A Study of Dulaglutide (LY2189265) in Children and Adolescents With Type 2 Diabetes
- Registration Number
- NCT02963766
- Lead Sponsor
- Eli Lilly and Company
- Brief Summary
The purpose of this study is to evaluate the safety, efficacy, pharmacokinetics and pharmacodynamics of the study drug dulaglutide compared to placebo in pediatric participants with type 2 diabetes. The study duration is approximately 60 weeks.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 154
- Have type 2 diabetes, treated with diet and exercise, with or without metformin and/or basal insulin. Metformin and/or basal insulin dose must be stable for at least 8 weeks prior to study screening.
- Have HbA1c >6.5% to ≤11% at screening visit. If newly diagnosed and not on medicine for diabetes, HbA1c must be between >6.5 % to ≤9%.
- Have a BMI (body mass index) >85 percentile for age, gender and body weight ≥50 kilograms (110 pounds).
- Known type 1 diabetes, or positive GAD65 or IA2 antibodies, or history of diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome.
- A history of, or at risk for pancreatitis.
- Self or family history of Multiple Endocrine Neoplasia (MEN) type 2A or B, thyroid C-cell hyperplasia or medullary thyroid cancer, or a blood calcitonin result ≥20 picograms per milliliter (pg/ml) at screening.
- A systolic blood pressure of ≥160 millimeters of mercury (mmHg) or diastolic ≥100 mmHg.
- Active or treated cancer.
- A blood disorder where an accurate HbA1c may not be obtainable.
- A female of childbearing age, sexually active and not on birth control.
- Pregnant or plan to be pregnant during the study, or breastfeeding.
- Taking any diabetic medication other than metformin or basal insulin and have not stopped it 3 months prior to the screening visit (6 weeks for bolus or mealtime insulin).
- Have taken oral steroids within the last 60 days or more than 20 days use within the past year or 1000 micrograms fluticasone propionate per day.
- Using prescription weight loss medications in the last 30 days, or plan to use.
- Taking psychiatric medications for depression or illness or attention deficit hyperactivity disorder (ADHD) if, the doses has changed within the last 3 months.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo/0.75 milligram (mg) Dulaglutide Placebo Participants received placebo administered subcutaneously (SC) for 26 weeks during the double-blind period and open-label 0.75 mg/week dulaglutide for 26 weeks during the Open Label Extension (OLE). Placebo/0.75 milligram (mg) Dulaglutide Dulaglutide Participants received placebo administered subcutaneously (SC) for 26 weeks during the double-blind period and open-label 0.75 mg/week dulaglutide for 26 weeks during the Open Label Extension (OLE). 1.5 mg Dulaglutide Dulaglutide Participants received 1.5 mg/week dulaglutide administered SC for 26 weeks during the double-blind period and open-label 1.5 mg/week for 26 weeks during the OLE. 0.75 mg Dulaglutide Dulaglutide Participants received 0.75 mg/week dulaglutide administered SC for 26 weeks during the double-blind period and open-label 0.75 mg/week for 26 weeks during the OLE.
- Primary Outcome Measures
Name Time Method Change From Baseline in Hemoglobin A1c (HbA1c) (Pooled Doses) at Week 26 Baseline, Week 26 HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. Least square (LS) mean in HbA1c was calculated using a restricted maximum likelihood (REML) based mixed-effects model for repeated measures (MMRM) and adjusted by, baseline + insulin Use + metformin Use + treatment + time + treatment\*time (Type III sum of squares). Variance-covariance structure = unstructured (for actual value) / unstructured (for change from baseline).
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Self-Reported Events of Hypoglycemia Week 26 Summary and analysis of Incidence of all hypoglycemia with Plasma Glucose \<54mg/dL.
Change From Baseline in Pancreatic Enzymes at Week 26 Baseline, Week 26 Serum Amylase (total and pancreas-derived) and lipase concentrations were measured.
Number of Participants With Thyroid Treatment-Emergent Adverse Events Week 26 Number of Participants with Thyroid Treatment-Emergent Adverse Events were summarized.
Percentage of Participants With Injection Site Reactions Week 26 The percentage of participants with at least one treatment-emergent injection site reaction is presented. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
Number of Participants With Adjudicated Pancreatitis Week 26 The number of participants with pancreatitis confirmed by adjudication is summarized cumulatively at 26 weeks. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
Change From Baseline in HbA1c (Individual Doses) at Week 26 Baseline, Week 26 HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. LS mean in HbA1c was calculated using a REML based MMRM and adjusted by, baseline + insulin use + metformin use + treatment + time + treatment\*time (Type III sum of squares). Variance-covariance structure = unstructured (for actual value) / unstructured (for change from baseline).
