E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with type 2 diabetes mellitus and diastolic dysfunction |
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E.1.1.1 | Medical condition in easily understood language |
to examine the effect of linagliptin versus placebo on heart failure in patients with diabetes mellitus type 2 |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | HLGT |
E.1.2 | Classification code | 10019280 |
E.1.2 | Term | Heart failures |
E.1.2 | System Organ Class | 10007541 - Cardiac disorders |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012601 |
E.1.2 | Term | 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 |
To examine the effect of Linagliptin 5mg qd versus placebo on diastolic function in patients with type 2 diabetes mellitus and diastolic dysfunction as assessed by transthoracic echocardiography. |
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E.2.2 | Secondary objectives of the trial |
To examine the effect of Linagliptin 5 mg qd versus placebo on serum levels of NT-pro BNP as a biomarker of heart failure. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Diabetes mellitus Type 2 2. Age > 18 years 3. HbA1c > 7% 4. Left ventricular diastolic dysfunction determined by echocardiography as é < 8 in addition to - E/A < 0.8 (Grade I) or - E/A 0.8-2 and left atrial volume ≥ 34 ml/m2 (Grade II) or - E/A ≥ 2 (Grade III) 5. Stable anti-diabetic medication for the last 6 weeks which should include a maximal tolerated dose of metformin (unless contraindication or intolerance to metformin does exist) 6. Indication to increase anti-diabetic medication as judged by the investigator 7. Written informed consent prior to study participation
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E.4 | Principal exclusion criteria |
Subjects, fulfilling one or more of the following exclusion criteria will not be included in the study: 1. Diabetes mellitus type 1 2. Echocardiography: - decreased left ventricular systolic function, ejection fraction (EF) <45% - regional wall motion abnormalities - Hypertrophic cardiomyopathy (septum >15mm) - Severe valvular dysfunction 3. Uncontrolled hypertension 4. Paroxysmal atrial fibrillation during the last two months 5. Use of DPP-4 Inhibitor (Dipeptidyyl-peptidase IV Inhibitor), GLP-1 agonists 6. Liver disease (ALT or AST > 3 times the upper limit of norm) or known liver cirrhosis 7. Active malignant disease 8. HbA1c > 10% 9. Recent (<6 weeks) clinically significant coronary or cerebral vascular event, current angina pectoris or ischemia on stress tests 10. Pregnant females as determined by positive [serum or urine] hCG test at Screening or prior to dosing. Participants of child-bearing age should use adequate contraception as defined in the study protocol. 11. Lactating females 12. The subject has a history of any other illness, which, in the opinion of the Investigator, might pose an unacceptable risk by administering study medication. 13. The subject received an investigational drug within 30 days prior to inclusion into this study 14. The subject has any current or past medical condition and/or required medication to treat a condition that could affect the evaluation of the study 15. The subject is unwilling or unable to follow the procedures outlined in the protocol 16. The subject is mentally or legally incapacitated 17. Patients with a history of pancreatitis |
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E.5 End points |
E.5.1 | Primary end point(s) |
-Change in left ventricular diastolic function between baseline and after 6 month as determined by 2D and novel 3D parameter global Strain Rate E -Change in left ventricular diastolic function between baseline and after 6 month as determined by standardized parameter E/é and left atrium (LA) volume
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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) |
-Change in serum NT-pro BNP levels |
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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 | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
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.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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-Lasting fasting blood glucose > 240mg/dl during first 12 weeks or > 200 mg/dl during weeks 13-24 though individualized anti diabetic therapy -hypersensitivity reactions (angioedema, anaphylaxis) -skin lesions (skin necrosis) -renal events (>2fold creatinine) -Pancreatitis -hepatic events (>3fold ULN of AST/ALT, etc.) -severe hypoglycaemic episode (> 3 accomp. by typ. symptoms of hypoglycaemia) -pregnancy -non-compliance -subject withdraws consent -administrative problems |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | |