A Comparison of Atorvastatin and Glimepiride Fixed Dose Combination and Atorvastatin and Glimepiride Loose Combination in the Treatment of Patients With Type 2 Diabetes Mellitus

Tracking Information
First Submitted Date ICMJE	December 15, 2011
First Posted Date ICMJE	December 19, 2011
Last Update Posted Date	November 21, 2016
Study Start Date ICMJE	December 2011
Actual Primary Completion Date	April 2013 (Final data collection date for primary outcome measure)
Current Primary Outcome Measures ICMJE; (submitted: December 15, 2011)	Non inferiority of glimepiride/atorvastatin compared with glimepiride + atorvastatin taken as separate tablets in reducing HbA1c levels [ Time Frame: Week 20 ]Change from baseline; Non inferiority of glimepiride/atorvastatin compared with glimepiride + atorvastatin taken as separate tablets in reducing LDL levels [ Time Frame: Week 20 ]Change from baseline
Original Primary Outcome Measures ICMJE	Same as current
Change History	Complete list of historical versions of study NCT01495013 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures ICMJE	Not Provided
Original Secondary Outcome Measures ICMJE	Not Provided
Current Other Outcome Measures ICMJE	Not Provided
Original Other Outcome Measures ICMJE	Not Provided
Descriptive Information
Brief Title ICMJE	A Comparison of Atorvastatin and Glimepiride Fixed Dose Combination and Atorvastatin and Glimepiride Loose Combination in the Treatment of Patients With Type 2 Diabetes Mellitus
Official Title ICMJE	Study ATG115317, a Comparison of Atorvastatin and Glimepiride Fixed Dose Combination and Atorvastatin and Glimepiride Loose Combination in the Treatment of Patients With Type 2 Diabetes Mellitus
Brief Summary	The aim of this 20 week study is to show that glimepiride/atorvastatin fixed dose combination tablet is safe and as effective as atorvastatin + glimepiride combination taken as separate tablets, in improving glycaemic control (glycated haemoglobin, HbA1c) and cholesterol levels (Low-density lipoprotein, LDL) in diabetic subjects, who are inadequately controlled on a stable dose of metformin. Eight dose combinations will be included.
Detailed Description	Patients diagnosed with Type 2 diabetes (T2D) are initially provided with lifestyle advice in order to manage the condition by diet, exercise and weight reduction, followed by treatment with metformin. However, many patients do not gain adequate control of fasting glucose by these methods and other anti-diabetic agents are needed. Furthermore, these patients have an increased cardiovascular risk compared with the general population. Approximately one half of patients with T2D die prematurely of a cardiovascular cause and approximately 10% die of renal failure. Atherogenic dyslipidemia, which is defined as the triad of elevated triglycerides, low high-density lipoprotein cholesterol (HDL-C), and small low-density lipoprotein cholesterol (LDL-C) particles, is commonly found in individuals with T2D. In diabetic patients, the LDL particles tend to be smaller, denser, and more atherogenic than in the general population. As a result, in patients with diabetes, lowering LDL-C levels may lead to a greater benefit in terms of Cardiovascular disease (CVD) risk reduction than in patients without diabetes. Multiple clinical trials have demonstrated significant benefits of lipid-lowering (primarily statin) therapy on CVD outcomes for primary and secondary prevention, irrespective of baseline lipid levels. Hence, clinical treatment guidelines recommend that patients with T2D should be treated with both an anti-diabetic agent and a statin. Glimepiride is an established once-daily sulphonylurea for use as first-line therapy, and is often used in patients who are metformin intolerant, or in those who are failing to achieve glucose control on metformin monotherapy. Atorvastatin is an established statin that is indicated for reducing the risk of cardiovascular events in diabetic patients, without clinically evident coronary heart disease (CHD), irrespective of whether cholesterol is raised. The risk:benefit of both glimepiride and atorvastatin is well established and described in the approved product labels. There is widespread use of both glimepiride and atorvastatin, prescribed separately, in the T2D population. The available literature indicates that there is no drug-drug interaction risk associated with this combination therapy and no clinical PK interactions between atorvastatin and glimepiride have been recorded. A once-daily combination product which combines both glimepiride and atorvastatin will fulfil an unmet clinical need in simplifying patient treatment regimens in a patient population who have a significant disease burden. Providing concurrent access to a statin in patients with T2D, in addition to medication to manage glucose levels, is a critical requirement for ensuring appropriate management of cardio-metabolic risk. In this study, subjects already on a stable dose of metformin will be randomised to either to receive the glimepiride/atorvastatin fixed dose combination treatment or atorvastatin + glimepiride combination taken as separate tablets. The starting dose for all subjects will be 1mg glimepiride and 10mg atorvastatin. The glimepiride dose will be titrated up if the average fasting glucose is >7.0mmol/L. The atorvastatin dose will be titrated up if LDL is >2.6mmol/L. The purpose of the study is to demonstrate non-inferiority of the glimepiride/atorvastatin fixed dose combination compared with glimepiride +atorvastatin taken as separate tablets in reducing HbA1c and LDL.
Study Type ICMJE	Interventional
Study Phase	Phase 3
Study Design ICMJE	Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: None (Open Label); Primary Purpose: Treatment
Condition ICMJE	Diabetes Mellitus, Type 2
Intervention ICMJE	Drug: 1mg Glimepiride/10mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 2mg Glimepiride/10mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 3mg Glimepiride/10mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 4mg Glimepiride/10mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 1mg Glimepiride/20mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 2mg Glimepiride/20mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 3mg Glimepiride/20mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 4mg Glimepiride/20mg Atorvastatin FDC 1 tablet by mouth once a day; Drug: 1mg Glimepiride 1 tablet of Glimepiride and 1 tablet of Atorvastatin co-administered once daily; Drug: 2mg Glimepiride 1 tablet of Glimepiride and 1 tablet of Atorvastatin co-administered once daily; Drug: 3mg Glimepiride 1 tablet of Glimepiride and 1 tablet of Atorvastatin co-administered once daily; Drug: 4mg Glimepiride 1 tablet of Glimepiride and 1 tablet of Atorvastatin co-administered once daily; Drug: 10mg Atorvastatin 1 tablet of Atorvastatin and 1 tablet of Glimepiride co-administered once daily; Drug: 20mg Atorvastatin 1 tablet of Atorvastatin and 1 tablet of Glimepiride co-administered once daily
Study Arms	Active Comparator: Glimepiride Atorvastatin fixed dose combination All subjects will start on 1mg glimepiride/10 mg atorvastatin fixed dose combination (FDC) and either treatment can be titrated up based on fasting glucose or LDL levels. The following glimepiride/atorvastations FDCs will be available for use 1mg/10mg, 2mg/10mg, 3mg/10mg, 4mg/10mg, 1mg/20mg, 2mg/20mg, 3mg/20mg, 4mg/20mg. Interventions: Drug: 1mg Glimepiride/10mg Atorvastatin FDC Drug: 2mg Glimepiride/10mg Atorvastatin FDC Drug: 3mg Glimepiride/10mg Atorvastatin FDC Drug: 4mg Glimepiride/10mg Atorvastatin FDC Drug: 1mg Glimepiride/20mg Atorvastatin FDC Drug: 2mg Glimepiride/20mg Atorvastatin FDC Drug: 3mg Glimepiride/20mg Atorvastatin FDC Drug: 4mg Glimepiride/20mg Atorvastatin FDC; Active Comparator: Glimepiride +Atrovastatin loose combination All subjects will start on 1mg glimepiride/10 mg atorvastatin loose combination (given as separate tablets) and either treatment can be titrated up based on fasting glucose or LDL levels. Glimepiride single dose tablets are available for 1mg, 2mg, 3mg and 4mg. Atorvastatin single dose tablets are available for 10mg and 20mg. Interventions: Drug: 1mg Glimepiride Drug: 2mg Glimepiride Drug: 3mg Glimepiride Drug: 4mg Glimepiride Drug: 10mg Atorvastatin Drug: 20mg Atorvastatin
Publications *	Not Provided
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status ICMJE	Completed
Actual Enrollment ICMJE; (submitted: January 23, 2014)	427
Original Estimated Enrollment ICMJE; (submitted: December 15, 2011)	424
Actual Study Completion Date	September 2013
Actual Primary Completion Date	April 2013 (Final data collection date for primary outcome measure)
Eligibility Criteria ICMJE	Inclusion Criteria: Adult (≥18 years of age) males and females ( including of child-bearing potential) with Type 2 diabetes mellitus.; Currently treated for Type 2 daibetes mellitus with metformin monotherapy and have been a stable dose of metformin for atleast 3 months; patients with CVD or ≥40 years old with a cardiovascular risk factor, or <40 years old with LDL-C level 100mg/dL; HbA1c levels ≥7.0 and <9.5% at screening or within 3 months prior to study enrollment; Fasting blood glucose >7.0 mmol/L on 4 days in a week; Statin-naïve or no statin use for 2 months prior to screening; Provision of informed consent Exclusion Criteria: Concomitant treatment:; Concomitant treatment with statins other than study medication; Concomitant treatment with fenofibrate or other lipid lowering agents; concomitant treatment with anti-diabetic therapy other than study treatment or change in metformin monotherapy for subjects already treated with metformin; Concurrent diseases and symptoms:; Subjects with Type 1 diabetes or who have a current need for insulin therapy; Subjects with symptomatic hyperglycaemia requiring immediate therapy in the judgement of the investigator; Subjects