Safety and Efficacy Study of Exenatide Once Weekly in Adolescents With Type 2 Diabetes

Primary Outcome Measures:

• Assess effect of EQW on glycemic control [ Time Frame: 24 Weeks ]
  measured by HbA1c from Baseline to 24 weeks
  
  
• Safety and tolerability of EQW vs placebo [ Time Frame: 24 weeks ]
  in all patients
  
  

Secondary Outcome Measures:

• Compare effects of EQW vs Placebo [ Time Frame: 24 Weeks ]
  compare effects on: fasting plasma glucose concentration, proportion of patients achieving HbA1c goals, body weight and tanner stage, blood pressure and lipids
  
  
• Assess effects of long term EQW therapy [ Time Frame: 52 weeks ]
  Assess effects on: Long-term safety and tolerability, parameters related to glycemic control, body weight and tanner stage, blood pressure and lipids
  
  
• examine effect of EQW on beta-cell function and insulin sensativity [ Time Frame: 52 weeks ]
  measured by HOMA in children and adolescents not taking insulin
  
  
• Assess pk of EQW [ Time Frame: 52 weeks ]
  in all patients
  
  

This Phase 3, double-blind (controlled assessment period), randomized, multicenter, placebo-controlled parallel study is designed to examine the efficacy and safety of EQW compared to placebo (PBO) in adolescents with type 2 diabetes for 24 weeks. This study will assess safety and efficacy of EQW (as monotherapy and adjunctive therapy to oral antidiabetic agents and/or insulin). At least 40% and not more than 60% of the randomized patients must be females. At least 40% of patients should be recruited from areas with similar ethnicity and lifestyle to those of the European Union member states. Long term safety and efficacy of EQW will subsequently be monitored for 28 weeks in the open-label, uncontrolled extension period (through Week 52). The study will be terminated at Visit 11 (Week 62/Study Termination) which will be a follow-up visit occurring 10 weeks after the last dose administration at Visit 10 (Week 52). This study will be conducted in 77 patients with type 2 diabetes treated with diet and exercise alone or in combination with a stable dose of oral antidiabetic agents and/or insulin for at least 2 months prior to screening. During the controlled assessment period, approximately 77 patients will be randomly assigned in a 5:2 ratio to either EQW 2 mg (Group A) or PBO (Group B), to yield at least 70 evaluable patients: at least 50 patients in the exenatide and at least 20 patients in the PBO group. Following the 24-week controlled assessment period, patients assigned to the EQW 2 mg treatment (Group A) will continue to be treated with EQW 2 mg during the extension period (through Week 52). Patients randomized to PBO (Group B) will receive EQW 2 mg beginning at the start of the extension period, Week 25 through Week 52. In addition to receiving study medications, all patients will participate in a lifestyle intervention program encompassing diet and physical activity modifications following the signing of the informed consent and assent forms (Visit 1 [Week -2]) through the end of the extension period (Week 52). Following Visit 11 (Week 62/Study Termination), patients whose height increase is at least 5 mm between Visit 8 (Week 28) and Visit 11 (Week 62/Study Termination) will participate in a long-term safety follow-up period. Patients who discontinue study medication prior to Visit 11 (Week 62/Study Termination) will also participate in the Extended Safety Follow-up Period, unless they have a height increase of less than 5 mm over a 6-month interval at study site visits prior to discontinuation of study medication. Patients who do not have height assessments at study-site visits over a 6-month interval prior to discontinuation of study medication will enter the Extended Safety Follow-up Period. The Extended Safety Follow Up Period will continue for up to 3 years or until the difference between two 6-month interval visits is less than a 5 mm increase (whichever comes first). No study medication will be administered during the Extended Safety Follow-up Period. Blood samples will be collected for calcitonin and carcinoembryonic antigen (CEA) laboratory measurements.