E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10067585 |
E.1.2 | Term | Type 2 diabetes mellitus |
E.1.2 | System Organ Class | 10027433 - Metabolism and nutrition disorders |
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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 test the hypothesis that LY2963016 administered once daily (QD) is noninferior to Lantus administered QD, as measured by change in hemoglobin A1c (HbA1c) from baseline to 24 weeks, when used in combination with OAMs. |
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E.2.2 | Secondary objectives of the trial |
To compare safety of LY2963016 relative to Lantus (eg, incidence of anti-insulin antibodies, hypoglycemia, adverse events [AEs]) when used in combination with OAMs.
To compare LY2963016 relative to Lantus for other efficacy variables (eg, change in HbA1c at 4, 8, 12, 16, and 20 weeks, 7-point self-monitored blood glucose profiles [as plasma equivalent values], percentage of patients with HbA1c <7%, percentage of patients with HbA1c ≤6.5%).
To compare LY2963016 relative to Lantus with regard to intrapatient blood glucose (BG) variability, basal insulin dose, and weight, when used in combination with OAMs.
To test the hypothesis that Lantus is noninferior to LY2963016 (QD), as measured by change in HbA1c from baseline to 24 weeks, when used in combination with OAMs.
To compare LY2963016 relative to Lantus for patient-reported outcomes (PRO) as measured by responses to the Adult Low Blood Sugar Survey (ALBSS) and the Insulin Treatment Satisfaction Questionnaire (ITSQ). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
[1] Have T2DM based on the disease diagnostic criteria World Health
Organization (WHO) classification.
[2] Are ≥18 years of age.
[3] Have been receiving 2 or more OAMs at stable doses for the 12
weeks prior to Visit 1, with or without Lantus. Note: use and dose of oral
agents in combination with insulin must be in accordance with the local product label. Patients taking metformin and who are found to have a
contraindicated serum creatinine level (≥1.4 mg/dL [123.8 μmol/L] for
females, ≥1.5 mg/dL [132.6 μmol/L] for males, or based on countryspecific
label) must be willing to discontinue use of metformin at
randomization.
Note: Sitagliptin is the only DPP-IV inhibitor currently approved for use
with insulin.
If on two OAMs at study entry and there is a need to discontinue one of
those agents due to country labeling requirements or clinical
parameters, that patient would not meet entry criteria.
[4] Have an HbA1c ≥7.0% and ≤11.0% if insulin naïve; if previously on
Lantus, then HbA1c ≤11.0%.
[5] Body mass index (BMI) ≤45 kg/m2.
[6] As determined by the investigator, are capable and willing to do the
following:
perform SMBG
complete patient diaries as instructed
use covered insulin vial and syringe according to study instructions
are receptive to diabetes education
comply with required study treatment and study visits.
[7] Have given written informed consent to participate in this study in
accordance with local regulations. |
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E.4 | Principal exclusion criteria |
[8] Have used any other insulin except Lantus, including commercial and
investigational insulins within the previous 30 days.
[9] Have been exposed to a biosimilar insulin glargine within the
previous 90 days.
[10] Have a history of taking basal bolus therapy or who, in the
investigator's opinion, require mealtime insulin in order to achieve
target control.
[11] Have used short-acting glucagon like peptide (GLP-1) agonist (eg,
exenatide) or long-acting GLP-1 agonist (eg, liraglutide) within the
previous 90 days.
[12] Have used pramlintide (eg, Symlin®) within the previous 30 days.
[13] Have excessive insulin resistance at study entry (total insulin dose
≥1.5 U/kg).
[14] Have had more than one episode of severe hypoglycemia within 6
months prior to entry into the study.
[15] Have known hypersensitivity or allergy to Lantus or its excipients.
[16] Are receiving chronic (lasting longer than 14 consecutive days)
systemic glucocorticoid therapy at pharmacological doses (excluding
topical, intraarticular, intraocular, or inhaled preparations and
physiologic replacement doses for adrenal deficiency) or have received
such therapy within 4 weeks immediately preceding Visit 1.
[17] Have obvious signs or symptoms, or laboratory evidence, of liver
disease (alanine aminotransferase [ALT]; or aspartate aminotransferase
[AST] greater than 2.5 times the upper limit of the reference range, as
defined by the central laboratory; or albumin value remarkably above or
below the normal reference range, as defined by the central laboratory).
[18] Have one of the following concomitant diseases: significant cardiac
(eg, congestive heart failure Class III or IV) or gastrointestinal disease
(eg, significant gastroparesis).
[19] Have a history of renal transplantation, are currently receiving
renal dialysis or have a serum creatinine greater than 2.0 mg/dL
[20] Have had a blood transfusion or severe blood loss within 3 months
prior to Visit 1 or have known hemoglobinopathy, hemolytic anemia, or
sickle cell anemia.
[21] Patients with active cancer or personal history of cancer within the previous 5 years (with the exception of basal cell carcinoma or
carcinoma in situ).
[22] Are investigator-site personnel directly affiliated with this study
and/or their immediate families. Immediate family is defined as a
spouse, parent, child, or sibling, whether biological or legally adopted.
[23] Have any other condition (including known drug or alcohol abuse or
psychiatric disorder) that precludes the patient from following and
completing
the protocol.
[24] Are Lilly employees.
[25] Are currently enrolled in, or discontinued within the last 30 days
from, a clinical trial involving an investigational product or non-approved
use of a drug or device other than LY2963016, or concurrently enrolled
in any other type of medical research judged not to be scientifically or
medically compatible with this study.
[26] Have previously completed or withdrawn from this study.
[27] Are pregnant or intend to become pregnant during the course of the
study or are sexually active women of childbearing potential not actively
practicing birth control by a method determined by the investigator to be
medically acceptable.
[28] Women who are breastfeeding. |
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 7 |
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 | No |
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 |
Czech Republic |
France |
Germany |
Greece |
Hungary |
Italy |
Korea, Republic of |
Mexico |
Poland |
Romania |
Russian Federation |
Slovakia |
Spain |
Taiwan |
United States |
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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 | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |