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    Clinical Trial Results:
    A Randomized, Double-blind, Placebo Controlled Trial to Assess Safety/Tolerability, Pharmacokinetics & Pharmacodynamics of Liraglutide in Paediatric (10 – 17 years old) Subjects with Type 2 Diabetes

    Summary
    EudraCT number
    2010-021057-39
    Trial protocol
    GB   SI   BE  
    Global end of trial date
    30 Sep 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Mar 2016
    First version publication date
    21 Jul 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    NN2211-1800
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00943501
    WHO universal trial number (UTN)
    U1111-1111-9256
    Sponsors
    Sponsor organisation name
    Novo Nordisk A/S
    Sponsor organisation address
    Novo Allè, Bagsvaerd, Denmark, 2880
    Public contact
    Global Clinical Registry (GCR,1452), Novo Nordisk A/S, clinicaltrials@novonordisk.com
    Scientific contact
    Global Clinical Registry (GCR,1452), Novo Nordisk A/S, clinicaltrials@novonordisk.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000128-PIP01-07
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    19 Mar 2012
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Sep 2011
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Sep 2011
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the safety and tolerability of 0.3, 0.6, 0.9, 1.2 and 1.8 mg doses of liraglutide in the paediatric population (10 – 17 years of age).
    Protection of trial subjects
    The trial was conducted in accordance with the Declaration of Helsinki (59th WMA General Assembly, Seoul, October 2008) and ICH Good Clinical Practice (01-May-1996).
    Background therapy
    Subject previously using metformin, the pre-trial treatment regimen was continued unaltered throughout the study as background medication. Some subjects were on diet and exercise only. Pre-trial regimen was continued during the trial.
    Evidence for comparator
    Not applicable
    Actual start date of recruitment
    02 Nov 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Slovenia: 2
    Country: Number of subjects enrolled
    United Kingdom: 3
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    United States: 15
    Worldwide total number of subjects
    21
    EEA total number of subjects
    6
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    3
    Adolescents (12-17 years)
    18
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    19 sites were activated in 4 countries; 14 sites enrolled study subjects (United States (9 sites –15 subjects), United Kingdom (3 sites –3 subjects), Slovenia (1 site – 2 subjects) and Belgium (1 site – 1 subject))

    Pre-assignment
    Screening details
    Not applicable

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Investigator, Subject, Monitor, Data analyst
    Blinding implementation details
    This trial is double-blind and placebo controlled.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Liraglutide
    Arm description
    Subjects randomised to liraglutide treatment received 0.3 mg liraglutide daily (starting on Day 1) during the first week, followed by 0.6 mg daily (starting on Day 8) during the second week, 0.9 mg daily (starting on Day 15) during the third week, 1.2 mg daily (starting on Day 22) during the fourth week, and 1.8 mg daily (starting on Day 29) during the fifth and final treatment week. If a subject did not meet the dose escalation criteria, he/she continued on the highest dose reached.
    Arm type
    Experimental

    Investigational medicinal product name
    Liraglutide
    Investigational medicinal product code
    Other name
    Victoza (R)
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Liraglutide was administered once-daily by a s.c. FlexPen injection in the abdomen.

    Arm title
    Placebo
    Arm description
    Liraglutide placebo, was administered once-daily by a s.c. FlexPen injection in the abdomen.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Liraglutide placebo, was administered once-daily by a s.c. FlexPen injection in the abdomen.

    Number of subjects in period 1
    Liraglutide Placebo
    Started
    14
    7
    Completed
    13
    6
    Not completed
    1
    1
         Withdrawal criteria
    1
    -
         Unclassified
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Liraglutide
    Reporting group description
    Subjects randomised to liraglutide treatment received 0.3 mg liraglutide daily (starting on Day 1) during the first week, followed by 0.6 mg daily (starting on Day 8) during the second week, 0.9 mg daily (starting on Day 15) during the third week, 1.2 mg daily (starting on Day 22) during the fourth week, and 1.8 mg daily (starting on Day 29) during the fifth and final treatment week. If a subject did not meet the dose escalation criteria, he/she continued on the highest dose reached.

    Reporting group title
    Placebo
    Reporting group description
    Liraglutide placebo, was administered once-daily by a s.c. FlexPen injection in the abdomen.

    Reporting group values
    Liraglutide Placebo Total
    Number of subjects
    14 7 21
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    2 1 3
        Adolescents (12-17 years)
    12 6 18
        Adults (18-64 years)
    0 0 0
        From 65-84 years
    0 0 0
        85 years and over
    0 0 0
    Gender categorical
    Units: Subjects
        Female
    9 5 14
        Male
    5 2 7

    End points

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    End points reporting groups
    Reporting group title
    Liraglutide
    Reporting group description
    Subjects randomised to liraglutide treatment received 0.3 mg liraglutide daily (starting on Day 1) during the first week, followed by 0.6 mg daily (starting on Day 8) during the second week, 0.9 mg daily (starting on Day 15) during the third week, 1.2 mg daily (starting on Day 22) during the fourth week, and 1.8 mg daily (starting on Day 29) during the fifth and final treatment week. If a subject did not meet the dose escalation criteria, he/she continued on the highest dose reached.

    Reporting group title
    Placebo
    Reporting group description
    Liraglutide placebo, was administered once-daily by a s.c. FlexPen injection in the abdomen.

    Primary: Adverse Events

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    End point title
    Adverse Events [1]
    End point description
    All AEs either observed by the investigator or reported spontaneously by the subjects were recorded by the investigator and evaluated. The AEs were collected from randomisation (Visit 2/week 1 day 1) to follow up (Visit 9/week 6 day 5+ 2 days)
    End point type
    Primary
    End point timeframe
    Randomisation (Visit 2/ week 1 day 1) to follow up (Visit 9/ week 6 day 5+ 2 days)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: Number of Adverse Events
    38
    18
    No statistical analyses for this end point

    Primary: Hypoglycaemic episodes

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    End point title
    Hypoglycaemic episodes [2]
    End point description
    1) Major-Subject unable to treat himself/herself. 2) Minor-An episode with symptoms consistent with hypoglycaemia with confirmation by plasma glucose <56mg/dL (3.1mmol/L) or full blood glucose<50mg/dL (2.8mmol/L) and which is self-handled by the subject. Any asymptomatic plasma glucose value <56mg/dl (3.1mmol/L) or full blood glucose value <50mg/dL (2.8mmol/L) ADA Classification- 1) Severe-An episode requiring assistance of another person to actively administer carbohydrate, glucagons or other resuscitative actions. 2) Documented symptomatic- An episode during which typical symptoms of hypoglycaemia are accompanied by a measured plasma glucose concentration of ≤ 70 mg/dL (3.9 mmol/L). 3)Asymptomatic -An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured plasma glucose concentration of ≤ 70 mg/dL (3.9 mmol/L).
    End point type
    Primary
    End point timeframe
    Randomisation (Visit 2/ week 1 day 1) to follow up (Visit 9/ week 6 day 5 + 2 days)
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: Number of hypoglycaemic episodes
        Major
    0
    0
        Minor
    4
    0
        ADA severe
    0
    0
        ADA documented Symptomatic
    2
    0
        ADA Asymptomatic
    9
    1
    No statistical analyses for this end point

    Primary: Anti-Liraglutide Antibodies

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    End point title
    Anti-Liraglutide Antibodies [3]
    End point description
    Anti-Liraglutide antibody assessment was a part of safety assessment in this trial.Blood samples for serum antibody against liraglutide were drawn at Visit 2 (randomisation/ week1 day 1) and Visit 9 (follow up/ week 6 day 5 + 2 days) . Blood samples for subjects discontinuing prematurely from the trial treatment (due to withdrawal) were drawn at the withdrawal visit. Antibody-positive samples were to be further characterised for neutralising effect and cross-reactivity.
    End point type
    Primary
    End point timeframe
    Visit 2 (Randomisation/ week 1 day 1) and Visit 9 (follow up/ week 6 day 5 + 2 days)
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: Number of subjects- negative antibodies
    14
    7
    No statistical analyses for this end point

    Primary: Biochemistry- Change from Baseline

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    End point title
    Biochemistry- Change from Baseline [4]
    End point description
    Biochemistry parameters were assessed at Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days).
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [4] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: U/L,mmol/L,g/L
    arithmetic mean (standard deviation)
        Alanine Aminotransferase (U/L)
    -6.79 ( 8.54 )
    -4.14 ( 10.64 )
        Albumin (g/L)
    -1.54 ( 2.77 )
    -0.4 ( 2.24 )
        Alkaline Phosphatase (U/L)
    -8.21 ( 23.39 )
    -6.71 ( 12.39 )
        Aspartate Aminotransferase (U/L)
    -5.86 ( 8.17 )
    -0.43 ( 7.81 )
        Bilirubin Total (umol/L)
    -1 ( 2.6 )
    -0.63 ( 2.13 )
        Calcium Total (mmol/L)
    0 ( 0.08 )
    0.07 ( 0.23 )
        Creatine Phosphokinase (U/L)
    -16.8 ( 47.51 )
    -3.86 ( 90.23 )
        Creatinine (umol/L)
    -4.57 ( 3.86 )
    -2.86 ( 6.47 )
        GGT (U/L)
    -2 ( 3.88 )
    3.14 ( 3.89 )
        LDH (U/L)
    -13.9 ( 25.46 )
    -15.7 ( 34.44 )
        Magnesium (mmol/L)
    0 ( 0.05 )
    0.02 ( 0.06 )
        Potassium (mmol/L)
    -0.03 ( 0.29 )
    0.09 ( 0.22 )
        Protein (g/L)
    -1.12 ( 4.06 )
    -0.43 ( 3.09 )
        Sodium (mmol/L)
    -0.57 ( 2.65 )
    2.43 ( 3.51 )
        Urea (mmol/L)
    -0.07 ( 1.01 )
    0.7 ( 0.78 )
        Uric Acid (umol/L)
    -47.2 ( 70.1 )
    -41.3 ( 46.45 )
    No statistical analyses for this end point

    Primary: Physical Examination- Change from previous visit.

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    End point title
    Physical Examination- Change from previous visit. [5]
    End point description
    Targeted physical examinations were performed at scheduled Visits and at any other time at the discretion of the Investigator.These results are based on assessments made at the final time point (Visit 8/Week 6 Day 3)
    End point type
    Primary
    End point timeframe
    Visit 2 (Randomisation/ week 1 day 1) to Visit 8 (Week 6 day 3)
    Notes
    [5] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: Subjects
        Yes (findings)
    0
    0
        No (No findings)
    13
    6
        Missing
    1
    1
    No statistical analyses for this end point

    Primary: ECG

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    End point title
    ECG [6]
    End point description
    A standard 12-lead ECG evaluation was performed by the investigator at screening (Visit 1/ week -2 relative to randomisation) Visit 2 (randomisation /week 1 day 1) and Follow-up (Visit 9/ week 6 day 5 +2 days) and recorded as: 1. Normal 2. Abnormal; not clinically significant 3. Abnormal; clinically significant. The values presented are overall interpretation for week 6 Day 5. (Follow up/Viist 9)
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week -2 relative to randomisation) Visit 2 (randomisation /week 1 day 1) and Follow-up (Visit 9/week 6 day 5 +2 days)
    Notes
    [6] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: Subjects
        Normal
    12
    7
        Abnormal, NCS
    2
    0
    No statistical analyses for this end point

    Primary: Funduscopy

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    End point title
    Funduscopy [7]
    End point description
    Funduscopy was a part of safety assessment of the trial. The occurences in both left and right eye at follow up are given below.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [7] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: Subjects
        Normal
    14
    7
        ANCS
    0
    0
        ACS
    0
    0
        Mis
    0
    0
    No statistical analyses for this end point

    Primary: Pulse-Change from baseline

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    End point title
    Pulse-Change from baseline [8]
    End point description
    Pulse was measured at all visits as necessary and as scheduled. Pulse was measured after subject has rested for 5 min.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) to follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [8] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: beats/min
    arithmetic mean (standard deviation)
        Week 6, Day 1
    2.4 ( 11.1 )
    3.3 ( 18 )
    No statistical analyses for this end point

    Primary: Systolic Blood Pressure- Change from baseline

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    End point title
    Systolic Blood Pressure- Change from baseline [9]
    End point description
    Systolic blood pressures were measured at all visits as necessary and as scheduled. Blood pressure was measured after the subject has rested for 5 min.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week -2 relative to randomisation) to follow up (Visit 9/week 6 Day 5+ 2days)
    Notes
    [9] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: mmHg
    arithmetic mean (standard deviation)
        Week 6, Day 1
    0.6 ( 17.5 )
    -3 ( 10.7 )
    No statistical analyses for this end point

    Primary: Diastolic Blood Pressure- Change from baseline

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    End point title
    Diastolic Blood Pressure- Change from baseline [10]
    End point description
    Diastolic blood pressures was measured at all visits as necessary and as scheduled. Blood pressure was measured after resting for 5 min.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to rando misation) to follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [10] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: mmHg
    arithmetic mean (standard deviation)
        Week 6, Day 1
    0.6 ( 8.7 )
    1.2 ( 4.8 )
    No statistical analyses for this end point

    Primary: Haematology-Change from baseline

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    End point title
    Haematology-Change from baseline [11]
    End point description
    Haematology parameters were assessed at screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [11] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    7
    Units: 10 ˆ9/L,g/L,%,fL,
    arithmetic mean (standard deviation)
        Basophile_abs (10^9/L)
    0.01 ( 0.03 )
    0.01 ( 0.04 )
        Basophils (%)
    0 ( 0.39 )
    0 ( 0 )
        Eosinophile_abs (10^9/L)
    0.06 ( 0.13 )
    0.03 ( 0.08 )
        Eosinophils (%)
    1.07 ( 3.32 )
    0.29 ( 0.76 )
        Erythrocytes (10^12/L)
    -0.16 ( 0.22 )
    -0.08 ( 0.26 )
        Haematocrit (ratio )
    -0.01 ( 0.02 )
    0 ( 0.02 )
        Haemoglobin (g/L)
    -3.36 ( 6.4 )
    -1.57 ( 5 )
        Lymphocytes (%)
    0.36 ( 11.95 )
    -1.29 ( 3.9 )
        Lymphocytes_abs (10^9/L)
    0.1 ( 0.43 )
    0.17 ( 0.28 )
        MCHC (g/L)
    1 ( 7.76 )
    -1.14 ( 2.79 )
        MCV (fL)
    0.21 ( 2.08 )
    1 ( 1.29 )
        Monocytes (%)
    -0.64 ( 2.1 )
    0 ( 3.65 )
        Monocytes_abs (10^9/L)
    -0.03 ( 0.17 )
    0.04 ( 0.21 )
        Neutrophil_abs (10^9/L)
    0.39 ( 2.01 )
    0.9 ( 1.62 )
        Neutrophils (%)
    -0.71 ( 15.57 )
    1.29 ( 4.86 )
        Reticulocyte (%)
    -0.02 ( 1.04 )
    0.53 ( 0.51 )
        Reticulocyte_abs (10^9/L)
    -3.62 ( 47.7 )
    25 ( 29.31 )
        Thrombocytes (10^9/L)
    1 ( 28.22 )
    14.43 ( 29.33 )
        Total Leucocytes (10^9/L)
    0.49 ( 2.08 )
    1.17 ( 1.7 )
    No statistical analyses for this end point

    Primary: Urinalysis-pH Change from baseline

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    End point title
    Urinalysis-pH Change from baseline [12]
    End point description
    The analysis of pH, ketones, protein, blood,leukocyte esterase, nitrite and glucose were perfomed.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [12] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    7
    Units: pH
        arithmetic mean (standard deviation)
    0.08 ( 0.34 )
    0.14 ( 0.48 )
    No statistical analyses for this end point

    Primary: Fasting Plasma Glucose - Change from baseline

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    End point title
    Fasting Plasma Glucose - Change from baseline
    End point description
    FPG (from glucometer) was asessed from screening (Visit 1/week-2 relative to randomisation) to follow up (Visit 9/week 6 day 5+ 2 days). Results presented are for the change from baseline (week 1day1) to the last dose. (after 5 weeks of treatment)
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) to follow up (Visit 9/week 6 day 5+ 2 days)
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    14
    6
    Units: mmol/L
        least squares mean (standard error)
    -1.27 ( 0.56 )
    0.17 ( 0.86 )
    Statistical analysis title
    FPG-Change from baseline
    Comparison groups
    Placebo v Liraglutide
    Number of subjects included in analysis
    20
    Analysis specification
    Pre-specified
    Analysis type
    other [13]
    P-value
    = 0.1797
    Method
    ANCOVA
    Parameter type
    Estimated treatmentdifference
    Point estimate
    -1.44
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.61
         upper limit
    0.73
    Notes
    [13] - Exploratory

    Primary: HbA1c (%) - Change from baseline

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    End point title
    HbA1c (%) - Change from baseline
    End point description
    Percentage point change in Glycosylated Haemoglobin A1c (HbA1c). Results presented are for the change from baseline (week1 day1) to the final time point (visit6/week 5 day7)
    End point type
    Primary
    End point timeframe
    Screening ( Visit 1/week -2 relative to randomisation) to Visit 6 (Week 5 day 7 )
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    6
    Units: percentage
        least squares mean (standard error)
    -0.86 ( 0.12 )
    0.04 ( 0.18 )
    Statistical analysis title
    HbA1c- Change from baseline
    Comparison groups
    Liraglutide v Placebo
    Number of subjects included in analysis
    19
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0007
    Method
    ANCOVA
    Parameter type
    Estimated treatment difference
    Point estimate
    -0.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.36
         upper limit
    -0.45

    Primary: Urinalysis -Glucose

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    End point title
    Urinalysis -Glucose [14]
    End point description
    The analysis of pH, ketones, protein, blood,leukocyte esterase, nitrite and glucose were perfomed.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [14] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    7
    Units: No of subjects
        Negative
    9
    5
        Positive
    4
    2
    No statistical analyses for this end point

    Primary: Urinalysis -Ketones

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    End point title
    Urinalysis -Ketones [15]
    End point description
    The analysis of pH, ketones, protein, blood,leukocyte esterase, nitrite and glucose were perfomed.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [15] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    7
    Units: No of subjects
        Negative
    13
    7
    No statistical analyses for this end point

    Primary: Urinalysis-Leucocytes

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    End point title
    Urinalysis-Leucocytes [16]
    End point description
    The analysis of pH, ketones, protein, blood,leukocyte esterase, nitrite and glucose were performed.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [16] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    7
    Units: No of subjects
        Negative
    12
    6
        Small
    1
    0
        Moderate
    0
    1
    No statistical analyses for this end point

    Primary: Urinalysis- Nitrite

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    End point title
    Urinalysis- Nitrite [17]
    End point description
    The analysis of pH, ketones, protein, blood,leukocyte esterase, nitrite and glucose were perfomed.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [17] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    7
    Units: No of subjects
        Negative
    10
    7
        Positive
    3
    0
    No statistical analyses for this end point

    Primary: Urinalysis-Protein

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    End point title
    Urinalysis-Protein [18]
    End point description
    The analysis of pH, ketones, protein, blood,leukocyte esterase, nitrite and glucose were perfomed.
    End point type
    Primary
    End point timeframe
    Screening (Visit 1/week-2 relative to randomisation) and follow up (Visit 9/week 6 day 5+ 2 days)
    Notes
    [18] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The summary statistics by treatment were the primary mode of statistical presentation of safety data.
    End point values
    Liraglutide Placebo
    Number of subjects analysed
    13
    7
    Units: Number of subjects
        Negative
    11
    6
        30
    2
    1
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were collected from visit 1 to follow-up.Treatment emergent AEs are reported below.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    14.0
    Reporting groups
    Reporting group title
    Liraglutide
    Reporting group description
    Subjects randomised to liraglutide treatment received 0.3 mg liraglutide daily (starting on Day 1) during the first week, followed by 0.6 mg daily (starting on Day 8) during the second week, 0.9 mg daily (starting on Day 15) during the third week, 1.2 mg daily (starting on Day 22) during the fourth week, and 1.8 mg daily (starting on Day 29) during the fifth and final treatment week. If a subject did not meet the dose escalation criteria, he/she continued on the highest dose until the end of the trial.

    Reporting group title
    Placebo
    Reporting group description
    Liraglutide placebo, was administered once-daily by a s.c. FlexPen injection in the abdomen.

    Serious adverse events
    Liraglutide Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 14 (0.00%)
    0 / 7 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Liraglutide Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    10 / 14 (71.43%)
    3 / 7 (42.86%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Hot flush
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Injection site pain
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Oropharyngeal pain
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Rhinorrhoea
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Psychiatric disorders
    Nervousness
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Joint sprain
         subjects affected / exposed
    2 / 14 (14.29%)
    0 / 7 (0.00%)
         occurrences all number
    2
    0
    Arthropod bite
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Contusion
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Incorrect dose administered
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Muscle strain
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Sunburn
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Ligament rupture
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 14 (21.43%)
    1 / 7 (14.29%)
         occurrences all number
    4
    2
    Dizziness
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    6 / 14 (42.86%)
    1 / 7 (14.29%)
         occurrences all number
    7
    1
    Nausea
         subjects affected / exposed
    3 / 14 (21.43%)
    1 / 7 (14.29%)
         occurrences all number
    4
    1
    Vomiting
         subjects affected / exposed
    2 / 14 (14.29%)
    2 / 7 (28.57%)
         occurrences all number
    2
    3
    Abdominal discomfort
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Abdominal pain
         subjects affected / exposed
    1 / 14 (7.14%)
    1 / 7 (14.29%)
         occurrences all number
    1
    2
    Abdominal pain upper
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Dry mouth
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Hyperhidrosis
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Rash
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Infections and infestations
    Gastroenteritis viral
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Nasopharyngitis
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Tonsillitis
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 14 (0.00%)
    1 / 7 (14.29%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 14 (7.14%)
    0 / 7 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    21 Jul 2009
    This substantial amendment primarily involves- 1. Addition of a new subject withdrawal criteria related to pancreatitis. 2.Update of one inclusion and two exclusion criteria. 3.Specification of the frequency of Safety Monitoring Board meetings. 4.Addition of new language to the Informed Consent as agreed with USFDA. In addition to the above, a few minor inconsistencies and clarifications are necessary to make the protocol complete, accurate and more informative. Those have also been included.
    20 Aug 2009
    This substantial amendment involves the addition of text related to liraglutide toxicology results and results in the addition of approved text to the protocol in order to be aligned with the text previously added to the informed consent as requested by the FDA.
    16 Jul 2010
    This substantial amendment primarily involves : 1.Expansion (widening) of the HBA1C inclusion criteria (to ≥ 6.5% and ≤ 11.0%). 2.Expansion (widening) of the FPG randomisation criterion [ to 110-240 mg/dL, (6.1-13.3 mmol/L). 3.Altering the language of exclusion criterion involving subjects on prior use of antidiabetic treatment. 4. Altering the pharmacokinetic (blood) sampling schedule. 5. Replacement of measurement of CGRP in this study with CEA. 6.Addition of new and updated language and safety information to the protocol and Informed Consent as agreed with the regulatrory authorities. (or approved product labelling). 7.Allowance for protocol to incorporate an IV/IWRS system for drug distribution. 8. Minor changes, clarifications and corrections to several sections for making the protocol clear for execution.
    09 Sep 2010
    In this substantial protocol amendment- 1. It was clarified that a calcitonin level was obtained at Visit 1, Screening, (and not at Visit 2, Randomisation) in order to be avialable for eligibility evaluation, and at Visit 7 in Part I,for paediatric subjects. 2. It was clarified that a calcitonin level was obtained at Visit 1, Screening (and not a Visit 2 Randomisation),to be available for eligibility evaluation and at Visit 6 in part II for paediatric subjects. 3. A calcitonin level for adult subjects will be obtained at Visit 1, Screening (and not at Visit 2 Randomisation ) to be available for eligibility evaluation, and at Visit 6 in Part II. 4.The calcitonin level in Exclusion Criteria number 22 was changed from ≥ 100ng/L to ›50 ng/L. 5.A review of withdrawal criteria was added to Visits 7 and 8 in Part I and to Visits 6 and 7 in Part II. 6.A check of vital signs was added to the Flow Chart, Part I day 35, Visit 6. 7.It was clarified that body temperature will be recorded in°F or °C. 8.°F as representing degrees Fahrenheit or °C as representing degrees Celsius were added to the List of Abbreviations.
    14 Dec 2010
    This amendment was implemented in order to add Belgium as a participating country in this trial. The language of the protocol and subject informed consent form was modified accordingly. A minor inconsistency was corrected, allowing for greater accuracy.
    30 Sep 2011
    The amendment was implemented in order to eliminate the part II of the trial, as per Novo Nordisk's agreement with PDCO on 3 May 2011 (Part II was to evaluate the dose range of 0.6 to 1.8mg liraglutide in paediatric subjects and also included a comparative adult group). In addition , minor inconsistencies were corrected in order to allow for greater accuracy. Justification for the date entered- The amendment date -31Oct 2011 entered showed a validation error , hence the date has been entered as 30 Sep 2011, to surpass the validation error. The date entered here is global end of the trial date. The actual amendment date is 31 Oct 2011.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Small number of subjects analysed was the limitation for the trial.

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/25036533
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