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The Effect of Liraglutide in Patients With Prediabetes and Kidney Failure

Phase 2
Withdrawn
Conditions
Kidney Failure, Chronic
Prediabetic State
Interventions
Drug: Placebo
Registration Number
NCT02284230
Lead Sponsor
Bo Feldt-Rasmussen
Brief Summary

The present study will examine the effects of liraglutide treatment during 26 weeks on several cardiovascular risk factors in patients with prediabetes and end-stage renal disease (ESRD). The primary objective is to determine the efficacy of the treatment on glucose tolerance evaluated during a 3h 75g-oral glucose tolerance test (OGTT). Secondary objectives include various clinical and biochemical cardiovascular and safety parameters.

We hypothesise that treatment with liraglutide can improve glucose tolerance in prediabetic patients with ESRD by normalizing plasma glucose excursions during an OGTT and ameliorate other cardiovascular risk factors.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • End-stage renal disease treated with chronic maintenance dialysis (haemodialysis or peritoneal dialysis)
  • Impaired glucose tolerance (2h plasma glucose ≥ 7,8 and < 11.1 mmol/l following a 75g-OGTT) and/or impaired fasting glucose (fasting plasma glucose ≥ 6.1 and < 7.0 mmol/l) evaluated at the screening visit
Exclusion Criteria
  • Diabetes mellitus type 1 or type 2 (diagnose according to WHO criteria)
  • Chronic pancreatitis / previous acute pancreatitis
  • Known or suspected hypersensitivity to trial product(s) or related products
  • Treatment with oral glucocorticoids, calcineurin inhibitors or incretin-based therapy which in the Investigator's opinion could interfere with glucose or lipid metabolism 90 days prior to screening
  • Cancer (except basal cell skin cancer or squamous cell skin cancer) or any other clinically significant disorder, which in the investigator's opinion could interfere with the results of the trial
  • Clinical suspicion of cardiac disease currently investigated
  • Cardiac disease defined as: decompensated heart failure (NYHA class III-IV) and/or diagnosis of unstable angina pectoris and/or myocardial infarction within the last 6 months
  • Body mass index (BMI) <20 kg/m2 and/or >50 kg/m2
  • Females of childbearing potential who are pregnant, breast-feeding, intend to become pregnant or are not using adequate contraceptive methods*
  • Impaired liver function (transaminases > two times upper reference levels)
  • The receipt of any investigational product 90 days prior to this trial
  • Known or suspected abuse of alcohol or narcotics
  • Screening calcitonin ≥ 50 ng/l
  • Subjects with personal or family history of medullary thyroid carcinoma or a personal history of multiple endocrine neoplasia type 2

Lawfully detained, institutionalised and patients who are unable to give informed consent due to physical or mental conditions will not be included.

* Intrauterine devices and hormonal contraceptives (oral pills, patches, implants, vaginal rings, and injections) are considered as adequate contraceptives. Females of childbearing potential must use one of these contraceptives throughout the entire study plus 1 week after last injection with study medication. Surgical sterile (by bilateral vasectomy, tubectomy, hysterectomy or oophorectomy) or postmenopausal (defined as amenorrheic for at least one year) female participants are not considered as having a childbearing potential and are not required to use contraception.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo treatmentPlaceboSubcutaneous, once daily injection of placebo, individually dosed up to 1.8 mg/day.
Liraglutide treatmentLiraglutideSubcutaneous, once daily injection of liraglutide, individually dosed up to 1.8 mg/day.
Primary Outcome Measures
NameTimeMethod
Plasma glucose during oral glucose tolerance test at week 26The trial visit of week 26

Difference between the two treatment arms in plasma glucose concentrations during a 3h 75g-OGTT on the trial visit of week 26

Secondary Outcome Measures
NameTimeMethod
Cardiac autonomic functionThe trial visit of week 26

Cardiac autonomic function evaluated by heart rate variability

Lipid profileThe trial visit of week 26

Lipid profile

Fasting values of glucometabolic hormonesThe trial visit of week 26

Fasting plasma glucose, proinsulin, insulin and glucagon

Blood pressureThe trial visit of week 26

Blood Pressure

PulseThe trial visit of week 26

Resting pulse

WeightThe trial visit of week 26

Weight

Hypoglycemic incidentsFrom the randomisation to trial visit of week 26

Total hypoglycemic episodes during intervention

Change in glycemic stateThe trial visit of week 26

Change in glycemic state following oral glucose tolerance test (normal glucose tolerance (NGT, fasting plasma glucose \< 6.1 mmol/l and 2h plasma glucose \< 7.8 mmol/l), impaired fasting glucose (IFG, fasting plasma glucose ≥ 6.1 and \< 7.0 mmol/l), impaired glucose tolerance (IGT, 2h plasma glucose ≥ 7,8 and \< 11.1 mmol/l) and diabetes mellitus (DM, fasting plasma glucose ≥ 7 mmol/l or 2h plasma glucose ≥ 11.1 mmol/l))

Insulin resistanceThe trial visit of week 26

Insulin resistance evaluated by homeostasis model assessment (HOMA)

Beta cell functionThe trial visit of week 26

Beta-cell function evaluated by HOMA

Body compositionThe trial visit of week 26

Body composition by dual energy x-ray absorptiometry (DXA) scan

Arterial stiffnessThe trial visit of week 26

Arterial stiffness evaluated by Augmentation index from Pulse wave analysis

Cardiac function and perfusionThe trial visit of week 26

Cardiac function and perfusion evaluated by Rb-PET/CT scan

Cardiovascular and endothelial risk markersThe trial visit of week 26

Cardiovascular and endothelial risk markers (troponin T, troponin I, creatine kinase-MB, high-sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), Tissue plasminogen activator (tPA), urat, von Willebrand factor (vWF), vascular endothelial cell adhesion molecule (VCAM), intercellular adhesion molecule (ICAM), TNFalpha, proBNP, E-selectin and asymmetric dimethylarginine)

Prothrombotic stateThe trial visit of week 26

Prothrombotic state (fibrinogen, activated partial thromboplastin time (APTT) and thromboelastography (TEG))

Plasma liraglutideThe trial visit of week 26

Plasma liraglutide

Trial Locations

Locations (1)

Department of Nephrology, Rigshospitalet

🇩🇰

Copenhagen, Denmark

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