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A Study of Tirzepatide (LY3298176) Versus Placebo in Participants With Type 2 Diabetes Inadequately Controlled on Insulin Glargine With or Without Metformin

Phase 3
Completed
Conditions
Type 2 Diabetes
Interventions
Drug: Placebo
Registration Number
NCT04039503
Lead Sponsor
Eli Lilly and Company
Brief Summary

The purpose of this study is to compare the safety and efficacy of the study drug tirzepatide to placebo in participants with type 2 diabetes that are already on insulin glargine, with or without metformin. Participants will administer tirzepatide or placebo along with their previous glucose lowering medications. The study will last approximately 47 weeks and may include about 23 visits.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
475
Inclusion Criteria
  • Have been diagnosed with type 2 diabetes mellitus (T2DM) and have been treated with insulin glargine (U100), once daily with or without metformin ≥3 months prior to screening visit.
  • Have HbA1c between ≥7.0% and ≤10.5%.
  • Have a stable weight (± 5%) for at least 3 months before screening.
  • Have a body mass index (BMI) ≥23 kilograms per meter squared (kg/m²) at screening.
Exclusion Criteria
  • Have type 1 diabetes mellitus.
  • Have had chronic or acute pancreatitis any time prior to study entry.
  • Have proliferative diabetic retinopathy or diabetic maculopathy or nonproliferative diabetic retinopathy requiring acute treatment.
  • Have disorders associated with slowed emptying of the stomach, or have had any stomach surgeries for the purpose of weight loss.
  • Have an estimated glomerular filtration rate <30 mL/minute/1.73 m² [for participants on metformin, estimated glomerular filtration rate <45 mL/min/1.73 m2 (or lower than the country-specific threshold for using the protocol-required dose of metformin per local label)]
  • Have had a heart attack, stroke, or hospitalization for congestive heart failure in the past 2 months.
  • Have a personal or family history of medullary thyroid carcinoma or personal history of multiple endocrine neoplasia syndrome type 2.
  • Have been taking weight loss drugs, including over-the-counter medications during the last 3 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
15 mg TirzepatideTirzepatide15 mg tirzepatide administered SC once a week.
PlaceboPlaceboPlacebo administered SC once a week.
5 mg TirzepatideTirzepatide5 milligrams (mg) tirzepatide administered subcutaneously (SC) once a week.
10 mg TirzepatideTirzepatide10 mg tirzepatide administered SC once a week.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Hemoglobin A1c (HbA1c) (10 mg and 15 mg)Baseline, Week 40

HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Baseline Metformin Use (Yes, No) + Pooled Country + Treatment + Time + Treatment\*Time (Type III sum of squares).

Secondary Outcome Measures
NameTimeMethod
Mean Change From Baseline in Daily Average 7-Point Self-Monitored Blood Glucose (SMBG) ValuesBaseline, Week 40

The self-monitored plasma glucose (SMBG) data were collected at the following 7 time points: Morning Premeal - Fasting, Morning 2-hour Postmeal, Midday Premeal, Midday 2-hour Postmeal, Evening Premeal, Evening 2-hour Postmeal and Bedtime. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Baseline HbA1c Group (\<= 8.0%, \>8.0%) + Baseline Metformin Use (Yes, No) + Pooled Country + Treatment (Type III sum of squares).

Percentage of Participants Achieving an HbA1c Target Value of <5.7%Week 40

Hemoglobin A1c (HbA1c) is the glycosylated fraction of hemoglobin A. HbA1c is measured to identify average plasma glucose concentration over prolonged periods of time.

Change From Baseline in HbA1c (5 mg)Baseline, Week 40

HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Baseline Metformin Use (Yes, No) + Pooled Country + Treatment + Time + Treatment\*Time (Type III sum of squares).

Change From Baseline in Body WeightBaseline, Week 40

Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with Baseline + Baseline HbA1c Group (\<= 8.0%, \>8.0%) + Baseline Metformin Use (Yes, No) + Pooled Country + Treatment + Time + Treatment\*Time (Type III sum of squares).

Change From Baseline in Fasting Serum GlucoseBaseline, Week 40

Fasting serum glucose (FSG) is a test to determine sugar levels in serum sample after an overnight fast. LS Mean was determined by MMRM model with Baseline + Pooled Country + Baseline Metformin Use (Yes, No) + Baseline HbA1c Group (\<= 8.0%, \>8.0%) + Treatment + Time + Treatment\*Time (Type III sum of squares) as variables.

Percentage of Participants Who Achieved Weight Loss ≥5%Week 40

Percentage of Participants who Achieved Weight Loss ≥5%.

Percentage Change From Baseline in Daily Mean Insulin Glargine DoseBaseline, Week 40

LS mean was calculated using MMRM model with log (Baseline) + Baseline Metformin Use (Yes, No) + Pooled Country + Baseline HbA1c Group (\<= 8.0%, \>8.0%) + Treatment + Time + Treatment\*Time (Type III sum of squares) as variables.

Rate of Hypoglycemia With Blood Glucose <54 Milligram/Deciliter (mg/dL) [<3.0 Millimole/Liter (mmol/L)] or Severe HypoglycemiaBaseline through Safety Follow-Up (Up to Week 44)

The hypoglycemia events were defined by participant reported events with blood glucose \<54mg/dL) (\<3.0 mmol/L\] or severe hypoglycemia. Severe hypoglycemia is defined as an episode with severe cognitive impairment requiring the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. These episodes may be associated with sufficient neuroglycopenia to induce seizure or coma. The rate of postbaseline hypoglycemia was estimated by negative binomial model: number of episodes = Pooled Country + Baseline Metformin Use (Yes, No) + Baseline HbA1c Group (\<= 8.0%, \>8.0%) + Treatment, with log (exposure in days/365.25) as an offset variable.

