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A study to evaluate the effect and safety of linagliptin 5 mg administered in combination with empagliflozin 10 mg or 25 mg in patients with type 2 diabetes mellitus whose glucose levels have not been controlled after 16 weeks of treatment with empagliflozin 10 mg or 25 mg and metformin.

Conditions
Diabetes mellitus type 2 is the medical condition to be investiagted
MedDRA version: 16.1Level: PTClassification code 10067585Term: Type 2 diabetes mellitusSystem Organ Class: 10027433 - Metabolism and nutrition disorders
Therapeutic area: Diseases [C] - Nutritional and Metabolic Diseases [C18]
Registration Number
EUCTR2012-002271-34-DE
Lead Sponsor
Boehringer Ingelheim Pharma GmbH & Co. KG
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
690
Inclusion Criteria

1. Diagnosis of type 2 diabetes mellitus prior to informed consent
2. Male and female patients who have received diet and exercise counselling and who are pre-treated with an unchanged dose of immediate release metformin for at least 12 weeks prior to Visit 2.
Minimum dose for metformin is defined as:
• =1500 mg/day of metformin or
• maximum tolerated dose (the investigator must have documented the reason why uptitration to e.g. = 1500 mg/day was not possible) or
• maximum dose according to the local label (the investigator must have documented the local label requirements in the medical records)
3. HbA1c = 8.0% (64 mmol/mol) and = 10.5% (91 mmol/mol) at Visit 1 for randomization into the 16 week treatment period.
4. HbA1c = 7.0% (53 mmol/mol) and = 10.5 % (91 mmol/mol) at Visit 4 for randomization into the 24 week treatment period.
5. Age = 18 years
6. Body Mass Index (BMI) =45 kg/m2 at Visit 1 (screening) as calculated in the eCRF.
7. Signed and dated written informed consent by date of Visit 1 in accordance with GCP and local legislation
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 517
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 173

Exclusion Criteria

1. Uncontrolled hyperglycaemia with a glucose level >270 mg/dl (>15.0 mmol/L) after an overnight fast during the open label period (from Visit 2 to Visit 4) and placebo add on run-in period (Visit 4 to Visit 5) confirmed by a second measurement (not on the same day and done either at the central or local laboratory).
2. Any other antidiabetic drug within 12 weeks prior to Visit 2 randomization (except metformin background therapy as defined via inclusion criterion 2).
3. Acute coronary syndrome (non-STEMI, STEMI and unstable angina pectoris), stroke or TIA within 3 months prior to informed consent
4. Indication of liver disease, defined by serum levels of either ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3 x upper limit of normal (ULN) based on Visit 1 or Visit 4 laboratory parameters.
Note: Each value should be assessed independently of one another, i.e Visit 1 assessments will determine randomization to the open label treatment period and Visit 4 assessments will determine randomization to the double blind treatment period
5. Impaired renal function, defined as eGFR <60 ml/min/1.73 m2 (MDRD formula) as determined during screening (Visit 1) or placebo add on run-in (Visit 4)
Note: Each eGFR value should be assessed independently of one another, i.e Visit 1 assessments will determine randomization to the open label treatment period and Visit 4 randomization and assessments will determine randomization to the double blind treatment period
6. Known hereditary galactose intolerance
7. Known contraindications to metformin or linagliptin according to the local label (where marketed)
8. Any previous (within the past two years) or planned bariatric surgery (or any other weight loss surgery) or other gastrointestinal surgery that induces chronic malabsorption
9. Medical history of cancer (except for basal cell carcinoma) and/or treatment for cancer within the last 5 years
10. Known blood dyscrasias or any disorders causing haemolysis or unstable red blood cell count (e.g. malaria, babesiosis, haemolytic anaemia) due to the short lifespan of the RBC
and its impact on HbA1c.
11. Treatment with anti-obesity drugs (e.g. sibutramine, orlistat) within 3 months prior to informed consent or any other treatment at the time of screening (i.e. surgery, aggressive
diet regimen, etc.) leading to unstable body weight
12. Current treatment with systemic steroids (other than inhaled or topical steroids) at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent or any other documented uncontrolled endocrine disorder except T2DM
13. Pre-menopausal women (last menstruation =1 year prior to informed consent) who:
- are nursing or pregnant or
- are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the trial and do not agree to submit to periodic pregnancy testing during participation in the trial. Acceptable methods of birth control include tubal ligation, transdermal patch, intra uterine devices/systems (IUDs/IUSs),
oral, implantable or injectable contraceptives, complete sexual abstinence (if acceptable by local health authorities), double barrier method and vasectomised partner
14. Known allergy or hypersensitivity to DPP4 inhibitors or SGLT-2 inhibitors
15. Alcohol or drug abuse within the 3 months prior to informed consent that would interfere with trial participation or any ongoi

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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