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 | 11.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045242 |
E.1.2 | Term | <Manually entered code. Term in E.1.1> |
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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 |
The primary objective of this study is to assess the effects on glycemic control of lixisenatide in comparison to placebo as an add-on treatment to insulin glargine and metformin in terms of HbA1c change over a period of 24 weeks. |
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E.2.2 | Secondary objectives of the trial |
• To assess the effects of lixisenatide on − the percentage of patients reaching HbA1c <7 % and ≤6.5 % − plasma glucose (fasting, post-prandial during a standardized meal challenge test, 7-point self monitored profiles) − body weight − insulin glargine doses
• To evaluate lixisenatide safety and tolerability (including anti-lixisenatide antibody assessment) as add on treatment to insulin glargine and metformin
• To assess the impact of lixisenatide on treatment satisfaction using the Diabetes Treatment Satisfaction Questionnaire (state) (DTSQs) in the participating countries where it is validated |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients meeting all of the following inclusion criteria will be screened:
I 01. Patients with type 2 diabetes mellitus, as defined by WHO, diagnosed for at least 1 year at the time of screening visit, insufficiently controlled with metformin at a stable dose of at least 1.5 g/day for at least 3 months prior to the screening visit. In addition to metformin, patients may receive sulfonylureas or glinides (both must be discontinued at the run-in visit (V2, week-12)) and/or thiazolidinediones (that can be continued).
I 02. Written informed consent obtained
At the end of the screening period (screening phase + run-in phase), patients with insufficient glycemic control (see E 27 and E 28) will enter the double-blind randomized treatment period |
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E.4 | Principal exclusion criteria |
E 01. At screening age < legal age of majority E 02. At screening: HbA1c < 7.0 or HbA1c >10% E 03. Pregnancy or lactation E 04. Women of childbearing potential with no effective contraceptive method. Women of childbearing potential must have a confirmed negative serum pregnancy test at screening visit. They must use an effective contraceptive method throughout the study, and agree to repeat pregnancy tests at designated visits. The applied methods of contraception have to meet the criteria for a highly effective method of birth control according to the “Note for guidance on non-clinical safety studies for the conduct of human clinical trials for pharmaceuticals” E 05. Type 1 diabetes mellitus E 06. Metformin not at a stable dose of at least 1.5 g/day for at least 3 months prior to the screening visit. E 07. Use of oral or injectable antidiabetic or hypoglycemic agents other than metformin, sulfonylurea, glinides and thiazolidinediones (e.g., alpha glucosidase inhibitor, other GPL-1 receptor agonists, DPP-IV inhibitors, insulin etc.) within 3 months prior to the time of screening E 08. History of hypoglycemia unawareness. E 09. Body Mass Index (BMI) ≤20 kg/m² E 10. History of unexplained pancreatitis, chronic pancreatitis, pancreatectomy, stomach/gastric surgery, inflammatory bowel disease, personal or family history of medullary thyroid cancer (MTC) or genetic conditions that predispose to MTC (e.g multiple endocrine neoplasia syndromes), E 11. History of metabolic acidosis, including diabetic ketoacidosis within 1 year prior to screening E 12. Hemoglobinopathy or hemolytic anemia, receipt of blood or plasma products within 3 months prior to the time of screening E 13. Within the last 6 months prior to screening: history of myocardial infarction, stroke, or heart failure requiring hospitalization E 14. Known history of drug or alcohol abuse within 6 months prior to the time of screening E 15. Any clinically significant abnormality identified on physical examination, laboratory tests, ECG or vital signs at the time of screening that in the judgment of the investigator or any sub investigator would preclude safe completion of the study or constrains efficacy assessment such as active malignant tumor or other major systemic diseases, presence of clinically significant diabetic retinopathy or presence of macular edema likely to require laser treatment within the study period. E 16. Uncontrolled or inadequately controlled hypertension at the time of screening with a resting systolic or diastolic blood pressure > 180 mmHg or > 110 mmHg, respectively E 17. Laboratory findings at the time of screening: • Amylase and/or lipase > 3 times the upper limit of the normal laboratory range • ALT > 3 ULN • Total bilirubin: > 1.5 times the upper limit of the normal laboratory range (except in case of Gilbert’s syndrome) •Hemoglobin < 11 g/dL and/or neutrophils < 1,500/mm3 and/or platelets < 100,000/mm3 • Positive test for Hepatitis B surface antigen and/or Hepatitis C antibody • Positive serum pregnancy test in females of childbearing potential • Calcitonin ≥ 20 pg/mL (5.9 pmol/L) E 19. Use of systemic glucocorticoids (excluding topical application or inhaled forms) for one week or more within 3 months prior to the time of screening E 20. Use of any investigational drug within 3 months prior to screening E 21. Renal impairment defined with serum creatinine > 1.4 mg/dL in women and > 1.5 mg/dL in men E 22. History of hypersensitivity to insulin glargine or to any of the excipients E 23. Clinically relevant history of gastrointestinal disease associated with prolonged nausea and vomiting, including (but not limited to): gastroparesis, unstable (i.e worsening) and not controlled (i.e prolonged nausea and vomiting) gastroesophageal reflux disease requiring medical treatment, within 6 months prior to the time of screening E 24. Any previous treatment with lixisenatide (e.g. participation in a previous study with lixisenatide) E 25. Allergic reaction to any GLP-1 receptor agonist in the past (e.g. exenatide, liraglutide) or to metacresol E 26. Informed consent withdrawal (patient who is not willing to continue or fails to return) E 27. Mean fasting SMPG calculated from the self-measurements for the 7 days prior to visit 12 (week -1) is > 140 mg/dl (7.8 mmol/l) E 28. HbA1c measured at visit 12 (week -1) is < 7% and >9 %, E 29. Amylase and/or lipase > 3 times the upper limit of the normal laboratory range at visit 12 (week -1) E 30. Patients with FPG above the threshold value described for rescue (i.e. FPG > 240 mg/dl (13.3 mmol/L) E 31. Patients with any AE, which, by the judgment of the investigator would preclude the inclusion in the double-blind randomized treatment phase E 32. Lack of compliance to protocol or to insulin glargine treatment during the run-in phase A patient may not be enrolled in this study more than once (i.e. reentering the run in phase or be randomized twice). |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change of HbA1c from baseline to week 24 |
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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 | 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 | 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 | No |
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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 55 |
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 | Yes |
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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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 | 9 |
E.8.9.1 | In the Member State concerned days | 13 |
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 | 9 |
E.8.9.2 | In all countries concerned by the trial days | 13 |