Ensayo clínico de 52 semanas, Fase III Internacional, multicentrico, aleatorizado, de grupos paralelos, doble ciego, controlado, con un periodo de extensión de 52 semanas, para evaluar la eficacia y seguridad de Dapaglifozina en combinación con Metformina frente a Sulfonilurea en combinación con Metformina en pacientes adultos con diabetes tipo 2 que tienen un mal control glucémico en tratamiento sólo con MetforminaA 52-Week, International, Multi-centre, Randomised, Parallel-group, Double-blind, Active-controlled, Phase III study with a 52-Week Extension Period to Evaluate the Efficacy and Safety of Dapagliflozin in Combination with Metformin compared with Sulphonylurea in Combination with Metformin in Adult Patients with Type 2 Diabetes who have Inadequate Glycaemic Control on Metformin Therapy Alone
- Conditions
- Diabetes tipo 2Type 2 diabetesMedDRA version: 9.1Level: LLTClassification code 10029505Term: Non-insulin-dependent diabetes mellitus
- Registration Number
- EUCTR2007-005220-33-ES
- Lead Sponsor
- AstraZeneca AB
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 746
Inclusion criteria at enrolment (visit 1):
1.Provision of a written informed consent
2.Diagnosed with type 2 diabetes
3.Men or women who are =18 years of age at time of consenting upon visit 1
4.Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 4 weeks after the study in such manner that the risk of pregnancy is minimized.
WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal (defined as amenorrhea =12 consecutive months; or women on hormone replacement therapy (HRT) with documented serum follicle stimulating hormone (FSH) level >35mIU/mL).
Even women who are using oral, implanted or injectable contraceptive hormones or mechanical products such as an intrauterine device or barrier methods (diaphragm, condoms, spermicides) to prevent pregnancy or practicing abstinence or where partner is sterile (e.g., vasectomy), should be considered to be of child bearing potential.
WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72 hours prior to the start of study medication.
5.Treated with OAD therapy that includes metformin for at least 8 weeks prior to enrolment; NB In addition to metformin patients are only allowed to be on one further OAD and only up to the half maximum dose available. This applies both to the administration of the other OAD as separate drug or as fixed dose combination.
Inclusion criteria at start of metformin dose-stabilisation period - if applicable
(visit 2, laboratory values from visit 1):
6.HbA1c >6.5% and =10.0%; NB Patients with HbA1c >6.5% to <7% will no longer be eligible when the cohort of randomised patients having HbA1c <7% is approximately 25% and the lower bound of HbA1c for enrolment will be set at HbA1c =7% for the remainder of the study.
7.FPG =270 mg/dL (=14.4 mmol/L)
8.C-peptide level =1.0 ng/mL (=0.375 nmol/L)
Inclusion criteria at placebo lead-in period (visit 4):
9.Treatment with metformin alone on a stable dose of 1500 mg/day up to 2500 mg/day for at least 8 weeks
For patients who entered the study on a stable dose of metformin monotherapy =1500 mg/day with no other OAD therapy in the last 8 weeks and who skipped the metformin dose-stabilisation period (laboratory values from visit 1):
10.HbA1c >6.5% and =10.0%; NB Patients with HbA1c >6.5% to <7% will no longer be eligible when the cohort of randomised patients having HbA1c <7% is approximately 25% and the lower bound of HbA1c for enrolment will be set at HbA1c =7% for the remainder of the study.
11.FPG =270 mg/dL (=14.4 mmol/L)
12.C-peptide level =1.0 ng/mL (=0.375 nmol/L)
Inclusion criteria at randomisation (visit 5, laboratory values from visit 4):
13.HbA1c >6.5% and =10.0%; NB Patients with HbA1c >6.5% to <7% will no longer be eligible when the cohort of randomised patients having HbA1c <7% is approximately 25% and the lower bound of HbA1c for enrolment will be set at HbA1c =7% for the remainder of the study.
14.FPG =270 mg/dL (=14.4 mmol/L)
For inclusion in the optional genetic research, patients must fulfil the following criterion:
15.Provision of written informed consent for genetic research
If a patient declines to participate in the genetic research, there will be no penalty or loss of benefit to the patient. The patient will
Exclusion criteria at enrolment (visit 1):
1.Type 1 diabetes, history of diabetic ketoacidosis or hyperosmolar non-ketonic coma, or corticosteroid-induced type 2 diabetes
2.History of diabetes insipidus
3.Symptoms of poorly controlled diabetes that would preclude participation in this trial including, but not limited to, marked polyuria and polydipsia with greater than 10% weight loss during the 3 months prior to enrolment, or other signs and symptoms.
4.History of unstable or rapidly progressing renal disease
5.Known condition of congenital renal glucosuria
6.History of severe hepatobiliary disease or hepatotoxicity with any medication
7.Pregnant or breastfeeding patients
8.BMI >45.0 kg/m2
9.Insulin therapy within one year of enrolment (with the exception of insulin therapy during a hospitalization or use in gestational diabetes)
10.Previous participation in a clinical trial with dapagliflozin and/or with any other SGLT2 inhibitor
11.Treatment with glucocorticoids equivalent to oral prednisolone >10 mg (betametasone >1.2 mg/dexametasone >1.5 mg/hydrocortisone >40 mg)/day within 30 days prior to enrolment; topical or inhaled corticosteroids are allowed
12.History of bariatric surgery
13.Administration of weight loss medication, including but not limited to sibutramine, phentermine, orlistat, rimonabant, benzphetamine, diethylpropion, methamphetamine, and/or phendimetrazine, within 30 days prior to enrolment
14.Treatment for HIV/use of antiviral drugs (delavirdine, indinavir, nelfinavir, ritonavir, saquinavir) and/or known immunocompromised status, including patients who have undergone organ transplantation
15.Intolerance, contraindication or potential allergy to metformin, dapagliflozin, glipizide, or placebo or formulation excepients
16.Congestive heart failure defined as NYHA class III or IV (see Appendix D), unstable congestive heart failure and/or left ventricular ejection fraction of = 40%
17. Significant cardiovascular history within the past 6 months upon visit 1 defined as: myocardial infarction, unstable angina pectoris, transient ischemic attack, unstable or previously undiagnosed arrhythmia, cardiac surgery or revascularization (coronary angioplasty or bypass grafts), or cerebrovascular accident
18.Severe respiratory failure or severe emphysema
19.Severe uncontrolled hypertension defined as systolic blood pressure =180 mm Hg and/or diastolic blood pressure =110 mm Hg
20.Patients who, in the judgement of the Investigator, may be at risk for dehydration
21.History of chronic haemolytic anaemia with the exception of sickle cell trait or thalassemia minor
22.History of alcohol abuse or illegal drug abuse within the past 12 months
23.History of malignancy within the last 5 years, excluding successful treatment of basal or squamous cell skin carcinoma
24.Involvement in the planning and conduct of the study
25.Previous enrolment or randomisation to treatment in the present study
26.Participation in a clinical study during the last 90 days prior to visit 1
27.Donation of blood, plasma or platelets within the past 3 months prior to visit 1
28.Suspected or confirmed poor protocol or medication compliance as judged by the investigator
Exclusion criteria at start of metformin dose-stabilisation period (visit 2, laboratory values from visit 1):
29.Renal failure or renal dysfunction (Creatinine-Clearance <60 ml/min)
30.UACR >1,800 mg/g (>203.4 mg/mmol/Cr)
31.Severe hepatic insufficiency and/or significant abnormal liver function defined
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method