A Phase 4, Randomized, Open-label, Active-controlled, Multicenter Study to Evaluate the Renal Protective Effect (UACR), Efficacy and Safety of Ipragliflozin in Type 2 Diabetes Mellitus Patients With Albuminuria
Overview
- Phase
- Phase 4
- Intervention
- metformin
- Conditions
- Type 2 Diabetes Mellitus
- Sponsor
- Astellas Pharma Korea, Inc.
- Enrollment
- 33
- Locations
- 8
- Primary Endpoint
- The percentage of change of Urine Albumin-to-Creatinine Ratio (UACR)
- Status
- Terminated
- Last Updated
- last year
Overview
Brief Summary
The primary purpose of this study is to assess the renal protective effect of ipragliflozin in combination with metformin on the percent change of UACR from baseline to 24 weeks against glimepiride in combination with metformin in type 2 diabetes mellitus patients with albuminuria. The secondary purpose of this study is to assess the efficacy, safety and impact on quality of life (QoL) of ipragliflozin in combination with metformin against glimepiride in combination with metformin in type 2 diabetes mellitus patients with albuminuria.
Detailed Description
This is a multicenter study that will compare ipragliflozin/metformin with glimepiride/metformin in the treatment of type 2 diabetes mellitus (T2DM) with albuminuria. The study will include screening and 24-week treatment period. Subjects entering the study have been on a stable dose of at least 1000 mg/day metformin monotherapy for at least 8 weeks (56 days) prior to Visit 1. For randomization, subject will be stratified by the site and the administration of renin-angiotensin system inhibitors (angiotensin receptor blockers and/or angiotensin-converting-enzyme inhibitors) at Visit 2. Subjects will be centrally randomized to either ipragliflozin/metformin group or glimepiride/metformin group and receive 24-week treatment by each group
Investigators
Eligibility Criteria
Inclusion Criteria
- •Inclusion Criteria assessed at Visit 1:
- •Subject who is outpatient.
- •Subject who has been diagnosed with type 2 diabetes mellitus.
- •Subject who has been on a stable dose of at least 1000 mg/day metformin monotherapy for at least 8 weeks (56 days) prior to Visit
- •Subject who has an HbA1C value between 7.0% and 9.0% at Visit
- •Subject who has a urinary albumin/creatinine ratio greater than or equal to 30 mg/g at Visit
- •Subject who has eGFR greater than or equal to 45 mL/min/1.73 m\^
- •Subject is on stable diet and exercise program for at least 8 weeks (56 days) prior to Visit
- •Inclusion Criterion assessed at Visit 2:
- •Subject who has a urinary albumin/creatinine ratio greater than or equal to 30 mg/g at Visit 2.
Exclusion Criteria
- •Subject who has been diagnosed with type 1 diabetes mellitus.
- •Subject who started or has changed the types and/or dosage of Renin Angiotensin System (RAS) inhibitors (Angiotensin II Receptor Blockers (ARBs), ACE inhibitors) within 12 weeks prior to Visit
- •Subject who has been treated with Sodium-Glucose Cotransporter-2 (SGLT-2) inhibitors within 12 weeks prior to Visit
- •Subject who has a history of clinically significant renal disease(s) (other than diabetic nephropathy) such as renovascular occlusive disease, nephrectomy, or renal transplant.
- •Subject who has a diabetic ketoacidosis, or history of diabetic ketoacidosis.
- •Subject with diabetic coma or precoma.
- •Subject with severe infection, serious trauma, or perioperative subject at Visit 1
- •Subject who has a history of hypersensitivity to ipragliflozin or glimepiride or other SGLT-2 inhibitors or sulfonylureas.
- •Subject has Aspartate Aminotransferase (GOT) (AST) or Alanine Aminotransferase (GPT) (ALT) value exceeding 3 times of upper limit of the normal range, or total bilirubin value exceeding 3 times of upper limit of the normal range at Visit
- •Subject has progressive proliferative diabetic retinopathy.
Arms & Interventions
ipragliflozin and metformin
Subjects will receive daily dosage of ipragliflozin and metformin as single tablets
Intervention: metformin
ipragliflozin and metformin
Subjects will receive daily dosage of ipragliflozin and metformin as single tablets
Intervention: ipragliflozin
glimepiride and metformin
Subjects will receive daily dosage of glimepiride and metformin as single tablets
Intervention: metformin
glimepiride and metformin
Subjects will receive daily dosage of glimepiride and metformin as single tablets
Intervention: glimepiride
Outcomes
Primary Outcomes
The percentage of change of Urine Albumin-to-Creatinine Ratio (UACR)
Time Frame: Baseline up to 24 weeks
Early morning urinary sample will be collected for the test
Secondary Outcomes
- Change from baseline in Hemoglobin A1c (HbA1c)(Baseline up to 24 weeks)
- Change from baseline in Fasting Plasma Glucose (FPG)(Baseline up to 24 weeks)
- Change from baseline in body weight(Baseline up to 24 weeks)
- Change from baseline in blood pressure(Baseline up to 24 weeks)
- Change from baseline in Uric Acid(Baseline up to 24 weeks)
- Change from baseline in health status as measured through EuroQol 5 Dimension 5 Level Health State Utility Index (EQ-5D-5L) questionnaire(Baseline up to 24 weeks)
- Change from baseline in health status as measured through EuroQol-Visual Analogue Scale (EQ VAS) questionnaire(Baseline up to 24 weeks)
- Change from baseline in Quality of Life as measured through Audit of Diabetes-Dependent Quality of Life-19 (ADDQoL-19) questionnaire(Baseline up to 24 weeks)
- The percentage of patients whose UACR level is normalized or improved more than 50%(Baseline up to 24 weeks)
- Change from baseline in Estimated glomerular filtration rate (e-GFR)(Baseline up to 24 weeks)