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A Study to Assess the Safety and Efficacy of SAR425899 in Patients With Type 2 Diabetes Mellitus

Phase 2
Completed
Conditions
Type 2 Diabetes Mellitus
Interventions
Registration Number
NCT02973321
Lead Sponsor
Sanofi
Brief Summary

Primary Objective:

The primary objective of this study was to assess the dose-response relationship of SAR425899 versus placebo in terms of glycemic control as measured by the change in glycosylated hemoglobin (HbA1c).

Secondary Objectives:

* To assess the effect of SAR425899 on body weight.

* To assess the safety and immunogenicity profile of SAR425899, including assessment of the heart rate (HR) change by electrocardiogram (ECG) and Holter monitor.

* To assess the proportion of participants achieving predefined HbA1c targets of \<7% and \<6.5% as well as the proportion of participants achieving \>=5% and \>=10% body weight loss.

* To assess the effect of once daily dosing of SAR425899 on additional parameters of glycemic control and lipid metabolism.

* To assess the effect of once daily dosing of SAR425899 on additional pharmacodynamic (PD) biomarkers.

* To assess the pharmacokinetic (PK) profile and parameters of SAR425899, inter-individual and inter-occasion variability in PK parameters using a population PK approach.

Detailed Description

The total study duration will be approximately 30 weeks, consisting of 3 weeks screening period at the site, a 26 weeks treatment period, and 3 days post treatment follow up period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
296
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo (for SAR425899) subcutaneous (SC) injection once daily (QD) from Week 1 to Week 26, matching 3 SAR425899 dose levels of 0.12 mg, 0.16 mg and 0.20 mg.
SAR425899 0.12 mgSAR425899SAR425899 SC injection QD at maintenance dose of 0.12 mg for 25 weeks (Week 2 to Week 26) following 1 week dose increase step (0.06 mg at Week 1).
SAR425899 0.20 mgSAR425899SAR425899 SC injection QD at maintenance dose of 0.20 mg for 23 weeks (Week 4 to Week 26) following 3 weeks dose increase step (0.06 mg at Week 1, 0.12 mg at Week 2 and 0.16 mg at Week 3).
SAR425899 0.16 mgSAR425899SAR425899 SC injection QD at maintenance dose of 0.16 mg for 24 weeks (Week 3 to Week 26) following 2 weeks dose increase step (0.06 mg at Week 1 and 0.12 mg at Week 2).
SAR425899 0.16 mgMetforminSAR425899 SC injection QD at maintenance dose of 0.16 mg for 24 weeks (Week 3 to Week 26) following 2 weeks dose increase step (0.06 mg at Week 1 and 0.12 mg at Week 2).
PlaceboMetforminPlacebo (for SAR425899) subcutaneous (SC) injection once daily (QD) from Week 1 to Week 26, matching 3 SAR425899 dose levels of 0.12 mg, 0.16 mg and 0.20 mg.
SAR425899 0.12 mgMetforminSAR425899 SC injection QD at maintenance dose of 0.12 mg for 25 weeks (Week 2 to Week 26) following 1 week dose increase step (0.06 mg at Week 1).
SAR425899 0.20 mgMetforminSAR425899 SC injection QD at maintenance dose of 0.20 mg for 23 weeks (Week 4 to Week 26) following 3 weeks dose increase step (0.06 mg at Week 1, 0.12 mg at Week 2 and 0.16 mg at Week 3).
LiraglutideLiraglutideLiraglutide SC injection QD at maintenance dose of 1.8 mg for 24 weeks (Week 3 to Week 26) following 2 weeks dose increase steps (0.6 mg daily at Week 1 and by 1.2 mg daily at Week 2).
LiraglutideMetforminLiraglutide SC injection QD at maintenance dose of 1.8 mg for 24 weeks (Week 3 to Week 26) following 2 weeks dose increase steps (0.6 mg daily at Week 1 and by 1.2 mg daily at Week 2).
Primary Outcome Measures
NameTimeMethod
Change From Baseline in HbA1c to Week 26Baseline, Week 26

Change in HbA1c was calculated by subtracting baseline value from Week 26 value. Missing post-baseline values were imputed by placebo control-based multiple imputation (MI) method under the missing not at random framework.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline in Beta-Cell Function to Week 26Baseline, Week 26

Beta-cell function was assessed by homeostatic model assessment (HOMA)-beta, derived from FPG and fasting plasma insulin (FPI). HOMA-beta was derived from FPG and FPI as (20\*FPI \[micro units/milliliter\]) divided by (FPG \[mmol/L\] minus 3.5). Change was calculated for HOMA-beta by subtracting the Baseline value from Week 26 value\*100.

Change From Baseline in Average 7 Point Self-Monitoring Plasma Glucose (SMPG) to Week 26Baseline, Week 26

Change in 7-point SMPG profile from baseline to Week 26 was assessed by summary statistics. 7-point SMPG profiles were measured at the following 7 points at each visit (Baseline, and Week 26): pre-prandial and 2 hours postprandial for breakfast, lunch, dinner and at bedtime. Two hours postprandial (breakfast, lunch and dinner) is defined as 2 hours after the start of the meal.

Percentage of Participants Requiring Rescue TherapyBaseline up to 26 weeks

Rescue medication was introduced in case FPG or HbA1c values were above pre-defined thresholds, and if no reasons were found for insufficient glucose control, and appropriate action failed to decrease FPG / HbA1c under the threshold values (from baseline to Week 8: FPG \>270 mg/dL 15.0 mmol/L, from Week 8 to Week 14: FPG \>13.3 mmol/L, and from Week 14 to Week 26: FPG \>11.1 mmol/L or HbA1c\>8%). The choice of rescue therapy was at the Investigator's discretion with the exception of using glucagon-like peptide-1 receptor (GLP-1R) agonists or dipeptidyl peptidase 4 (DPP4) inhibitors.

Change From Baseline in Insulin Resistance to Week 26Baseline, Week 26

Insulin Resistance was assessed by homeostasis model assessment for insulin resistance (HOMA-IR), derived from FPG and FPI. HOMA-IR was derived from FPG and FPI as (FPI \[micro units per milliliter\] \* FPG \[mmol/L\]) divided by 22.5. Change was calculated for HOMA-beta by subtracting the Baseline value from Week 26 value.

Change From Baseline in Pharmacodynamic Biomarkers to Week 26 - Waist and Hip CircumferencesBaseline,Week 26

Waist circumference was measured at the midpoint between the lower margin of the least palpable rib and the top of the iliac crest, using a stretch-resistant tape providing a constant 100 gm tension. Hip circumference was measured around the widest portion of the buttocks, with the tape parallel to the floor. Each measurement was repeated twice; if the measurements were within 1 cm of one another, the average was calculated, and if the difference exceeded 1 cm, the measurements were repeated.

Mean Change From Baseline in Body Weight to Week 26Baseline, Week 26

Change in body weight was calculated by subtracting baseline value from Week 26 value. Missing post- baseline values were imputed by placebo control-based MI method under the missing not at random framework.

Percentage of Participants Reached HbA1c Target of <6.5% or <7% at Week 26Week 26

The analysis included assessment collected during the study, including those obtained after IMP discontinuation or introduction of rescue therapy. Participants with no measurement at Week 26 were treated as non-responders.

Percentage of Participants Achieving >=5% or >=10% Body Weight Loss at Week 26Week 26

The analysis included assessment collected during the study, including those obtained after IMP discontinuation or introduction of rescue therapy. Participants with no measurement at Week 26 were treated as non-responders.

Change From Baseline in Fasting Plasma Glucose (FPG) to Week 26Baseline, Week 26

Change in FPG was calculated by subtracting baseline value from Week 26 value. Missing post-baseline values were imputed by placebo control-based MI method under the missing not at random framework.

Trial Locations

Locations (59)

Investigational Site Number 6430003

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Saratov, Russian Federation

Investigational Site Number 6430001

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St-Petersburg, Russian Federation

Investigational Site Number 6430005

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Voronezh, Russian Federation

Investigational Site Number 6430002

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St-Petersburg, Russian Federation

Investigational Site Number 8400001

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Los Angeles, California, United States

Investigational Site Number 8400014

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Flint, Michigan, United States

Investigational Site Number 8400021

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Houston, Texas, United States

Investigational Site Number 8400023

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Wichita, Kansas, United States

Investigational Site Number 8400024

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Los Angeles, California, United States

Investigational Site Number 8400025

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Miami, Florida, United States

Investigational Site Number 8400027

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Denver, Colorado, United States

Investigational Site Number 8400002

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Huntington Park, California, United States

Investigational Site Number 8400012

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Port Hueneme, California, United States

Investigational Site Number 8400019

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Rockville, Maryland, United States

Investigational Site Number 8400005

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Fargo, North Dakota, United States

Investigational Site Number 8400007

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Palm Harbor, Florida, United States

Investigational Site Number 8400022

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New York, New York, United States

Investigational Site Number 8400003

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Troy, Michigan, United States

Investigational Site Number 1240005

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Sainte-Foy, Canada

Investigational Site Number 2030004

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Praha 10 - Uhrineves, Czechia

Investigational Site Number 8400006

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Dallas, Texas, United States

Investigational Site Number 8400026

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San Antonio, Texas, United States

Investigational Site Number 8400004

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Austin, Texas, United States

Investigational Site Number 1240002

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Sherbrooke, Canada

Investigational Site Number 1240003

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Vancouver, Canada

Investigational Site Number 2030001

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Krnov, Czechia

Investigational Site Number 1240001

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Toronto, Canada

Investigational Site Number 2030003

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Ceske Budejovice, Czechia

Investigational Site Number 3480005

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Budapest, Hungary

Investigational Site Number 4840002

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Monterrey, Mexico

Investigational Site Number 3480007

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Budapest, Hungary

Investigational Site Number 2030002

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Praha 9 - Klanovice, Czechia

Investigational Site Number 7240005

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Barcelona, Spain

Investigational Site Number 4840004

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Actopan, Mexico

Investigational Site Number 2760003

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Berlin, Germany

Investigational Site Number 3480008

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Budapest, Hungary

Investigational Site Number 7240007

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Ferrol, Spain

Investigational Site Number 2760006

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Hohenmölsen, Germany

Investigational Site Number 3480006

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Budapest, Hungary

Investigational Site Number 4840001

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Guadalajara, Mexico

Investigational Site Number 4840003

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Guadalajara, Mexico

Investigational Site Number 4840006

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San Juan Del Rio, Mexico

Investigational Site Number 7240002

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Madrid, Spain

Investigational Site Number 7240006

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Las Palmas De Gran Canaria, Spain

Investigational Site Number 7240003

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Málaga, Spain

Investigational Site Number 7240004

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Málaga, Spain

Investigational Site Number 7240008

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Sevilla, Spain

Investigational Site Number 8400013

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Chicago, Illinois, United States

Investigational Site Number 8400017

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Sugar Land, Texas, United States

Investigational Site Number 8400020

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Linden, New Jersey, United States

Investigational Site Number 1240008

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Quebec, Canada

Investigational Site Number 8400028

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Sheffield, Alabama, United States

Investigational Site Number 8400016

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Wichita, Kansas, United States

Investigational Site Number 8400018

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New Orleans, Louisiana, United States

Investigational Site Number 3480001

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Balatonfüred, Hungary

Investigational Site Number 3480002

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Budapest, Hungary

Investigational Site Number 2760001

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Dresden, Germany

Investigational Site Number 6430004

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St. Petersburg, Russian Federation

Investigational Site Number 7240001

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La Coruña, Spain

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