A Study of GWP42004 as Add on to Metformin in the Treatment of Participants With Type 2 Diabetes

NCT ID: NCT02053272

Last Updated: 2022-12-20

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

207 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-02-28

Study Completion Date

2016-02-29

Brief Summary

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A study to compare the change in glycaemic control in participants with Type 2 diabetes when treated with GWP42004 or placebo as add-on therapy to metformin over a period of 12 weeks. The safety and tolerability of GWP42004 compared with placebo will also be assessed.

Detailed Description

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This 14 week (one week baseline, 12 week treatment period and one week follow-up), multicentre, randomised, double blind, placebo controlled, parallel group study will evaluate the efficacy, safety and tolerability of 2, 5 and 15 mg of GWP42004 as add on to metformin compared with placebo in participants with Type 2 diabetes.

Eligible participants will enter the study at a screening visit (Visit 1, Day -7) where the following information will be obtained for each participant:

1. Informed consent
2. Demographics
3. Medical history
4. Concomitant medications
5. Electrocardiogram (ECG)
6. Physical examination
7. Vital signs
8. Body weight
9. Height
10. Body Mass Index (BMI)
11. Beck Depression Inventory-II (BDI-II)
12. Safety blood test (biochemistry and haematology)
13. Efficacy blood test (HbA1c)
14. Urinalysis (including drugs of abuse screen)
15. Pregnancy test (if appropriate)

Once all inclusion and exclusion criteria have been reviewed, participants will be commence a seven day baseline period. The day before Visit 2, participants will perform blood glucose tests and record the results, along with the associated time of assessment, in the study diary. Participants will then fast overnight.

Participants will return to the clinic at Visit 2 (Day 1) and following review of all inclusion and exclusion criteria, the following information will be obtained for each participant:

1. Body weight
2. BMI
3. Physical examination
4. Vital signs
5. Safety blood test (biochemistry and haematology)
6. GWP42004 exposure blood test (plasma levels)
7. Efficacy blood test (HbA1c, fasting plasma glucose, serum fructosamine, fasting plasma insulin, HOMA2-IR, pro-insulin, C-peptide, HOMA2-%B, total cholesterol, HDL-cholesterol, serum triglycerides, C-reactive protein)
8. Urinalysis
9. Concomitant medications
10. Adverse events (AEs)
11. BDI-II
12. Columbia-Suicide Severity Rating Scale (C-SSRS)
13. Diabetes Treatment Satisfaction Questionnaire (DTSQs)
14. Overall health Visual Analogue Scale (VAS)
15. Cannabis withdrawal scale assessment (UK only).

Participants will then be randomised to receive either GWP42004 (2, 5 or 15 mg bid) or placebo to be taken adjunctive to their currently prescribed medication. The first dose will be administered and a Oral Glucose Tolerance Test (OGTT) performed.

A third (Visit 3, Day 29) and fourth (Visit 4, Day 57) visit will take place mid-treatment. The day before these visits, participants will perform blood glucose tests and record the results, along with the associated time of assessment, in the study diary. Participants will then fast overnight. The following information will be obtained for each participant at Visits 3 and 4:

1. Body weight
2. BMI
3. Physical examination
4. Vital signs
5. Safety blood test (biochemistry and haematology)
6. Efficacy blood test (HbA1c, fasting plasma glucose, fasting plasma insulin, HOMA2-IR, HOMA2-%B)
7. Urinalysis
8. Concomitant medications
9. AEs
10. BDI-II
11. C-SSRS
12. DTSQs
13. Overall health VAS

A cannabis withdrawal scale assessment will be made by telephone (UK only) between Visits 4 and 5.

A further visit will take place at the end of treatment (Visit 5, Day 85). Two days before this visit, a cannabis withdrawal scale assessment will be made by telephone (UK only). The day before Visit 5, participants will perform blood glucose tests and record the results, along with the associated time of assessment, in the study diary. Participants will then fast overnight. The following information will be obtained for each participant at Visit 5:

the following information will be obtained for each participant:

1. Body weight
2. BMI
3. Physical examination
4. ECG
5. Vital signs
6. Safety blood test (biochemistry and haematology)
7. GWP42004 exposure blood test (plasma levels)
8. Efficacy blood test (HbA1c, fasting plasma glucose, serum fructosamine, fasting plasma insulin, HOMA2-IR, pro-insulin, C-peptide, HOMA2-%B, total cholesterol, HDL-cholesterol, serum triglycerides, C-reactive protein)
9. Urinalysis (including drugs of abuse screen)
10. Pregnancy test (if appropriate)
11. Concomitant medications
12. Adverse events (AEs)
13. BDI-II
14. OGTT
15. C-SSRS
16. DTSQs
17. Overall health VAS

One, three and seven days following Visit 5 (Days 86, 89 and 92, respectively), further cannabis withdrawal scale assessments will be made by telephone (UK only). A final review of AEs and concomitant medications will be made by telephone to all participants on Day 92.

Conditions

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Diabetes Mellitus, Type 2

Keywords

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Diabetes Glycaemic control Delta-9-tetrahydrocannabivarin Cannabinoids

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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2 mg GWP42004 bid

Licaps® size double zero (Size 00) hard gelatin capsules containing 2 mg GWP42004 dissolved in excipients Macrogolglycerol Ricinoleate and Oleoyl macrogol-6-glycerides. One capsule taken twice daily for 12 weeks.

Group Type ACTIVE_COMPARATOR

GWP42004

Intervention Type DRUG

The total dose administered within any 24-hour interval will be two capsules (typically 12 hours apart).

5 mg GWP42004 bid

Licaps® size double zero (Size 00) hard gelatin capsules containing 5 mg GWP42004 dissolved in excipients Macrogolglycerol Ricinoleate and Oleoyl macrogol-6-glycerides. One capsule taken twice daily for 12 weeks.

Group Type ACTIVE_COMPARATOR

GWP42004

Intervention Type DRUG

The total dose administered within any 24-hour interval will be two capsules (typically 12 hours apart).

15 mg GWP42004 bid

Licaps® size double zero (Size 00) hard gelatin capsules containing 15 mg GWP42004 dissolved in excipients Macrogolglycerol Ricinoleate and Oleoyl macrogol-6-glycerides. One capsule taken twice daily for 12 weeks.

Group Type ACTIVE_COMPARATOR

GWP42004

Intervention Type DRUG

The total dose administered within any 24-hour interval will be two capsules (typically 12 hours apart).

Placebo

Licaps® size double zero (Size 00) hard gelatin capsules containing excipients Macrogolglycerol Ricinoleate and Oleoyl macrogol-6-glycerides. One capsule taken twice daily for 12 weeks.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

The total dose administered within any 24-hour interval will be two capsules (typically 12 hours apart).

Interventions

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GWP42004

The total dose administered within any 24-hour interval will be two capsules (typically 12 hours apart).

Intervention Type DRUG

Placebo

The total dose administered within any 24-hour interval will be two capsules (typically 12 hours apart).

Intervention Type DRUG

Other Intervention Names

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Delta-9-tetrahydrocannabivarin Placebo control

Eligibility Criteria

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Inclusion Criteria

* Participant is willing and able to give informed consent for participation in the study (see Section 15.2).
* Male or female participants aged 18 years or above.
* Clinically diagnosed with Type 2 diabetes.
* Participants receiving oral metformin (≥1000 mg per day) as anti-diabetic treatment who have received a stable dose for at least three months prior to enrolment (Visit 1) and willing to maintain a stable dose for the duration of the trial.
* HbA1c level of \>7% - ≤9% (53 - 74.9 mmol/mol).
* BMI of \>25 - \<40 (\>23 - \<40 for Asian populations).
* No changes in diet or exercise for three months prior to study entry and participant agrees to keep stable for the duration of the study.
* Capable of complying with the study requirements and completing the study (in the opinion of the investigator).
* Participant is able (in the investigators opinion) and willing to comply with all study requirements.
* Participant is willing for his or her name to be notified to the responsible authorities for participation in this study, as applicable in individual countries.
* Participant is willing to allow his or her primary care practitioner and consultant, if appropriate, to be notified of participation in the study.

Exclusion Criteria

* Participant is taking or has taken insulin at any point in the last year (does not include short term use (\<10 days) to treat acute events).
* Participant is taking or has taken anti-diabetic treatment (other than metformin) in the three months prior to screening.
* Any concomitant medications which, in the opinion of the investigator, could affect the primary endpoint should remain stable or not be prescribed in the one month prior to Visit 1 or during the study period.
* Any known of suspected history of:
* Alcohol or substance abuse.
* Epilepsy or recurrent seizures.
* Participants receiving treatment with antidepressants or under observation for depression.
* BDI-II item 9 score of 1, 2 or 3.
* Participant who has significant history of suicidal ideation or self-harm.
* Recent (within three months of screening) blood loss (including blood donation).
* Haemolytic anaemia.
* Genetic abnormality in haemoglobin molecule (e.g. sickle cell anaemia).
* Clinically significant cardiac, renal or hepatic impairment in the opinion of the investigator.
* Has significantly impaired renal function as evidenced by a creatinine clearance lower than 40 mL/min at Visit 1.
* Has significantly impaired hepatic function at Visit 1 (alanine aminotransferase (ALT) levels \>5x upper limit of normal (ULN) or total bilirubin (TBL) levels \> 2x ULN). If the ALT or aspartate aminotransferase (AST) levels are \>3x ULN and the TBL levels \>2x ULN (or International Normalised Ratio (INR) \>1.5), then this participant should not enter the study.
* Any known or suspected hypersensitivity to cannabinoids or any of the excipients of the IMPs.
* Female participants of child bearing potential and male participants whose partner is of child bearing potential, unless willing to ensure that they or their partner use effective double barrier contraception.
* Female participant who is pregnant, lactating or planning pregnancy during the course of the study and for three months thereafter.
* Participants who have received an Investigational Medicinal Product (IMP) within the 12 weeks prior to the screening visit.
* Any other significant disease or disorder which, in the opinion of the investigator, may either put the participant at risk because of participation in the study, may influence the result of the study, or the participant's ability to participate in the study.
* Following a physical examination, the participant has any abnormalities that, in the opinion of the investigator would prevent the participant from safe participation in the study.
* Unwilling to abstain from donation of blood during the study.
* Participants who have previously undergone bariatric surgery.
* Travel outside the country of residence planned during the study, unless the participant has prior permission from the embassy of the destination country.
* Participants previously randomised into this study.
* The patient is currently using or has used cannabis or cannabinoid based medications within 30 days of study entry and is unwilling to abstain for the duration of the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jazz Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Diabol SRL

Brasov, , Romania

Site Status

Nicodiab SRL

Bucharest, , Romania

Site Status

Spitalul Universitar de Urgenta Militar Central "Dr. Carol Davila"

Bucharest, , Romania

Site Status

Institutul National de Diabet

Bucharest, , Romania

Site Status

Centrul Medical 'Sanatatea Ta' SRL

Bucharest, , Romania

Site Status

ArtMedical Clinic

Bucharest, , Romania

Site Status

Societatea Civila Medicala dr. Paveliu

Bucharest, , Romania

Site Status

Consultmed SRL

Iași, , Romania

Site Status

Cabinet Medical Individual Diabet Nutritie si Boli Metabolice

Maramures, , Romania

Site Status

Grandmed SRL

Oradea, , Romania

Site Status

Spitalul Judetean de Urgente Satu Mare

Satu Mare, , Romania

Site Status

Spitalul Clinic Judetean de Urgenta Sibiu

Sibiu, , Romania

Site Status

Gagiu D. Remus Cabinet Medical Individual

Târgovişte, , Romania

Site Status

Mediab SRL Diabet Zaharat

Târgu Mureş, , Romania

Site Status

Avondale Surgery

Chesterfield, Derbyshire, United Kingdom

Site Status

Hull and East Yorkshire Hospitals NHS Trust

Hull, East Yorkshire, United Kingdom

Site Status

Salford Royal NHS Foundation Trust

Salford, Greater Manchester, United Kingdom

Site Status

University Hospitals of Leicester NHS Trust

Leicester, Leicestershire, United Kingdom

Site Status

Aintree University Hospitals NHS Foundation Trust

Liverpool, Merseyside, United Kingdom

Site Status

Strensall Medical Practice

York, North Yorkshire, United Kingdom

Site Status

Churchill Hospital

Oxford, Oxfordshire, United Kingdom

Site Status

Hathaway Surgery

Chippenham, Wiltshire, United Kingdom

Site Status

Avenue Surgery

Warminster, Wiltshire, United Kingdom

Site Status

St Chad's Surgery

Bath, , United Kingdom

Site Status

Barts and The London NHS Trust

London, , United Kingdom

Site Status

Countries

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Romania United Kingdom

Other Identifiers

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2013-001140-61

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

GWDM1302

Identifier Type: -

Identifier Source: org_study_id