Percentage of Participants Achieving an HbA1c Target Value of <7%Week 40

Hemoglobin A1c (HbA1c) is the glycosylated fraction of hemoglobin A.HbA1c is measured to identify average plasma glucose concentration over prolonged periods of time.

Pharmacokinetics (PK): Steady State Area Under the Concentration Time Curve (AUC) of TirzepatideWeek 7, 15, 23 and 39 post dose

AUC is a combined measure obtained from Week 7, 15, 23 and 39 and a single averaged measure of AUC was reported.

Trial Locations

Locations (47)

Schwerpunktpraxis Diabetes

🇩🇪

Saint Ingbert-Oberwürzbach, Saarland, Germany

Tokyo Center Clinic

🇯🇵

Chuo-ku, Tokyo, Japan

Sun Coast Clinical Research, Inc

🇺🇸

New Port Richey, Florida, United States

Diabetologische Schwerpunktpraxis B. Scholz/Dr. B. Paschen

🇩🇪

Hamburg, Germany

Arztpraxis Dr. Cornelia Marck

🇩🇪

Pohlheim, Hessen, Germany

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

Diacentrum Brandys n.L. s.r.o.

🇨🇿

Brandys Nad Labem-Stara Bolesl, Czechia

Praxis Dr. Jörg Lüdemann

🇩🇪

Falkensee, Brandenburg, Germany

Sin Azucar

🇸🇰

Malacky, Slovakia

Hospital Infanta Luisa

🇪🇸

Sevilla, Spain

Manhattan Medical Research

🇺🇸

New York, New York, United States

RED-Institut GmbH

🇩🇪

Oldenburg in Holstein, Schleswig Holstein, Germany

Hospital Universitari i Politecnic La Fe-ENDO

🇪🇸

València, Spain

Diabetologicka ordinace pro dospele

🇨🇿

Krnov, Czechia

Milan Kvapil s.r.o.

🇨🇿

Praha 4, Czechia

Diahelp s.r.o., Interni a diabetologicka ambulance

🇨🇿

Pardubice, Czechia

Institut für Diabetesforschung Münster GmbH

🇩🇪

Münster, Nordrhein-Westfalen, Germany

Sato Naika Clinic

🇯🇵

Ota-ku, Tokyo, Japan

NZOZ ZDROWIE Osteo-Medic

🇵🇱

Bialystok, Podlaskie, Poland

Centro de Endocrinologia y Nutricion del Turabo

🇵🇷

Caguas, Puerto Rico

Kashiwa hospital

🇯🇵

Kashiwa, Chiba, Japan

RESTRIAL s.r.o.

🇨🇿

Praha 8, Czechia

Southern New Hampshire Diabetes and Endocrinology

🇺🇸

Nashua, New Hampshire, United States

InnoDiab Forschung GmbH

🇩🇪

Essen, Nordrhein-Westfalen, Germany

Dia-Clarus.s.r.o.

🇸🇰

Prievidza, Slovakia

Hospital de la Ribera

🇪🇸

Alcira, Valencia, Spain

JAL

🇸🇰

Trnava, Slovakia

Medivasa, s.r.o.

🇸🇰

Zilina, Slovakia

Hospital Clinico Universitario Virgen de la Victoria

🇪🇸

Malaga, Andalucia, Spain

Valley Endocrine, Fresno

🇺🇸

Fresno, California, United States

Intend Research

🇺🇸

Norman, Oklahoma, United States

Manda Hospital

🇯🇵

Sapporo, Hokkaido, Japan

Takatsuki Red Cross Hospital

🇯🇵

Takatsuki, Osaka, Japan

Gemeinschaftspraxis für innere Medizin und Diabetologie

🇩🇪

Hamburg, Germany

SMO.MD GmbH

🇩🇪

Magdeburg, Sachsen-Anhalt, Germany

Lekarna Dr. Max

🇨🇿

Praha 1, Czechia

Praxis Dr. Kempe - Dr. Stemler

🇩🇪

Ludwigshafen am Rhein, Rheinland-Pfalz, Germany

Takai Naika Clinic

🇯🇵

Kamakura, Kanagawa, Japan

Tokyo-Eki Center-building Clinic

🇯🇵

Chuo-ku, Tokyo, Japan

The Institute for Adult Diseases, Asahi Life Foundation

🇯🇵

Chuou-ku, Tokyo, Japan

Jinnouchi Hospital

🇯🇵

Kumamoto, Japan

Tokyo Clinical Trial Centre Fukuwa Clinic

🇯🇵

Chuo-ku, Tokyo, Japan

NZOZ Przychodnia Specjalistyczna MEDICA

🇵🇱

Lublin, Poland

Manati Center for Clinical Research Inc

🇵🇷

Manati, Puerto Rico

Ambulancia vnútorného lekárstva Hnúša (Diabetes care)

🇸🇰

Hnusta, Slovakia

Centrum Medyczne AMED

🇵🇱

Warszawa, Mazowieckie, Poland

Centrum Badan Klinicznych, PI House

🇵🇱

Gdansk, Pomorskie, Poland

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