Change From Baseline in Fasting Blood Glucose (FBG) at Week 26 Baseline, Week 26 Fasting blood glucose is a test to determine how much glucose (sugar) is in a blood sample after an overnight fast. Least squares (LS) means were calculated using a mixed-effects model for repeated measures (MMRM) analysis and adjusted by baseline, strata, treatment, time, treatment\*time, (Type III sum of squares). Variance-Covariance structure = Unstructured (for actual value) / Unstructured (for change from baseline). Strata refer to: insulin use + metformin use + baseline HbA1c group \[ less than (\<) 8%, greater than or equal to (\>=) 8%).
Change From Baseline in Body Mass Index (BMI) at Week 26 Baseline, Week 26 BMI is an estimate of body fat based on body weight divided by height squared. LS mean were calculated using a MMRM analysis and adjusted by baseline, strata, treatment, time, treatment\*time, (Type III sum of squares). Variance-Covariance structure = Unstructured (for actual value) / Unstructured (for change from baseline). Strata refer to: insulin use + metformin use + baseline HbA1c group (\< 8%, \>= 8%).
Percentage of Participants Requiring Rescue for Severe, Persistent Hyperglycemia Week 26 Percentage of Participants Requiring Rescue for Severe, Persistent Hyperglycemia was summarized.
Percentage of Participants With HbA1c ≤7.0% Week 26 The percentage of participants was calculated by dividing the number of participants reaching target HbA1c by the total number of participants analyzed, multiplied by 100.
Change From Baseline in Serum Calcitonin at Week 26 Baseline, Week 26 Change from Baseline in Serum Calcitonin was evaluated.
Percentage of Participants With Allergic, Hypersensitivity Reactions Week 26 The percentage of Participants with Allergic and hypersensitivity reactions that were considered possibly related to study drug by the investigator are presented. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.
PK: Area Under the Concentration Time Curve Over a 1-week Interval of Dulaglutide at Steady-State [AUC(0-168)ss] Week 9: pre-dose,1 to 12 hours post dose and 24 to 96 hours post dose; Week 13: predose and 1 to 12 hours post dose; Week 26: predose; Week 39: up to 2 days postdose; Week 52 and Week 56: PK sample can be taken at any time during the visit PK: Area Under the Concentration Time Curve over a 1-week interval of Dulaglutide at Steady-State \[AUC(0-168)ss\] was derived by a population pharmacokinetics approach. As part of addendum, additional PK samples were taken at week 9.
Number of Participants With Anti-Dulaglutide Antibodies Baseline through Week 56 Dulaglutide anti-drug antibodies (ADA) were assessed at baseline, Weeks 26 and 56. A participant was considered to have treatment-emergent (TE) dulaglutide ADAs if the participant had at least 1 titer that was TE relative to baseline, defined as a 4-fold or greater increase in titer from baseline measurement.
Pharmacokinetics (PK): Maximum Concentration of Dulaglutide at Steady-state (Cmax,ss) Week 9: pre-dose,1 to 12 hours post dose and 24 to 96 hours post dose; Week 13: predose and 1 to 12 hours post dose; Week 26: predose; Week 39: up to 2 days postdose; Week 52 and Week 56: PK sample can be taken at any time during the visit PK: Maximum Concentration of Dulaglutide at steady-state (Cmax,ss) was derived by a population pharmacokinetics approach. As part of addendum, additional PK samples were taken at week 9.
Trial Locations
- Locations (61)
ECU Pediatric Specialty Care
🇺🇸Greenville, North Carolina, United States
Pennington Biomedical Research Center
🇺🇸Baton Rouge, Louisiana, United States
Division of Endocrinology, Diabetes, and Metabolism
🇺🇸Los Angeles, California, United States
Childrens Hospital of Pittsburgh
🇺🇸Pittsburgh, Pennsylvania, United States
M S Ramaiah Medical College Hospital
🇮🇳Bangalore, Karnataka, India
Rady Childrens Hospital - San Diego
🇺🇸San Diego, California, United States
University of Illinois at Chicago
🇺🇸Chicago, Illinois, United States
Indiana University Health Hospital
🇺🇸Indianapolis, Indiana, United States
Cincinnati Childrens Hospital Medical Center
🇺🇸Cincinnati, Ohio, United States
Seattle Children's Hospital Research Foundation
🇺🇸Seattle, Washington, United States
JC Cabaccan
🇺🇸San Jose, California, United States
Advanced Research Center
🇺🇸Anaheim, California, United States
University of Alabama Birmingham
🇺🇸Birmingham, Alabama, United States
RED-Institut GmbH
🇩🇪Oldenburg in Holstein, Schleswig Holstein, Germany
Zentrum für klinische Studien
🇩🇪Sankt Ingbert, Saarland, Germany
Centro de Pesquisas em Diabetes
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Instituto da Criança com Diabetes
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Childrens Hospital of Orange County
🇺🇸Orange, California, United States
University of Arizona
🇺🇸Tucson, Arizona, United States
Center of Excellence in Diabetes & Endocrinology
🇺🇸Sacramento, California, United States
Touro University
🇺🇸Vallejo, California, United States
St. Luke's Regional Medical Center
🇺🇸Boise, Idaho, United States
Florida Center for Endocrinology & Metabolism
🇺🇸Orlando, Florida, United States
Children's National Medical Center
🇺🇸Washington, District of Columbia, United States
Children's Mercy Hospital
🇺🇸Kansas City, Missouri, United States
Children's Hospital of Philadelphia
🇺🇸Philadelphia, Pennsylvania, United States
Multicare Health System
🇺🇸Tacoma, Washington, United States
CAMC Institute
🇺🇸Charleston, West Virginia, United States
Instituto Estadual de Diabetes e Endocrinologia
🇧🇷Rio de Janeiro, RJ, Brazil
Hospital PUC-CAMPINAS
🇧🇷Campinas, Sao Paulo, Brazil
CPCLIN
🇧🇷São Paulo, SP, Brazil
Hospital da Clinicas da Faculdade de Medicina da USP
🇧🇷São Paulo, SP, Brazil
Hospital das Clinicas da FMRP
🇧🇷Ribeirão Preto, São Paulo, Brazil
UNIFESP - Escola Paulista de Medicina
🇧🇷São Paulo, Brazil
Hopital Robert Debre
🇫🇷Paris, France
Praxis Dr. med. Landers
🇩🇪Mayen, Rheinland-Pfalz, Germany
Hôpitaux Universitaires Paris Sud - Hôpital Bicêtre
🇫🇷Le Kremlin Bicetre, France
Manipal Hospital
🇮🇳Bangalore, Karmnataka, India
Heim Pal Gyermekkorhaz
🇭🇺Budapest, Hungary
Deenanath Mangeshkar Hospital & Research Centre
🇮🇳Pune, Maharashtra, India
Dr Jivraj Mehta Smarak Health Foundation Bakeri Medical Research Centre
🇮🇳Ahmedabad, Gujarat, India
Post Graduate Institute of Medical Education & Research
🇮🇳Chandigarh, Punjab, India
Apollo Gleneagles Hospitals Kolkata
🇮🇳Kolkata, West Bengal, India
Health Pharma Professional Research, S.A. de C.V.
🇲🇽Mexico City, Federal District, Mexico
Banaras Hindu University - BHU
🇮🇳Varanasi, Uttar Pradesh, India
Centro de Inv. Medica de Occidente, SC
🇲🇽Zapopan, Jalisco, Mexico
Centro de Diabetes y Endocrinologia Pediatrica de PR
🇵🇷Bayamon, Puerto Rico
Cli-nica Hospital Cemain
🇲🇽Tampico, Tamaulipas, Mexico
Centro Medico San Francisco
🇲🇽Monterrey, Nuevo Leon, Mexico
Arke Estudios Clinicos S.A. de C.V.
🇲🇽Veracruz, Mexico
Sami Ulus Education & Research Hospital
🇹🇷Ankara, Turkey
King Saud University Hospital
🇸🇦Riyadh, Saudi Arabia
King Salman bin Abdulaziz Hospital - Diabetic Center
🇸🇦Riyadh, Saudi Arabia
Hospital Angeles Puebla
🇲🇽Puebla, Mexico
Ankara University Medicine Hospital
🇹🇷Ankara, Mamak, Turkey
Duzce University Medical Faculty
🇹🇷Duzce, Turkey
St James's University Hospital
🇬🇧Leeds, West Yorkshire, United Kingdom
Alder Hey Children's Hospital
🇬🇧Liverpool, Lancashire, United Kingdom
Ondokuz Mayis University Medical Faculty
🇹🇷Samsun, Turkey
Park Clinic
🇮🇳Kolkata, West Bengal, India
Sir Ganga Ram Hospital
🇮🇳New Delhi, Delhi, India