Establishing Cardiovascular Biomarkers to Define Preferred Lantus® Use

NCT ID: NCT01500850

Last Updated: 2011-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-31

Study Completion Date

2012-10-31

Brief Summary

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The aim of this study is to observe changes in cardiovascular biomarkers during treatment with Lantus in patients with Type 2 Diabetes mellitus.

Detailed Description

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* Phase IV
* Indication: Diabetes mellitus Type 2
* Primary objective:

To compare fasting intact proinsulin secretion at the beginning and after a 24 week treatment period.

\- Secondary objectives: To evaluate changes in the parameters

* insulin,
* glucose,
* intact proinsulin (after a glucose challenge),
* hsCRP,
* adiponectin,
* MMP-9,
* HbA1c,
* weight

after 24 weeks of treatment.

To investigate the changes of

* glucose,
* intact proinsulin,
* hsCRP,
* adiponectin,
* HbA1c
* weight

between visit 2 (baseline), visit 6 (12 weeks) and visit 8 (final visit after 24 weeks).

To investigate the number of patients with normal values for parameters hsCRP, adiponectin, and intact proinsulin after 24 weeks of treatment (responder rates).

-Primary efficacy variable: Fasting intact proinsulin concentration at timepoint Visit 2 (Baseline) and Visit 8 (after 24 week treatment)

-Secondary efficacy variables: All secondary parameters will be assessed after 24 weeks of treatment and compared versus baseline assessment.

* Weight
* hsCRP
* Adiponectin
* MMP-9
* OGTT parameters (insulin, intact proinsulin, glucose at time point 0, 60 and 120 minutes after 24 weeks
* HOMA-IR score
* HbA1c

Additionally the following parameters will be assessed at visit 6 and will be compared with visit 2 and visit 8:

* Weight
* hsCRP
* Adiponectin
* Fasting intact Proinsulin
* Glucose
* HbA1c
* Safety Variables:
* Adverse Events
* Hypoglycaemic events

Medication/Dosage:

Insulin glargine, dose individually adapted to reach treatment goal (FBG ≤ 100 mg/dL)NPH Insulin, dose individually adapted to reach treatment goal (FBG ≤ 100 mg/dL)Insulin glulisine, dose individually adapted to reach treatment goal (FBG ≤ 100 mg/dL)Human Insulin, dose individually adapted to reach treatment goal (FBG ≤ 100 mg/dL)

-Study Duration: Duration of study participation for one patient is approximately 26 weeks. Overall total duration of the study is approximately 10 months.

Design:

This is a randomized in four arms, open-label, multi-center study. Population Patients with Type 2 Diabetes mellitus, Sample Size n = 60 (15 per arm)

Conditions

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Insulin-requiring Type 2 Diabetes Mellitus

Keywords

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Type 2 Diabetes mellitus NPH insulin Insulin Glargine cardiovascular biomarkers hsCRP, adiponectin intact proinsulin cardiovascular risk

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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NPH insulin + insulin glulisine

Patients will be randomized to be treated with NPH insulin + Insulin Glulisine for 24 weeks.

Group Type ACTIVE_COMPARATOR

nph insulin

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Insulin glulisine

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Insulin glulisine: bolus injections before each main meal

NPH insulin + human insulin

Patients will be randomized to be treated with NPH insulin + human insulin for 24 weeks.

Group Type ACTIVE_COMPARATOR

human insulin

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

human insulin: bolus injections before each main meal

Insulin glargine + insulin glulisine

Patients will be randomized to be treated with insulin glargine + insulin glulisine for 24 weeks.

Group Type EXPERIMENTAL

Insulin Glargine

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Insulin glulisine

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Insulin glulisine: bolus injections before each main meal

Insulin Glargine + Human insulin

Patients will be randomized to be treated with insulin glargine + human insulin for 24 weeks.

Group Type EXPERIMENTAL

human insulin

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

human insulin: bolus injections before each main meal

Insulin Glargine

Intervention Type DRUG

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Interventions

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nph insulin

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Intervention Type DRUG

human insulin

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

human insulin: bolus injections before each main meal

Intervention Type DRUG

Insulin Glargine

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Intervention Type DRUG

Insulin glulisine

Dosage will be pro re nata. Patients should aim an blood glucose level of ≤ 100 mg/dL.

Insulin glulisine: bolus injections before each main meal

Intervention Type DRUG

Other Intervention Names

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Insuman Basal Insuman Rapid Lantus Apidra

Eligibility Criteria

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Inclusion Criteria

* Give written informed consent.
* Patient consents that his/her family physician/diabetologist will be informed of trial participation
* Type-2 diabetes mellitus ≥ 1 year of diagnosis (male and female)
* Experienced in self blood glucose measurement for ≥ 3 months.
* HbA1c ≤ 9% and \>6,5%
* BMI \> 30 kg/m²
* Age ≥ 18 years
* Waist circumference \> 88 cm (female) and \> 102 cm (male)
* NPH insulin treatment plus 1 or 2 OAD (except TZD)

Exclusion Criteria

* History of drug or alcohol abuse within the last five years prior to screening
* Anamnestic history of hypersensitivity to the study drugs (or any component of the study drug) or to drugs with similar chemical structures
* History of severe or multiple allergies
* Treatment with any other investigational drug within 3 months prior to screening
* Progressive fatal disease
* History of significant cardiovascular, respiratory, gastrointestinal, hepatic (ALAT and/or ASAT \> 3 times the normal reference range), renal (creatinine \> 1.3 mg/dl in women and \>1.6 mg/dl in men), neurological, psychiatric and/or hematological disease as judged by the investigator
* Pregnant or lactating women
* Sexually active women of childbearing potential not consistently and correctly practicing birth control by implants, injectables, combined oral contraceptives, hormonal intrauterine devices (IUDs), sexual abstinence or vasectomized partner
* Treatment with GLP1-analog or Thiazolidinediones (TZD)
* hsCRP \> 10 mg/l (by rapid test at screening visit).
* Lack of compliance or other similar reason that, according to investigator, precludes satisfactory participation in the study
* Type 1 Diabetes mellitus
* Patients already treated with intensified conventional insulin therapy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IKFE Institute for Clinical Research and Development

OTHER

Sponsor Role collaborator

ikfe-CRO GmbH

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andreas Pfützner, Professor

Role: PRINCIPAL_INVESTIGATOR

Ikfe GmbH

Locations

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ikfe GmbH

Mainz, Rhineland-Palatinate, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Andreas Pfützner, Professor

Role: CONTACT

Phone: 00496131-57636-0

Email: [email protected]

Thomas Forst, Professor

Role: CONTACT

Phone: 00496131-57636-0

Email: [email protected]

Facility Contacts

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Thomas Forst, MD

Role: primary

Daniela Sachsenheimer, MD

Role: backup

References

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Semlitsch T, Engler J, Siebenhofer A, Jeitler K, Berghold A, Horvath K. (Ultra-)long-acting insulin analogues versus NPH insulin (human isophane insulin) for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2020 Nov 9;11(11):CD005613. doi: 10.1002/14651858.CD005613.pub4.

Reference Type DERIVED
PMID: 33166419 (View on PubMed)

Other Identifiers

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Lantu_L_05720

Identifier Type: -

Identifier Source: org_study_id