Empagliflozin Add on to Linagliptin Study in Japanese Patient With Type 2 Diabetes Mellitus

NCT ID: NCT02453555

Last Updated: 2019-02-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 275 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-05-14
• Study Completion Date: 2017-03-27

Brief Summary

This trial will compare the use of fixed dose combination of empagliflozin and linagliptin to linagliptin alone in patient with type 2 diabetes mellitus

Conditions

Diabetes Mellitus, Type 2

Study Design

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

Study Groups

Linagliptin

patient to receive 5 mg linagliptin once daily

Group Type: ACTIVE_COMPARATOR

Linagliptin

Intervention Type: DRUG

Empagliflozin placebo + linagliptin placebo low dose

Intervention Type: DRUG

Matching placebo empagliflozin + linagliptin

Empa + lina highdose placebo

Intervention Type: DRUG

Empagliflozin + linagliptin low dose

patient to receive one tablet once daily

Group Type: EXPERIMENTAL

Empagliflozin + linagliptin low dose

Intervention Type: DRUG

tablet

Linagliptin placebo

Intervention Type: DRUG

Matching placebo linagliptin

Empagliflozin + linagliptin high dose

patient to receive one tablet once daily

Group Type: EXPERIMENTAL

Linagliptin placebo

Intervention Type: DRUG

Matching placebo linagliptin

Empagliflozin + linagliptin high dose

Intervention Type: DRUG

tablet

Linagliptin placebo

Group Type: PLACEBO_COMPARATOR

Empagliflozin + linagliptin low dose

Intervention Type: DRUG

tablet

Linagliptin placebo

Intervention Type: DRUG

Matching placebo linagliptin

Empagliflozin + linagliptin high dose

Intervention Type: DRUG

tablet

Empagliflozin + linagliptin high dose placebo

Group Type: PLACEBO_COMPARATOR

Linagliptin

Intervention Type: DRUG

Empa + lina highdose placebo

Intervention Type: DRUG

Empagliflozin + linagliptin low dose placebo

Group Type: PLACEBO_COMPARATOR

Linagliptin

Intervention Type: DRUG

Empagliflozin placebo + linagliptin placebo low dose

Intervention Type: DRUG

Matching placebo empagliflozin + linagliptin

Interventions

Linagliptin

Intervention Type: DRUG

Empagliflozin placebo + linagliptin placebo low dose

Matching placebo empagliflozin + linagliptin

Intervention Type: DRUG

Empagliflozin + linagliptin low dose

tablet

Intervention Type: DRUG

Linagliptin placebo

Matching placebo linagliptin

Intervention Type: DRUG

Empagliflozin + linagliptin high dose

tablet

Intervention Type: DRUG

Empa + lina highdose placebo

Intervention Type: DRUG

Other Intervention Names

tablet

Eligibility Criteria

Inclusion Criteria

1. Diagnosis of Type-2 Diabetes Mellitus (T2DM) prior to informed consent

2. Male and female patients on diet and exercise regimen for at least 12 weeks prior to informed consent who are:

• 1 drug-naïve, defined as no antidiabetic drugs for at least 12 weeks prior to informed consent, or
• 2 pre-treated with one oral antidiabetic drug (for sulfonylurea, with up to half of the maximum approved dose) on stable dosage for at least 12 weeks prior to informed consent (for thiazolidinedione, therapy has to be unchanged for at least 18 weeks prior to the informed consent, for linagliptin 5 mg at least 16 weeks prior to Visit 1). Individual antidiabetic drug (except linagliptin) will have to be discontinued at Visit 1.

3. HbA1c at Visit 1

• 1 HbA1c =8.0% and =10.5% for patients who are drug-naïve, or
• 2 HbA1c =7.5% and =10.5% for patients with one oral antidiabetic drug (except linagliptin), or
• 3 HbA1c =7.5% and =10.0% for patients with linagliptin 5 mg

4. HbA1c =7.5% and =10.0% at Visit 4 for randomisation into the double-blind treatment period. Patient who are pre-treated with linagliptin 5 mg for 16 weeks or more prior to Visit 1 and meet the criteria of HbA1c can directly move on to the run-in (Visit 4).

5. Age =20 years at informed consent

6. BMI =40.0 kg/m2 at Visit 1 (screening)

7. Signed and dated written informed consent by date of Visit 1 in accordance with Good Clinical Practice (GCP) and local legislation

Exclusion Criteria

1. Uncontrolled hyperglycemia with a glucose level >270 mg/dL (>15.0 mmol/L) after an overnight fast during the open-label stabilisation period (from Visit 2 to Visit 4) and run-in period (from Visit 4 to Visit 5) , confirmed by a second measurement (not on the same day and done either at the central or at local laboratory).

2. Acute coronary syndrome (ST-elevation myocardial infarction [STEMI], non-STEMI, and unstable angina pectoris), stroke or transient ischemic attack within 12 weeks prior to informed consent

3. Indication of liver disease, defined by serum levels of either alanine aminotransferase (ALT Serum glutamic pyruvate transaminase [SGPT]), aspartate aminotransferase (AST, Serum glutamic oxaloacetic transaminase [SGOT]), or alkaline phosphatase (ALP) above 3 x upper limit of normal (ULN) as determined during screening, open-label stabilisation period and/or run-in period

4. Impaired renal function, defined as estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2 (MDRD formula) as determined during screening, open-label stabilisation period and/or run-in period

5. Known hereditary galactose intolerance

6. Known contraindications to linagliptin and empagliflozin according to the Japanese label

7. Any previous (within 2 years prior to informed consent) or planned bariatric surgery (or any other weight loss surgery) or other gastrointestinal surgery that induce chronic malabsorption

8. Medical history of cancer (except for resected non-invasive basal cell or squamous carcinoma) and/or treatment for cancer within the last 5 years

9. Known blood dyscrasias or any disorders causing haemolysis or unstable red blood cell (RBC) count (e.g. malaria, babesiosis, haemolytic anaemia).

10. Treatment with insulin, Glucagon-like peptide-1 agonists, within 12 weeks prior to informed consent

11. Treatment with anti-obesity drugs within 12 weeks prior to informed consent or any other treatment at the time of screening (i.e., surgery, aggressive diet regimen, etc.) leading to unstable body weight

12. Current treatment with systemic steroids (other than inhaled or topical steroids) at informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent or any other uncontrolled endocrine disorder except T2DM

13. Pre-menopausal women (last menstruation =1 year prior to informed consent) who:

• 1 are nursing or pregnant or
• 2 are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the trial and do not agree to submit to periodic pregnancy testing during participation in the trial. Acceptable methods of birth control include tubal ligation, intra uterine devices/systems, oral contraceptives, complete sexual abstinence, double barrier method and vasectomised partner

14. Known or suspected allergy or hypersensitivity to trial products or related products (e.g., Dipeptidyl-peptidase-4 inhibitors or Sodium-glucose co-transporter-2 inhibitors)

15. Alcohol or drug abuse within the 12 weeks prior to informed consent that would interfere with trial participation or any ongoing condition leading to a decreased compliance to trial procedures or trial drug intake, by the judgment of the investigator

16. Intake of an investigational drug in another trial within 30 days prior to Visit 1 or participation in the follow-up period of another trial (participation in observational studies is permitted)

17. Any other clinical condition that, in the opinion of the investigator, would jeopardize patient's safety while participating in this clinical trial

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

Sponsors

Eli Lilly and Company

INDUSTRY

Sponsor Role: collaborator

Boehringer Ingelheim

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Boehringer Ingelheim

Role: STUDY_CHAIR

Boehringer Ingelheim

Locations

Nagoya Kyoritsu Hospital

Aichi, Nagoya, , Japan

Kashiwa City Hospital

Chiba, Kashiwa, , Japan

Otabe internal medicine clinic

Fukuoka, Fukuoka, , Japan

Nakamura Cardiovascular Clinic

Fukuoka, Itoshima, , Japan

Tanaka I.M. Clinic, Fukuoka, I.M.

