Study of TAK-559 in Treating Subjects With Type 2 Diabetes Mellitus

This study has been terminated.
(Hepatic safety signal identified.)
Sponsor:
Information provided by (Responsible Party):
Takeda
ClinicalTrials.gov Identifier:
NCT00762190
First received: September 26, 2008
Last updated: November 8, 2012
Last verified: November 2012
  Purpose

The purpose of this study was to determine the safety of TAK-559, once daily (QD), in treating subjects receiving a stable dose of insulin to control type 2 diabetes mellitus.


Condition Intervention Phase
Diabetes Mellitus
Drug: TAK-559 and insulin
Drug: Insulin
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multicenter, Double-Blind, Placebo-Controlled, Randomized Study of the Safety of TAK-559 in the Treatment of Patients With Type 2 Diabetes Mellitus

Resource links provided by NLM:


Further study details as provided by Takeda:

Primary Outcome Measures:
  • Incidence of Adverse events. [ Time Frame: All visits or at occurrence. ] [ Designated as safety issue: Yes ]
  • Clinical safety lab tests. [ Time Frame: Weeks 12, 24, and Final Visit. ] [ Designated as safety issue: Yes ]
  • 12-lead electrocardiogram. [ Time Frame: Weeks: 24 and Final Visit. ] [ Designated as safety issue: Yes ]
  • Urinalysis. [ Time Frame: Weeks: 12, 24, 36, 48 and Final Visit. ] [ Designated as safety issue: Yes ]
  • Change from Baseline in Blood pressure and pulse. [ Time Frame: At all visits. ] [ Designated as safety issue: Yes ]
  • Change from Baseline in Body weight. [ Time Frame: At all visits. ] [ Designated as safety issue: Yes ]
  • Left ventricular mass index by body surface area measured by echocardiogram. [ Time Frame: Weeks: 24 and Final Visit. ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Change from Baseline in total daily dose of insulin. [ Time Frame: At all visits. ] [ Designated as safety issue: No ]
  • Change from Baseline in triglycerides. [ Time Frame: Weeks: 24 and Final Visit. ] [ Designated as safety issue: No ]
  • Change from Baseline in cholesterol. [ Time Frame: Weeks 24 and Final Visit ] [ Designated as safety issue: No ]
  • Change from Baseline in total, high-density lipoproteins. [ Time Frame: Weeks: 24 and Final Visit. ] [ Designated as safety issue: No ]
  • Change from Baseline in low-density lipoproteins. [ Time Frame: Weeks 24 and Final Visit ] [ Designated as safety issue: No ]
  • Change from Baseline in low-density lipoprotein fractionation. [ Time Frame: Weeks 24 and Final Visit ] [ Designated as safety issue: No ]
  • Change from Baseline in very low-density lipoprotein. [ Time Frame: Weeks 24 and Final Visit ] [ Designated as safety issue: No ]
  • Change from Baseline in free fatty acids. [ Time Frame: Weeks 24 and Final Visit ] [ Designated as safety issue: No ]
  • Change from Baseline in apolipoproteins (AI, B). [ Time Frame: Weeks 24 and Final Visit ] [ Designated as safety issue: No ]

Enrollment: 348
Study Start Date: November 2003
Study Completion Date: December 2004
Primary Completion Date: December 2004 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: TAK-559 32 mg QD + Insulin Drug: TAK-559 and insulin
TAK-559 32 mg, tablets, orally, once daily and insulin stable dose injection for up to 54 weeks.
Active Comparator: Insulin Drug: Insulin
TAK-559 placebo-matching, tablets, orally, once daily and insulin stable dose injection for up to 54 weeks.

Detailed Description:

Insulin is a primary regulator of blood glucose concentrations. A subnormal response to circulating insulin levels at target tissues leads to a decrease in insulin-mediated glucose uptake. Insulin resistance is associated with normal to high insulin levels and is often accompanied by dyslipidemia, a disruption in lipid metabolism resulting in increased triglycerides and low-density lipoprotein levels as well as decreased high-density lipoprotein levels in patients with type 2 diabetes mellitus. In the early stages of insulin resistance, a compensatory mechanism of increased insulin secretion by the pancreas maintains normal to near-normal glucose levels. Once the pancreas fails to maintain the increased insulin output, overt type 2 diabetes mellitus occurs.

Insulin also plays an important role in the metabolism of fat and proteins and exerts its influence at the peroxisome proliferator-activated receptor level. Peroxisome proliferator-activated receptor -alpha receptors are expressed predominantly in skeletal muscle, adipose tissue, heart, liver, kidney, gut, macrophages, and vascular tissue, and play a key role in energy storage, glucose homeostasis, and vascular biology. Thus, as insulin activates peroxisome proliferator-activated receptor-alpha receptors, this results in the cellular uptake of glucose. Peroxisome proliferator-activated receptor receptors are ligand-activated transcription elements that regulate gene expression necessary for metabolism. For this reason, peroxisome proliferator-activated receptors play a pivotal role in glucose homeostasis, adipocyte differentiation, and lipid storage. The genes predominantly targeted by transcription activity of activated peroxisome proliferator-activated receptor-alpha receptors are those that mediate fatty acid uptake, fatty acid oxidation, and lipoprotein metabolism. As such, peroxisome proliferator-activated receptor-alpha agonists have their greatest effect on lipid metabolism and vascular biology.

TAK-559 is a novel oxyiminoalkanoic acid under investigation for use as an oral agent in the treatment of patients with type 2 diabetes mellitus. TAK-559 has partial peroxisome proliferator-activated receptor-alpha agonist activity, potent peroxisome proliferator-activated receptor-alpha activity, and modest peroxisome proliferator-activated receptor-gamma activity at high concentrations in nonclinical models.

This study was designed to evaluate the safety of TAK-559 in the treatment of patients with type 2 diabetes mellitus who were on a stable dose of insulin.

  Eligibility

Ages Eligible for Study:   25 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Had type 2 diabetes mellitus using American Diabetes Association diagnostic criteria, currently treated with insulin therapy.
  • Required sponsor approval if older than 65 years.
  • Had a Screening glycosylated hemoglobin less than or equal to 8.0%.
  • Had a Screening fasting plasma glucose less than or equal to 200 mg/dL (11.1 mmol/L).
  • Had a Screening low density lipoprotein less than or equal to 160 mg/dL (4.1 mmol/L).
  • Had a Screening thyroid stimulating hormone level less than or equal to 5.5 μU/mL (5.5 μU/L) and greater than or equal to 0.35 μU/mL (0.35 μU/L).
  • Was willing to continue dietary counseling during study and had dietary advice greater than or equal to 2.5 months prior to Screening.
  • Had a Screening ejection fraction greater than or equal to 40% from echocardiogram.
  • Had a Screening blood pressure less than or equal to 140/95 mm Hg.
  • Was willing to perform daily self-monitoring blood glucose tests.
  • A female subject of childbearing potential who was sexually active agreed to use adequate contraception, and was neither pregnant nor lactating from Screening throughout the duration of the study.
  • Was in good health as determined by physician (via medical history and physical examination) other than having type 2 diabetes mellitus.
  • Had clinical laboratory evaluations within normal reference range or deemed not clinically significant by the investigator or sponsor.
  • Started insulin therapy at least 3 months prior to Randomization.

Exclusion Criteria:

  • Had a hypersensitivity to peroxisome proliferator-activated receptor -alpha or gamma agonists, thiazolidinediones, or fibrates.
  • Was diagnosed with type 1 diabetes mellitus or hemochromatosis, or had a history of ketoacidosis.
  • Required greater than 2 hypertension medications to achieve adequate blood pressure control.
  • Had a history of coronary angioplasty or bypass graft, or unstable angina pectoris within 1 year of Screening.
  • Had a history of myocardial infarction.
  • Had a history of transient ischemic attack or documented cerebrovascular accident within 6 months of Screening.
  • Abdominal, thoracic, or vascular surgery within 6 months of Screening warranting exclusion (investigator's opinion).
  • Had a screening creatine phosphokinase value greater than 3 times the upper limit of normal.
  • Had persistent unexplained microscopic or macroscopic hematuria or history of bladder cancer.
  • Had a screening triglyceride level greater than 500 mg/dL (5.6 mmol/L).
  • Experienced a change in allowed lipid-lowering medication (dose or drug) within 2 months of Randomization.
  • Experienced a change in blood pressure medication (dose or drug) within 1 month of Randomization.
  • Had systemic corticosteroids within 1 month of Randomization.
  • Had donated or received blood products within 3 months of Randomization.
  • Had a condition known to invalidate glycosylated hemoglobin.
  • Had a history of drug abuse or alcohol abuse within 2 years.
  • Had a significant cardiovascular disease, including New York Heart Association Functional (Cardiac) Classification II, III or IV.
  • Had a Screening B-Type Natriuretic Peptide greater than 100 pg/mL (100 ng/L).
  • Had a history of left ventricular hypertrophy (women greater than 110 g/m2 and men greater than 134 g/m2).
  • Had a clinically significant mitral insufficiency at Screening.
  • Had a clinically significant aortic stenosis at Screening.
  • Had a Screening body mass index greater than 45.
  • Had a history of cancer with no remission within 5 years of Randomization, other than basal cell or stage 1 squamous cell carcinoma of the skin.
  • Had an alanine transaminase or aspartate transaminase level greater than 3 times the upper limit of normal, active liver disease or jaundice at Screening.
  • Had a positive human immunodeficiency virus, hepatitis B surface antigen, or hepatitis B e antigen test at Screening.
  • Was required to take or intended to continue taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfered with the evaluation of the study medication, including:

    • oral antidiabetic agents (including sulfonylureas, alpha-glucosidase inhibitors, thiazolidinediones, peroxisome proliferator-activated receptor agonists and metformin)
    • fibrates
    • systemic corticosteroids
    • warfarin
    • rifampin
    • nicotinic acid
    • minoxidil
    • hydralazine
    • St. John's Wort
  • Was participating or had participated in an investigational study within the past 30 days.
  • Had a serious disease or condition at Screening or Randomization that could affect life expectancy or made it difficult to manage/follow patient according to protocol.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00762190

Sponsors and Collaborators
Takeda
Investigators
Study Director: VP Biological Sciences Takeda
  More Information

No publications provided

Responsible Party: Takeda
ClinicalTrials.gov Identifier: NCT00762190     History of Changes
Other Study ID Numbers: 01-03-TL-559-016, U1111-1128-1034
Study First Received: September 26, 2008
Last Updated: November 8, 2012
Health Authority: United States: Food and Drug Administration

Keywords provided by Takeda:
Glucose Metabolism Disorder
Dysmetabolic Syndrome
Type II Diabetes
Diabetes Mellitus, Lipoatrophic
Dyslipidemia
Drug Therapy

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Insulin
Hypoglycemic Agents
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on July 23, 2014