A Phase 2 Dose-finding Study of TAK-272 in Participants With Type 2 Diabetes Mellitus and Microalbuminuria

NCT ID: NCT02332824

Last Updated: 2018-08-13

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 415 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2014-10-16
• Study Completion Date: 2016-08-18

Brief Summary

The purpose of this study is to test the efficacy and safety on daily oral doses of TAK-272 5 mg, 20 mg, 40 mg and 80 mg in patients with type 2 diabetes mellitus and microalbuminuria by randomized, double-blind, placebo-controlled, parallel-group comparison in order to determine the clinical dose of TAK-272.

Detailed Description

The drug being tested in this study is called TAK-272. This study evaluated the dose-response relationship of the efficacy and safety of TAK-272 in participants with type 2 diabetes mellitus and microalbuminuria.

The study enrolled 415 patients. Participants were randomly assigned to one of the 6 treatment groups:

• TAK-272 5 mg
• TAK-272 20 mg
• TAK-272 40 mg
• TAK-272 80 mg
• Candesartan cilexetil 8 mg
• Placebo (dummy inactive pill) for TAK-272 or Candesartan cilexetil - this was a tablet that looks like the study drug but had no active ingredient

All participants were administered tablets, orally at the same time each day for 12 weeks in double-blind manner. Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

This multi-center trial was conducted in Japan. The overall time to participate in this study is 22 weeks including 2 weeks of follow-up assessment period after last dose of study drug. Participants made multiple visits to the clinic during these periods.

Conditions

Type 2 Diabetes Mellitus and Microalbuminuria

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Placebo

TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet orally, once daily for up to 12 weeks.

Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

Group Type: PLACEBO_COMPARATOR

TAK-272 Placebo

Intervention Type: DRUG

TAK-272 placebo-matching tablets

Candesartan cilexetil Placebo

Intervention Type: DRUG

Candesartan cilexetil placebo-matching tablets

TAK-272 5 mg

TAK-272 5 mg one tablet, TAK-272 placebo 3 tablets and Candesartan cilexetil placebo one tablet, orally, once daily for up to 12 weeks.

Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

Group Type: EXPERIMENTAL

TAK-272

Intervention Type: DRUG

TAK-272 tablets

TAK-272 Placebo

Intervention Type: DRUG

TAK-272 placebo-matching tablets

Candesartan cilexetil Placebo

Intervention Type: DRUG

Candesartan cilexetil placebo-matching tablets

TAK-272 20 mg

TAK-272 20 mg one tablet, TAK-272 placebo 3 tablets and Candesartan cilexetil placebo one tablet, orally, once daily for up to 12 weeks.

Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

Group Type: EXPERIMENTAL

TAK-272

Intervention Type: DRUG

TAK-272 tablets

TAK-272 Placebo

Intervention Type: DRUG

TAK-272 placebo-matching tablets

Candesartan cilexetil Placebo

Intervention Type: DRUG

Candesartan cilexetil placebo-matching tablets

TAK-272 40 mg

TAK-272 20 mg 2 tablets, TAK-272 placebo 2 tablets, and Candesartan cilexetil placebo one tablet, orally, once daily for up to 12 weeks.

Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

Group Type: EXPERIMENTAL

TAK-272

Intervention Type: DRUG

TAK-272 tablets

TAK-272 Placebo

Intervention Type: DRUG

TAK-272 placebo-matching tablets

Candesartan cilexetil Placebo

Intervention Type: DRUG

Candesartan cilexetil placebo-matching tablets

TAK-272 80 mg

TAK-272 20 mg 4 tablets and Candesartan cilexetil placebo one tablet, orally, once daily for up to 12 weeks.

Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

Group Type: EXPERIMENTAL

TAK-272

Intervention Type: DRUG

TAK-272 tablets

Candesartan cilexetil Placebo

Intervention Type: DRUG

Candesartan cilexetil placebo-matching tablets

Candesartan cilexetil 8 mg

TAK-272 placebo 4 tablets and Candesartan cilexetil 8 mg one tablet, orally, once daily for up to 12 weeks.

Participants were administered TAK-272 placebo 4 tablets and Candesartan cilexetil placebo one tablet for 4 weeks (Week -4 to 0) in placebo run-in period and follow-up period (Week 12-14).

