Trial Outcomes & Findings for Study to Evaluate the Efficacy and Safety of Exenatide Once-Weekly Injection Compared to Once-Daily Insulin in Type 2 Diabetes Mellitus (NCT NCT00935532)

NCT ID: NCT00935532

Last Updated: 2015-06-15

Results Overview

Change in HbA1c from baseline to endpoint (Week 26).

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

427 participants

Primary outcome timeframe

Baseline, Week 26

Results posted on

2015-06-15

Participant Flow

Participant milestones

Participant milestones
Measure
Exenatide Once Weekly
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Overall Study
STARTED
215
212
Overall Study
COMPLETED
193
201
Overall Study
NOT COMPLETED
22
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Exenatide Once Weekly
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Overall Study
Adverse Event
11
6
Overall Study
Death
1
0
Overall Study
Lost to Follow-up
1
0
Overall Study
Physician Decision
1
2
Overall Study
Protocol Violation
2
1
Overall Study
Subject Decision
2
1
Overall Study
Sponsor Decision
0
1
Overall Study
Loss Glucose Control
4
0

Baseline Characteristics

Study to Evaluate the Efficacy and Safety of Exenatide Once-Weekly Injection Compared to Once-Daily Insulin in Type 2 Diabetes Mellitus

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Exenatide Once Weekly
n=215 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Total
n=427 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
160 Participants
n=5 Participants
156 Participants
n=7 Participants
316 Participants
n=5 Participants
Age, Categorical
>=65 years
55 Participants
n=5 Participants
56 Participants
n=7 Participants
111 Participants
n=5 Participants
Age, Continuous
57.1 years
STANDARD_DEVIATION 10.44 • n=5 Participants
56.4 years
STANDARD_DEVIATION 11.16 • n=7 Participants
56.8 years
STANDARD_DEVIATION 10.80 • n=5 Participants
Sex: Female, Male
Female
73 Participants
n=5 Participants
64 Participants
n=7 Participants
137 Participants
n=5 Participants
Sex: Female, Male
Male
142 Participants
n=5 Participants
148 Participants
n=7 Participants
290 Participants
n=5 Participants
Glycosylated hemoglobin (HbA1c)
8.51 percentage of total hemoglobin
STANDARD_DEVIATION 0.823 • n=5 Participants
8.50 percentage of total hemoglobin
STANDARD_DEVIATION 0.791 • n=7 Participants
8.50 percentage of total hemoglobin
STANDARD_DEVIATION 0.806 • n=5 Participants
Weight
69.95 kg
STANDARD_DEVIATION 13.246 • n=5 Participants
71.03 kg
STANDARD_DEVIATION 13.932 • n=7 Participants
70.49 kg
STANDARD_DEVIATION 13.586 • n=5 Participants
Background Oral Antidiabetic Agent (OAD)
Biguanide (BG)
145 participants
n=5 Participants
142 participants
n=7 Participants
287 participants
n=5 Participants
Background Oral Antidiabetic Agent (OAD)
BG+Thiazolidine Derivative (TZD)
70 participants
n=5 Participants
70 participants
n=7 Participants
140 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline, Week 26

Population: Statistical analysis of this study was performed for the full analysis set (FAS). FAS consisted of randomized patients who received administration of the study drug at least once and had measurement values after administration. Missing data at endpoint was imputed using last observation carried forward (LOCF) approach.

Change in HbA1c from baseline to endpoint (Week 26).

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=214 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Change in HbA1c From Baseline to Endpoint (Week 26)
-1.11 percentage of total hemoglobin
Standard Error 0.06
-0.68 percentage of total hemoglobin
Standard Error 0.06

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Only subjects with baseline HbA1c \> target were included in calculation. Missing data at endpoint was imputed using LOCF approach.

Percentage of subjects achieving HbA1c \<=7.0% (for subjects with HbA1c \>7% at baseline)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=211 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=210 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Percentage of Subjects Achieving HbA1c<=7%
42.2 percentage of subjects
21.0 percentage of subjects

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Only subjects with baseline HbA1c \> target were included in calculation. Missing data at endpoint was imputed using LOCF approach.

Percentage of subjects achieving HbA1c \<=6.5% (for subjects with HbA1c \>6.5% at baseline)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=214 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Percentage of Subjects Achieving HbA1c<=6.5%
20.6 percentage of subjects
4.2 percentage of subjects

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Missing data at endpoint was imputed using LOCF approach.

Change in FSG (centralized measurement) from baseline to endpoint (Week 26)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=212 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=211 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Change in Fasting Serum Glucose (FSG) From Baseline to Endpoint (Week 26)
-46.09 mg/dL
Standard Error 2.40
-40.82 mg/dL
Standard Error 2.39

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Missing data at endpoint was imputed using LOCF approach.

Change in Body Weight from baseline to endpoint (Week 26)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=214 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Change in Body Weight From Baseline to Endpoint (Week 26)
-1.67 kg
Standard Error 0.17
0.34 kg
Standard Error 0.17

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Missing data at endpoint was imputed using LOCF approach.

Change in Total Cholesterol from baseline to endpoint (Week 26)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=213 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Change in Total Cholesterol From Baseline to Endpoint (Week 26)
-14.21 mg/dL
Standard Error 1.67
-6.32 mg/dL
Standard Error 1.67

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Missing data at endpoint was imputed using LOCF approach.

Change in HDL-C from baseline to endpoint (Week 26)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=213 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Change in High-density Lipoprotein Cholesterol (HDL-C) From Baseline to Endpoint (Week 26)
-0.99 mg/dL
Standard Error 0.52
-0.71 mg/dL
Standard Error 0.51

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Missing data at endpoint was imputed using LOCF approach.

