24-week Study Comparing Lixisenatide (AVE0010) to Sitagliptin as add-on to Metformin in Obese Type 2 Diabetic Patients Younger Than 50

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Sanofi
ClinicalTrials.gov Identifier:
NCT00976937
First received: September 14, 2009
Last updated: May 7, 2012
Last verified: May 2012
  Purpose

The primary objective of this study is to assess the efficacy of lixisenatide (AVE0010) on a composite endpoint of glycemic control (HbA1c) and body weight in comparison to sitagliptin as an add-on treatment to metformin over a period of 24 weeks in obese type 2 diabetic patients younger than 50.

Secondary Objectives:

To assess the effects of AVE0010 on:

  • Absolute changes in HbA1c and body weight
  • Fasting plasma glucose
  • Plasma glucose, insulin, C peptide, glucagon and proinsulin during a 2-hour standardized meal test
  • Insulin resistance assessed by HOMA-IR
  • Beta cell function assessed by HOMA-beta
  • To assess AVE0010 safety and tolerability
  • To assess AVE0010 PK using the population PK approach and to assess anti-AVE0010 antibody development

Condition Intervention Phase
Type 2 Diabetes Mellitus
Drug: Lixisenatide (AVE0010)
Drug: Sitagliptin
Drug: Metformin
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Double-dummy, 2-arm Parallel-group, Multicenter 24-week Study Comparing the Efficacy and Safety of AVE0010 to Sitagliptin as add-on to Metformin in Obese Type 2 Diabetic Patients Younger Than 50 and Not Adequately Controlled With Metformin

Resource links provided by NLM:


Further study details as provided by Sanofi:

Primary Outcome Measures:
  • Percentage of patients with HbA1c values <7% AND a weight loss of at least 5% of baseline body weight [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Absolute change in HbA1c values [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Percentage of patients with HbA1c values < or = 6.5% [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Absolute change in body weight [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Change in fasting plasma glucose [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Change in plasma glucose and in ß-cell function during a test meal [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Change in insulin resistance assessed by HOMA-IR [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Change in ß-cell function assessed by HOMA-ß [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]
  • Percentage of patients requiring rescue therapy during the double-blind treatment period [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]

Enrollment: 319
Study Start Date: August 2009
Study Completion Date: March 2011
Primary Completion Date: March 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Lixisenatide
Injection of lixisenatide once a day in the morning within 1 hour prior to breakfast (first 2 weeks of double-blind period: titration 10 to 15 µg, then 15 to 20 µg) and one capsule of sitagliptin placebo intake in the morning with or without food. On top of metformin background therapy
Drug: Lixisenatide (AVE0010)

Pharmaceutical form:Injection

Route of administration: Subcutaneous

Drug: Metformin
continued at a stable dose throughout the study
Active Comparator: Sitagliptin
One capsule of sitagliptin intake in the morning with or without food and lixisenatide matched placebo injection once a day in the morning within 1 hour prior to breakfast. On top of metformin background therapy.
Drug: Sitagliptin

Pharmaceutical form:capsules

Route of administration: Oral

Drug: Metformin
continued at a stable dose throughout the study

Detailed Description:

Maximum duration of 27 weeks ± 7 days (3-week screening + 24- week double-blind, double-dummy, active-controlled treatment + 3- day follow-up)

  Eligibility

Ages Eligible for Study:   18 Years to 49 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria

  • Patients with type 2 diabetes mellitus, as defined by WHO (25), diagnosed for at least 1 year at the time of screening visit, insufficiently controlled with metformin at a stable dose of at least 1.5 g/day for at least 3 months prior to the screening visit.
  • Patients with obesity (BMI ≥ 30kg/m2) and aged from 18 years to less than 50 years.

Exclusion criteria

  • HbA1c < 7.0% or HbA1c >10% at screening
  • Type 1 diabetes mellitus
  • Pregnancy or lactation
  • Women of childbearing potential with no effective contraceptive method
  • Fasting Plasma Glucose at screening > 250 mg/dL (> 13.9 mmol/L)
  • Weight change of more than 5 kg during the 3 months preceding the screening visit
  • History of unexplained pancreatitis, chronic pancreatitis, pancreatectomy, stomach/gastric surgery, inflammatory bowel disease, personal or family history of medullary thyroid cancer (MTC) or genetic conditions that predispose to MTC (e.g. multiple endocrine neoplasia syndromes),
  • History of metabolic acidosis, including diabetic ketoacidosis within 1 year prior to screening
  • Hemoglobinopathy or hemolytic anemia or receipt of blood or plasma products within 3 months prior to the time of screening
  • Within the last 6 months prior to screening: history of myocardial infarction, stroke, or heart failure requiring hospitalization
  • Known history of drug or alcohol abuse within 6 months prior to the time of screening
  • Any clinically significant abnormality identified on physical examination, laboratory tests, ECG or vital signs at the time of screening that in the judgment of the investigator or any sub investigator would preclude safe completion of the study or constrains efficacy assessment such as major systemic diseases, presence of clinically significant diabetic retinopathy or presence of macular edema likely to require laser treatment within the study period.
  • Uncontrolled or inadequately controlled hypertension at the time of screening with a resting systolic or diastolic blood pressure > 180 mmHg or > 110 mmHg, respectively
  • Laboratory findings at the time of screening:

    • Amylase and/or lipase > 3 times the upper limit of the normal laboratory range
    • Total bilirubin: > 1.5 times the upper limit of the normal laboratory range (except in case of Gilbert's syndrome)
    • Hemoglobin < 11 g/dL and/or neutrophils < 1,500/mm3 and/or platelets < 100,000/mm3
    • Positive test for Hepatitis B surface antigen and/or Hepatitis C antibody
    • Positive serum pregnancy test in females of childbearing potential
    • Calcitonin ≥ 20 pg/mL (5.9 pml/L)
  • Use of other oral or injectable antidiabetic or hypoglycemic agents than metformin (e.g., sulfonylurea, alpha glucosidase inhibitor, thiazolidinedione, exenatide, DPP-IV inhibitors, insulin etc.) within 3 months prior to the time of screening
  • Unstable diet or unstable anti-obesity treatment within 3 months prior to the time of screening
  • Use of systemic glucocorticoids (excluding topical application or inhaled forms) for one week or more within 3 months prior to the time of screening
  • Use of any investigational drug within 3 months prior to screening Clinically relevant history of gastrointestinal disease associated with prolonged nausea and vomiting, including, but not limited to gastroparesis and gastroesophageal reflux disease requiring medical treatment, within 6 months prior to the time of screening
  • Any previous treatment with AVE0010 (e.g. participation in a previous study with AVE0010)
  • Allergic reaction to any GLP 1-agonist in the past (e.g. exenatide, liraglutide) or to metacresol
  • History of a serious hypersensitivity reaction to sitagliptin.
  • Moderate or severe renal impairment (creatinine clearance inferior to 50 ml/mn)

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00976937

  Show 98 Study Locations
Sponsors and Collaborators
Sanofi
Investigators
Study Director: Clinical Sciences & Operations Sanofi
  More Information

No publications provided

Responsible Party: Sanofi
ClinicalTrials.gov Identifier: NCT00976937     History of Changes
Other Study ID Numbers: EFC10780, EudraCT:2008-007 334-22
Study First Received: September 14, 2009
Last Updated: May 7, 2012
Health Authority: United States: Food and Drug Administration

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Sitagliptin
Metformin
Hypoglycemic Agents
Physiological Effects of Drugs
Pharmacologic Actions
Dipeptidyl-Peptidase IV Inhibitors
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on May 19, 2013