A Safety and Efficacy Study of Canagliflozin in Older Patients (55 to 80 Years of Age) With Type 2 Diabetes Mellitus

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Janssen Research & Development, LLC
ClinicalTrials.gov Identifier:
NCT01106651
First received: April 1, 2010
Last updated: September 24, 2013
Last verified: September 2013
Results First Received: April 1, 2013  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Safety/Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Double Blind (Subject, Caregiver, Investigator);   Primary Purpose: Treatment
Condition: Diabetes Mellitus, Type 2
Interventions: Drug: Canagliflozin 100 mg
Drug: Canagliflozin 300 mg
Drug: Antihyperglycemic agent(s)
Drug: Placebo

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
This study evaluated the efficacy and safety of canagliflozin in older patients with type 2 diabetes mellitus with inadequate control on their current diabetes treatment regimen. The study began on 07 June 2010 and ended on 23 May 2013. Patients were recruited from 90 study centers located in 17 countries worldwide.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
716 patients were randomly allocated to the 3 treatment arms. 714 patients received at least 1 dose of study drug and were included in the modified intent-to-treat (mITT) analysis set and safety analysis set. Participant flow is presented for Baseline to Week 26 but termed "Overall Study"; Week 104 data will be presented when available.

Reporting Groups
  Description
Placebo: Baseline to Week 26 Each patient received matching placebo once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry. Data are presented for Baseline to Week 26.
Canagliflozin 100 mg: Baseline to Week 26 Each patient received 100 mg of canagliflozin once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry. Data are presented for Baseline to Week 26.
Canagliflozin 300 mg: Baseline to Week 26 Each patient received 300 mg of canagliflozin once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry. Data are presented for Baseline to Week 26.

Participant Flow:   Overall Study
    Placebo: Baseline to Week 26     Canagliflozin 100 mg: Baseline to Week 26     Canagliflozin 300 mg: Baseline to Week 26  
STARTED     237     241     236  
COMPLETED     197     226     209  
NOT COMPLETED     40     15     27  
Adverse Event                 8                 4                 10  
Lost to Follow-up                 3                 0                 4  
Physician Decision                 1                 0                 0  
Protocol Violation                 1                 2                 1  
Withdrawal by Subject                 11                 2                 6  
Noncompliance with study drug                 1                 0                 0  
Not specified                 15                 7                 6  



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
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Reporting Groups
  Description
Placebo Each patient received matching placebo once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry.
Canagliflozin 100 mg Each patient received 100 mg of canagliflozin once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry.
Canagliflozin 300 mg Each patient received 300 mg of canagliflozin once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry.
Total Total of all reporting groups

Baseline Measures
    Placebo     Canagliflozin 100 mg     Canagliflozin 300 mg     Total  
Number of Participants  
[units: participants]
  237     241     236     714  
Age  
[units: participants]
       
<=18 years     0     0     0     0  
Between 18 and 65 years     151     141     149     441  
>=65 years     86     100     87     273  
Age  
[units: years]
Mean ± Standard Deviation
  63.2  ± 6.21     64.3  ± 6.46     63.4  ± 5.99     63.6  ± 6.24  
Gender  
[units: participants]
       
Female     94     117     107     318  
Male     143     124     129     396  
Region of Enrollment  
[units: participants]
       
AUSTRALIA     6     6     11     23  
CANADA     24     32     28     84  
COLOMBIA     18     15     20     53  
FRANCE     2     2     3     7  
GREECE     1     1     1     3  
HONG KONG     1     1     2     4  
INDIA     8     3     11     22  
NEW ZEALAND     16     10     11     37  
POLAND     11     12     14     37  
ROMANIA     8     10     7     25  
SOUTH AFRICA     9     12     10     31  
SPAIN     2     3     8     13  
SWEDEN     4     4     2     10  
SWITZERLAND     2     2     0     4  
UKRAINE     3     8     3     14  
UNITED KINGDOM     19     22     8     49  
UNITED STATES     103     98     97     298  



  Outcome Measures
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1.  Primary:   Change in HbA1c From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

2.  Secondary:   Percentage of Patients With HbA1c <7% at Week 26   [ Time Frame: Week 26 ]

3.  Secondary:   Change in Fasting Plasma Glucose (FPG) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

4.  Secondary:   Percent Change in Body Weight From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

5.  Secondary:   Change in Total Fat From Baseline to Week 26 in a Subset of Patients Undergoing Specific Dual-energy X-ray Absorptiometry (DXA) Analysis for Body Composition   [ Time Frame: Day 1 (Baseline) and Week 26 ]

