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Linagliptin Versus Placebo in Type 2 Diabetic Patients With Inadequate Glycaemic Control on Metformin in Combination With Pioglitazone

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: NCT00996658
Recruitment Status : Completed
First Posted : October 16, 2009
Results First Posted : March 26, 2013
Last Update Posted : March 26, 2014
Sponsor:
Collaborator:
Eli Lilly and Company
Information provided by (Responsible Party):
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: Placebo
Drug: Linagliptin
Enrollment 278
Recruitment Details  
Pre-assignment Details  
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description Placebo matching linagliptin 5 mg tablet Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Period Title: Overall Study
Started 92 186
Completed 76 165
Not Completed 16 21
Reason Not Completed
Adverse Event             2             5
Protocol Violation             0             1
Lost to Follow-up             2             5
Non-compliance issues             3             3
Other             9             7
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet Total
Hide Arm/Group Description [Not Specified] [Not Specified] Total of all reporting groups
Overall Number of Baseline Participants 89 183 272
Hide Baseline Analysis Population Description
Six participants (three participants per treatment) were excluded from all analyses due to serious site non-compliance. Thus, the total participants in Baseline Measures (272) is six less than total in Participant Flow (278).
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 89 participants 183 participants 272 participants
55.2  (8.4) 53.1  (9.7) 53.8  (9.3)
Age, Customized  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 89 participants 183 participants 272 participants
< 65 years 79 162 241
65 to 74 years 8 20 28
>= 75 years 2 1 3
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 89 participants 183 participants 272 participants
Female
40
  44.9%
100
  54.6%
140
  51.5%
Male
49
  55.1%
83
  45.4%
132
  48.5%
Weight  
Mean (Standard Deviation)
Unit of measure:  Kilograms
Number Analyzed 89 participants 183 participants 272 participants
74.4  (19.8) 74.4  (20.4) 74.4  (20.2)
Weight categories  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 89 participants 183 participants 272 participants
<= 70 kilograms 46 97 143
> 70 to 80 kilograms 17 32 49
> 80 to 90 kilograms 10 18 28
> 90 kilograms 16 36 52
Body Mass Index (BMI)  
Mean (Standard Deviation)
Unit of measure:  Kilograms per square meter
Number Analyzed 89 participants 183 participants 272 participants
28.1  (5.5) 28.2  (5.2) 28.2  (5.3)
Body Mass Index (BMI) categories  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 89 participants 183 participants 272 participants
< 25 kilograms/square meter 29 51 80
>= 25 and < 30 kilograms/square meter 38 76 114
>= 30 kilograms/square meter 22 56 78
Height  
Mean (Standard Deviation)
Unit of measure:  Centimeters
Number Analyzed 89 participants 183 participants 272 participants
162.0  (11.0) 161.4  (11.4) 161.6  (11.2)
Waist circumference  
Mean (Standard Deviation)
Unit of measure:  Centimeters
Number Analyzed 89 participants 183 participants 272 participants
97.7  (13.5) 98.1  (13.1) 98.0  (13.2)
Smoking status  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 89 participants 183 participants 272 participants
Never smoked 75 151 226
Ex-smoker 12 16 28
Currently smokes 2 16 18
Alcohol status  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 89 participants 183 participants 272 participants
Non drinker 79 156 235
Drinks - no interference with study 10 27 37
Drinks - investigator opinion/interfere with study 0 0 0
1.Primary Outcome
Title Change From Baseline in HbA1c (Glycosylated Hemoglobin) After 24 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame baseline, 24 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline HbA1c value and an on-treatment HbA1c value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 89 179
Least Squares Mean (Standard Error)
Unit of Measure: Percentage
-0.27  (0.13) -0.84  (0.11)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value < 0.0001
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.57
Confidence Interval 95%
-0.83 to -0.31
Estimation Comments [Not Specified]
2.Secondary Outcome
Title Change From Baseline in HbA1c (Glycosylated Hemoglobin) After 6 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame baseline, 6 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline HbA1c value and an on-treatment HbA1c value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 89 179
Least Squares Mean (Standard Error)
Unit of Measure: Percentage
-0.19  (0.11) -0.60  (0.09)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value < 0.0001
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.41
Confidence Interval 95%
-0.61 to -0.21
Estimation Comments [Not Specified]
3.Secondary Outcome
Title Change From Baseline in HbA1c (Glycosylated Hemoglobin) After 12 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame baseline, 12 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline HbA1c value and an on-treatment HbA1c value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 89 179
Least Squares Mean (Standard Error)
Unit of Measure: Percentage
-0.28  (0.12) -0.82  (0.10)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value < 0.0001
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.54
Confidence Interval 95%
-0.79 to -0.28
Estimation Comments [Not Specified]
4.Secondary Outcome
Title Change From Baseline in HbA1c (Glycosylated Hemoglobin) After 18 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame baseline, 18 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline HbA1c value and an on-treatment HbA1c value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 89 179
Least Squares Mean (Standard Error)
Unit of Measure: Percentage
-0.37  (0.12) -0.91  (0.10)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value < 0.0001
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -0.54
Confidence Interval 95%
-0.80 to -0.29
Estimation Comments [Not Specified]
5.Secondary Outcome
Title Occurrence of Absolute Efficacy Response (HbA1c < 7%) After 24 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame 24 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had HbA1c >=7.0% at baseline (NCF). Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 87 176
Measure Type: Number
Unit of Measure: Participants
Responder (HbA1c < 7.0%) 12 57
Non-responder (HbA1c >= 7.0%) 75 118
Missing 0 1
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments Linagliptin vs Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0033
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 2.939
Confidence Interval (2-Sided) 95%
1.432 to 6.032
Estimation Comments [Not Specified]
6.Secondary Outcome
Title Occurrence of Absolute Efficacy Response (HbA1c < 6.5%) After 24 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame 24 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had HbA1c >=6.5% at baseline (NCF). Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 89 178
Measure Type: Number
Unit of Measure: Participants
Responder (HbA1c < 6.5%) 5 34
Non-responder (HbA1c >= 6.5%) 84 143
Missing 0 1
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments Linagliptin vs Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0074
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 3.902
Confidence Interval (2-Sided) 95%
1.440 to 10.572
Estimation Comments [Not Specified]
7.Secondary Outcome
Title Occurrence of Relative Efficacy Response (Reduction in HbA1c >= 0.5%) After 24 Weeks
Hide Description Glycosylated hemoglobin is reported as a percentage of the total hemoglobin
Time Frame 24 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 89 179
Measure Type: Number
Unit of Measure: Participants
Responder (reduction in HbA1c >= 0.5%) 44 117
Non-responder (reduction in HbA1c < 0.5%) 45 61
Missing 0 1
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments Linagliptin vs. Placebo
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0071
Comments [Not Specified]
Method Regression, Logistic
Comments [Not Specified]
Method of Estimation Estimation Parameter Odds Ratio (OR)
Estimated Value 2.059
Confidence Interval (2-Sided) 95%
1.216 to 3.485
Estimation Comments [Not Specified]
8.Secondary Outcome
Title Change From Baseline in Fasting Plasma Glucose (FPG) After 24 Weeks
Hide Description Adjusted mean change in fasting plasma glucose (FPG) from baseline at week 24
Time Frame baseline, 24 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline FPG value and an on-treatment FPG value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 86 175
Least Squares Mean (Standard Error)
Unit of Measure: mg/dL (milligrams per deciliter)
0.1  (3.8) -10.3  (2.7)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0280
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c, baseline FPG, and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -10.4
Confidence Interval 95%
-19.6 to -1.1
Estimation Comments [Not Specified]
9.Secondary Outcome
Title Change From Baseline in Fasting Plasma Glucose (FPG) After 6 Weeks
Hide Description Adjusted mean change in fasting plasma glucose (FPG) from baseline at week 6
Time Frame baseline, 6 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline FPG value and an on-treatment FPG value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 86 175
Least Squares Mean (Standard Error)
Unit of Measure: mg/dL (milligrams per deciliter)
12.4  (5.4) -3.3  (4.6)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0006
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c, baseline FPG, and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -15.7
Confidence Interval 95%
-24.5 to -6.8
Estimation Comments [Not Specified]
10.Secondary Outcome
Title Change From Baseline in Fasting Plasma Glucose (FPG) After 12 Weeks
Hide Description Adjusted mean change in fasting plasma glucose (FPG) from baseline at week 12
Time Frame baseline, 12 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline FPG value and an on-treatment FPG value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 86 175
Least Squares Mean (Standard Error)
Unit of Measure: mg/dL (milligrams per deciliter)
3.8  (4.6) -7.1  (3.6)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.0210
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c, baseline FPG, and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -10.9
Confidence Interval 95%
-20.2 to -1.7
Estimation Comments [Not Specified]
11.Secondary Outcome
Title Change From Baseline in Fasting Plasma Glucose (FPG) After 18 Weeks
Hide Description Adjusted mean change in fasting plasma glucose (FPG) from baseline at week 18
Time Frame baseline, 18 weeks
Hide Outcome Measure Data
Hide Analysis Population Description
Full Analysis Set (FAS) includes all randomized patients who received study medication and had both a baseline FPG value and an on-treatment FPG value. Three subjects in each arm excluded for site non-compliance.
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description:
Placebo matching linagliptin 5 mg tablet
Linagliptin 5 mg (milligrams) tablet given by mouth once daily
Overall Number of Participants Analyzed 86 175
Least Squares Mean (Standard Error)
Unit of Measure: mg/dL (milligrams per deciliter)
-2.4  (4.1) -8.6  (2.8)
Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Placebo Tablet, Linagliptin 5 mg Tablet
Comments [Not Specified]
Type of Statistical Test Superiority or Other
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.2137
Comments [Not Specified]
Method ANCOVA
Comments ANCOVA model included terms for treatment, baseline HbA1c, baseline FPG, and centre
Method of Estimation Estimation Parameter Mean Difference (Final Values)
Estimated Value -6.2
Confidence Interval 95%
-16.0 to 3.6
Estimation Comments [Not Specified]
Time Frame From drug start up to drug stop (max 24 weeks)+ 7 days
Adverse Event Reporting Description For the analysis of AEs, all events with an onset after the first dose of trial medication up to a period of 7 days after the last dose of trial medication were assigned to the randomised treatment period.
 
Arm/Group Title Placebo Tablet Linagliptin 5 mg Tablet
Hide Arm/Group Description Placebo matching linagliptin 5 mg tablet Linagliptin 5 mg (milligrams) tablet given by mouth once daily
All-Cause Mortality
Placebo Tablet Linagliptin 5 mg Tablet
Affected / at Risk (%) Affected / at Risk (%)
Total   --/--   --/-- 
Hide Serious Adverse Events
Placebo Tablet Linagliptin 5 mg Tablet
Affected / at Risk (%) Affected / at Risk (%)
Total   3/89 (3.37%)   4/183 (2.19%) 
Blood and lymphatic system disorders     
Anaemia  1  0/89 (0.00%)  1/183 (0.55%) 
Cardiac disorders     
Acute myocardial infarction  1  1/89 (1.12%)  0/183 (0.00%) 
Eye disorders     
Cataract  1  0/89 (0.00%)  1/183 (0.55%) 
Gastrointestinal disorders     
Upper gastrointestinal haemorrhage  1  0/89 (0.00%)  1/183 (0.55%) 
Infections and infestations     
Hepatitis E  1  1/89 (1.12%)  0/183 (0.00%) 
Neoplasms benign, malignant and unspecified (incl cysts and polyps)     
Colon cancer  1  0/89 (0.00%)  1/183 (0.55%) 
Renal and urinary disorders     
Calculus bladder  1  0/89 (0.00%)  1/183 (0.55%) 
Skin and subcutaneous tissue disorders     
Skin ulcer  1  1/89 (1.12%)  0/183 (0.00%) 
Indicates events were collected by systematic assessment
1
Term from vocabulary, MedDRA version 15.0
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
Placebo Tablet Linagliptin 5 mg Tablet
Affected / at Risk (%) Affected / at Risk (%)
Total   16/89 (17.98%)   31/183 (16.94%) 
Blood and lymphatic system disorders     
Anaemia  1  6/89 (6.74%)  13/183 (7.10%) 
Metabolism and nutrition disorders     
Hyperglycaemia  1  7/89 (7.87%)  11/183 (6.01%) 
Hypoglycaemia  1  4/89 (4.49%)  10/183 (5.46%) 
Indicates events were collected by systematic assessment
1
Term from vocabulary, MedDRA version 15.0
During the conduct of this trial, pioglitazone was removed from the market in France due to safety issues, and this resulted in premature termination of a number of French patients.
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
ClinicalTrials.gov Identifier: NCT00996658    
Other Study ID Numbers: 1218.61
2009-013289-20 ( EudraCT Number: EudraCT )
First Submitted: October 15, 2009
First Posted: October 16, 2009
Results First Submitted: February 13, 2013
Results First Posted: March 26, 2013
Last Update Posted: March 26, 2014