A Pragmatic Randomized Trial to Evaluate the Comparative Effectiveness Between Dapagliflozin and Standard of Care in Type 2 Diabetes Patients

NCT ID: NCT02616666

Last Updated: 2024-12-16

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

632 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-25

Study Completion Date

2026-07-31

Brief Summary

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A trial of patients with type 2 diabetes mellitus to evaluate the comparative effectiveness between dapagliflozin and Standard of Care (SOC)

Detailed Description

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A longitudinal, open labelled, pragmatic randomized 104 week multicentre trial of patients with type 2 diabetes mellitus to evaluate the comparative effectiveness between dapagliflozin and Standard of Care (SOC)

Conditions

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Type 2 Diabetes Mellitus

Keywords

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Type 2 diabetes mellitus Randomised Pragmatic Standard of Care Dapagliflozin FORXIGA

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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Dapagliflozin 10 mg

Patients will be randomized to receive either dapagliflozin or SOC. As this is a pragmatic trial, there will be no additional interventions (apart from collection of PROs and occurrence of hypoglycaemias) and there will be no restriction on how GPs change the randomized treatment regimen (e.g., switch or add drugs). Patients will be followed up for 2 years (+ 12 weeks = 116 weeks) after randomization, regardless of the status of medication.

Group Type EXPERIMENTAL

Dapagliflozin

Intervention Type DRUG

The product in study is dapagliflozin (FORXIGA™), 10 mg film-coated tablets, and FORXIGA™ should be prescribed according to the instructions in the SmPC and current practice, including up-titration (if considered appropriate by the investigator). Dapagliflozin will be given in combination with metformin.

Standard of Care (SOC)

Patients will be randomized to receive either dapagliflozin or SOC. As this is a pragmatic trial, there will be no additional interventions (apart from collection of PROs and occurrence of hypoglycaemias) and there will be no restriction on how GPs change the randomized treatment regimen (e.g., switch or add drugs). Patients will be followed up for 2 years (+ 12 weeks = 116 weeks) after randomization, regardless of the status of medication.

Group Type ACTIVE_COMPARATOR

Standard of Care

Intervention Type DRUG

The comparator arm consists of SOC. The SOC arm can be sulphonylurea (SU) or non-SU treatments. SU treatments will include any SU and the related insulin secretagogues repaglinide or nateglinide, each of them in combination with metformin. The non-SU treatments can be metformin and dipeptidyl peptidase 4 inhibitors (DPP-4i), or metformin and glitazones (pioglitazone) combination therapy. Other SGLT-2 inhibitors are excluded. All these treatments are approved in the UK for use in this patient population.

Interventions

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Dapagliflozin

The product in study is dapagliflozin (FORXIGA™), 10 mg film-coated tablets, and FORXIGA™ should be prescribed according to the instructions in the SmPC and current practice, including up-titration (if considered appropriate by the investigator). Dapagliflozin will be given in combination with metformin.

Intervention Type DRUG

Standard of Care

The comparator arm consists of SOC. The SOC arm can be sulphonylurea (SU) or non-SU treatments. SU treatments will include any SU and the related insulin secretagogues repaglinide or nateglinide, each of them in combination with metformin. The non-SU treatments can be metformin and dipeptidyl peptidase 4 inhibitors (DPP-4i), or metformin and glitazones (pioglitazone) combination therapy. Other SGLT-2 inhibitors are excluded. All these treatments are approved in the UK for use in this patient population.

Intervention Type DRUG

Other Intervention Names

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FORXIGA

Eligibility Criteria

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Inclusion Criteria

For inclusion in the study patients should fulfil the following criteria at the time of screening:

1. Provision of informed consent prior to any study specific procedures
2. Females and males aged ≥18 years up to ≤ 75 years
3. Diagnosed with Type 2 Diabetes Mellitus.
4. Uncontrolled on first-line metformin treatment, defined as ≥8 weeks on maximum tolerated dose of metformin and HbA1c \> 6.5%.
5. Ability to read and write as judged by the investigator.

Exclusion Criteria

1. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site)
2. Previous enrolment or randomization in the present study
3. Age \> 75 years
4. Pregnancy/active breast feeding at the time of inclusion
5. Known moderate to severe renal impairment (eGFR\<60ml/min).
6. Participation in an interventional clinical trial ≤ 3 months before enrolment.
7. Unsuitable to participate on mental health grounds, as judged by the investigator.
8. Physician decision to use, as second line treatment, insulin, a GLP1 agonist compound or a SGLT2 inhibitor different from dapagliflozin.
9. Presence of any of the characteristics in which the products in study are contraindicated, as per current labels.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AstraZeneca

INDUSTRY

Sponsor Role collaborator

Clinical Practice Research Datalink

OTHER_GOV

Sponsor Role collaborator

University of Liverpool

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John Wilding, MBChB, DM

Role: PRINCIPAL_INVESTIGATOR

Universtiy of Liverpool, University Hospital, Aintree, Longmoor Lane, Liverpool, L9 7AL, UK

Jesús Medina, PhD

Role: STUDY_DIRECTOR

AstraZeneca

Susan Beatty, MSc

Role: STUDY_DIRECTOR

Clinical Practice Research Datalink

Locations

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Forfar, Angus, United Kingdom

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Yate, Avon, United Kingdom

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Bracknell, Berkshire, United Kingdom

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Reading, Berkshire, United Kingdom

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Wokingham, Berkshire, United Kingdom

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Research Site, Alum Rock

Birmingham, Birmingham, United Kingdom

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Maesteg, Bridgend, United Kingdom

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Chew Stoke, Bristol, United Kingdom

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Yate, Bristol, United Kingdom

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Iver, Bucks, United Kingdom

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Blackwood, Caerphilly, United Kingdom

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Hengoed, Caerphilly, United Kingdom

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Greenisland, Carrickfergus, United Kingdom

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Whitehead, Carrickfergus, United Kingdom

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Macclesfield, Cheshire, United Kingdom

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Crook, County Durham, United Kingdom

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Denbigh, Denbighshire, United Kingdom

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Exeter, Devon, United Kingdom

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Hull, East Yorkshire, United Kingdom

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Romford, Essex, United Kingdom

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Pinhoe, Exeter, United Kingdom

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Cheltenham, Gloucestershire, United Kingdom

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Trafford, Greater Manchester, United Kingdom

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Worsley, Greater Manchester, United Kingdom

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Alton, Hampshire, United Kingdom

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Farnborough, Hampshire, United Kingdom

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Gosport, Hampshire, United Kingdom

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Havant, Hampshire, United Kingdom

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Romsey, Hampshire, United Kingdom

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Southampton, Hampshire, United Kingdom

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Waterlooville, Hampshire, United Kingdom

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Winchester, Hampshire, United Kingdom

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Southampton, Hants, United Kingdom

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Leominster, Herefordshire, United Kingdom

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Fortrose, Highland, United Kingdom

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Beckenham, Kent, United Kingdom

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Canterbury, Kent, United Kingdom

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Faversham, Kent, United Kingdom

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Gravesend, Kent, United Kingdom

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Rainham, Kent, United Kingdom

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Research Site, Market Square

Kineton, Kineton, United Kingdom

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Barnoldswick, Lancashire, United Kingdom

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Blackburn, Lancashire, United Kingdom

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Darwen, Lancashire, United Kingdom

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Lancaster, Lancashire, United Kingdom

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Nelson, Lancashire, United Kingdom

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Thornton-Cleveleys, Lancashire, United Kingdom

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Thornton-Cleveleys, Lancs, United Kingdom

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Loughborough, Leicestershire, United Kingdom

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Balham, London, United Kingdom

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Brockley, London, United Kingdom

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London, London, United Kingdom

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Rotherhithe, London, United Kingdom

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Streatham, London, United Kingdom

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Trafford, Manchester, United Kingdom

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Liverpool, Merseyside, United Kingdom

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Metropolitan Borough of Wirral, Merseyside, United Kingdom

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Wembley, Middlesex, United Kingdom

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Glyncorrwg, Neath Port Talbot, United Kingdom

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Newport, Newport, United Kingdom

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Swaffham, Norfolk, United Kingdom

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Clevedon, North Somerset, United Kingdom

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Pickering, North Yorkshire, United Kingdom

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Ripon, North Yorkshire, United Kingdom

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Nottingham, Nottinghamshire, United Kingdom

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Nottingham, Notts, United Kingdom

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Bicester, Oxfordshire, United Kingdom

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Carterton, Oxfordshire, United Kingdom

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Oxford, Oxfordshire, United Kingdom

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Wantage, Oxfordshire, United Kingdom

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Witney, Oxfordshire, United Kingdom

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Oxford, Oxford, United Kingdom

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Oxford, Oxon, United Kingdom

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Milford Haven, Pembrokeshire, United Kingdom

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Tonypandy, Rhondda Cynon Taff, United Kingdom

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Pontypridd, Rhondda Cynon Taf, United Kingdom

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Telford, Shropshire, United Kingdom

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Axbridge, Somerset, United Kingdom

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Ayr, South Ayrshire, United Kingdom

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Conisbrough, South Yorkshire, United Kingdom

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Worsborough, South Yorkshire, United Kingdom

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Bury St Edmunds, Suffolk, United Kingdom

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Camberley, Surrey, United Kingdom

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Guildford, Surrey, United Kingdom

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London, Surrey, United Kingdom

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Killay, Swansea, United Kingdom

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Barry, Vale of Glamorgan, United Kingdom

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Nuneaton, Warks, United Kingdom

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Alcester, Warwickshire, United Kingdom

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Atherstone, Warwickshire, United Kingdom

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Bidford-on-Avon, Warwickshire, United Kingdom

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Nuneaton, Warwickshire, United Kingdom

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Stratford-upon-Avon, Warwickshire, United Kingdom

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Warwick, Warwickshire, United Kingdom

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Walsall, West Midlands, United Kingdom

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Wolverhampton, West Midlands, United Kingdom

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Crawley, West Sussex, United Kingdom

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Swindon, Wiltshire, United Kingdom

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Droitwich, Worcestershire, United Kingdom

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Kidderminster, Worcestershire, United Kingdom

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Malvern, Worcestershire, United Kingdom

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Alton, , United Kingdom

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Altrincham, , United Kingdom

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Blackburn, , United Kingdom

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Cambridge, , United Kingdom

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Cirencester, , United Kingdom

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Cockermouth, , United Kingdom

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Colchester, , United Kingdom

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Colindale, , United Kingdom

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Dudley, , United Kingdom

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Edmonton, , United Kingdom

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Fareham, , United Kingdom

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Fleet, , United Kingdom

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Gravesend, , United Kingdom

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Hull, , United Kingdom

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Kings Norton, , United Kingdom

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Langport, , United Kingdom

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Liphook, , United Kingdom

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Liverpool, , United Kingdom

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London, , United Kingdom

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Maryport, , United Kingdom

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Morriston, , United Kingdom

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Oxford, , United Kingdom

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Petersfield, , United Kingdom

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Rowlands Castle, , United Kingdom

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Royal Leamington Spa, , United Kingdom

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Stansted, , United Kingdom

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Stratford-upon-Avon, , United Kingdom

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Torquay, , United Kingdom

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Wallsend, , United Kingdom

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Waterlooville, , United Kingdom

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Wembley, , United Kingdom

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Countries

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United Kingdom

Other Identifiers

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2015-001873-42

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

D1690R00009

Identifier Type: -

Identifier Source: org_study_id