A Study to Evaluate the Efficacy and Safety of Ertugliflozin in Asian Participants With Type 2 Diabetes and Inadequate Glycemic Control on Metformin Monotherapy (MK-8835-012)

NCT ID: NCT02630706

Last Updated: 2018-12-07

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

506 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-16

Study Completion Date

2017-12-27

Brief Summary

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This is a study to evaluate the efficacy and safety of the addition of ertugliflozin to metformin monotherapy in Asian participants with Type 2 diabetes mellitis (T2DM) who have inadequate glycemic control on metformin monotherapy. The primary hypothesis is that the mean reduction from baseline in HbA1C for 15 mg and 5 mg ertugliflozin (tested sequentially) is greater than for placebo.

Detailed Description

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This study includes a 1-week screening period, an 8-week (or greater) antihyperglycemic agent (AHA) wash-off and/or metformin dose stable period (as necessary), a 2-week single-blind placebo run-in period, a 26-week double-blind treatment period, and a post-treatment telephone contact 14 days after the last dose of study drug.

Conditions

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Type 2 Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Sponsor was masked.

Study Groups

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Ertugliflozin 5 mg

Ertugliflozin 5 mg oral and matching placebo for ertugliflozin 10 mg, oral, once daily for 26 weeks, while maintaining metformin at a stable dose (\>=1500 mg/day). Glycemic rescue therapy with open-label glimepiride was initiated in participants with glucose values exceeding protocol-specified values.

Group Type EXPERIMENTAL

Ertugliflozin 5 mg

Intervention Type DRUG

Ertugliflozin 5 mg oral tablet taken once daily

Placebo matching ertugliflozin

Intervention Type DRUG

Placebo matching ertugliflozin (5-mg and/or 10-mg tablet) oral taken once daily

Metformin

Intervention Type DRUG

Participants are to remain on their stable doses of metformin (oral, \>=1500 mg/day) while receiving blinded investigational product during the double-blind treatment period. Participants on metformin \<1500 at screening are up-titrated to \>= 1500 daily.

Glimepiride

Intervention Type DRUG

Glycemic rescue therapy with open-label glimepiride will be initiated in participants with glucose values exceeding protocol-specified values. Dosing and titration of open-label glimepiride rescue therapy will be at the Investigator's discretion.

Ertugliflozin 15 mg

Ertugliflozin 15 mg (ertugliflozin 5 mg + ertugliflozin 10 mg) administered orally once daily for 26 weeks, while maintaining metformin at a stable dose (\>=1500 mg/day). Glycemic rescue therapy with open-label glimepiride was initiated in participants with glucose values exceeding protocol-specified values.

Group Type EXPERIMENTAL

Ertugliflozin 15 mg

Intervention Type DRUG

Ertugliflozin 15 mg (5-mg and 10-mg tablets) oral taken once daily

Metformin

Intervention Type DRUG

Participants are to remain on their stable doses of metformin (oral, \>=1500 mg/day) while receiving blinded investigational product during the double-blind treatment period. Participants on metformin \<1500 at screening are up-titrated to \>= 1500 daily.

Glimepiride

Intervention Type DRUG

Glycemic rescue therapy with open-label glimepiride will be initiated in participants with glucose values exceeding protocol-specified values. Dosing and titration of open-label glimepiride rescue therapy will be at the Investigator's discretion.

Placebo

Placebo matching ertugliflozin administered orally once daily for 26 weeks, while maintaining metformin at a stable dose (\>=1500 mg/day). Glycemic rescue therapy with open-label glimepiride was initiated in participants with glucose values exceeding protocol-specified values.

Group Type PLACEBO_COMPARATOR

Placebo matching ertugliflozin

Intervention Type DRUG

Placebo matching ertugliflozin (5-mg and/or 10-mg tablet) oral taken once daily

Metformin

Intervention Type DRUG

Participants are to remain on their stable doses of metformin (oral, \>=1500 mg/day) while receiving blinded investigational product during the double-blind treatment period. Participants on metformin \<1500 at screening are up-titrated to \>= 1500 daily.

Glimepiride

Intervention Type DRUG

Glycemic rescue therapy with open-label glimepiride will be initiated in participants with glucose values exceeding protocol-specified values. Dosing and titration of open-label glimepiride rescue therapy will be at the Investigator's discretion.

Interventions

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Ertugliflozin 5 mg

Ertugliflozin 5 mg oral tablet taken once daily

Intervention Type DRUG

Ertugliflozin 15 mg

Ertugliflozin 15 mg (5-mg and 10-mg tablets) oral taken once daily

Intervention Type DRUG

Placebo matching ertugliflozin

Placebo matching ertugliflozin (5-mg and/or 10-mg tablet) oral taken once daily

Intervention Type DRUG

Metformin

Participants are to remain on their stable doses of metformin (oral, \>=1500 mg/day) while receiving blinded investigational product during the double-blind treatment period. Participants on metformin \<1500 at screening are up-titrated to \>= 1500 daily.

Intervention Type DRUG

Glimepiride

Glycemic rescue therapy with open-label glimepiride will be initiated in participants with glucose values exceeding protocol-specified values. Dosing and titration of open-label glimepiride rescue therapy will be at the Investigator's discretion.

Intervention Type DRUG

Other Intervention Names

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MK-8835 PF-04971729 MK-8835 PF-04971729

Eligibility Criteria

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Inclusion Criteria

* Asian participants ≥18 years of age at the time of initial Screening.
* Type 2 diabetes mellitus as per American Diabetes Association guidelines.
* Metformin monotherapy (≥1500 mg/day) with an initial Screening A1C of 7.0-10.5% (53-91 mmol/mol) OR metformin monotherapy (\<1500 mg/day) with an initial Screening A1C of 7.5-11.0% (58-97 mmol/mol) OR dual combination therapy with metformin + sulfonylurea, dipeptidyl peptidase-4 (DDP-4) inhibitor, meglitinide, or alpha-glucosidase inhibitor with an initial Screening A1C of 6.5-9.5% (48-80 mmol/mol).
* Body mass index (BMI) ≥18.0 kg/m\^2.
* Male or female not of reproductive potential.
* Female of reproductive potential who agrees to remain abstinent from heterosexual activity or to use 2 acceptable combinations of contraception.

