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Efficacy of Once-Weekly Exenatide Versus Once or Twice Daily Insulin Detemir in Patients With Type 2 Diabetes

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ClinicalTrials.gov Identifier: NCT01003184
Recruitment Status : Completed
First Posted : October 28, 2009
Results First Posted : December 18, 2012
Last Update Posted : April 7, 2015
Sponsor:
Collaborator:
Eli Lilly and Company
Information provided by (Responsible Party):
AstraZeneca

Study Description
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Brief Summary:
The purpose of this study is to compare the effects of exenatide once weekly (QW) and insulin detemir with respect to glycemic control, body weight, lipids, safety, tolerability, and patient reported outcomes.

Condition or disease Intervention/treatment Phase
Type 2 Diabetes Mellitus Drug: exenatide once weekly Drug: insulin detemir Phase 3

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 222 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Efficacy of Once-Weekly Exenatide Versus Once or Twice Daily Insulin Detemir in Patients With Type 2 Diabetes Treated With Metformin Alone or in Combination With Sulphonylurea
Study Start Date : October 2009
Actual Primary Completion Date : July 2011
Actual Study Completion Date : December 2011

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: 1 Drug: exenatide once weekly
subcutaneous injection, 2mg, once a week
Active Comparator: 2 Drug: insulin detemir
subcutaneous injection, with dosage titrated according to the determir label and published titration schedule, once or twice a day
Other Name: Levemir


Outcome Measures
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Primary Outcome Measures :
  1. Percentage of Patients Achieving Glycosylated Hemoglobin (HbA1c) Concentration ≤7.0% With Weight Loss (≥1.0 kg) at Endpoint (Week 26) [ Time Frame: Baseline, Week 26 ]
    The primary endpoint is the percentage of patients achieving HbA1c concentration ≤7.0% with weight loss (≥1.0 kg) at endpoint. The last post-baseline measurement set of both non-missing HbA1c concentration and weight (measured at the same time point, i.e. visit) is used as endpoint value. Patients who do not have a baseline weight measurement, have a protocol violation of baseline HbA1c <=7.0%, and/or have missing post-baseline measurements for HbA1c concentration and/or weight, are included in the analysis as non-responders regarding the primary objective.


Secondary Outcome Measures :
  1. Percentage of Patients Who Have Achieved HbA1c ≤7.4% With Weight Loss (≥1.0 kg) at Endpoint (Week 26) [ Time Frame: Baseline, Week 26 ]
    Percentage of patients who have achieved HbA1c ≤7.4% with weight loss (≥1.0 kg) at endpoint (Week 26)

  2. Change in HbA1c From Baseline to Week 26 [ Time Frame: Baseline, Week 26 ]
    Change in HbA1c from baseline to week 26

  3. Change in Body Weight From Baseline to Week 26 [ Time Frame: Baseline, Week 26 ]
    Change in body weight from baseline to week 26

  4. Percentage of Patients Achieving HbA1c ≤7.4% at Endpoint [ Time Frame: Week 26 ]
    Percentage of patients who have achieved HbA1c ≤.7.4% at endpoint

  5. Percentage of Patients Achieving ≤7.0% at Endpoint [ Time Frame: Week 26 ]
    Percentage of patients achieving ≤7.0% at endpoint.

  6. Percentage of Patients Achieving ≤6.5% at Endpoint [ Time Frame: Week 26 ]
    Percentage of patients achieving HbA1c ≤6.5% at endpoint

  7. Change in Fasting Serum Glucose From Baseline to Endpoint (Week 26). [ Time Frame: Baseline, Week 26 ]
    Change in fasting serum glucose from baseline to endpoint (Week 26).

  8. Changes in Systolic Blood Pressure From Baseline to Week 26 [ Time Frame: Baseline, Week 26 ]
    Change in systolic blood pressure from baseline to Week 26

  9. Change in Diastolic Blood Pressure From Baseline to Week 26. [ Time Frame: Baseline, Week 26 ]
    Change in diastolic blood pressure from baseline to week 26.

  10. Change in Total Cholesterol From Baseline to Endpoint (Week 26). [ Time Frame: Baseline, Week 26 ]
    Change in total cholesterol from baseline to endpoint (week 26).

  11. Change in High-density Lipoprotein (HDL) Cholesterol From Baseline to Endpoint (Week 26). [ Time Frame: Baseline, Week 26 ]
    Change in High-density lipoprotein (HDL) cholesterol from baseline to endpoint (week 26).

  12. Change in Triglycerides From Baseline to Endpoint (Week 26). [ Time Frame: Baseline, Week 26 ]
    Change in triglycerides from baseline to endpoint (week 26).

  13. Hypoglycemia Rate Per Year [ Time Frame: Baseline, Week 26 ]
    All confirmed hypoglycemia episodes defined as either minor (any time a patient feels that he or she is experiencing a sign or symptom associated with hypoglycaemia and blood glucose (BG) <3.0 mmol/L (54 mg/dL)) or major (any hypoglycaemic episode with symptoms consistent with hypoglycaemia, resulting in loss of consciousness or seizure, and shows prompt recovery in response to administration of glucagon or glucose, or BG measurement < 3.0mmol/L is available and the patient is not capable of self-treating were taken into account.


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Have suboptimal glycaemic control as evidenced by an HbA1c 7.1% to 10.0%, inclusive
  • Have a body mass index (BMI) of 25 kg/m2 to 45 kg/m2, inclusive
  • Are receiving metformin at a stable dose (consistent with country specific requirements) of a minimum of 1000mg for at least 3 months prior to start start OR are receiving metformin at a minimum dose (consistent with country specific requirements) of 1000mg and sulphonylurea (as separate medications not as a fixed dose combination) at stable doses for 3 months prior to study start

Exclusion Criteria:

  • Have any contraindication for the OAD that they have been using
  • Have a known allergy or hypersensitivity to insulin detemir, exenatide or excipients contained in these agents
  • Have been treated within 4 weeks of screening with systemic glucocorticoid therapy by oral, intravenous (IV) or intramuscular (IM) route, or are regularly treated with potent, inhaled intranasal steroids that are known to have a high rate of systemic absorption. Exceptions to this criterion include patients who are receiving glucocorticoid therapy for corticotropic hypopituitary deficiency (e.g. Addison disease)
  • Have been treated with drugs that promote weight loss, within 3 months of screening
  • Have been treated for longer than 2 weeks with any of the following excluded medications within 3 months prior to screening: insulin, alpha-glucosidase, Byetta® (exenatide BID formulation), thiazolidinediones (TZD), dipeptidyl peptidase (DPP)-4 inhibitors
  • Have previously completed or withdrawn from this study or any other study investigating exenatide QW
  • Have received treatment within the last 30 days with a drug that has not received regulatory approval for any indication at the time of study entry
  • Are currently enrolled in, or discontinued within the last 30 days from, a clinical trial involving an off-label use of an investigational drug or device (other than the study drug/device used in this study), or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01003184


Locations
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Ireland
Research Site
Dublin, Ireland
United Kingdom
Research Site
Addlestone, England, United Kingdom
Research Site
Bath, England, United Kingdom
Research Site
Birmingham, England, United Kingdom
Research Site
Blackburn, England, United Kingdom
Research Site
Bournemouth, England, United Kingdom
Research Site
Chippenham, England, United Kingdom
Research Site
Derby, England, United Kingdom
Research Site
Exeter, England, United Kingdom
Research Site
High Wycombe, England, United Kingdom
Research Site
Hull, England, United Kingdom
Research Site
Leicester, England, United Kingdom
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Liverpool, England, United Kingdom
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London, England, United Kingdom
Research Site
Manchester, England, United Kingdom
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Merseyside, England, United Kingdom
Research Site
Middlesborough, England, United Kingdom
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Newcastle, England, United Kingdom
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Northampton, England, United Kingdom
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Oldham, England, United Kingdom
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Plymouth, England, United Kingdom
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Portsmouth, England, United Kingdom
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Sheffield, England, United Kingdom
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Stevenage, England, United Kingdom
Research Site
Suffolk, England, United Kingdom
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Wakefield, England, United Kingdom
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Wiltshire, England, United Kingdom
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Aberdeen, Scotland, United Kingdom
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Dundee, Scotland, United Kingdom
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Carmathen, Wales, United Kingdom
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Swansea, Wales, United Kingdom
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Wrexham, Wales, United Kingdom
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Leytonstone, United Kingdom
Research Site
Livingston, United Kingdom
Sponsors and Collaborators
AstraZeneca
Eli Lilly and Company
Investigators
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Study Director: Chief Medical Officer, MD Eli Lilly and Company
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: AstraZeneca
ClinicalTrials.gov Identifier: NCT01003184    
Other Study ID Numbers: H8O-EW-GWDL
First Posted: October 28, 2009    Key Record Dates
Results First Posted: December 18, 2012
Last Update Posted: April 7, 2015
Last Verified: March 2015
Keywords provided by AstraZeneca:
diabetes
exenatide once weekly
Byetta
insulin detemir
 Levemir
Amylin
Lilly
Additional relevant MeSH terms:
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Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Exenatide
Insulin Detemir
 Hypoglycemic Agents
Physiological Effects of Drugs
Anti-Obesity Agents
Incretins
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists