Site Number 752006

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Göteborg, Sweden

Investigational Site Number 724001

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Alcira, Spain

Investigational Site Number 724003

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Madrid, Spain

Investigational Site Number 276001

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Münster, Germany

Investigational Site Number 578005

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Kongsvinger, Norway

Investigational Site Number 578003

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Oslo, Norway

Investigational Site Number 616006

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Szczecin, Poland

Investigational Site Number 710003

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Cape Town, South Africa

Investigational Site Number 208004

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København S, Denmark

Investigational Site Number 208002

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Slagelse, Denmark

Investigational Site Number 208003

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Svendborg, Denmark

Investigational Site Number 124007

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London, Canada

Investigational Site Number 124005

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Vancouver, Canada

Investigational Site Number 124006

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Vancouver, Canada

Investigational Site Number 276008

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Potsdam, Germany

Investigational Site Number 724002

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Sanlúcar De Barrameda, Spain

Investigational Site Number 100005

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Plovdiv, Bulgaria

Investigational Site Number 100003

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Sofia, Bulgaria

Investigational Site Number 100001

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Varna, Bulgaria

Investigational Site Number 826003

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Bexhill-On-Sea, United Kingdom

Investigational Site Number 840010

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La Jolla, California, United States

Investigational Site Number 036004

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Camperdown, Australia

Investigational Site Number 036005

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Gosford, Australia

Investigational Site Number 840011

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St. George, Utah, United States

Investigational Site Number 036002

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Box Hill, Australia

Investigational Site Number 124001

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St-Romuald, Canada

Investigational Site Number 208005

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Esbjerg, Denmark

Investigational Site Number 124008

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Westmount, Canada

Investigational Site Number 208001

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København Nv, Denmark

Investigational Site Number 276002

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München, Germany

Investigational Site Number 276005

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Dresden, Germany

Investigational Site Number 276003

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Saarlouis, Germany

Investigational Site Number 604002

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Lima, Peru

Investigational Site Number 616001

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Poznan, Poland

Investigational Site Number 710002

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Cape Town, South Africa

Investigational Site Number 710004

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Somerset West, South Africa

Investigational Site Number 724005

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Barcelona, Spain

Investigational Site Number 724006

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Hostalets De Balenyà, Spain

Investigational Site Number 752007

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Härnösand, Sweden

Investigational Site Number 752001

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Stockholm, Sweden

Investigational Site Number 752002

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Lund, Sweden

Investigational Site Number 752003

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Stockholm, Sweden

Investigational Site Number 826001

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Glasgow, United Kingdom

Investigational Site Number 826002

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Irvine, United Kingdom

Investigational Site Number 826004

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Trowbridge, United Kingdom

Investigational Site Number 840003

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Miami, Florida, United States

Investigational Site Number 840012

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Miami, Florida, United States

Investigational Site Number 578004

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Trondheim, Norway

Investigational Site Number 604005

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Lima, Peru

Investigational Site Number 604003

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Lima, Peru

Investigational Site Number 604006

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Lima, Peru

Investigational Site Number 604007

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Lima, Peru

Investigational Site Number 604008

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Piura, Peru

Investigational Site Number 578006

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Stavanger, Norway

Investigational Site Number 604001

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Arequipa, Peru

Investigational Site Number 604011

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Lima, Peru

Investigational Site Number 840002

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Des Moines, Iowa, United States

Investigational Site Number 840006

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Fargo, North Dakota, United States

Investigational Site Number 840008

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Oxon Hill, Maryland, United States

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