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Efficacy and Safety of BI 1356 BS (Linagliptin) in Combination With Metformin in Patients With type2 Diabetes

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00309608
Recruitment Status : Completed
First Posted : April 3, 2006
Results First Posted : June 15, 2011
Last Update Posted : July 8, 2014
Sponsor:
Information provided by:
Boehringer Ingelheim

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Double;   Primary Purpose: Treatment
Condition Diabetes Mellitus, Type 2
Interventions Drug: Linagliptin
Drug: Placebo
Drug: Glimepiride
Enrollment 333
Recruitment Details  
Pre-assignment Details  
Arm/Group Title Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Hide Arm/Group Description Patients randomized to receive treatment with matching placebo Patients randomized to receive treatment with Linagliptin 1 mg Patients randomized to receive treatment with Linagliptin 5 mg Patients randomized to receive treatment with Linagliptin 10 mg Patients randomized to receive treatment with Glimepiride
Period Title: Overall Study
Started 71 65 66 66 65
Completed 57 52 56 60 61
Not Completed 14 13 10 6 4
Reason Not Completed
Adverse Event             1             5             3             2             3
Protocol Violation             2             0             0             0             0
Lost to Follow-up             0             0             2             0             1
Withdrawal by Subject             1             4             2             0             0
Other incl. Lack of efficacy             10             4             3             4             0
Arm/Group Title Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride Total
Hide Arm/Group Description Patients randomized to receive treatment with matching placebo Patients randomized to receive treatment with Linagliptin 1 mg Patients randomized to receive treatment with Linagliptin 5 mg Patients randomized to receive treatment with Linagliptin 10 mg Patients randomized to receive treatment with Glimepiride Total of all reporting groups
Overall Number of Baseline Participants 71 65 66 66 65 333
Hide Baseline Analysis Population Description
[Not Specified]
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 71 participants 65 participants 66 participants 66 participants 65 participants 333 participants
60.1  (8.1) 59.2  (8.4) 59.6  (9.8) 61.8  (8.8) 59.4  (9.9) 60.0  (9.0)
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 71 participants 65 participants 66 participants 66 participants 65 participants 333 participants
Female
27
  38.0%
29
  44.6%
29
  43.9%
31
  47.0%
24
  36.9%
140
  42.0%
Male
44
  62.0%
36
  55.4%
37
  56.1%
35
  53.0%
41
  63.1%
193
  58.0%
Body Mass Index (BMI) continuous  
Mean (Standard Deviation)
Unit of measure:  Kg/m^2
Number Analyzed 71 participants 65 participants 66 participants 66 participants 65 participants 333 participants
32.2  (4.2) 32.3  (4.3) 31.7  (4.5) 31.7  (4.5) 31.5  (4.2) 31.9  (4.3)
Glycosylated Hemoglobin A1 (HbA1C) continuous  
Mean (Standard Deviation)
Unit of measure:  Percent
Number Analyzed 71 participants 65 participants 66 participants 66 participants 65 participants 333 participants
8.37  (0.74) 8.24  (0.74) 8.46  (0.85) 8.35  (0.73) 8.22  (0.70) 8.33  (0.75)
Fasting plasma glucose (FPG) continuous  
Mean (Standard Deviation)
Unit of measure:  mg/dL
Number Analyzed 71 participants 65 participants 66 participants 66 participants 65 participants 333 participants
185.5  (38.8) 182.3  (42.0) 189.3  (42.4) 188.7  (42.4) 179.9  (40.4) 185.1  (41.0)
1.Primary Outcome
Title HbA1c Change From Baseline at Week 12
Hide Description HbA1c is measured as a percentage. Thus, this change from baseline reflects the Week 12 HbA1c percent minus the HbA1c percent baseline value. Means are treatment adjusted for baseline HbA1c.
Time Frame Baseline and week 12
Hide Outcome Measure Data
Hide Analysis Population Description
The Full Analysis Set (FAS) included all treated and randomised patients with a baseline and at least one on-treatment HbA1c measurement available. Last observation carried forward (LOCF) was used as the imputation rule.
Arm/Group Title Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Hide Arm/Group Description:
Patients randomized to receive treatment with matching placebo
Patients randomized to receive treatment with Linagliptin 1 mg
Patients randomized to receive treatment with Linagliptin 5 mg
Patients randomized to receive treatment with Linagliptin 10 mg
Patients randomized to receive treatment with Glimepiride
Overall Number of Participants Analyzed 70 64 62 66 64
Mean (Standard Error)
Unit of Measure: Percent
0.25  (0.10) -0.15  (0.10) -0.48  (0.11) -0.42  (0.10) -0.59  (0.10)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 10 mg
Comments

Linagliptin 10 mg vs. Placebo

Missing endpoints after 12 weeks of treatment were replaced using "Last Observation Carried Forward" (LOCF)

Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <0.0001
Comments There was no adjustment for multiple testing, however a hierarchy approach to control for the Type-I error was used. If the 10mg was not successful, any analysis of the 5mg will be descriptive, and similarly for the next step for the 1mg.
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.67
Confidence Interval 95%
-0.95 to -0.39
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.14
Estimation Comments [Not Specified]
Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 5 mg
Comments

Linagliptin 5 mg vs. Placebo

missing endpoints after 12 weeks of treatment were replaced using "Last Observation Carried Forward" (LOCF)

Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <0.0001
Comments There was no adjustment for multiple testing, however a hierarchy approach to control for the Type-I error was used. If the 10mg was not successful, any analysis of the 5mg will be descriptive, and similarly for the next step for the 1mg.
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.73
Confidence Interval 95%
-1.01 to -0.44
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.14
Estimation Comments [Not Specified]
Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 1 mg
Comments

Linagliptin 1 mg vs. Placebo

Missing endpoints after 12 weeks of treatment were replaced using "Last Observation Carried Forward" (LOCF)

Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0055
Comments There was no adjustment for multiple testing, however a hierarchy approach to control for the Type-I error was used. If the 10mg was not successful, any analysis of the 5mg will be descriptive, and similarly for the next step for the 1mg.
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.4
Confidence Interval 95%
-0.68 to -0.12
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.14
Estimation Comments [Not Specified]
Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 10 mg
Comments

Placebo vs. Linagliptin 10 mg

Analysis additionally adjusted for previous anti-diabetic medication.

Missing endpoints after 12 weeks of treatment were replaced using Last Observation Carried Forward (LOCF).

Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <0.0001
Comments [Not Specified]
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.73
Confidence Interval 95%
-0.99 to -0.46
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.14
Estimation Comments [Not Specified]
Hide Statistical Analysis 5
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 5 mg
Comments

Linagliptin 5 mg vs. Placebo

Analysis additionally adjusted for previous anti-diabetic medication.

Missing endpoints after 12 weeks of treatment were replaced using "last observation carried forward" (LOCF).

Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <0.0001
Comments [Not Specified]
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.75
Confidence Interval 95%
-1.02 to -0.48
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.14
Estimation Comments [Not Specified]
Hide Statistical Analysis 6
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 1 mg
Comments

Linagliptin 1 mg vs. Placebo

Analysis additionally adjusted for previous anti-diabetic medication.

Missing endpoints after 12 weeks of treatment were replaced using "last observation carried forward" (LOCF).

Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0049
Comments [Not Specified]
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.39
Confidence Interval 95%
-0.66 to -0.12
Parameter Dispersion
Type: Standard Error of the mean
Value: 0.14
Estimation Comments [Not Specified]
2.Secondary Outcome
Title Percentage of Patients With HbA1c<=7.0% at Week 12
Hide Description Descriptive calculation of Patients with HbA1c <= 7.0% at Week 12.
Time Frame week 12
Hide Outcome Measure Data
Hide Analysis Population Description
This population includes the Full Analysis Set (FAS). Last observation carried forward (LOCF) was used as the imputation rule.
Arm/Group Title Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Hide Arm/Group Description:
Patients randomized to receive treatment with matching placebo
Patients randomized to receive treatment with Linagliptin 1 mg
Patients randomized to receive treatment with Linagliptin 5 mg
Patients randomized to receive treatment with Linagliptin 10 mg
Patients randomized to receive treatment with Glimepiride
Overall Number of Participants Analyzed 70 64 62 66 64
Measure Type: Number
Unit of Measure: Percentage of Patients
1.4 15.6 14.5 21.2 31.3
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 10 mg
Comments Linagliptin 10 mg vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0054
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 18.575
Confidence Interval (2-Sided) 95%
2.367 to 145.781
Estimation Comments [Not Specified]
Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 5 mg
Comments Linagliptin 5 mg vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0214
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 11.715
Confidence Interval (2-Sided) 95%
1.439 to 95.351
Estimation Comments [Not Specified]
Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 1 mg
Comments Linagliptin 1 mg vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0167
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 12.776
Confidence Interval (2-Sided) 95%
1.586 to 102.895
Estimation Comments [Not Specified]
Hide Statistical Analysis 4
Statistical Analysis Overview Comparison Group Selection Placebo, Glimepiride
Comments Glimepiride vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0010
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 31.360
Confidence Interval (2-Sided) 95%
4.063 to 242.028
Estimation Comments [Not Specified]
3.Secondary Outcome
Title Fasting Blood Plasma Glucose Level (FPG) Change From Baseline at Week 12
Hide Description This change from baseline reflects the Week 12 FPG minus the baseline FPG. Means are treatment adjusted for baseline HbA1c, baseline FPG and previous anti-diabetic medication.
Time Frame Baseline and week 12
Hide Outcome Measure Data
Hide Analysis Population Description
This population includes the FAS using the LOCF imputation, with the further restriction of patients with a baseline and post-baseline FPG value.
Arm/Group Title Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg
Hide Arm/Group Description:
Patients randomized to receive treatment with matching placebo
Patients randomized to receive treatment with Linagliptin 1 mg
Patients randomized to receive treatment with Linagliptin 5 mg
Patients randomized to receive treatment with Linagliptin 10 mg
Overall Number of Participants Analyzed 68 63 62 66
Mean (Standard Error)
Unit of Measure: mg/dL
13.63  (4.30) -5.32  (4.51) -21.29  (4.48) -15.87  (4.33)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 10 mg
Comments Linagliptin 10mg vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <0.0001
Comments [Not Specified]
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -29.5
Confidence Interval 95%
-41.4 to -17.5
Parameter Dispersion
Type: Standard Error of the mean
Value: 6.07
Estimation Comments [Not Specified]
Hide Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 5 mg
Comments Linagliptin 5mg vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value <0.0001
Comments [Not Specified]
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -34.92
Confidence Interval 95%
-47.0 to -22.8
Parameter Dispersion
Type: Standard Error of the mean
Value: 6.16
Estimation Comments [Not Specified]
Hide Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection Placebo, Linagliptin 1 mg
Comments Linagliptin 1 mg vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0022
Comments [Not Specified]
Method Pairwise comparison based on ANCOVA
Comments [Not Specified]
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -18.95
Confidence Interval 95%
-31.0 to -6.87
Parameter Dispersion
Type: Standard Error of the mean
Value: 6.13
Estimation Comments [Not Specified]
Time Frame 12 Weeks + 30 Days
Adverse Event Reporting Description MedDRA version 10.0 was used for reporting.
 
Arm/Group Title Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Hide Arm/Group Description Patients randomized to receive treatment with matching placebo Patients randomized to receive treatment with Linagliptin 1 mg Patients randomized to receive treatment with Linagliptin 5 mg Patients randomized to receive treatment with Linagliptin 10 mg Patients randomized to receive treatment with Glimepiride
All-Cause Mortality
Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   --/--   --/--   --/--   --/--   --/-- 
Hide Serious Adverse Events
Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   1/71 (1.41%)   3/65 (4.62%)   1/66 (1.52%)   4/66 (6.06%)   1/65 (1.54%) 
Cardiac disorders           
Angina pectoris  0/71 (0.00%)  0/65 (0.00%)  1/66 (1.52%)  0/66 (0.00%)  1/65 (1.54%) 
Coronary artery disease  0/71 (0.00%)  1/65 (1.54%)  0/66 (0.00%)  0/66 (0.00%)  0/65 (0.00%) 
Myocardial infarction  0/71 (0.00%)  1/65 (1.54%)  0/66 (0.00%)  0/66 (0.00%)  0/65 (0.00%) 
Endocrine disorders           
Goitre  0/71 (0.00%)  0/65 (0.00%)  0/66 (0.00%)  1/66 (1.52%)  0/65 (0.00%) 
General disorders           
Chest pain  0/71 (0.00%)  0/65 (0.00%)  0/66 (0.00%)  1/66 (1.52%)  0/65 (0.00%) 
Musculoskeletal and connective tissue disorders           
Flank pain  1/71 (1.41%)  0/65 (0.00%)  0/66 (0.00%)  0/66 (0.00%)  0/65 (0.00%) 
Nervous system disorders           
Hemiparesis  0/71 (0.00%)  0/65 (0.00%)  0/66 (0.00%)  1/66 (1.52%)  0/65 (0.00%) 
Psychiatric disorders           
Confusional state  0/71 (0.00%)  0/65 (0.00%)  0/66 (0.00%)  1/66 (1.52%)  0/65 (0.00%) 
Renal and urinary disorders           
Nephrolithiasis  0/71 (0.00%)  1/65 (1.54%)  0/66 (0.00%)  0/66 (0.00%)  0/65 (0.00%) 
Renal mass  0/71 (0.00%)  0/65 (0.00%)  0/66 (0.00%)  1/66 (1.52%)  0/65 (0.00%) 
Urinary tract obstruction  0/71 (0.00%)  1/65 (1.54%)  0/66 (0.00%)  0/66 (0.00%)  0/65 (0.00%) 
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
Placebo Linagliptin 1 mg Linagliptin 5 mg Linagliptin 10 mg Glimepiride
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   10/71 (14.08%)   4/65 (6.15%)   8/66 (12.12%)   8/66 (12.12%)   4/65 (6.15%) 
Gastrointestinal disorders           
Nausea   3/71 (4.23%)  0/65 (0.00%)  4/66 (6.06%)  3/66 (4.55%)  0/65 (0.00%) 
Infections and infestations           
Nasopharyngitis   7/71 (9.86%)  4/65 (6.15%)  5/66 (7.58%)  5/66 (7.58%)  4/65 (6.15%) 
Indicates events were collected by systematic assessment
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Any publication of the result of this trial must be consistent with the Boehringer Ingelheim publication policy. The rights of the investigator and of the sponsor with regard to publication of the results of this trial are described in the investigator contract.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Boehringer Ingelheim Call Center
Organization: Boehringer Ingelheim Pharmaceuticals
Phone: 1-800-243-0127
EMail: clintriage.rdg@boehringer-ingelheim.com
Layout table for additonal information
Responsible Party: Boehringer Ingelheim, Study Chair, Boehringer Ingelheim
ClinicalTrials.gov Identifier: NCT00309608    
Other Study ID Numbers: 1218.6
2005-004597-24 ( EudraCT Number: EudraCT )
First Submitted: March 31, 2006
First Posted: April 3, 2006
Results First Submitted: May 13, 2011
Results First Posted: June 15, 2011
Last Update Posted: July 8, 2014