6.  Secondary:   Change in Region Percent Total Fat From Baseline to Week 26 in a Subset of Patients Undergoing Specific Dual-energy X-ray Absorptiometry (DXA) Analysis for Body Composition   [ Time Frame: Day 1 (Baseline) and Week 26 ]

7.  Secondary:   Change in Tissue Percent Total Fat From Baseline to Week 26 in a Subset of Patients Undergoing Specific Dual-energy X-ray Absorptiometry (DXA) Analysis for Body Composition   [ Time Frame: Day 1 (Baseline) and Week 26 ]

8.  Secondary:   Change in Systolic Blood Pressure (SBP) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

9.  Secondary:   Percent Change in Triglycerides From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

10.  Secondary:   Percent Change in High-density Lipoprotein Cholesterol (HDL-C) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

11.  Secondary:   Percent Change in Lumbar Spine Bone Mineral Density (BMD) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

12.  Secondary:   Percent Change in Distal Forearm Bone Mineral Density (BMD) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

13.  Secondary:   Percent Change in Femoral Neck Bone Mineral Density (BMD) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]

14.  Secondary:   Percent Change in Total Hip Bone Mineral Density (BMD) From Baseline to Week 26   [ Time Frame: Day 1 (Baseline) and Week 26 ]


  Serious Adverse Events
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Time Frame Adverse event data was collected for the duration of the study (104 weeks). Data currently reported are for the core period of the study (26 weeks); extension period data (104 weeks) will be reported after they become available.
Additional Description The total number of adverse events listed in the "Other (non-Serious) Adverse Event" table are based upon a cut-off of greater than or equal to 5 percent of patients experiencing the adverse event in any treatment arm.

Reporting Groups
  Description
Placebo: Baseline to Week 26 Each patient received matching placebo once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry. Data are presented for Baseline to Week 26.
Canagliflozin 100 mg: Baseline to Week 26 Each patient received 100 mg of canagliflozin once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry. Data are presented for Baseline to Week 26.
Canagliflozin 300 mg: Baseline to Week 26 Each patient received 300 mg of canagliflozin once daily for 104 weeks with/without stable doses of antihyperglycemic agent(s) taken at the time of study entry. Data are presented for Baseline to Week 26.

Serious Adverse Events
    Placebo: Baseline to Week 26     Canagliflozin 100 mg: Baseline to Week 26     Canagliflozin 300 mg: Baseline to Week 26  
Total, serious adverse events        
# participants affected / at risk     12/237 (5.06%)     10/241 (4.15%)     8/236 (3.39%)  
Cardiac disorders        
Angina pectoris * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Atrial fibrillation * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Bradycardia * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     1/236 (0.42%)  
Cardiac failure congestive * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     1/236 (0.42%)  
Coronary artery disease * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Myocardial infarction * 1      
# participants affected / at risk     2/237 (0.84%)     0/241 (0.00%)     1/236 (0.42%)  
Myocarditis * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Eye disorders        
Diplopia * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Gastrointestinal disorders        
Haematochezia * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     1/236 (0.42%)  
Intestinal infarction * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Umbilical hernia, obstructive * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Infections and infestations        
Pneumonia * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     2/236 (0.85%)  
Urinary tract infection * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Urosepsis * 1      
# participants affected / at risk     2/237 (0.84%)     0/241 (0.00%)     0/236 (0.00%)  
Injury, poisoning and procedural complications        
Ankle fracture * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Cervical vertebral fracture * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Metabolism and nutrition disorders        
Hypoglycaemia * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Musculoskeletal and connective tissue disorders        
Osteoarthritis * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Neoplasms benign, malignant and unspecified (incl cysts and polyps)        
Bronchioloalveolar carcinoma * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     1/236 (0.42%)  
Metastases to central nervous system * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     1/236 (0.42%)  
Prostate cancer * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Squamous cell carcinoma * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Nervous system disorders        
Carotid artery stenosis * 1      
# participants affected / at risk     0/237 (0.00%)     0/241 (0.00%)     1/236 (0.42%)  
Cerebrovascular accident * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Presyncope * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Psychiatric disorders        
Post-traumatic stress disorder * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Renal and urinary disorders        
Renal colic * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     0/236 (0.00%)  
Renal impairment * 1      
# participants affected / at risk     1/237 (0.42%)     0/241 (0.00%)     1/236 (0.42%)  
Respiratory, thoracic and mediastinal disorders        
Chronic obstructive pulmonary disease * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
Respiratory failure * 1      
# participants affected / at risk     0/237 (0.00%)     1/241 (0.41%)     0/236 (0.00%)  
* Events were collected by non-systematic assessment
1 Term from vocabulary, MEDDRA 14.0




  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
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