Ratio of Triglycerides (measured in mg/dL) at endpoint (Week 26) to Baseline. Log(Postbaseline Triglycerides) - log(Baseline Triglycerides); change from baseline to endpoint is presented as ratio of endpoint to baseline.

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=213 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Ratio of Fasting Triglycerides at Endpoint (Week 26) to Baseline
1.00 ratio
Standard Error 1.02
1.00 ratio
Standard Error 1.02

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS Population. Missing data at endpoint was imputed using LOCF approach.

Change in Blood Pressure from baseline to endpoint (Week 26)

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=214 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Change in Blood Pressure From Baseline to Endpoint (Week 26)
Systolic Blood Pressure
-4.5 mmHg
Standard Deviation 14.04
-2.6 mmHg
Standard Deviation 14.29
Change in Blood Pressure From Baseline to Endpoint (Week 26)
Diastolic Blood Pressure
-1.1 mmHg
Standard Deviation 9.25
-2.5 mmHg
Standard Deviation 8.88

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: FAS Population.

Major confirmed hypoglycemia was defined as (1) any event accompanying symptoms consistent with hypoglycemia that resulted in loss of consciousness or seizure but resolved promptly in response to administration of glucagon or (2) glucose, or documented hypoglycemia (blood glucose \<3.0 mmol/L \[54 mg/dL\]) requiring assistance because of severe impairment in consciousness or motor activity whether or not symptoms of hypoglycemia were felt by the patient. Event rate per subject year was calculated for each subject: (number of events observed from a subject/exposure from a subject)\*365.25 where exposure = last postbaseline visit date - baseline visit date. Mean and SE were then derived from FAS.

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=215 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Assessment on Event Rate of Treatment-emergent Major Hypoglycemic Events
0.00 events per subject-year
Standard Error 0.00
0.00 events per subject-year
Standard Error 0.00

SECONDARY outcome

Timeframe: Baseline to Week 26

Population: FAS Population.

Minor confirmed hypoglycemia was defined as any event a patient felt that he or she was experiencing a sign or symptom associated with hypoglycemia that resolved by self-treatment or on its own, and a concurrent self-monitoring fingerstick blood glucose \<3.0 mmol/L (54 mg/dL) and not classified as major hypoglycemia. Event rate per subject year was calculated for each subject: (number of events observed from a subject/exposure from a subject)\*365.25 where exposure = last postbaseline visit date - baseline visit date. Mean and SE were then derived from FAS.

Outcome measures

Outcome measures
Measure
Exenatide Once Weekly
n=215 Participants
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 Participants
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Assessment on Event Rate of Treatment-emergent Minor Hypoglycemic Events
0.01 events per subject-year
Standard Error 0.01
0.16 events per subject-year
Standard Error 0.13

Adverse Events

Exenatide Once Weekly

Serious events: 6 serious events
Other events: 145 other events
Deaths: 0 deaths

Insulin Glargine

Serious events: 5 serious events
Other events: 65 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Exenatide Once Weekly
n=215 participants at risk
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 participants at risk
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
Cardiac disorders
Atrial fibrillation
0.47%
1/215
0.00%
0/212
Cardiac disorders
Cardiac failure
0.47%
1/215
0.00%
0/212
Injury, poisoning and procedural complications
Fibula fracture
0.47%
1/215
0.00%
0/212
Hepatobiliary disorders
Jaundice cholestatic
0.47%
1/215
0.00%
0/212
Nervous system disorders
Lacunar infarction
0.47%
1/215
0.00%
0/212
Respiratory, thoracic and mediastinal disorders
Status asthmaticus
0.47%
1/215
0.00%
0/212
Injury, poisoning and procedural complications
Tibia fracture
0.47%
1/215
0.00%
0/212
Hepatobiliary disorders
Cholecystitis
0.00%
0/215
0.47%
1/212
Hepatobiliary disorders
Cholecystitis acute
0.00%
0/215
0.47%
1/212
Gastrointestinal disorders
Diverticulitis intestinal haemorrhagic
0.00%
0/215
0.47%
1/212
Metabolism and nutrition disorders
Hyperglycaemia
0.00%
0/215
0.47%
1/212
Metabolism and nutrition disorders
Hypoglycaemia
0.00%
0/215
0.47%
1/212

Other adverse events

Other adverse events
Measure
Exenatide Once Weekly
n=215 participants at risk
Subcutaneous injection, 2.0mg, once a week.
Insulin Glargine
n=212 participants at risk
Subcutaneous injection, titrated to achieve fasting serum glucose target, once a day
General disorders
Injection site induration
27.0%
58/215
1.4%
3/212
Infections and infestations
Nasopharyngitis
25.6%
55/215
21.2%
45/212
Gastrointestinal disorders
Nausea
12.6%
27/215
2.8%
6/212
Gastrointestinal disorders
Constipation
11.2%
24/215
3.3%
7/212
Gastrointestinal disorders
Diarrhoea
8.8%
19/215
2.4%
5/212
General disorders
Induration
8.4%
18/215
0.00%
0/212
Gastrointestinal disorders
Vomiting
8.4%
18/215
2.4%
5/212
General disorders
Injection site pruritus
6.5%
14/215
0.00%
0/212
Gastrointestinal disorders
Abdominal discomfort
5.1%
11/215
0.94%
2/212
Metabolism and nutrition disorders
Decreased appetite
5.1%
11/215
0.47%
1/212

Additional Information

Peter Ohman, Medical Science Director

AstraZeneca

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60