E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045242 |
E.1.2 | Term | Type II diabetes mellitus |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess and compare the efficacy (as assessed by HbA1c) of insulin detemir in combination with liraglutide and metformin versus liraglutide and metformin in subjects with type 2 diabetes after 26 weeks of randomised treatment. |
|
E.2.2 | Secondary objectives of the trial |
To assess and compare the efficacy (as assessed by HbA1c) of insulin detemir in combination with liraglutide and metformin versus liraglutide and metformin and with the possibility of intensified treatment with insulin detemir from week 26, in subjects with type 2 diabetes, after totally 52 weeks of randomised treatment. To assess and compare the effects of insulin detemir in combination with liraglutide and metformin versus liraglutide and metformin on other descriptors of glycaemic control (FPG, 7-point self-monitored glucose profiles, proportion of subjects reaching target HbA1c), C-peptide, proinsulin to C-peptide ratio, body weight, waist and hip circumference including the waist to hip ratio, lipids and blood pressure after 26 and 52 weeks.
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Informed consent obtained before any trial-related activities (trial-related activities are any procedure that would not have been performed during normal management of the subject) 2. Subjects diagnosed with type 2 diabetes, insulin naïve and treated with metformin as monotherapy for ≥ 3 months prior to screening, at a stable dose of ≥ 1500 mg/day or metformin (≥ 1500 mg/day) and a sulfonylurea (less than or equal to ½ of the maximum approved dose according to local label), both at a stable dose for ≥ 3 months prior to screening. Previous short-term insulin treatment in connection with intercurrent illness is allowed, at the discretion of the Investigator. 3. HbA1c 7.0-10.0% (both inclusive) for subjects on metformin monotherapy HbA1c 7.0-8.5% (both inclusive) for subjects on metformin with a sulfonylurea 4. Age 18-80 years, both inclusive (or as allowed according to local guidelines) 5. Able and willing to perform self-monitoring of plasma glucose according to the protocol, to keep a diabetes diary and willing to use pen-injector device and FlexPen® device if necessary
|
|
E.4 | Principal exclusion criteria |
1. Previous treatment with insulin (except for short-term treatment in connection with intercurrent illness at the discretion of the Investigator) 2. Treatment with glucose-lowering agent(s) other than stated in the inclusion criteria in a period of 3 months prior to screening 3. Impaired liver function, defined as alanine aminotransferase (ALAT) ≥ 2.5 times upper normal limit (one retest analysed at the central laboratory within a week is permitted with the result of the last sample being the conclusive) 4. Impaired renal function defined as serum-creatinine ≥ 133 µmol/L (≥ 1.5 mg/dL) for males and ≥ 115 µmol/L (≥ 1.4 mg/dL) for females, or as allowed according to local contraindications for metformin or sulfonylurea use (one retest analysed at the central laboratory within a week permitted with the result of the last sample being the conclusive) 5. History of chronic pancreatitis or idiopathic acute pancreatitis 6. Known history of unstable angina, acute coronary event, other significant cardiac event (including history of arrhythmias or conduction delays on ECG), or cerebral stroke within the past 6 months. 7. Heart failure NYHA class IV (see appendix D) 8. Known proliferative retinopathy or maculopathy requiring acute treatment as judged by the Investigator 9. Uncontrolled treated or untreated hypertension (systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 110 mmHg) 10. Cancer (except basal cell skin cancer or squamous cell skin cancer) or any clinically significant disorder, except for conditions associated with type 2 diabetes history which in the Investigator’s opinion could interfere with the results of the trial 11. Recurrent major hypoglycaemia or hypoglycaemic unawareness as judged by the Investigator 12. Known or suspected allergy to trial product(s) or related products 13. Use of any drug (except for those stated in the inclusion criteria), which in the Investigator’s opinion could interfere with the glucose level (eg systemic corticosteroids) 14. Receipt of any other investigational drug within 3 months prior to screening into this trial 15. Any contraindications to metformin or insulin detemir according to the local label 16. Surgery scheduled for the trial duration period (excluding minor surgical procedures performed in local anaesthesia, as judged by the Investigator) 17. Previous participation in the run-in period of this trial. 18. Known or suspected abuse of alcohol or narcotics 19. Females of child bearing potential who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods (adequate contraceptive measures as required by local law or practice) UK: Adequate contraceptive measures are defined as established use of oral, injected or implanted hormonal methods of contraception, sterilisation, intrauterine device or intrauterine system, or consistent use of barrier methods. France: Adequate contraceptive measures are defined as oral hormonal method of contraception or intrauterine device. Germany: Adequate contraceptive measures are implants, injectables, combined oral contraceptives, hormonal IUD, sexual abstinence or vasectomised partner. 20. Mental incapacity, unwillingness or language barrier precluding adequate understanding or cooperation
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
• Change in HbA1c from baseline to week 26 (using last observation carried forward) |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 21 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 150 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
|
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
| |
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 8 |