Trial Outcomes & Findings for Effect of Detemir and Sitagliptin on Blood Glucose Control in Type 2 Diabetes (NCT NCT00789191)

NCT ID: NCT00789191

Last Updated: 2017-03-14

Results Overview

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

222 participants

Primary outcome timeframe

Week 26

Results posted on

2017-03-14

Participant Flow

48 sites in 8 countries: Canada, Finland, France, Hungary, Slovakia, Republic of Korea, Turkey, and the United States of America (USA)

Between screening and randomisation, eligible subjects were to continue their usual pre-trial oral anti-diabetic drug (OAD) dose and dosing frequency. Subjects on sulphonylurea (SU) treatment randomised to the insulin detemir group had their SU discontinued

Participant milestones

Participant milestones
Measure
Comb
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Overall Study
STARTED
111
111
Overall Study
Exposed
107
110
Overall Study
COMPLETED
97
92
Overall Study
NOT COMPLETED
14
19

Reasons for withdrawal

Reasons for withdrawal
Measure
Comb
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Overall Study
Adverse Event
2
4
Overall Study
Lack of Efficacy
0
5
Overall Study
Protocol Violation
5
3
Overall Study
Withdrawal Criteria
2
4
Overall Study
Unclassified
5
3

Baseline Characteristics

Effect of Detemir and Sitagliptin on Blood Glucose Control in Type 2 Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Comb
n=107 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=110 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Total
n=217 Participants
Total of all reporting groups
Age, Continuous
56.70 years
STANDARD_DEVIATION 9.96 • n=5 Participants
57.10 years
STANDARD_DEVIATION 8.41 • n=7 Participants
56.90 years
STANDARD_DEVIATION 9.19 • n=5 Participants
Sex: Female, Male
Female
39 Participants
n=5 Participants
60 Participants
n=7 Participants
99 Participants
n=5 Participants
Sex: Female, Male
Male
68 Participants
n=5 Participants
50 Participants
n=7 Participants
118 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
96 Participants
n=5 Participants
101 Participants
n=7 Participants
197 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
8 Participants
n=5 Participants
6 Participants
n=7 Participants
14 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
13 Participants
n=5 Participants
17 Participants
n=7 Participants
30 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
Race (NIH/OMB)
White
83 Participants
n=5 Participants
84 Participants
n=7 Participants
167 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
8 Participants
n=5 Participants
7 Participants
n=7 Participants
15 Participants
n=5 Participants
HbA1c
8.52 Percent (%) glycosylated haemoglobin
STANDARD_DEVIATION 0.65 • n=5 Participants
8.52 Percent (%) glycosylated haemoglobin
STANDARD_DEVIATION 0.65 • n=7 Participants
8.52 Percent (%) glycosylated haemoglobin
STANDARD_DEVIATION 0.65 • n=5 Participants
Height
1.71 meters
STANDARD_DEVIATION 0.10 • n=5 Participants
1.66 meters
STANDARD_DEVIATION 0.09 • n=7 Participants
1.68 meters
STANDARD_DEVIATION 0.10 • n=5 Participants
Body Weight
93.1 kg
STANDARD_DEVIATION 20.2 • n=5 Participants
88.2 kg
STANDARD_DEVIATION 19.2 • n=7 Participants
90.6 kg
STANDARD_DEVIATION 19.8 • n=5 Participants
BMI
31.79 kg/m^2
STANDARD_DEVIATION 5.20 • n=5 Participants
31.90 kg/m^2
STANDARD_DEVIATION 5.91 • n=7 Participants
31.85 kg/m^2
STANDARD_DEVIATION 5.56 • n=5 Participants
Stratification
Previous Metformin + Other OAD therapy
83 participants
n=5 Participants
86 participants
n=7 Participants
169 participants
n=5 Participants
Stratification
Previous Metformin Monotherapy
24 participants
n=5 Participants
24 participants
n=7 Participants
48 participants
n=5 Participants
FPG
9.69 mmol/L
STANDARD_DEVIATION 2.23 • n=5 Participants
9.79 mmol/L
STANDARD_DEVIATION 2.36 • n=7 Participants
9.74 mmol/L
STANDARD_DEVIATION 2.29 • n=5 Participants
Diabetes History
9.58 years
STANDARD_DEVIATION 5.62 • n=5 Participants
9.90 years
STANDARD_DEVIATION 5.65 • n=7 Participants
9.74 years
STANDARD_DEVIATION 5.63 • n=5 Participants

PRIMARY outcome

Timeframe: Week 26

Population: Sample size calculation: Assuming a standard deviation of 1.0 for HbA1c, 100 subjects in each treatment arm would be required to obtain a power of 80% for detecting a HbA1c difference of 0.4%. FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=106 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
HbA1c (Glycosylated Haemoglobin A1c)
7.08 Percent (%) glycosylated haemoglobin
Standard Error 0.09
7.64 Percent (%) glycosylated haemoglobin
Standard Error 0.09

SECONDARY outcome

Timeframe: Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=106 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Number of Subjects Achieving HbA1c Less Than or Equal to 7.0%
Target achieved
46 Subjects
25 Subjects
Number of Subjects Achieving HbA1c Less Than or Equal to 7.0%
Target not achieved
57 Subjects
81 Subjects

SECONDARY outcome

Timeframe: Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Symptomatic hypoglycaemia is biochemically confirmed hypoglycaemia or major hypoglycaemia

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=106 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Number of Subjects Achieving HbA1c Less Than or Equal to 7.0% Without Symptomatic Hypoglycaemia
Target achieved
37 Subjects
21 Subjects
Number of Subjects Achieving HbA1c Less Than or Equal to 7.0% Without Symptomatic Hypoglycaemia
Target not achieved
66 Subjects
85 Subjects

SECONDARY outcome

Timeframe: Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=106 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Number of Subjects Achieving HbA1c Less Than or Equal to 6.5%
Target achieved
20 Subjects
11 Subjects
Number of Subjects Achieving HbA1c Less Than or Equal to 6.5%
Target not achieved
83 Subjects
95 Subjects

SECONDARY outcome

Timeframe: Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Symptomatic hypoglycaemia is biochemically confirmed hypoglycaemia or major hypoglycaemia

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=106 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Number of Subjects Achieving HbA1c Less Than or Equal to 6.5% Without Symptomatic Hypoglycaemia
Target achieved
15 Subjects
8 Subjects
Number of Subjects Achieving HbA1c Less Than or Equal to 6.5% Without Symptomatic Hypoglycaemia
Target not achieved
88 Subjects
98 Subjects

SECONDARY outcome

Timeframe: Week 0, Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=107 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Change in BMI (Body Mass Index)
-0.30 kg/m^2
Standard Error 0.15
-0.58 kg/m^2
Standard Error 0.14

SECONDARY outcome

Timeframe: Week 0, Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=107 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Change in Body Weight
-0.81 kg
Standard Error 0.44
-1.66 kg
Standard Error 0.42

SECONDARY outcome

Timeframe: Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=103 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=106 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
FPG (Fasting Plasma Glucose)
6.08 mmol/L
Standard Error 0.24
8.52 mmol/L
Standard Error 0.23

SECONDARY outcome

Timeframe: Weeks 0-26

Population: SAS (safety analysis set) is all randomised subjects exposed to at least one dose of trial product.

Overall: All episodes. Minor: Symptomatic, with PG \< 3.1 mmol/L. Symptoms only: Symptomatic with PG ≥ 3.1 mmol/L

Outcome measures

Outcome measures
Measure
Comb
n=107 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=110 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Hypoglycemic Episodes
Overall
1 episodes
1 episodes
Hypoglycemic Episodes
Minor
0 episodes
0 episodes
Hypoglycemic Episodes
Symptoms Only
0 episodes
0 episodes
Hypoglycemic Episodes
Unclassified
0 episodes
0 episodes

SECONDARY outcome

Timeframe: Weeks 0-26

Population: SAS (safety analysis set) is all randomised subjects exposed to at least one dose of trial product.

Day time: Episodes between 6 pm and 11 am. Overall: All episodes. Minor: Symptomatic, with PG \< 3.1 mmol/L. Symptoms only: Symptomatic with PG ≥ 3.1 mmol/L

Outcome measures

Outcome measures
Measure
Comb
n=107 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=110 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Hypoglycemic Episodes: Day Time
Overall
1 episodes
1 episodes
Hypoglycemic Episodes: Day Time
Minor
0 episodes
0 episodes
Hypoglycemic Episodes: Day Time
Symptoms Only
0 episodes
0 episodes
Hypoglycemic Episodes: Day Time
Unclassified
0 episodes
0 episodes

SECONDARY outcome

Timeframe: Weeks 0-26

Population: SAS (safety analysis set) is all randomised subjects exposed to at least one dose of trial product.

Night time: Episodes between 11 am and 6 pm. Overall: All episodes. Minor: Symptomatic, with PG \< 3.1 mmol/L. Symptoms only: Symptomatic with PG ≥ 3.1 mmol/L

Outcome measures

Outcome measures
Measure
Comb
n=107 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=110 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Hypoglycemic Episodes: Night Time
Overall
0 episodes
0 episodes
Hypoglycemic Episodes: Night Time
Minor
0 episodes
0 episodes
Hypoglycemic Episodes: Night Time
Symptoms Only
0 episodes
0 episodes
Hypoglycemic Episodes: Night Time
Unclassified
0 episodes
0 episodes

SECONDARY outcome

Timeframe: Week 26

Population: FAS (Full Analysis Set) is all randomised subjects exposed to at least one dose of trial product with a post baseline observation.