Exclusion Criteria

* History of type 1 diabetes mellitus or a history of ketoacidosis.
* History of other specific types of diabetes (e.g., genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical-induced, and post-organ transplant.)
* History of myocardial infarction, unstable angina, arterial revascularization, stroke, transient ischemic attack, or New York Heart Association (NYHA) functional class III-IV heart failure within 3 months of study start.
* Mean value for triplicate screening sitting systolic blood pressure \>160 mm Hg and/or diastolic blood pressure \>90 mm Hg after at least a 5-minute seated rest at screening
* Active, obstructive uropathy or indwelling urinary catheter.
* History of malignancy ≤5 years prior to study start, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer.
* Routinely consumes \>2 alcoholic drinks per day or \>14 alcoholic drinks per week or engages in binge drinking.
* Any clinically significant malabsorption condition.
* Is on a weight-loss program or weight-loss medication or other medication associated with weight changes and is not weight stable prior to study start.
* Has undergone bariatric surgery within the past 12 months or \>12 months and is not weight stable prior to study start.
* A known hypersensitivity or intolerance to any sodium glucose co-transporter (SGLT2) inhibitor.
* On a previous clinical study with ertugliflozin.
* Is taking blood pressure or lipid altering medications that have not been on a stable dose for at least 4 weeks prior to study start.
* Current treatment for hyperthyroidism.
* Male participants with a serum creatinine \>=1.3 mg/dL (\>=115 mol/L) or female participants with a serum creatinine \>=1.2 mg/dL (\>=106 mol/L) or participants with an estimated glomerular filtration rate (eGFR) \<55 mL/min/1.73m\^2 according to the 4-variable Modification of Diet in Renal Disease (MDRD) equation at screening.
* An aspartate transaminase (AST) or alanine transaminase (ALT) \>2X the upper limit of normal (ULN) range at screening, or a total bilirubin \>1.5 X the ULN unless the participant has a history of Gilbert's.
* On thyroid replacement therapy and has not been on a stable dose for at least 6 weeks prior to study start.
* A medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic active hepatitis B or C, primary biliary cirrhosis, or symptomatic gallbladder disease.
* Has been treated with any of the following agents within 12 weeks of study start or during the pre-randomization period: Insulin of any type (except for short-term use during concomitant illness or other stress), other injectable anti-hyperglycemic agents (e.g., pramlintide, exenatide, liraglutide), another SGLT2 inhibitor, bromocriptine, colesevelam, rosiglitazone or pioglitazone, or any other AHA with the exception of the protocol-approved agents.
* Is on or likely to require treatment ≥14 consecutive days or repeated courses of pharmacologic doses of corticosteroids.
* Has undergone a surgical procedure within 6 weeks prior to study start or has planned major surgery during the study.
* Pregnant or breast-feeding, or planning to conceive during the trial, including 14 days following the last dose of study medication.
* Planning to undergo hormonal therapy in preparation for egg donation during the trial, including 14 days following the last dose of study medication.
* Donated blood or blood products within 6 weeks of study start.
* Has Human Immunodeficiency Virus (HIV).
* Has blood dyscrasias or any disorders causing hemolysis or unstable red blood cells.
* Has clinically important hematological disorders (such as aplastic anemia, myeloproliferative or myelodyplastic syndromes, thrombocytopenia.)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pfizer

INDUSTRY

Sponsor Role collaborator

Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Countries

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China Hong Kong Philippines South Korea Taiwan

References

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Ji L, Liu J, Xu ZJ, Wei Z, Zhang R, Malkani S, Cater NB, Frederich R. Efficacy and Safety of Ertugliflozin Added to Metformin: A Pooled Population from Asia with Type 2 Diabetes and Overweight or Obesity. Diabetes Ther. 2023 Feb;14(2):319-334. doi: 10.1007/s13300-022-01345-6. Epub 2023 Feb 3.

Reference Type DERIVED
PMID: 36763328 (View on PubMed)

Xu H, O'Gorman MT, Nepal S, James LP, Ginman K, Pithavala YK. Phase 1 Study Evaluating the Effects of the Proton Pump Inhibitor Rabeprazole and Food on the Pharmacokinetics of Lorlatinib in Healthy Participants. Clin Pharmacol Drug Dev. 2021 Nov;10(11):1395-1404. doi: 10.1002/cpdd.1000. Epub 2021 Jul 20.

Reference Type DERIVED
PMID: 34288547 (View on PubMed)

Fediuk DJ, Sahasrabudhe V, Dawra VK, Zhou S, Sweeney K. Population Pharmacokinetic Analyses of Ertugliflozin in Select Ethnic Populations. Clin Pharmacol Drug Dev. 2021 Nov;10(11):1297-1306. doi: 10.1002/cpdd.970. Epub 2021 Jul 2.

Reference Type DERIVED
PMID: 34213819 (View on PubMed)

Ji L, Liu Y, Miao H, Xie Y, Yang M, Wang W, Mu Y, Yan P, Pan S, Lauring B, Liu S, Huyck S, Qiu Y, Terra SG. Safety and efficacy of ertugliflozin in Asian patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: VERTIS Asia. Diabetes Obes Metab. 2019 Jun;21(6):1474-1482. doi: 10.1111/dom.13681. Epub 2019 Apr 5.

Reference Type DERIVED
PMID: 30830724 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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B1521045

Identifier Type: OTHER

Identifier Source: secondary_id

MK-8835-012

Identifier Type: OTHER

Identifier Source: secondary_id

8835-012

Identifier Type: -

Identifier Source: org_study_id