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The Effect of the drug Tirzepatide compared with the drug Dulaglutide on the Cardiovascular Risk in Patients with Type 2 Diabetes

Phase 1
Conditions
Type 2 diabetes mellitus
MedDRA version: 21.1Level: LLTClassification code 10045242Term: Type II diabetes mellitusSystem Organ Class: 100000004861
Therapeutic area: Diseases [C] - Hormonal diseases [C19]
Registration Number
EUCTR2019-002735-28-FR
Lead Sponsor
Eli Lilly and Company
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
12500
Inclusion Criteria

[1] Men or women at least 40 years old with a diagnosis of T2DM (WHO 2019).
[2] Established CVD, including at least 1 of the following (a-c):
a. Coronary artery disease (CAD) with EITHER of the following:
- Documented history of spontaneous MI
- =50% stenosis in 1 or more major coronary arteries, determined by invasive angiography
- =50% stenosis in 2 or more major coronary arteries, determined by computed tomography coronary angiography (CTCA), or
- History of surgical or percutaneous coronary revascularization procedure;
b. Cerebrovascular disease – ANY of the following:
- Documented history of ischemic stroke
- Carotid arterial disease with =50% stenosis, documented by carotid ultrasound, magnetic resonance imaging (MRI), or angiography
- Carotid stenting or surgical revascularization;
c. Peripheral arterial disease with EITHER of the following:
- Intermittent claudication and ankle-brachial index <0.9
- Prior nontraumatic amputation or peripheral vascular procedure (eg, stenting or surgical revascularization), due to peripheral arterial ischemia.
[3] HbA1c =7% (=53 mmol/mol) and =10.5% (=91.3 mmol/mol) based on central laboratory assessment at screening.
[4] Body mass index (BMI) =25 kg/m2.
[5] At the time of signing the informed consent: Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical trials.
[6] In the investigator’s opinion, patients are well motivated, capable, and willing to learn how to self-inject treatment (tirzepatide or dulaglutide), as required for this protocol (visually impaired persons and/or persons with physical limitations who are not able to perform the injections must have the assistance of an individual trained to inject the study drug).
[7] Patients are capable of giving signed informed consent.
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 6250
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 6250

Exclusion Criteria

[8] Have type 1 diabetes mellitus.
[9] Have uncontrolled diabetes requiring immediate therapy (such as diabetic ketoacidosis) at screening or randomization, in the judgment of the physician.
[10] Have had 1 or more events of severe hypoglycemia and/or 1 or more events of hypoglycemia unawareness within 6 months prior to screening.
[11] Have a history of proliferative retinopathy or macular edema. A dilated fundoscopic exam, evaluated by an eye care professional (ophthalmologist or optometrist) is required to confirm eligibility. In addition, nonproliferative diabetic retinopathy that requires acute treatment according to the opinion of the investigator is also excluded.
[12] Have been hospitalized for CHF within 2 months prior to screening.
[13] Have chronic New York Heart Association Functional Classification IV CHF.
[14] Are currently planning a coronary, carotid, or peripheral artery revascularization.
[15] Had chronic or acute pancreatitis any time prior to screening, irrespective of etiology.
[16] Have a known clinically significant gastric emptying abnormality (eg, severe diabetic gastroparesis or gastric outlet obstruction), have undergone gastric bypass (bariatric) surgery or restrictive bariatric surgery (eg, Lap-Band®, vertical sleeve gastrectomy), or chronically take drugs that directly affect GI motility.
[17] Have acute or chronic hepatitis, signs or symptoms of any other liver disease, or an alanine aminotransferase (ALT) level =3X the upper limit of normal (ULN) for the reference range, as determined by the central laboratory.
[18] Have known chronic severe renal failure (defined as a known eGFR <15 mL/minute/1.73 m2) or are on chronic dialysis.
[19] Have evidence of a significant, uncontrolled endocrine abnormality (eg, thyrotoxicosis or adrenal crises).
[20] Have a family or personal history of multiple endocrine neoplasia type 2 (MEN2) or familial medullary thyroid carcinoma (MTC) or personal history of nonfamilial MTC.
[21] Have a serum calcitonin level at screening of: (based on central laboratory results)
- =20 ng/L at Visit 1, if eGFR =60 mL/min/1.73 m2, or
- =35 ng/L at Visit 1, if eGFR <60 mL/min/1.73 m2.
[22] Have a history of an active or untreated malignancy or are in remission from a clinically significant malignancy for less than 5 years. An exception for this criterion is basal or squamous cell skin cancer, in situ carcinomas of the cervix, or in situ prostate cancer.
[23] Have a history of any other condition (such as known drug or alcohol abuse or psychiatric disorder) that, in the opinion of the investigator, may preclude the patient from following and completing the protocol.
[24] Have had a transplanted organ (corneal transplants [keratoplasty] allowed) or awaiting an organ transplant.
[25] Have any other condition (eg, hypersensitivity) that is a contraindication to any incretin or GLP-1 RAs.
[26] Have had an MI, surgical or percutaneous coronary revascularization procedure, ischemic stroke, carotid stenting or surgical revascularization, nontraumatic amputation or peripheral vascular procedure (eg, stenting or surgical revascularization) less than 60 days prior to screening.
[27] Have had coronary artery bypass graft surgery less than 5 years prior to Screening.
[28] Treatment with any incretin, GLP-1 RA, or pramlintide in a period of 3 months prior to Visit 1.
[29] Discontinuation of any incretin, GLP-1 RA, or pramlintide due to intolerability any time prior to Visit 1.
[30]

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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