Outcome measures

Outcome measures
Measure
Comb
n=98 Participants
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=98 Participants
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Self-measured 9-point Plasma Glucose Profile
Before breakfast the following day
6.07 mmol/L
Standard Error 0.19
7.87 mmol/L
Standard Error 0.19
Self-measured 9-point Plasma Glucose Profile
Before breakfast
6.16 mmol/L
Standard Error 0.20
8.17 mmol/L
Standard Error 0.20
Self-measured 9-point Plasma Glucose Profile
120 minutes after start of breakfast
8.82 mmol/L
Standard Error 0.28
10.50 mmol/L
Standard Error 0.28
Self-measured 9-point Plasma Glucose Profile
Before Lunch
6.99 mmol/L
Standard Error 0.26
8.01 mmol/L
Standard Error 0.26
Self-measured 9-point Plasma Glucose Profile
120 minutes after start of lunch
8.69 mmol/L
Standard Error 0.28
9.99 mmol/L
Standard Error 0.28
Self-measured 9-point Plasma Glucose Profile
Before dinner
7.85 mmol/L
Standard Error 0.31
8.61 mmol/L
Standard Error 0.31
Self-measured 9-point Plasma Glucose Profile
120 minutes after start of dinner
9.30 mmol/L
Standard Error 0.32
10.20 mmol/L
Standard Error 0.32
Self-measured 9-point Plasma Glucose Profile
Bedtime
8.38 mmol/L
Standard Error 0.32
9.42 mmol/L
Standard Error 0.31
Self-measured 9-point Plasma Glucose Profile
At 03:00 A.M.
6.85 mmol/L
Standard Error 0.26
8.02 mmol/L
Standard Error 0.26

Adverse Events

Comb

Serious events: 2 serious events
Other events: 76 other events
Deaths: 0 deaths

Sita

Serious events: 4 serious events
Other events: 72 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Comb
n=107 participants at risk
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=110 participants at risk
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Cardiac disorders
Atrial fibrillation
0.00%
0/107 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
0.91%
1/110 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Eye disorders
Optic ischaemic neuropathy
0.00%
0/107 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
0.91%
1/110 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Hepatobiliary disorders
Bile duct obstruction
0.00%
0/107 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
0.91%
1/110 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Infections and infestations
Bronchopneumonia
0.00%
0/107 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
0.91%
1/110 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Fibromatosis
0.93%
1/107 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
0.00%
0/110 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Psychiatric disorders
Alcohol withdrawal syndrome
0.93%
1/107 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
0.00%
0/110 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.

Other adverse events

Other adverse events
Measure
Comb
n=107 participants at risk
Combination therapy of insulin detemir once daily plus sitagliptin added to subject's own pre-trial metformin treatment
Sita
n=110 participants at risk
Monotherapy of sitagliptin once daily added to subject's own pre-trial metformin and/or sulphonylurea (SU) treatment
Infections and infestations
Nasopharyngitis
13.2%
10/76 • Number of events 13 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
19.4%
14/72 • Number of events 16 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Infections and infestations
Upper Respiratory Tract Infection
9.2%
7/76 • Number of events 7 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
13.9%
10/72 • Number of events 12 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Blood and lymphatic system disorders
Influenza
10.5%
8/76 • Number of events 9 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
5.6%
4/72 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Blood and lymphatic system disorders
Bronchitis
5.3%
4/76 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
5.6%
4/72 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Gastrointestinal disorders
Nausea
6.6%
5/76 • Number of events 7 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
11.1%
8/72 • Number of events 20 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Gastrointestinal disorders
Dyspepsia
6.6%
5/76 • Number of events 11 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
4.2%
3/72 • Number of events 11 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Nervous system disorders
Headache
14.5%
11/76 • Number of events 17 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
18.1%
13/72 • Number of events 32 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Nervous system disorders
Dizziness
3.9%
3/76 • Number of events 3 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
5.6%
4/72 • Number of events 21 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Musculoskeletal and connective tissue disorders
Arthralgia
3.9%
3/76 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
5.6%
4/72 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Musculoskeletal and connective tissue disorders
Back pain
10.5%
8/76 • Number of events 9 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
2.8%
2/72 • Number of events 2 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Musculoskeletal and connective tissue disorders
Pain in extremity
3.9%
3/76 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
6.9%
5/72 • Number of events 5 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Musculoskeletal and connective tissue disorders
Myalgia
5.3%
4/76 • Number of events 4 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
2.8%
2/72 • Number of events 2 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
General disorders
Fatigue
9.2%
7/76 • Number of events 8 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
1.4%
1/72 • Number of events 1 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
General disorders
Asthenia
0.00%
0/76 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
6.9%
5/72 • Number of events 12 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Respiratory, thoracic and mediastinal disorders
Cough
3.9%
3/76 • Number of events 3 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
6.9%
5/72 • Number of events 5 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
2.6%
2/76 • Number of events 2 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.
15.3%
11/72 • Number of events 12 • Weeks 0-26
Safety Analysis Set is all participants treated with trial product.

Additional Information

Public Access to Clinical Trials

Novo Nordisk A/S

Results disclosure agreements

  • Principal investigator is a sponsor employee Novo Nordisk reserves the right not to release data before passing specified milestones. This includes the right not to release interim results that may later be found to be incorrect. At the end of the trial, one or more manuscripts will be prepared in collaboration between Investigator(s) and Novo Nordisk. Novo Nordisk will not suppress or veto publications but will reserve the right to postpone publication and/or communication for a short time to protect intellectual property.
  • Publication restrictions are in place

Restriction type: OTHER