Fukuoka, Kurume, , Japan

Seino I.M. Clinic, Fukushima, I.M.

Fukushima, Koriyama, , Japan

Hiraoka Naika Clinic, Hiroshima, I.M.

Hiroshima, Hiroshima, , Japan

Matsuda Cardiovascular Clinic

Hokkaido, Sapporo, , Japan

Teine Keijinkai Clinic

Hokkaido, Sapporo, , Japan

Mita Internal Medicine Cardiology Clinic

Hokkaido, Sapporo, , Japan

Miyanosawa Clinic of Internal Medicine and Cardiology

Hokkaido, Sapporo, , Japan

Itabashi Diabetic medicine and Dermatology Clinic

Ibaraki, Koga, , Japan

Nakakinen Clinic

Ibaraki, Naka, , Japan

Kubota Clinic

Kanagawa, Kawasaki, , Japan

Kitasato University Hospital

Kanagawa, Sagamihara, , Japan

H.E.C Science Clinic

Kanagawa, Yokohama, , Japan

Yoshimasa Diabetes & Endocrine Clinic

Kyoto, Kyoto, , Japan

Rakuwakai Otowa Hospital

Kyoto, Kyoto, , Japan

Medical Corporation Hayashi Katagihara Clinic

Kyoto, Kyoto, , Japan

Miyamoto Naika Clinic, Nagano, I.M.

Nagano, Matsumoto, , Japan

Gibo Hepatology Clinic, Nagano, Digestive Tract I.M.

Nagano, Matsumoto, , Japan

Takekawa Clinic, Osaka, I.M.

Osaka, Higashi-Osaka, , Japan

Medical Corporation Koseikai Fukuda Naika Clinic

Osaka, Osaka, , Japan

Kinugawa Cardiovascular Internal Medicine clinic

Osaka, Osaka, , Japan

Sato Hospital

Osaka, Osaka, , Japan

Nakaoka Clinic

Osaka, Osaka, , Japan

OCROM Clinic

Osaka, Suita, , Japan

Miyauchi Medical Center

Osaka, Takatsuki, , Japan

Medical Corporation Shinseikai Mashiba Clinic

Saitama, Hanno, , Japan

Asano Clinic

Saitama, Kawagoe, , Japan

Medical Corporation Fusa Shimizu Clinic Fusa

Saitama, Saitama, , Japan

Ogino Clinic

Saitama, Tokorozawa, , Japan

Kanda Clinic

Tokyo, Chiyoda-ku, , Japan

Fukuwa Clinic

Tokyo, Chuo-ku, , Japan

Tokyo-Eki Center-building Clinic

Tokyo, Chuo-ku, , Japan

Myojin Tou Clinic

Tokyo, Hachioji, , Japan

Sawai Medical Clinic

Tokyo, Koto-ku, , Japan

Mishuku Hospital

Tokyo, Meguro-ku, , Japan

Toshiba General Hospital

Tokyo, Shinagawa-ku, , Japan

ToCROM Clinic

Tokyo, Shinjuku-ku, , Japan

Countries

Japan

References

Kawamori R, Haneda M, Suzaki K, Cheng G, Shiki K, Miyamoto Y, Solimando F, Lee C, Lee J, George J. Empagliflozin as add-on to linagliptin in a fixed-dose combination in Japanese patients with type 2 diabetes: Glycaemic efficacy and safety profile in a 52-week, randomized, placebo-controlled trial. Diabetes Obes Metab. 2018 Sep;20(9):2200-2209. doi: 10.1111/dom.13352. Epub 2018 Jun 1.

Reference Type: DERIVED

PMID: 29766636 (View on PubMed)

Other Identifiers

1275.19

Identifier Type: -

Identifier Source: org_study_id