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 | 12.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10067585 |
E.1.2 | Term | Type 2 diabetes mellitus |
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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 objective of the study is to investigate the efficacy and safety of linagliptin 2.5 mg twice daily compared to 5 mg once daily compared to placebo given orally for 12 weeks as add-on therapy to metformin in patients with type 2 diabetes mellitus with insufficient glycaemic control. It is planned to show non-inferiority of linagliptin 2.5 mg twice daily to 5mg once daily and each treatment’s superiority over placebo. |
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E.2.2 | Secondary objectives of the trial |
• Occurrence of relative efficacy response (HbA1c lowering by at least 0.5% after 12 weeks of treatment) • Change from baseline in HbA1c by visit over time • Change from baseline in fasting plasma glucose (FPG) after 12 weeks of treatment • Change from baseline in FPG by visit over time • Use of rescue therapy |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Diagnosis of type 2 diabetes mellitus prior to informed consent. 2. Male and female patients, currently treated with metformin alone, or with metformin and not more than one other oral antidiabetic drug (antidiabetic therapy may be a sulphonylurea, meglitinide, DPP-4 inhibitor or α-glucosidase inhibitor and its dose has to be unchanged for 12 weeks prior to informed consent). A total daily dose of ≥1500 mg/day metformin divided into twice daily administration (e.g., 850 mg bid, 1000 mg bid, 850/1000 mg bid or 500/1000 mg bid) is required for inclusion into the trial. A patient taking metformin tid can be included if switched to a bid dosing regimen at the time of informed consent. In this case, the total daily dose must be maintained (e.g., 500 mg tid to 1000/500 mg bid, 1000/500/500 mg tid to 1000 bid, 500/500/850 mg tid to 1000/850 mg bid). Patients treated with a total daily dose of metformin of less than 1500 mg (e.g., 500 mg bid) can be included in the trial only if the Investigator has documented that the dose is the maximum tolerated dose for that patient. The total daily dosage of metformin needs to be stable for at least 12 weeks prior to randomisation and throughout the duration of the study. 3. Glycosylated haemoglobin A1 (HbA1c) at Visit 1a (Screening) fulfils the following criteria: For patients undergoing wash out of previous medication: ≥7.0 % to ≤9.5 %.. For patients not undergoing wash-out of previous medication: ≥7.0% to ≤10.0%. 4. Glycosylated haemoglobin A1 (HbA1c) ≥7.0 to ≤10.0% at Visit 2 (Start of Run-in). 5. Age ≥18 and ≤80 years at Visit 1a (Screening). 6. BMI ≤45 kg/m2 (Body Mass Index) at Visit 1a (Screening). 7. Signed and dated written informed consent by date of Visit 1a in accordance with GCP and local legislation.
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E.4 | Principal exclusion criteria |
1. Treatment with extended release formulations of metformin within 12 weeks prior to consent. 2. Uncontrolled hyperglycaemia with a glucose level >240 mg/dL (>13.3 mmol/L) after an overnight fast during wash-out/placebo run-in and confirmed by a second measurement (not on the same day). 3. Myocardial infarction, stroke or TIA within 6 months prior to informed consent. 4. Impaired hepatic function, defined by serum levels of either ALT (SGPT), AST (SGOT), or alkaline phosphatase above 3 x upper limit of normal (ULN) as determined at Visit 1a. 5. Gastric bypass surgery. 6. Known hypersensitivity or allergy to the investigational product or its excipients or to the trial background therapy (i.e., metformin). 7. Contraindication to metformin therapy according to local label, for example: • Renal disease or renal dysfunction (e.g., as specified by product information of locally approved metformin) • Dehydration by clinical judgement of the investigator • Acute or chronic metabolic acidosis (present condition in patient history) • Hereditary galactose intolerance. 8. Renal failure or renal impairment (serum creatinine ≥1.5 mg/dL [132 μmol/L]) as determined at Visit 1a (Screening). 9. Treatment with rosiglitazone, pioglitazone, GLP-1 analogues/mimetics or insulin within 3 months prior to informed consent. 10. Treatment with anti-obesity drugs (e.g., sibutramine, orlistat, rimonabant) 3 months prior to informed consent. 11. Alcohol or drug abuse within the 3 months prior to informed consent that would interfere with trial participation. 12. Current treatment with systemic steroids at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent. However, the use of inhaled steroids (e.g., for asthma, COPD) is not an exclusion as these do not cause systemic steroid action. 13. Participation in another trial with an investigational drug within 2 months prior to informed consent. 14. Pre-menopausal women (last menstruation ≥1 year prior to informed consent) who: • are nursing or pregnant or • are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the study and do not agree to submit to periodic pregnancy testing during participation in the trial. Acceptable methods of birth control include transdermal patch, intra uterine devices/systems (IUDs/IUSs), oral, implantable or injectable contraceptives, sexual abstinence and vasectomised partner. No exception will be made.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint in this study is the change from baseline in HbA1c after 12 weeks of treatment. Throughout the study protocol, the term "baseline" refers to the last observation prior to the randomised treatment phase.
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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 | No |
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 | Yes |
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 | 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 | Yes |
E.8.2.3.1 | Comparator description |
2.5 mg BID versus 5 mg QD |
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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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 39 |
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 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 | 0 |
E.8.9.1 | In the Member State concerned months | 11 |
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 | 11 |
E.8.9.2 | In all countries concerned by the trial days | 0 |