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Effic. PK + safety in paed. patients

Phase 1
Conditions
Patients with type 2 diabetes.
MedDRA version: 14.0Level: LLTClassification code 10045242Term: Type II diabetes mellitusSystem Organ Class: 10027433 - Metabolism and nutrition disorders
Therapeutic area: Diseases [C] - Nutritional and Metabolic Diseases [C18]
Registration Number
EUCTR2009-017004-91-IT
Lead Sponsor
BOEHRINGER ING.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
255
Inclusion Criteria

1.Paediatric patients (children and adolescents), aged 10 to 17 years at the time of screening (i.e. Visit 1A) 2.Documented diagnosis of type 2 diabetes mellitus at least 3 months prior to randomisation (i.e. Visit 2) 3.Insufficient glycaemic control (i.e. an HbA1c > 7.0% and <= 10.0%) at screening (i.e. Visit 1A) despite treatment with diet and exercise alone 4.Negative for islet cell antigen (ICA) auto-antibodies and glutamic acid decarboxylase (GAD) auto-antibodies at Visit 2 5.C-peptide levels (serum) >= 1.5 ng/ml (at 90 min following a Boost challenge) at Visit 2 6.Compliance during the open-label placebo run-in period between 75% and 125%. 7.Written informed consent provided by the patient's parent(s) (or legal guardian) and assent by the patient at the latest by the date of Visit 1A in accordance with GCP and local legislation. Informed assent will be sought according to the patient's age, level of maturity, competence and capacity. All informed consent/assent forms will be consistent with ICH-GCP and local IEC/IRB requirements.
Are the trial subjects under 18? yes
Number of subjects for this age range:
F.1.2 Adults (18-64 years) no
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1.Uncontrolled hyperglycaemia with a glucose level > 240 mg/dl (> 13.3 mmol/l) after an overnight fast during placebo run-in and confirmed by a second measurement (not on the same day) 2.History of acute metabolic decompensation, such as diabetic ketoacidosis, within 3 months of screening (i.e. Visit 1A) 3.Current insulin therapy, or having received insulin for > 4 weeks within the 3 months prior to randomisation (i.e. Visit 2) 4. Treatment with weight reduction medications (including anti-obesity treatments) within 3 months prior to randomisation (i.e. the date of Visit 2) 5. Chronic treatment – treatment duration of more than two weeks - with medication known to affect glucose metabolism (e.g. metformin or systemic corticosteroids) within 3 months prior to randomisation (i.e. Visit 2) 6. Anticipated need for treatment with PGP (P-glycoprotein) and CYP 3A4 inhibitors or inducers during the placebo run-in period (Visit 1B onwards) and randomised period (Visits 2-6) of the study 7. Clinically significant renal disease (defined as estimated Glomerular Filtration Rate [eGFR] < 60 ml/min, i.e. moderate and severe renal impairment, calculated according to the Schwarz formula) as determined at screening 8. Clinically significant hepatic disease (defined as persistent serum levels of ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3 x upper limit of normal (ULN)) as determined at screening 9. Gastrointestinal disorders that might interfere with study drug absorption 10.Patients presenting a secondary obesity as part of a syndrome (e.g. : Prader-Willi syndrome) 11.Female patients who are nursing or are pregnant 12. Female patients who have reached menarche (i.e. ANY vaginal bleeding, however scant or irregular) with a positive pregnancy test or who are sexually active and not using a medically accepted contraceptive method. 13. Patients with a history of belonephobia (needle phobia) in this age group 14. Patients with anaemia defined as shown below and as determined at screening(Visit 1A): -children aged up to 12: haemoglobin of < 11.5 g/dl and haematocrit <35% -females aged > 12 or who reached menarche before this age: haemoglobin of < 12 g/dl and haematocrit < 36% -males aged > 12: haemoglobin of < 13 g/dl and haematocrit < 39%. 15. Active alcohol or drug abuse within the 3 months prior to informed consent that would interfere with trial participation according to the Investigator opinion. 16. Patients whose parent(s) (or legal guardian) will be unable to support the reporting of adverse event information (e.g. not fluent in an appropriate language, or no access to a telephone). 17. Patients whose home circumstances will mean they are unable to store the study rescue medication (insulin) appropriately. 18. Known hypersensitivity or allergy to the investigational product or its excipients or placebo 19. Participation in another trial with an investigational drug within 2 months prior to informed consent 20. Patients considered unreliable by the Investigator concerning the requirements for follow-up during the study and/or compliance with study medication administration 21. Any disease or clinically significant abnormality/clinical condition that may increase the risk associated with study participation or affect the study outcome, and in the judgement of the Investigator would make the patient inappropriate for entry into the study.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: The main objective of this study is to identify the dose of linagliptin (BI1356) in paediatric patients.;Secondary Objective: The study will also investigate the pharmacokinetics (PK), the pharmacodynamics (PD) and the PK/PD relationship, efficacy and safety of linagliptin in the paediatric population.;Primary end point(s): The primary endpoint in this trial is the change from baseline in HbA1c (%) after 12 weeks of treatment.;Timepoint(s) of evaluation of this end point: after 12 weeks of treatment
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): The study will also investigate the pharmacokinetics (PK), the pharmacodynamics (PD) and the PK/PD relationship, efficacy and safety of linagliptin in the paediatric;Timepoint(s) of evaluation of this end point: dopo 12 settimane
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