Group Type: ACTIVE_COMPARATOR

TAK-272 Placebo

Intervention Type: DRUG

TAK-272 placebo-matching tablets

Candesartan cilexetil

Intervention Type: DRUG

Candesartan cilexetil tablets

Interventions

TAK-272

TAK-272 tablets

Intervention Type: DRUG

TAK-272 Placebo

TAK-272 placebo-matching tablets

Intervention Type: DRUG

Candesartan cilexetil

Candesartan cilexetil tablets

Intervention Type: DRUG

Candesartan cilexetil Placebo

Candesartan cilexetil placebo-matching tablets

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• In the opinion of the investigator or the sub-investigator, the participant is capable of understanding and complying with protocol requirements.
• The participant signs and dates a written, informed consent form prior to the initiation of any study procedures.
• The participant is either male or female and aged 20 to less than 75 years at signing of informed consent.
• The participant is an early-stage nephropathy (Stage 2) patient with type 2 diabetes mellitus.
• Inpatient/outpatient: outpatient
• The participant is a patient with type 2 diabetes mellitus on a certain diet therapy and/or exercise therapy (if any).
• The participant has stability controlled blood glucose, blood pressure and lipid, and does not need any change in the drug and the dose of any antihypertensive, antidiabetic and antidyslipidemia or antihyperlipidemic drugs throughout the study period as judged by the investigator or the sub-investigator.
• The participant has urine albumin/creatinine ratio (UACR) of the first morning urine (the first urine immediately after rising prior to activities in standing position in the morning) is ≥30 to <300 mg/gCr on at least two of three measurements at the start of the pre-treatment period (Week -8), at Week -4 or Week -2.
• The participant has estimated glomerular filtration rate according to creatinine (eGFRcreat) ≥45 mL/min/1.73 m^2 at Week -4.
• A male participant who is nonsterilized and sexually active with a female partner of childbearing potential agrees to use adequate contraception from signing of informed consent throughout the study period and for 12 weeks after the completion of the study.
• A female participant of childbearing potential who is sexually active with a nonsterilized male partner who agrees to routinely use adequate contraception from signing of informed consent until 1 month after the completion of the study.

Exclusion Criteria

• The participant received TAK-272 in a previous clinical study.
• The participant is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in the conduct of this study (e.g., spouse, parent, child, sibling) or may consent to participate under duress.
• The participant has a history of hypersensitivity or allergies to TAK-272, candesartan cilexetil and other renin-angiotensin system (RAS) inhibitors (angiotensin converting enzyme [ACE] inhibitors, angiotensin II receptor blocker [ARBs] or direct renin inhibitor [DRIs]).
• The participant needs to take the prohibited medications during the study period.
• The participant has hyperkalemia (e.g., serum potassium ≥ 5.0 mEq/L at the start of the pretreatment period (Week -8) and Week -4 or requiring regular use of a potassium adsorbent) or onset of hyperkalemia within 2 years prior to starting the pre-treatment period.
• The participant has at least class II hypertension (e.g., sitting systolic blood pressure [SBP] ≥160 mmHg or sitting diastolic blood pressure [DBP] ≥100 mmHg in the pre-treatment period) or malignant hypertension.
• The participant has a renal disease other than type 2 diabetic nephropathy (e.g., patients with renal sclerosis, acute or chronic glomerular nephritis, or polycystic kidney).
• The participant has bilateral or unilateral renal artery stenosis.
• The participant requires regular use of nonsteroidal anti-inflammatory drugs (excluding low-dose aspirin and locally-acting agents such as topical drugs) (e.g., rheumatoid arthritis patients, osteoarthritis patients, and low back pain patients).
• The participant has a history of any of the cardiovascular diseases listed below within 2 years prior to starting the pre-treatment period:

• Cardiac diseases: myocardial infarction, coronary arterial revascularization
• Cerebrovascular diseases: cerebral infarction (excluding lacunar infarction), cerebral hemorrhage, transient ischemic attack
• The participant has any of the cardiovascular diseases listed below:

• Cardiac diseases: angina pectoris, arrhythmia, and congested heart failure that requires medication
• Vascular diseases: arteriosclerosis obliterans with symptoms (e.g., intermittent claudication)
• The participant has a clinically significant hepatic disorder (e.g., either of alanine aminotransferase [ALT] or aspartate aminotransferase [AST] is ≥ 2.5 times the upper limit of normal at the start of the pre-treatment period (Week -8) or at Week -4).
• The participant has a complication of malignant tumor.
• If female, the participant is pregnant, lactating, or is intending to become pregnant before, during or within 1 month after participating in this study; or intending to donate ova during such time period.
• If male, the participant intends to donate sperm during the course of this study or for 12 weeks thereafter.
• The participant is judged by the investigator or the sub-investigator as being ineligible for any other reason.

• The participant has participated in another clinical study or post-marketing study within 30 days prior to starting the pre-treatment period.
• The participant has received the study medication within 12 weeks prior to starting the pre-treatment period.
• The participant has a history of drug abuse (defined as the use of an illicit drug) or history of alcohol abuse within 2 years prior to starting the pre-treatment period.
• The participant has changed the renin angiotensin system (RAS) inhibitor (angiotensin-converting enzyme [ACE] inhibitor, angiotensin II receptor blocker [ARB] or direct renin inhibitors [DRI]) or its dose and regimen within 12 weeks prior to starting the pre-treatment period.
• The participant is treated with any RAS inhibitor (ACE inhibitor, ARB or DRI) at signing of informed consent, and whose UACR is <30 mg/gCr at the start of the pre-treatment period (Week -8).

• The participant has hemoglobin A1c (HbA1c) (National Glycohemoglobin Standardization Program [NGSP]) ≥9.0% at Week -4.
• The participant has change in HbA1c (NGSP) from the start of the pre-treatment period (Week -8) to Week -4 by ≥10.0%* compared to the higher value of them.

• The participant's sitting SBP and sitting DBP changed by ≥20 mmHg or ≥10 mmHg, respectively, at the end of the pre-treatment period (Week 0) compared to Week -2.
• The participant's sitting SBP is <130 mmHg at the end of the pre-treatment period (Week 0).
• The participant's study drug compliance rate* during the pre-treatment period is <80.0%.

• Compliance rate (%)=(Prescribed amount-Retrieved amount)/ {(Completion date of study drug for the pre-treatment period-Starting date of study drug for the pre-treatment period+1)×5}×100, second decimal place to be rounded off.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 74 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Takeda

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Medical Director Clinical Science

Role: STUDY_DIRECTOR

Takeda

Locations

Nagoya, Aichi-ken, Japan

Chiba, Chiba, Japan

Kisarazu-shi, Chiba, Japan

Fukuoka, Fukuoka, Japan

Fukutsu-shi, Fukuoka, Japan

Kitakyuushu-shi, Fukuoka, Japan

Kouriyama-shi, Fukushima, Japan

Anchu-shi, Gunma, Japan

Ota-shi, Gunma, Japan

Ishikari-shi, Hokkaido, Japan

Obihiro-shi, Hokkaido, Japan

Sapporo, Hokkaido, Japan

Kobe, Hyōgo, Japan

Nishinomiya-shi, Hyōgo, Japan

Moriya-shi, Ibaragi, Japan

Naka, Ibaragi, Japan

Koga, Ibarakgi, Japan

Koga-shi, Ibaraki, Japan

Mito, Ibaraki, Japan

Takamatsu, Kagawa-ken, Japan

Ebina-shi, Kanagawa, Japan

Hiratsuka-shi, Kanagawa, Japan

Kawasaki-shi, Kanagawa, Japan

Miura-shi, Kanagawa, Japan

Shounann-shi, Kanagawa, Japan

Yokohama, Kanagawa, Japan

Kochi, Kochi, Japan

Kumamoto, Kumamoto, Japan

Yatsushiro-shi, Kumamoto, Japan

Kyoto, Kyoto, Japan

Uji-shi, Kyoto, Japan

Sendai, Miyagi, Japan

Miyazaki, Miyazaki, Japan

Azumino-shi, Nagano, Japan

Matsumoto-shi, Nagano, Japan

Nakano-shi, Nagano, Japan

Sasebo-shi, Nagasaki, Japan

Kasaoka-shi, Okayama-ken, Japan

Kurashiki-shi, Okayama-ken, Japan

Naha, Okinawa, Japan

Shimajiri-gun, Okinawa, Japan

Tomigusuku-shi, Okinawa, Japan

Kashiwara-shi, Osaka, Japan

Matsubara-shi, Osaka, Japan

Neyagawa, Osaka, Japan

Osaka, Osaka, Japan

Suita-shi, Osaka, Japan

Tondabayashi-shi, Osaka, Japan

Kawagoe-shi, Saitama, Japan

Kyuki-shi, Saitama, Japan

Saitama-shi, Saitama, Japan

Hamamatsu, Shizuoka, Japan

Shizuoka, Shizuoka, Japan

Koyama-shi, Tochigi, Japan

Shimono-shi, Tochigi, Japan

Chiyoda-ku, Tokyo, Japan

Chuo-ku, Tokyo, Japan

Hachioji-shi, Tokyo, Japan

Hino-shi, Tokyo, Japan

Itabashi-ku, Tokyo, Japan

Katsushika-ku, Tokyo, Japan

Nerima-ku, Tokyo, Japan

Ōta-ku, Tokyo, Japan

Shibuya-ku, Tokyo, Japan

Shinagawa-ku, Tokyo, Japan

Shinjuku-ku, Tokyo, Japan

Shinjyuku-ku, Tokyo, Japan

Ube-shi, Yamaguchi, Japan

Countries

Japan

References

Wang GM, Li LJ, Fan L, Xu M, Tang WL, Wright JM. Renin inhibitors versus angiotensin receptor blockers for primary hypertension. Cochrane Database Syst Rev. 2025 Feb 27;2(2):CD012570. doi: 10.1002/14651858.CD012570.pub2.

Reference Type: DERIVED

PMID: 40013543 (View on PubMed)

Other Identifiers

JapicCTI-142658

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1161-6858

Identifier Type: REGISTRY

Identifier Source: secondary_id

TAK-272/CCT-101

Identifier Type: -

Identifier Source: org_study_id