E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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 | 10012613 |
E.1.2 | Term | Diabetes mellitus non-insulin-dependent |
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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 measure the effect of the two 11β-HSD1 inhibitors RO5093151 and RO5027838 on mean daily plasma glucose (change from baseline at Week 4) in type 2 diabetic patients treated with a stable dose of metformin compared to placebo |
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E.2.2 | Secondary objectives of the trial |
1. To measure the effect of RO5093151 and RO5027838 on fasting plasma glucose, insulin, C-peptide, glucagon, HbA1c as well as β-cell function 2. To evaluate the tolerability/safety of RO5093151 and RO5027838, including measurements of the function of the hypothalamic-pituitary-adrenal axis 3. To measure the effect of RO5093151 and RO5027838 on lipid parameters 4. To measure the effect of RO5093151 and RO5027838 on arterial blood pressure and body weight 5. To investigate, using population analysis approach, the pharmacokinetics and the exposure-response relationship of RO5093151 and RO5027838 in the target population, including the influence of covariates such as age, gender and body weight 6. To assess the systemic concentration of metformin in combination with RO5093151 or RO5027838 in patients
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male and female patients with type 2 diabetes, diagnosed for at least 3 months at screening examination based on WHO criteria 2. Patients who have been treated for at least 3 months with a stable dose of metformin ≥ 1.5 g/day or maximum tolerated dose (MTD), but not higher than recommended in the locally approved label prior to screening 3. If patients are taking any additional oral anti-diabetic and/or weight-lowering medication besides metformin except thiazolidinediones (pioglitazone, rosiglitazone) or dual PPAR α/γ agonists and are willing to drop this additional T2D medication during the trial, they will be considered providing their medical status including plasma glucose level matches all selection criteria at the end of the pre-randomization period 4. HbA1c ≥ 7.0% and ≤ 10.0% at screening for patients on metformin monotherapy or HbA1c ≥ 7.0% and ≤ 8.5% at screening for patients on a combination of oral anti-diabetic agents. 5. Fasting serum C-peptide ≥1 ng/ml (0.33nmol/l) at screening 6. Age 35-65 years (inclusive) at the time of screening 7. BMI > 27 kg/m2 and ≤ 42 kg/m2 at screening 8. Females of non-childbearing potential, i.e. postmenopausal (defined as more than one year after the cessation of menses without an alternative medical cause and documented by FSH levels >40 UI/L and Oestrogen < 30 pg/mL) or surgically sterilized (by means of hysterectomy, bilateral oopherectomies or tubal ligations) for at least 3 months 9. Negative alcohol breath test and negative drug screen for cannabinoids, amphetamines, opiates, methadone, cocaine, benzodiazepines, and barbiturates (retest at the discretion of the investigator). 10. Able and willing to give written informed consent and to comply with the requirements of the study |
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E.4 | Principal exclusion criteria |
1. History of diabetic ketoacidosis 2. Fasting plasma glucose (FPG) >240 mg/dL (13.3 mmol/L) at pre-randomization visit (stopping rule) 3. Patients currently or previously treated with insulin (with the exception of emergency situations in which insulin was given for less than 7 consecutive days, but not within the last 6 months before screening) 4. Patients currently or within the previous 6 months before screening treated with a thiazolidinedione (pioglitazone, rosiglitazone) or a dual PPAR α/γ agonist 5. Patients treated with lipoprotein modifying therapy (fibrates, niacin) within a month before screening (stable statin therapy unchanged for at least 1 month prior to screening is allowed) 6. If receiving antihypertensive medication and/or thyroid hormones, and the dose(s) have not been stable for at least 6 weeks prior to baseline 7. Systemic, topical, intranasal or inhaled corticosteroid therapy for more than 2 weeks, within 3 months prior to screening examination 8. Impaired liver function (as suggested by SGOT, SGPT, GGT > 2.5 x ULN, bilirubin or alkaline phosphatase > 1.5 x ULN) at screening 9. Myocardial infarction or stroke within 6 months prior to screening 10. Uncontrolled hypertension (SBP ≥ 160 mmHg and/or DBP ≥ 100 mmHg) at the time of screening 11. Known proliferative diabetic retinopathy 12. Known autoimmune disease or chronic inflammatory condition. 13. Known Glucose-6-phosphate dehydrogenase deficiency 14. Any other clinically significant major organ system disease at screening (other than diabetes mellitus Type 2) such as relevant cardiovascular, gastrointestinal, hepatic, neurologic, psychiatric, endocrine (i.e. pancreatic), hematologic, malignant, infection or other major systemic diseases making implementation of the protocol or interpretation of the study results difficult 15. Any contraindication to metformin or lidocaine as indicated in the local label such as congestive heart failure (NYHA class III or IV or requiring pharmacological treatment), respiratory failure 16. Renal disease or dysfunction (as suggested by serum creatinine levels ≥1.5 mg/dL (133 µmol/L) [males], ≥1.4 mg/dL (124 µmol/L) [females]) at screening and Creatinine Clearance based upon the Cockcroft-Gault formula of <60ml/min at screening. 17. Positive result on hepatitis B (HBs-AG), hepatitis C (HCV-AB), or HIV 1 and 2 18. Donation of blood (>400 ml) during the previous 3 months prior to the screening visit or during the duration of the study 19. Clinically relevant QTc prolongation (e.g. QTc > 480 ms), history of additional risk factor for torsade de point (e.g. family history of long QT syndrome, hearth failure, hypokalemia) or concomitant use of medications, that prolong the QT/QTc interval. 20. Any other abnormalities in clinical laboratory tests which precludes safe involvement in the study as judged by the Investigator 21. Participation in another trial having received study medication within two months or 5 half-lives of that drug (whichever is longer) before the screening visit 22. History of alcohol or drug abuse 23. Patient treated with concomitant medication that are known to be strong CYP3A4 inhibitors and inducers 24. Smoking more than 10 cigarettes or equivalent / day 25. Known hypersensitivity to RO5093151 or RO5027838 or any of the components of their formulation 26. Night shift workers 27. Any subject who is the investigator or any sub-investigator, research assistant, pharmacist, study coordinator, other staff thereof, directly involved in the conduct of the protocol 28. Subjects with a history of keloidal scar formation that had developed following surgeries, trauma and/or other skin procedures |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint for this study is the absolute change in mean daily plasma glucose from baseline (Day -1) to Day 27 of the treatment period. Mean daily plasma glucose (assessed by a 9-point plasma glucose profile before and after 3 standardized test meals at bedtime, 3:00 am and 8:00 am) absolute change from baseline to Day 27 of the treatment period. |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
double dummy (placebo) will be used |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 3 |
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 |
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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
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The end of the study is defined as the date of the last visit of the last patient. Last patient last visit is either the date of the last patient visit of the last patient to complete the study, or the date at which the last data point from the last patient, which was required for statistical analysis (i.e. key safety and efficacy results for decision making), was received, whichever is the later date. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |