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To Compare the Effect of a Subcutaneous Canakinumab Administration to Placebo in Patients With Impaired Glucose Tolerance or Patients With Type 2 Diabetes With Differing Baseline Diabetes Therapies

Phase 2
Completed
Conditions
Type 2 Diabetes Mellitus
Impaired Glucose Tolerance
Interventions
Registration Number
NCT01068860
Lead Sponsor
Novartis
Brief Summary

This was a 10-week, placebo-controlled, randomized study to investigate the effect of injectable IL-1B antagonist, Canakinumab , in participants with impaired glucose tolerance or Type 2 Diabetes Mellitus (T2DM) already treated on different background diabetes therapies.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
246
Inclusion Criteria
  1. Patient must fulfill all criteria in one of the following groups:

    • Impaired Glucose Tolerance (IGT) as diagnosed per protocol and not on an anti-diabetic medicine during the study
    • Diagnosis of Type 2 diabetes in stable treatment with metformin
    • Diagnosis of Type 2 diabetes in stable treatment with metformin (at least 1000 mg/day) in combination with a sulfonylurea
    • Diagnosis of Type 2 diabetes in stable treatment with metformin (at least 1000 mg/day), sulfonylurea and thiazolidinedione combination therapy
    • Diagnosis of Type 2 diabetes in stable treatment with at least two insulin injections a day with or without metformin
  2. HbA1c between 6.5% and 8%, inclusive, at Screening; this criterion does not apply to the IGT group

  3. Age from 18-74 years, inclusive, and of either sex

Exclusion Criteria
  1. Type 1 diabetes or diabetes that is a result of pancreatic injury or other secondary forms of diabetes
  2. History or current findings of active pulmonary disease (e.g. tuberculosis, fungal diseases) as defined in the protocol:
  3. Known presence or suspicion of active or recurrent bacterial, fungal or viral infection at the time of enrollment proven.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Canakinumab 150 mg + Metforimin + SulfonylureaCanakinumab 150 mgEligible participants received a single subcutaneous injection of Canakinumab 150 mg.Patients must have had documented diagnosis of Type 2 Diabetes Mellitus and be on a stable dose of Metformin (Met) at least 1000 mg/day , and a Sulfonylurea (Sulfonyl), at least 1/2 the maximally labeled dose combination therapy, for 3 months prior to screening.
Canakinumab 150 mg + Met + Sulfonyl + ThiazolidinedioneCanakinumab 150 mgEligible participants received a single subcutaneous injection of Canakinumab 150 mg.Patients must have had documented diagnosis of Type 2 Diabetes Mellitus and be on a stable dose of Metformin (Met) at least 1000 mg/day , and a Sulfonylurea (Sulfonyl), at least 1/2 the maximally labeled dose, and a Thiazolidinedione (Thiaz)at least 1/2 the maximally labeled dose combination therapy, for 3 months prior to screening.
Canakinumab 150 mg + MetforminCanakinumab 150 mgEligible participants received a single subcutaneous injection Canakinumab 150 mg.Patients must have had documented diagnosis of Type 2 Diabetes Mellitus and be on a stable dose of Metformin (Met) monotherapy treatment at least 1000 mg/day for 3 months prior to screening
Canakinumab 150 mg in patients with IGTCanakinumab 150 mgEligible participants received a single subcutaneous injection of Canakinumab 150 mg. Patients must have had Impaired Glucose Tolerance (IGT) as defined by the World Health Organization (WHO) criteria confirmed at screening visit.
Placebo in patients with IGTPlacebo to CanakinumabEligible participants received a single subcutaneous injection of Placebo to Canakinumab. Patients must have had Impaired Glucose Tolerance (IGT) as defined by the World Health Organization (WHO) criteria confirmed at screening visit.
Placebo + MetforminPlacebo to CanakinumabEligible participants received a single subcutaneous injection of Placebo to Canakinumab. Patients must have had documented diagnosis of Type 2 Diabetes Mellitus and be on a stable dose of Metformin (Met) monotherapy treatment at least 1000 mg/day for 3 months prior to screening
Placebo + Metforimin + SulfonylureaPlacebo to CanakinumabEligible participants received a single subcutaneous injection of Placebo to Canakinumab.Patients must have had documented diagnosis of Type 2 Diabetes Mellitus and be on a stable dose of Metformin (Met) at least 1000 mg/day , and a Sulfonylurea (Sulfonyl), at least 1/2 the maximally labeled dose combination therapy, for 3 months prior to screening.
Placebo + Met + Sulfonyl + ThiazolidinedionePlacebo to CanakinumabEligible participants received a single subcutaneous injection of Placebo to Canakinumab. Patients must have had documented diagnosis of Type 2 Diabetes Mellitus and be on a stable dose of Metformin (Met) at least 1000 mg/day , and a Sulfonylurea (Sulfonyl), at least 1/2 the maximally labeled dose, and a Thiazolidinedione (Thiaz)at least 1/2 the maximally labeled dose combination therapy, for 3 months prior to screening.
Canakinumab 150 mg + InsulinCanakinumab 150 mgEligible participants received a single subcutaneous injection of Canakinumab 150 mg. Patients must have had documented diagnosis of Type 2 Diabetes Mellitus for 3 months prior to screening and be on a stable dose of Insulin, 2 insulin injections per day for a total daily dose of less than 100 U with or without Metformin (Met)for 3 months prior to screening
Placebo + InsulinPlacebo to CanakinumabEligible participants received a single subcutaneous injection of Placebo to Canakinumab. Patients must have had documented diagnosis of Type 2 Diabetes Mellitus for 3 months prior to screening and be on a stable dose of Insulin, 2 insulin injections per day for a total daily dose of less than 100 U with or without Metformin (Met)for 3 months prior to screening
Primary Outcome Measures
NameTimeMethod
Mean Change in Meal Stimulated Insulin Secretion Rate (ISR) Relative to Glucose 0-2 Hours, From Baseline to 4 Weeks.Baseline, 4 weeks

Change in Insulin Secretion Rate stimulated by Liquid mixed-meal challenge. Blood samples were taken prior to and after meal for glucose and insulin at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes relative to the start of the meal.A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include patients from the IGT population

Secondary Outcome Measures
NameTimeMethod
Mean Change in Meal Stimulated Insulin Secretion Rate (ISR) Relative to Glucose 2-4 Hours, From Baseline to 4 WeeksBaseline, 4 weeks

Change in Insulin Secretion Rate stimulated by Liquid mixed-meal challenge Blood samples were taken prior to and after meal for glucose and insulin at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes relative to the start of the meal. A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population

Mean Change in Meal Stimulated Insulin Secretion Rate (ISR) Relative to Glucose 0-4 Hours, From Baseline to 4 Weeks.Baseline, 4 weeks

Change in Insulin Secretion Rate stimulated by Liquid mixed-meal challenge. Blood samples were taken prior to and after meal for glucose, insulin and C-peptide at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes relative to the start of the meal. A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population.

Mean Change in Fasting Plasma Glucose, From Baseline to 4 WeeksBaseline, 4 weeks

Change in Fasting Glucose Level measured from plasma taken at Baseline and after 4 weeks of treatment.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population

Mean Change in Fructosamine, From Baseline to 4 WeeksBaseline, 4 weeks

Change in Fructosamine Level taken from plasma, measured at Baseline and after 4 weeks of treatment.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population

Mean Change in Fasting Plasma Insulin, From Baseline to 4 WeeksBaseline, 4 weeks

Change in Fasting Insulin level taken from plasma, measured at Baseline and after 4 weeks of treatment.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population

Mean Change in Quantitative Insulin Sensitivity Check Index (QUICKI) Score, From Baseline to 4 WeeksBaseline, 4 weeks

The Quantitative Insulin Sensitivity Check Index (QUICKI) score, measures insulin sensitivity which is the inverse of insulin resistance. The score is calculated by the equation: 1 /(log(fasting insulin µU/mL) + log(fasting glucose mg/dL)). In normal subjects the mean score ± SE is 0.366 ± 0.029.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population.

Mean Change in Fasting Glucose Disposition Index(GDI)1 and Index 2, From Baseline to 4 WeeksBaseline, 4 weeks

GDI 1 is the product of insulin sensitivity index (Si)during the 1st phase of insulin secretion and β-cell function as measured by the acute insulin response (AIR).GDI 2 is the product of (Si)during the 2nd phase of insulin secretion and β-cell function as measured by the acute insulin response (AIR). A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT group.

Mean Change in Absolute Glucose Level at 2 Hours, From Baseline to 4 WeeksBaseline, 4 weeks

Change in glucose level measured after 2 hours of fasting. Blood sample was drawn at 0 minutes and at 240 minutes.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population.

Mean Change in Insulin Area Under the Curve (AUC) 0-4 Hours, From Baseline to 4 WeeksBaseline, 4 weeks

Blood samples were drawn after a test meal at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Insulin levels over 4 hrs were shown as Area Under the Curve,(AUC). AUC was calculated as: x=1 AUC ΣAx n Where Ax = AUC for the 240 min.interval, and X = 1 for the 1st interval. A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab vs placebo within each T2DM group. The mixed model didn't include the IGT group.

Mean Change in C-peptide Area Under the Curve (AUC), 0-4 Hours, From Baseline to 4 WeeksBaseline, 4 weeks

Blood samples were drawn after a test meal at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Insulin levels over 4 hrs were shown as Area Under the Curve,(AUC). AUC was calculated as: x=1 AUC ΣAx n Where Ax = AUC for the 240 min.interval, and X = 1 for the 1st interval. A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab vs placebo within each T2DM group. The mixed model didn't include the IGT group.

Mean Change in Post-prandial Glucose Area Under the Curve (AUC)0-4 Hours, From Baseline to 4 WeeksBaseline, 4 weeks

Blood samples were drawn after a test meal at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Insulin levels over 4 hrs were shown as Area Under the Curve,(AUC). AUC was calculated as: x=1 AUC ΣAx n Where Ax = AUC for the 240 min.interval, and X = 1 for the 1st interval. A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab vs placebo within each T2DM group. The mixed model didn't include the IGT group.

Mean Change in Peak Plasma Glucose, From Baseline to 4 WeeksBaseline, 4 weeks

Change in peak plasma glucose level as measured from Baseline to 4 weeks of treatment.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population.

Mean Change in Peak Plasma Insulin, From Baseline to 4 WeeksBaseline, 4 weeks

Change in mean peak plasma Insulin level as measured from Baseline to 4 weeks of treatment. A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population.

Mean Change in Peak Plasma C-peptide Level, From Baseline to 4 WeeksBaseline, 4 weeks

Change in mean peak plasma C-peptide level measured from Baseline to 4 weeks of treatment.

A mixed model with treatment fitted as fixed effect, and population and the interaction of population and treatment fitted as random effects were used for the comparison of Canakinumab versus placebo within each T2DM population. The mixed model did not include participants from the IGT population.

Number of Participants Reporting Death, Serious Adverse Events (SAEs) and Adverse Events (AEs) Above 5% Frequency, From Baseline to 4 WeeksBaseline, 4 weeks

An adverse event is any unwanted event, whether related to study drug or not occuring during the study period. A Serious Adverse Event (SAE) is an event resulting in death, requiring or prolonging hospitalization, a congenital anomaly or other important medical event. AEs and SAEs were recorded at each visit.

Trial Locations

Locations (52)

Commonwealth Biomedical Research LLC

🇺🇸

Madisonville, Kentucky, United States

LMC Endocrinology Centres (Markham) Ltd

🇨🇦

Markham, Ontario, Canada

ODL Terveys Oy

🇫🇮

Oulu, Finland

Crest Clinical Trials

🇺🇸

Santa Ana, California, United States

Utah Clinical Trials

🇺🇸

Salt Lake City, Utah, United States

Praxis Dr. med. Joerg Luedemann

🇩🇪

Falkensee, Germany

Hôpital Maisonneuve-Rosemont

🇨🇦

Montreal, Quebec, Canada

Dr. Helmut Anderten Gemeinschaftspraxis Dres. Anderten und Krok

🇩🇪

Hildesheim, Germany

Gemeinschaftspraxis Dr. Ingo Zeissig

🇩🇪

Duisburg, Germany

Texas Center for Drug Development P.A.

🇺🇸

Houston, Texas, United States

Lihavuustutkimusyksikkö

🇫🇮

Helsinki, Finland

Dallas Diabetes and Endocrine Center

🇺🇸

Dallas, Texas, United States

Praxis Dr. Thorsten Rau

🇩🇪

Essen, Germany

Praxis Dr. Julia Chevts

🇩🇪

Karlsruhe, Germany

VA Medical Center

🇺🇸

Omaha, Nebraska, United States

Lillestol Research LLC

🇺🇸

Fargo, North Dakota, United States

Lifestyle Metabolism Centre (Etobicoke)

🇨🇦

Etobicoke, Ontario, Canada

Centre de recherche clinique de Laval

🇨🇦

Laval, Quebec, Canada

Pro Scientia Med

🇩🇪

Luebeck, Germany

Praxis Dr. Winfried Keuthage

🇩🇪

Muenster, Germany

Dr. Klaus Funke IkFE Studiencenter Potsdam GMBH I.G.

🇩🇪

Potsdam, Germany

Azienda Ospedaliera S. Paolo-Polo Universitario

🇮🇹

Milano, MI, Italy

Fondazione Centro San Raffaele del Monte Tabor-IRCCSUnità

🇮🇹

Milano, Mi, Italy

Az. Ospedaliera Della Prov.di Pavia

🇮🇹

Casorate Primo, PV, Italy

Azienda Ospedaliera-Ospedali Riuniti di BergamoU

🇮🇹

Bergamo, BG, Italy

Praxis Dr. Uwe Boeckmann

🇩🇪

Neumuenster, Germany

Praxis Dr. Reinhold U. Schneider

🇩🇪

Wetzlar-Naunheim, Germany

LMC Endocrinology Centres (Thornhill) Ltd

🇨🇦

Thornhill, Ontario, Canada

Clintrial Berlin Praxis fuer medizinische Studien

🇩🇪

Berlin, Germany

Encompass Clinical Research

🇺🇸

Spring Valley, California, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

National Research Institute

🇺🇸

Los Angeles, California, United States

Preferred Primary Care Physicians

🇺🇸

Pittsburgh, Pennsylvania, United States

Melbourne Health - Royal Melbourne Hospital

🇦🇺

Melbourne, Victoria, Australia

Klinische Forschung Berlin-Buch Dr. Andrei Khariouzov

🇩🇪

Berlin, Germany

"Sana Krankenhaus Gerresheim

🇩🇪

Duesseldorf, Germany

Praxis Dr. Gerhard Steinmaier

🇩🇪

Viernheim, Germany

Az. Ospedaliera Universit. S.Martino-Universita degli Studi

🇮🇹

Genova, GE, Italy

Policlinico A.Gemelli - Univ.Cattolica del Sacro Cuore

🇮🇹

Roma, Italy

S.C.D.U. Endocrinologia e Malattie del Metabolismo

🇮🇹

Torino, To, Italy

A.O.Universitaria Senese, Universita degli Studi di Siena

🇮🇹

Siena, SI, Italy

Diabetes Thyroid Hormone Research Institute Pvt .Ltd.

🇮🇳

Indore, MP, India

Jnana Sanjeevini Medical Center

🇮🇳

Bangalore, Kar, India

Madras Diabetes Research Foundation

🇮🇳

Chennai, TN, India

Lääkärikeskus Mehiläinen Töölö

🇫🇮

Helsinki, Finland

Bangalore Diabetes Hospital,

🇮🇳

Banglore, KAR, India

Barwon Health - Geelong Hospital

🇦🇺

Geelong, Victoria, Australia

Visakha Diabetes & Endocrine Centre

🇮🇳

Visakhapatnam, AP, India

Health & Research Centre

🇮🇳

Trivandrum, Ker, India

Indrayani Speciality Hospital,

🇮🇳

Nagpur, Maharastra, India

Sahyadri Hospital Bibewewadi Centre of Excellence for Diabetics

🇮🇳

Pune, Mah, India

Austin Health - Heidelberg Repatriation Hospital

🇦🇺

Heidelberg Heights, Victoria, Australia

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