Trial Outcomes & Findings for Safety and Efficacy of Dapagliflozin in Triple Therapy to Treat Subjects With Type 2 Diabetes (NCT NCT01646320)

NCT ID: NCT01646320

Last Updated: 2016-06-22

Results Overview

HbA1c was measured as percent of hemoglobin by a central laboratory. Data after rescue medication was excluded from this analysis. Baseline was defined as the last assessment prior to the start date and time of the first dose of the double-blind study medication. In cases where time of the first dose or time of the assessment was not available, baseline was defined as the last assessment on or prior to the date of the first dose of the double-blind study medication. HbA1c measurements were obtained during the qualification and lead-in periods and on Day 1 and Weeks 6, 12, 18, and 24 in the double-blind period.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

320 participants

Primary outcome timeframe

From Baseline to Week 24

Results posted on

2016-06-22

Participant Flow

Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Phase 3 Trial with Dapagliflozin added to Saxagliptin in Combination with Metformin compared to placebo added to Saxagliptin in combination with Metformin in Subjects with Type 2 Diabetes who have Inadequate Glycemic Control on Metformin and Saxagliptin

Arm1: Dapagliflozin (10 mg) + Saxagliptin + Metformin IR Arm 2: Placebo + Saxagliptin + Metformin IR

Participant milestones

Participant milestones
Measure
Dapa+Saxa+Met
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Short-term Period (Day 1 to Week 24)
STARTED
160
160
Short-term Period (Day 1 to Week 24)
COMPLETED
148
153
Short-term Period (Day 1 to Week 24)
NOT COMPLETED
12
7
Long-term Period (Weeks 24 to 52)
STARTED
147
147
Long-term Period (Weeks 24 to 52)
COMPLETED
141
140
Long-term Period (Weeks 24 to 52)
NOT COMPLETED
6
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Dapa+Saxa+Met
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Short-term Period (Day 1 to Week 24)
Adverse Event
3
0
Short-term Period (Day 1 to Week 24)
No longer meets study criteria
0
1
Short-term Period (Day 1 to Week 24)
Not reported
2
2
Short-term Period (Day 1 to Week 24)
Other
1
0
Short-term Period (Day 1 to Week 24)
Lost to Follow-up
4
4
Short-term Period (Day 1 to Week 24)
Withdrawal by Subject
2
0
Long-term Period (Weeks 24 to 52)
Subject no longer meets study criteria
2
0
Long-term Period (Weeks 24 to 52)
Withdrawal by Subject
0
2
Long-term Period (Weeks 24 to 52)
Adverse Event
4
2
Long-term Period (Weeks 24 to 52)
Lack of Efficacy
0
1
Long-term Period (Weeks 24 to 52)
Lost to Follow-up
0
2

Baseline Characteristics

Safety and Efficacy of Dapagliflozin in Triple Therapy to Treat Subjects With Type 2 Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Dapa+Saxa+Met
n=160 Participants
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
n=160 Participants
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Total
n=320 Participants
Total of all reporting groups
Age, Continuous
55.2 YEARS
STANDARD_DEVIATION 8.61 • n=5 Participants
55.0 YEARS
STANDARD_DEVIATION 9.60 • n=7 Participants
55.1 YEARS
STANDARD_DEVIATION 9.10 • n=5 Participants
Age, Customized
< 65 years
137 Participants
n=5 Participants
132 Participants
n=7 Participants
269 Participants
n=5 Participants
Age, Customized
>= 65 years
23 Participants
n=5 Participants
28 Participants
n=7 Participants
51 Participants
n=5 Participants
Sex: Female, Male
Female
90 Participants
n=5 Participants
84 Participants
n=7 Participants
174 Participants
n=5 Participants
Sex: Female, Male
Male
70 Participants
n=5 Participants
76 Participants
n=7 Participants
146 Participants
n=5 Participants
Race/Ethnicity, Customized
ASIAN
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race/Ethnicity, Customized
BLACK/AFRICAN AMERICAN
8 Participants
n=5 Participants
10 Participants
n=7 Participants
18 Participants
n=5 Participants
Race/Ethnicity, Customized
OTHER
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race/Ethnicity, Customized
WHITE
150 Participants
n=5 Participants
147 Participants
n=7 Participants
297 Participants
n=5 Participants
Race/Ethnicity, Customized
AMERICAN INDIAN/ALASKA NATIVE
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: From Baseline to Week 24

Population: The Randomized Subjects Data Set consists of all randomized subjects who received at least one dose of double-blind study medication during the double-blind treatment period.

HbA1c was measured as percent of hemoglobin by a central laboratory. Data after rescue medication was excluded from this analysis. Baseline was defined as the last assessment prior to the start date and time of the first dose of the double-blind study medication. In cases where time of the first dose or time of the assessment was not available, baseline was defined as the last assessment on or prior to the date of the first dose of the double-blind study medication. HbA1c measurements were obtained during the qualification and lead-in periods and on Day 1 and Weeks 6, 12, 18, and 24 in the double-blind period.

Outcome measures

Outcome measures
Measure
Dapa+Saxa+Met
n=158 Participants
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
n=158 Participants
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Adjusted Mean Change From Baseline in Hemoglobin A1C (HbA1c) at Week 24
-0.82 Percentage of glycosylated hemoglobin
Standard Error 0.0686
-0.1 Percentage of glycosylated hemoglobin
Standard Error 0.0704

SECONDARY outcome

Timeframe: From Baseline to Week 24

Population: The Randomized Subjects Data Set consists of all randomized subjects who received at least one dose of double-blind study medication during the double-blind treatment period. Number of participants analyzed corresponds to the number of randomized subjects with non-missing baseline value and at least one post-baseline value.

Data after rescue medication was excluded from this analysis. Baseline was defined as the last assessment prior to the start date and time of the first dose of the double-blind study medication. In cases where time of the first dose or time of the assessment was not available, baseline was defined as the last assessment on or prior to the date of the first dose of the double-blind study medication. FPG measurements were obtained during the qualification and lead-in periods and on Day 1 and Weeks 6, 12, 18, and 24 in the double-blind period

Outcome measures

Outcome measures
Measure
Dapa+Saxa+Met
n=158 Participants
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
n=157 Participants
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Adjusted Mean Change From Baseline in Fasting Plasma Glucose at Week 24
-32.7 mg/dL
Standard Error 2.821
-5.3 mg/dL
Standard Error 2.968

SECONDARY outcome

Timeframe: From Baseline to Week 24

Population: The Randomized Subjects Data Set consists of all randomized subjects who received at least one dose of double-blind study medication during the double-blind treatment period. Number of participants analyzed is the number of randomized subjects with non-missing baseline and Week 24 (LOCF) values.

2-hour postprandial glucose (PPG) from a liquid meal tolerance test (2-h MTT) Subject must be fasted for at least 8 hrs prior to the MTT.

Outcome measures

Outcome measures
Measure
Dapa+Saxa+Met
n=134 Participants
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
n=132 Participants
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Adjusted Mean Change From Baseline in 120-minute Postprandial Glucose (PPG) at Week 24
-73.5 mg/dL
Standard Error 4.055
-38.0 mg/dL
Standard Error 4.104

SECONDARY outcome

Timeframe: From baseline to Week 24

Population: The Randomized Subjects Data Set consists of all randomized subjects who received at least one dose of double-blind study medication during the double-blind treatment period

Data after rescue medication was excluded from this analysis. Baseline was defined as the last assessment prior to the start date and time of the first dose of the double-blind study medication. In cases where time of the first dose or time of the assessment was not available, baseline was defined as the last assessment on or prior to the date of the first dose of the double-blind study medication. Body weights were measured during the qualification and lead-in periods and on Day 1 and Weeks 6, 12, 18, and 24 in the double-blind period.

Outcome measures

Outcome measures
Measure
Dapa+Saxa+Met
n=158 Participants
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
n=158 Participants
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Adjusted Mean Change From Baseline in Body Weight at Week 24
-1.91 kg
Standard Error 0.2191
-0.41 kg
Standard Error 0.2270

SECONDARY outcome

Timeframe: From baseline to week 24

Population: The Randomized Subjects Data Set consists of all randomized subjects who received at least one dose of double-blind study medication during the double-blind treatment period

Percent adjusted for baseline HbA1c. Therapeutic glycemic response is defined as HbA1c \<7.0%. Data after rescue medication was excluded from this analysis.

Outcome measures

Outcome measures
Measure
Dapa+Saxa+Met
n=158 Participants
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Pla+Saxa+Met
n=158 Participants
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Percentage of Subjects Achieving a Therapeutic Glycemic Response (Hemoglobin A1c [HbA1C]) <7.0% at Week 24 (Last Observation Carried Forward [LOCF])
36.7 Percentage of subjects
13.3 Percentage of subjects

Adverse Events

DAPA + SAXA + MET

Serious events: 7 serious events
Other events: 103 other events
Deaths: 0 deaths

PLA + SAXA + MET

Serious events: 4 serious events
Other events: 112 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
DAPA + SAXA + MET
n=160 participants at risk
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
PLA + SAXA + MET
n=160 participants at risk
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Blood and lymphatic system disorders
THROMBOCYTOPENIA
0.62%
1/160 • Number of events 1
0.00%
0/160
Cardiac disorders
ACUTE MYOCARDIAL INFARCTION
0.62%
1/160 • Number of events 1
0.00%
0/160
Cardiac disorders
ANGINA UNSTABLE
0.62%
1/160 • Number of events 1
0.00%
0/160
Cardiac disorders
ATRIAL FIBRILLATION
0.62%
1/160 • Number of events 1
0.00%
0/160
Cardiac disorders
CARDIAC FAILURE
0.62%
1/160 • Number of events 1
0.00%
0/160
Cardiac disorders
CARDIAC FAILURE ACUTE
0.62%
1/160 • Number of events 1
0.00%
0/160
Cardiac disorders
VENTRICULAR TACHYCARDIA
0.62%
1/160 • Number of events 1
0.00%
0/160
Gastrointestinal disorders
GASTRIC ULCER
0.00%
0/160
0.62%
1/160 • Number of events 1
Infections and infestations
ABSCESS LIMB
0.00%
0/160
0.62%
1/160 • Number of events 1
Infections and infestations
APPENDICITIS
0.62%
1/160 • Number of events 1
0.00%
0/160
Infections and infestations
GANGRENE
0.00%
0/160
0.62%
1/160 • Number of events 1
Infections and infestations
POSTOPERATIVE WOUND INFECTION
0.62%
1/160 • Number of events 1
0.00%
0/160
Injury, poisoning and procedural complications
ANKLE FRACTURE
0.00%
0/160
0.62%
1/160 • Number of events 1
Investigations
LIVER FUNCTION TEST ABNORMAL
0.00%
0/160
0.62%
1/160 • Number of events 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
INVASIVE DUCTAL BREAST CARCINOMA
0.62%
1/160 • Number of events 1
0.00%
0/160
Respiratory, thoracic and mediastinal disorders
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
0.62%
1/160 • Number of events 1
0.00%
0/160

Other adverse events

Other adverse events
Measure
DAPA + SAXA + MET
n=160 participants at risk
Participants received dapagliflozin, 10 mg, and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
PLA + SAXA + MET
n=160 participants at risk
Participants received dapagliflozin matching placebo and open-label saxagliptin 5 mg and metformin ≥1500 mg per day for up to 52 weeks
Gastrointestinal disorders
ABDOMINAL PAIN
2.5%
4/160 • Number of events 4
1.9%
3/160 • Number of events 3
Gastrointestinal disorders
DIARRHOEA
4.4%
7/160 • Number of events 7
5.6%
9/160 • Number of events 11
Gastrointestinal disorders
DYSPEPSIA
1.2%
2/160 • Number of events 2
2.5%
4/160 • Number of events 4
Gastrointestinal disorders
NAUSEA
2.5%
4/160 • Number of events 4
5.0%
8/160 • Number of events 9
General disorders
CHEST PAIN
0.62%
1/160 • Number of events 1
2.5%
4/160 • Number of events 5
Hepatobiliary disorders
HEPATIC STEATOSIS
0.62%
1/160 • Number of events 1
2.5%
4/160 • Number of events 4
Infections and infestations
INFLUENZA
7.5%
12/160 • Number of events 14
7.5%
12/160 • Number of events 14
Infections and infestations
NASOPHARYNGITIS
3.1%
5/160 • Number of events 5
5.0%
8/160 • Number of events 9
Infections and infestations
PHARYNGITIS
3.8%
6/160 • Number of events 6
1.9%
3/160 • Number of events 3
Infections and infestations
URINARY TRACT INFECTION
9.4%
15/160 • Number of events 19
10.0%
16/160 • Number of events 19
Infections and infestations
VULVOVAGINAL MYCOTIC INFECTION
4.4%
7/160 • Number of events 9
0.62%
1/160 • Number of events 1
Injury, poisoning and procedural complications
CONTUSION
0.62%
1/160 • Number of events 1
2.5%
4/160 • Number of events 4
Metabolism and nutrition disorders
DYSLIPIDAEMIA
4.4%
7/160 • Number of events 7
1.9%
3/160 • Number of events 3
Metabolism and nutrition disorders
HYPERTRIGLYCERIDAEMIA
3.1%
5/160 • Number of events 5
5.6%
9/160 • Number of events 10
Musculoskeletal and connective tissue disorders
ARTHRALGIA
2.5%
4/160 • Number of events 4
1.2%
2/160 • Number of events 2
Musculoskeletal and connective tissue disorders
BACK PAIN
3.1%
5/160 • Number of events 5
6.2%
10/160 • Number of events 10
Musculoskeletal and connective tissue disorders
MUSCLE SPASMS
1.2%
2/160 • Number of events 2
3.8%
6/160 • Number of events 6
Musculoskeletal and connective tissue disorders
MUSCULOSKELETAL PAIN
1.9%
3/160 • Number of events 4
2.5%
4/160 • Number of events 4
Musculoskeletal and connective tissue disorders
PAIN IN EXTREMITY
1.9%
3/160 • Number of events 3
3.8%
6/160 • Number of events 6
Nervous system disorders
DIZZINESS
3.8%
6/160 • Number of events 6
0.00%
0/160
Nervous system disorders
HEADACHE
6.9%
11/160 • Number of events 16
8.1%
13/160 • Number of events 15
Psychiatric disorders
DEPRESSION
0.00%
0/160
3.1%
5/160 • Number of events 5
Respiratory, thoracic and mediastinal disorders
COUGH
3.1%
5/160 • Number of events 5
1.9%
3/160 • Number of events 3
Skin and subcutaneous tissue disorders
RASH
0.00%
0/160
2.5%
4/160 • Number of events 4

Additional Information

Eva Johnsson, Clinical Science Lead

AstraZeneca Pharmaceuticals

Phone: +46 31 7762484

Results disclosure agreements

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