with myalgia; Significant hypertriglyceridaemia as defined by fasting triglycerides >3.5 mmol/L; Clinically significant ongoing cardiovascular disease:; Subjects who have had an acute cardiovascular event within 30 days prior to randomisation; Subjects with unstable or severe angina, coronary insufficiency or New York Heart Association class III-IV heart failure; subjects with a prior heart transplant or who are awaiting a heart transplant; Subjects with systolic blood pressure >160 mmHg or diastolic blood pressure >90 mmHg while on anti-hypertensive treatment; General Health:; Subjects with end stage renal disease requiring renal replacement therapy; Subjects receiving drug therapy to treat liver disease; Subjects with diagnosis of cancer ( other than superficial squamous. basal cell skin cancer or adequately treated cervical carcinoma in situ) in the past 3 years or who are currently receiving treatment for an active cancer ( other than prophylactic); Subjects with a clinically significant abnormality identified at screening on physical examination or laboratory tests (including thyroid stimulating hormone) which, in the judgement of the investigator, would preclude safe completion of the study; Subjects with anaemia defined by a haemoglobin concentration <10 g/dL (100) g/L) for females and <12 g/dL (120 g/L) for males or a haemoglobinopathy that could interfere with the assessment of HbA1c; Subjects with clinically significant liver disease as defined by alanine aminotransferase ( ALT) or aspartate aminotransferase (AST) levels >2.5 times the upper limit of normal (ULN) or a diagnosis of Chronic active hepatitis including that of viral aetiology, or on antiviral or immunosuppressive therapy; Subjects with contraindications to or history of hypersensitivity to, the investigational products; Subjects who are clinically or medically unstable, with expected survival <1 year; Subjects with a recent history ( within the last 6 months ) or suspicion of current drug abuse or alcohol abuse; Any other factor likely to limit protocol compliance or reporting of adverse events; Previous study participation:; Participation in another clinical trial of an investigational agent, if the subject has used an investigational agent within 30 days or 5 half lives (whichever is longer) preceding the Screening Visit; Previous randomisation in this study Contraception: Females of child-bearing potential who are not using highly effective methods for avoiding pregnancy. Highly effective methods include:; Oral Contraceptive, either combined or progestogen alone; Injectable progestogen; Implants of levonorgestrel; Estrogenic vaginal ring; Percutaneous contraceptive patches; Intrauterine device or intrauterine system with a failure rate of less than 1% per year; Male partner sterilisation (vasectomy with documentation of azoospermia) prior to the female subject's entry into the study, and this male is the sole partner for that subject. For this definition, "documented" refers to the outcome of the investigator's/designee's medical examination of the subject or review of the subject's medical history for study eligibility, as obtained via a verbal interview with the subject or from the subject's medical records; Double barrier method: condom and an occlusive cap(diaphragm or cervical/vault caps) with a vaginal spermicidal agent (foam/gel/film/cream/suppository), including nonoxynol-9
Sex/Gender	Sexes Eligible for Study: All
Ages	18 Years and older (Adult, Senior)
Accepts Healthy Volunteers	No
Contacts ICMJE	Contact information is only displayed when the study is recruiting subjects
Listed Location Countries ICMJE	Korea, Republic of, Malaysia, Mexico, Philippines, Russian Federation, Thailand
Removed Location Countries
Administrative Information
NCT Number ICMJE	NCT01495013
Other Study ID Numbers ICMJE	115317
Has Data Monitoring Committee	No
U.S. FDA-regulated Product	Not Provided
IPD Sharing Statement	Plan to Share IPD: Yes Plan Description: Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.
Responsible Party	GlaxoSmithKline
Study Sponsor ICMJE	GlaxoSmithKline
Collaborators ICMJE	Not Provided
Investigators ICMJE	Study Director: GSK Clinical Trials GlaxoSmithKline
PRS Account	GlaxoSmithKline
Verification Date	November 2016
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP