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    Summary
    EudraCT Number:2013-002518-11
    Sponsor's Protocol Code Number:8835-004
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2013-12-05
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2013-002518-11
    A.3Full title of the trial
    RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PARALLEL-GROUP STUDY TO ASSESS CARDIOVASCULAR OUTCOMES FOLLOWING TREATMENT WITH ERTUGLIFLOZIN (MK-8835/PF-04971729) IN SUBJECTS WITH TYPE 2 DIABETES MELLITUS AND ESTABLISHED VASCULAR DISEASE
    ESTUDIO ALEATORIZADO, DOBLE CIEGO, CONTROLADO CON PLACEBO Y DE GRUPOS PARALELOS PARA EVALUAR LOS SUCESOS CARDIOVASCULARES TRAS EL TRATAMIENTO CON ERTUGLIFLOZINA (MK-8835/PF-04971729) EN PACIENTES CON DIABETES MELLITUS TIPO 2 Y ENFERMEDAD CARDIOVASCULAR ESTABILIZADA.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    STUDY TO ASSESS CARDIOVASCULAR OUTCOMES FOLLOWING
    TREATMENT WITH ERTUGLIFLOZIN IN SUBJECTS WITH TYPE 2 DIABETES
    MELLITUS AND ESTABLISHED VASCULAR DISEASE
    ESTUDIO PARA EVALUAR LOS SUCESOS CARDIOVASCULARES TRAS EL TRATAMIENTO CON ERTUGLIFLOZINA EN PACIENTES CON DIABETES MELLITUS TIPO 2 Y ENFERMEDAD CARDIOVASCULAR ESTABILIZADA
    A.4.1Sponsor's protocol code number8835-004
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.4.2CountryUnited States
    B.4.1Name of organisation providing supportPfizer Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc.
    B.5.2Functional name of contact pointSenior Director, Clinical Sciences
    B.5.3 Address:
    B.5.3.1Street Address620 Memorial Drive
    B.5.3.2Town/ cityCambridge
    B.5.3.3Post codeMA 02139
    B.5.3.4CountryUnited States
    B.5.4Telephone number+16175513252
    B.5.5Fax number+18606866427
    B.5.6E-mailsteven.g.terra@pfizer.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameErtugliflozin
    D.3.2Product code PF-04971729 / MK-8835
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNErtugliflozin
    D.3.9.2Current sponsor codePF-04971729 / MK-8835
    D.3.9.3Other descriptive namePF-04971729 / MK-8835
    D.3.9.4EV Substance CodeSUB31037
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameErtugliflozin
    D.3.2Product code PF-04971729 / MK-8835
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNErtugliflozin
    D.3.9.2Current sponsor codePF-04971729 / MK-8835
    D.3.9.3Other descriptive namePF-04971729 / MK-8835
    D.3.9.4EV Substance CodeSUB31037
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Type 2 Diabetes Mellitus
    DIABETES MELLITUS TIPO 2
    E.1.1.1Medical condition in easily understood language
    Type 2 Diabetes Mellitus
    DIABETES MELLITUS TIPO 2
    E.1.1.2Therapeutic area Diseases [C] - Nutritional and Metabolic Diseases [C18]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.1
    E.1.2Level PT
    E.1.2Classification code 10067585
    E.1.2Term Type 2 diabetes mellitus
    E.1.2System Organ Class 10027433 - Metabolism and nutrition disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Objective: To demonstrate the non inferiority of ertugliflozin compared with a non ertugliflozin comparator group on the time to first occurrence of any of the components of the composite endpoint of cardiovascular death, non-fatal myocardial infarction or non fatal stroke. Hypothesis: The time to first occurrence of any of the components of the composite endpoint of cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke in subjects treated with ertugliflozin is non-inferior compared to that in subjects not treated with ertugliflozin.
    Objetivo: demostrar la no inferioridad de ertugliflozina en comparación con un grupo de comparación sin ertugliflozina en el tiempo hasta la primera aparición de cualquiera de los componentes del parámetro de valoración combinado de muerte cardiovascular, infarto de miocardio no mortal o accidente cerebrovascular no mortal.
    Hipótesis: el tiempo hasta la primera aparición de cualquiera de los componentes del parámetro de valoración combinado de muerte cardiovascular, infarto de miocardio no mortal o accidente cerebrovascular no mortal en los sujetos tratados con ertugliflozina es no inferior en comparación con el de los sujetos no tratados con ertugliflozina.
    E.2.2Secondary objectives of the trial
    Objective: To demonstrate the non inferiority of ertugliflozin as compared with a non ertugliflozin comparator group on the time to first occurrence of any of the components of the composite endpoint of cardiovascular death, non fatal myocardial infarction, non fatal stroke or hospitalization for unstable angina. Hypothesis: The time to first occurrence of any of the components of the composite endpoint of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for unstable angina in subjects treated with ertugliflozin is non-inferior compared to that in subjects not treated with ertugliflozin.
    Objective: To assess the effect of ertugliflozin as compared with a non ertugliflozin comparator group on the time to first occurrence of:
    -Fatal or non fatal myocardial infarction;
    -Fatal or non fatal stroke;
    -Hospitalization for a primary diagnosis of heart failure;
    -Individual components of MACE plus
    Obj: demostrar la no inferioridad de ertugliflozina en comparación con un grupo sin ertugliflozina en el tiempo hasta la 1ª aparición de los componentes del parámetro de valoración combinado de muerte cardiovascular, infarto de miocardio no mortal, accidente cerebrovascular no mortal u hospitalización por angina inestable.Hipótesis: tiempo hasta la 1ª aparición de los componentes de valoración combinado de muerte cardiovascular, infarto de miocardio no mortal, accidente cerebrovascular no mortal u hospitalización por angina inestable en sujetos tratados con ertugliflozina es no inferior en comparación con el de los sujetos no tratados con ertugliflozina.Obj: evaluar el efecto de ertugliflozina en comparación con un grupo sin ertugliflozina en el tiempo hasta la primera aparición de: Infarto de miocardio mortal o no mortal; Accidente cerebrovascular mortal o no mortal; Hospitalización por un diagnóstico primario de insuficiencia cardíaca;Componentes individuales de MACE plus
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Insulin +/- Metformin Add-on Glycemic Sub-Study
    Pre specified 18 week sub study to generate safety and efficacy data in T2DM subjects using insulin therapy alone or insulin with metformin. The insulin +/- metformin sub study has different requirements with respect to allowable background AHA than the main cardiovascular study.

    SU Monotherapy Add-on Glycemic Sub-Study
    Pre specified 18 week sub study to generate safety and efficacy data in subjects using a SU (sulfonylurea) as monotherapy at the pre-specified doses. The SU monotherapy sub study has different requirements with respect to allowable background AHA than the main cardiovascular study.
    Subestudio glucémico adicional con insulina ± metformina.
    Este ensayo incluye un subestudio preespecificado de 18 semanas para generar datos de seguridad y eficacia en sujetos con DMT2 que utilizan un tratamiento con insulina solo o con insulina y metformina. El subestudio con insulina ± metformina tiene diferentes requisitos con respecto a los AHA de base permitidos que el estudio cardiovascular principal.
    Subestudio glucémico adicional con SU en monoterapia.
    Este ensayo incluye un subestudio preespecificado de 18 semanas para generar datos de seguridad y eficacia en sujetos que utilizan una SU en monoterapia a las dosis preespecificadas. El subestudio con SU en monoterapia tiene diferentes requisitos con respecto a los AHA de base permitidos que el estudio cardiovascular principal.
    E.3Principal inclusion criteria
    1. Subjects > or =40 years of age at the time of the initial Screening visit (V1) with a diagnosis of T2DM in accordance with American Diabetes Association (ADA) guidelines.13
    2. HbA1c at the Screening visit (V1) of 7.0 10.5% (53 91 mmol/mol) on stable allowable AHA(s) or on no background AHA for at least 8 weeks prior to the Screening visit (V1).
    3. Body Mass Index (BMI) >or =18.0 kg/m2.
    4. Subjects must have evidence or a history of atherosclerosis involving the coronary, cerebral or peripheral vascular systems as follows (must have at least one of the following a-d):
    a. Coronary artery disease as indicated by a history of presumed spontaneous myocardial infarction (hospitalized with final diagnosis of myocardial infarction, excluding peri-procedural or definite secondary myocardial infarction [eg, due to profound anemia or hypertensive emergency, troponin increase in sepsis] in which the most recent event occurred at least 3 months (90 days) prior to the Screening visit (V1); OR
    b. Coronary artery disease as indicated by a history of coronary revascularization through either a Percutaneous Coronary Intervention (PCI) at least 3 months (90 days) prior to the Screening visit (V1) or Coronary Artery Bypass Graft (CABG) at least 3 months (90 days) prior to the Screening visit (V1); OR
    c. Ischemic (presumed thrombotic) cerebrovascular disease as indicated by a history of ischemic stroke (hospitalized with a final diagnosis of non hemorrhagic stroke [includes completion of a standard evaluation for stroke in an acute care facility or stroke clinic without hospital admission] with the most recent event occurring at least 3 months (90 days) prior to the Screening visit (V1) or a history of carotid revascularization at least 3 months (90 days) prior to the Screening visit (V1); OR
    d. Peripheral arterial disease as indicated by:
    1. Angiographically documented peripheral vascular disease; or
    2. Resting ankle/brachial index (ABI) of <0.85 (measured by a certified vascular laboratory) plus symptoms of claudication; or
    3. Amputation, peripheral bypass, or peripheral angioplasty of the extremities secondary to ischemia occurring at least 3 months (90 days) prior to the Screening visit (V1).
    5. Subject meets one of the following criteria (a, b or c):
    a. Is a male;
    b. Is a female not of reproductive potential defined as one who (See Section 4.4.4.1 and Section 4.4.4.2 for reference on childbearing potential):
    1. Is postmenopausal: defined as at least 12 months with no menses in women>=45 years of age. or
    2. Has had a hysterectomy and/or bilateral oophorectomy, or had bilateral tubal ligation or occlusion at least 6 weeks prior to the Screening visit (V1).
    c. Is a female of reproductive potential and:
    1. Agrees to remain abstinent from heterosexual activity (if this form of birth control is accepted by local regulatory agencies and ethics review committees as the sole method of birth control); or
    2. Agrees to use (or have their partner use) acceptable contraception to prevent pregnancy while the subject is receiving investigational product and for 14 days after the last dose of investigational product. Two methods of contraception will be used to avoid pregnancy. Acceptable combinations of methods include:
    -Use of one of the following double-barrier methods: diaphragm with spermicide and a condom; cervical cap and a condom; or a contraceptive sponge and condom;
    -Use of hormonal contraception (any registered and marketed contraceptive agent that contains an estrogen and/or a progestational agent [including oral, subcutaneous, intrauterine and intramuscular agents, and cutaneous patch]) with one of the following: diaphragm with spermicide; cervical cap; contraceptive sponge; condom; vasectomy; or intrauterine device (IUD);
    -Use of an IUD with one of the following: condom; diaphragm with spermicide; contraceptive sponge; vasectomy; or hormonal contraception (see above);
    -Vasectomy with one of the following: diaphragm with spermicide; cervical cap; contraceptive sponge; condom; IUD; or hormonal contraception (see above).
    6. Evidence of a personally signed and dated informed consent document (ICD) indicating that the subject (or a legal representative) has been informed of all pertinent aspects of the trial. The subject may also provide consent for Future Biomedical Research. However, the subject may participate in the main trial without participating in Future Biomedical Research.
    7. In the investigators opinion subjects are willing and likely able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures whether or not they receive investigational product for the duration of the trial.
    1.Sujetos >=40 años de edad en el momento de la visita de selección (V1) con un diagnóstico previo de DMT2, de acuerdo con las directrices de la Asociación Americana de la Diabetes (ADA).
    2.HbA1c del 7,0-10,5 % (53-91 mmol/mol) en el momento de la visita de selección (V1) con AHA permitidos de forma estable o sin AHA de base durante al menos 8 semanas antes de la visita de selección (V1).
    3. Índice de masa corporal (Body Mass Index, BMI) >=18,0 kg/m2.
    4. Los sujetos deben tener evidencia o antecedentes de aterosclerosis en el sistema coronario, cerebral o vascular periférico como sigue:
    a.enfermedad arterial coronaria tal como se indica por antecedentes de un presunto infarto de miocardio espontáneo (hospitalizado con el diagnóstico final de infarto de miocardio, excluido un infarto de miocardio relacionado con un procedimiento o secundario definitivo en el que el caso más reciente ocurrió al menos 3 meses (90 días) antes de la visita de selección (V1); O
    b.enfermedad arterial coronaria tal como se indica por antecedentes de revascularización coronaria ya sea mediante una intervención coronaria percutánea (ICP) al menos 3 meses (90 días) antes de la visita de selección (V1) o una revascularización coronaria por lo menos 3 meses (90 días) antes de la visita de selección (V1); O
    c.enfermedad cerebrovascular isquémica (presunta trombosis) tal como se indica por antecedentes de un accidente cerebrovascular isquémico (hospitalizado con un diagnóstico final de accidente cerebrovascular no hemorrágico, cuyo acontecimiento más reciente se haya producido al menos 3 meses (90 días) antes de la visita de selección (V1) o antecedentes de revascularización carotídea al menos 3 meses (90 días) antes de la visita de selección (V1); O
    d.Arteriopatía periférica tal como se indica por:
    1. Enfermedad vascular periférica documentada por medio de una angiográficamente; o
    2. Índice tobillo/brazo (ITB) en reposo de <0,85 (medido en un laboratorio vascular certificado), además de síntomas de claudicación; o
    3. Amputación, derivación periférica o angioplastia periférica de las extremidades secundarias a la isquemia que ocurre por lo menos 3 meses (90 días) antes de la visita de selección (V1).
    5. El sujeto cumple uno de los siguientes criterios (a, b o c):
    a.es un hombre; b.es una mujer sin capacidad reproductiva definido como alguien que: 1.es posmenopáusica: se define como al menos 12 meses sin menstruación en mujeres>=45 años de edad; o 2.ha tenido una histerectomía y/o una oforectomía bilateral, o ha tenido una ligadura de trompas o una oclusión bilateral al menos 6 semanas antes de la visita de selección (V1).
    c.es una mujer con capacidad reproductiva y:
    1.está de acuerdo en mantener la abstinencia de la actividad heterosexual (si las agencias reguladoras locales y los comités de revisión ética aceptan esta forma de método anticonceptivo como único método de control de la natalidad); o
    2.está de acuerdo en utilizar (o que su pareja utilice) anticonceptivos aceptables para prevenir el embarazo mientras el sujeto está recibiendo el producto en investigación y durante 14 días después de la última dosis del producto en investigación. Se utilizarán dos métodos anticonceptivos para evitar el embarazo. Las combinaciones aceptables de los métodos incluyen:
    -El uso de uno de los siguientes métodos de doble barrera: diafragma con espermicida y un condón; un capuchón cervical y un condón; o una esponja anticonceptiva y preservativos;
    -El uso de anticoncepción hormonal (cualquier agente anticonceptivo registrado y comercializado que contenga un estrógeno y/o un progestágeno [incluidos los fármacos orales, subcutáneos, intrauterinos e intramusculares, y el parche cutáneo]) con uno de los siguientes: diafragma con espermicida; capuchón cervical; esponja anticonceptiva; condón; vasectomía; o dispositivo intrauterino (DIU);
    -El uso de un DIU con uno de los siguientes: condón; diafragma con espermicida; esponja anticonceptiva; vasectomía; o anticoncepción hormonal
    -Vasectomía con uno de los siguientes: diafragma con espermicida; capuchón cervical; esponja anticonceptiva; condón; DIU; o anticoncepción hormonal (véase más arriba).
    6.Evidencia de un documento de consentimiento informado (DCI), firmado y fechado personalmente, que indica que el sujeto ha sido informado de todos los aspectos pertinentes del estudio. El sujeto puede dar también su consentimiento para la investigación biomédica futura. Sin embargo, el sujeto puede participar en el ensayo principal sin participar en la investigación biomédica futura.
    7.En opinión del investigador, los sujetos están dispuestos y es probable que puedan cumplir con las visitas programadas, el plan de tratamiento, las pruebas de laboratorio y otros procedimientos del estudio, reciban o no el producto en investigación durante la duración del ensayo.
    E.4Principal exclusion criteria
    1. Subjects who had been previously randomized into this trial.
    2. Subjects experiencing a cardiovascular event (eg, myocardial infarction or stroke) or undergoing coronary angioplasty or peripheral intervention procedure between the Screening visit (V1) and randomization.
    3. Subjects undergoing any cardiovascular surgery (eg, valvular surgery) within 3 months (90 days) of the Screening visit (V1).
    4. Subjects with any planned coronary revascularization or peripheral intervention procedure or other cardiovascular surgery.
    5. Subjects with New York Heart Association (NYHA) Class III or IV heart failure at the Screening visit (V1).
    6. Mean value for triplicate screening sitting systolic blood pressure >160 mm Hg and/or diastolic blood pressure >90 mm Hg after at least a 5 minute seated rest at the Screening visit (V1), confirmed via 1 repeat triplicate set at the Screening visit (V1) if deemed necessary. For subjects with a mean triplicate value of sitting systolic blood pressure >160 mm Hg and/or diastolic blood pressure >90 mm Hg after at least a 5 minute seated rest at the Screening visit (V1) the investigator or the treating physician is allowed to adjust background blood pressure medication(s) to lower blood pressure values in order for the subject to be re-assessed for enrollment eligibility.
    7. Subject has a clinically significant ECG abnormality at Screening visit (V1) that requires further diagnostic evaluation or intervention (eg, new, clinically significant arrhythmia or a conduction disturbance).
    8. History of type 1 diabetes mellitus or a history of ketoacidosis.
    9. History of other specific types of diabetes (eg, genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical induced, and post organ transplant).
    10. Subject has active, obstructive uropathy or indwelling urinary catheter.
    11. Subject has a history of malignancy ?5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer.
    Note (1) A subject with a history of malignancy >5 years prior to signing informed consent should have no evidence of residual or recurrent disease.
    Note (2) A subject with any history of melanoma, leukemia, lymphoma, or renal cell carcinoma is excluded.
    12. Subject routinely consumes >2 alcoholic drinks per day or >14 alcoholic drinks per week, or engages in binge drinking.
    Note (1): One alcoholic drink is defined as 5 oz (150 mL) of wine, or 12 oz (350 mL) of beer, or 1.5 oz (50 mL) of 80 proof liquor.
    Note (2): Binge drinking is defined as a pattern of 5 or more alcoholic drinks (male), or 4 or more alcoholic drinks (female) in about 2 hours.
    13. Any clinically significant malabsorption condition.
    14. Subjects with a known hypersensitivity or intolerance to any SGLT2 inhibitor.
    15. Screening fasting plasma or finger stick glucose >270 mg/dL (15 mmol/L), confirmed by a single repeat following counseling on exercise and diet.
    16. History of one or more severe hypoglycemic episodes within 6 months of Screening (V1) or a severe hypoglycemic episode occurring during the interval between the Screening visit (V1) and randomization.
    17. Fasting triglycerides >600 mg/dL (6.78 mmol/L) at Screening (V1), confirmed by a single repeat if deemed necessary. For subjects with fasting triglycerides >600 mg/dL the investigator or treating physician is allowed to adjust background lipid altering medication(s) to lower fasting triglycerides in order for the subject to be re-assessed for enrollment eligibility.
    18. Subjects currently taking blood pressure or lipid altering medications that have not been on a stable dose for at least 4 weeks prior to randomization. Subjects who require a change in blood pressure and/or lipid altering medications to meet the entry criteria related to blood pressure and/or triglycerides must be on a stable dose of such therapy for at least 4 weeks prior to randomization.
    19. Subjects who meet any of the following categories:
    -Subject is on a weight-loss program and is not weight-stable.
    -Subject is on a weight-loss medication (eg, orlistat, phentermine/topiramate, lorcaserin) and is not weight-stable.
    -Subject is on other medications associated with weight changes (eg, anti-psychotic agents) and is not weight-stable.
    -Subject has undergone bariatric surgery >12 months prior to Visit 1/Screening and is not weight-stable.
    -Subject has undergone bariatric surgery within 12 months of Screening visit (visit 1).
    Note: Weight-stable is defined as <5% change in body weight in the last 6 months.
    20. Subjects currently being treated for hyperthyroidism, subjects on thyroid replacement therapy that have not been on a stable dose for at least 6 weeks prior to the Screening visit (V1) and/or subjects who have a TSH outside of the laboratory reference range at the Screening visit (V1).
    1. Sujetos que se habían aleatorizado previamente en este ensayo
    2.Sujetos que experimenten un acontecimiento cardiovascular o se sometan a una angioplastia coronaria o un procedimiento de intervención periférica en la (V1) y la aleatorización.
    3. Sujetos sometidos a cualquier tipo de cirugía cardiovascular en los 3 meses (90 días) antes de (V1).
    4. Sujetos con cualquier revascularización coronaria o procedimiento de intervención periférica u otra cirugía cardiovascular, planeados.
    5. Sujetos con insuficiencia cardíaca de clase III o IV de la Asociación del Corazón de Nueva York en (V1)
    6.Valor medio para la detección por triplicado de la presión arterial sistólica >160 mmHg y/o presión arterial diastólica >90 mmHg, en posición sentada, después de permanecer sentado en reposo al menos unos 5 minutos en la (V1), confirmado por 1 medición repetida por triplicado en la (V1), En los sujetos con un valor medio por triplicado de la presión arterial sistólica >160 mmHg y/o presión arterial diastólica >90 mmHg, en posición sentada, después de permanecer sentado en reposo al menos unos 5 minutos en la (V1), se permite que el investigador o el médico encargado ajuste la medicación de base para la presión arterial para reducir los valores de la presión arterial con el fin de que el sujeto se vuelva a evaluar para la elegibilidad de inscripción.
    7.El sujeto tiene una anomalía clínicamente significativa en el ECG en la (V1) que requiere una evaluación diagnóstica adicional o una intervención
    8. Antecedentes de diabetes mellitus de tipo 1 o antecedentes de cetoacidosis.
    9.Antecedentes de otros tipos específicos de diabetes 10. Subject has active, obstructive uropathy or indwelling urinary catheter.
    10.El sujeto tiene una uropatía obstructiva activa o un catéter urinario permanente.
    11.El sujeto tiene antecedentes de neoplasia maligna =<5 años antes de firmar el consentimiento informado, excepto el cáncer de piel basocelular o de células escamosas tratado adecuadamente o el cáncer de cuello uterino in situ.
    Nota (1) Un sujeto con antecedentes de neoplasia maligna >5 años antes de la firma del consentimiento informado no debe tener ninguna evidencia de enfermedad residual o recurrente. Nota (2) Los sujetos con antecedentes de melanoma, leucemia, linfoma o carcinoma de células renales están excluidos
    12.El sujeto consume habitualmente >2 bebidas alcohólicas al día o >14 bebidas alcohólicas por semana, o se dedica a beber en exceso.
    Nota (1) Una bebida alcohólica se define como 5 oz (150 ml) de vino o 12 oz (350 ml) de cerveza o 1,5 oz (50 ml) de licor de 80 grados.Nota (2) El consumo excesivo de alcohol se define como un patrón de 5 o más bebidas alcohólicas (hombres), o 4 o más bebidas alcohólicas (mujeres), en aprox 2 horas.
    13.Cualquier síndrome de malabsorción clínicamente significativo.
    14.Sujetos con hipersensibilidad conocida o intolerancia a cualquier inhibidor de SGLT2.
    15.Detección en glucosa plasmática en ayunas o mediante punción digital >270 mg/dl (15 mmol/l), confirmada por una sola repetición siguiendo el asesoramiento sobre el ejercicio y la dieta.
    16.Antecedentes de uno o más episodios graves de hipoglucemia dentro de los 6 meses antes de la selección (V1) o un episodio grave de hipoglucemia que se produce durante el intervalo entre la visita de selección (V1) y la aleatorización.
    17.Triglicéridos en ayunas >600 mg/dl (6,78 mmol/l) en la (V1), confirmado por una sola repetición si se considera necesario. En pacientes con triglicéridos en ayunas >600 mg/dl, se permite que el investigador o el médico encargado ajuste la medicación de base de alteración lipídica para bajar los triglicéridos en ayunas con el fin de que el sujeto se vuelva a evaluar para la elegibilidad de inscripción
    18.Sujetos que toman actualmente medicación para la presión arterial o para alterar los lípidos que no han tenido una dosis estable durante al menos 4 semanas antes de la aleatorización. Los sujetos, que requieren un cambio en la medicación para la presión arterial y/o alterar los lípidos para cumplir con los criterios de entrada relacionados con la presión sanguínea y/o los triglicéridos, deben tener una dosis estable de dicho tratamiento durante al menos 4 semanas antes de la aleatorización.
    19.Sujetos que cumplan alguna de las siguientes categorías:
    -El sujeto está en un programa de pérdida de peso y no tiene un peso estable.
    -El sujeto está tomando un medicamento para bajar de peso y no tiene un peso estable.
    -El sujeto está tomando otros medicamentos asociados a los cambios de peso (p. ej., fármacos antipsicóticos) y no tiene un peso estable.
    -El sujeto se ha sometido a una cirugía bariátrica >12 meses antes de la visita 1/selección y no tiene un peso estable.
    -El sujeto se ha sometido a una cirugía bariátrica en los 12 meses antes de la (visita 1).Nota: El peso estable se define como <5 % de cambio en el peso corporal en los últimos 6 meses.
    Véase en el protocolo el resto de criterios.
    E.5 End points
    E.5.1Primary end point(s)
    - The primary cardiovascular endpoint is time to first occurrence of any of the components of the composite endpoint of:
    -Cardiovascular death;
    - Non-fatal myocardial infarction;
    - Non-fatal stroke.
    -El parámetro de valoración cardiovascular primario es el tiempo hasta la primera aparición de cualquiera de los componentes del parámetro de valoración combinado de:
    -Muerte cardiovascular;
    -Infarto de miocardio no mortal;
    -Accidente cerebrovascular no mortal.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Assessment according to protocol
    Evaluación conforme al protocolo.
    E.5.2Secondary end point(s)
    Time to first occurrence of any of the components of the composite endpoint of:
    -Cardiovascular death;
    -Non-fatal myocardial infarction;
    -Non-fatal stroke;
    -Hospitalization for unstable angina.
    Time to first occurrence of:
    -Fatal or non fatal myocardial infarction;
    -Fatal or non fatal stroke;
    -Hospitalization for a primary diagnosis of heart failure;
    -Individual components of the MACE plus (cardiovascular death, non-fatal myocardial infarction, non fatal stroke, hospitalization for unstable angina).
    -All MACE plus events (ie, not censored at the time of the first event).
    -All cause mortality.
    Tiempo hasta la primera aparición de cualquiera de los componentes del parámetro de valoración combinado de:
    -Muerte cardiovascular;
    -Infarto de miocardio no mortal;
    -Accidente cerebrovascular no mortal;
    - Hospitalización por angina inestable.
    Tiempo hasta la primera aparición de:
    -Infarto de miocardio mortal o no mortal;
    -Accidente cerebrovascular mortal o no mortal;
    -Hospitalización por un diagnóstico primario de insuficiencia cardíaca;
    -Componentes individuales de MACE plus (muerte cardiovascular, infarto de miocardio no mortal, accidente cerebrovascular no mortal, hospitalización por angina inestable).
    -Todos los acontecimientos MACE plus (es decir, no censurados en el momento del primer acontecimiento).
    -Todas las causas de mortalidad
    E.5.2.1Timepoint(s) of evaluation of this end point
    Assessment according to protocol
    Evaluación conforme al protocolo.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    To demonstrate the non inferiority of ertugliflozin compared with a non ertugliflozin comparator group on the time to first occurrence of any of the components of the composite endpoint of cardiovascular death, non-fatal myocardial infarction or non fatal stroke.
    Demostrar la no inferioridad de ertugliflozina en comparación con un grupo de comparación sin ertugliflozina en el tiempo hasta la primera aparición de cualquiera de los componentes del parámetro de valoración combinado de muerte cardiovascular, infarto de miocardio no mortal o accidente cerebrovascular no mortal.
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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.8.4.1Number of sites anticipated in Member State concerned14
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA123
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Brazil
    Bulgaria
    Canada
    Colombia
    Germany
    Greece
    Hong Kong
    Israel
    Italy
    Philippines
    Croatia
    Mexico
    Netherlands
    Peru
    Poland
    Romania
    Ukraine
    Korea, Republic of
    South Africa
    Spain
    Sweden
    Taiwan
    Thailand
    Turkey
    United Kingdom
    Georgia
    E.8.7Trial 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
    End of Trial in all other participating countries is defined as Database Lock.
    End of Trial in a Member State of the European Union is defined as the time at which it is deemed that sufficient subjects have been recruited and completed the study as stated in the regulatory application (ie, Clinical Trial Application (CTA)) and ethics application in the
    Member State.
    El fin del ensayo en todos los demás países participantes se define como el cierre de base de datos.
    El fin del ensayo en un Estado miembro de la Unión Europea se define como el momento en el que se considera que ha sido reclutado y ha completado el estudio el número suficiente de sujetos indicado en la solicitud reguladora (es decir, la solicitud de ensayo clínico [Clinical Trial Application, CTA]) .
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 1950
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 1950
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state272
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 1400
    F.4.2.2In the whole clinical trial 3900
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Each randomized subject should have a follow-up phone call 14 days after the last dose of
    investigational product to assess for AEs, SAEs and collect information on clinical events, if applicable.
    Cada sujeto aleatorizado debe tener una llamada telefónica de seguimiento 14 días después de la última dosis del producto en investigación para evaluar los AA, los AAG y recopilar información sobre los acontecimientos clínicos, si corresponde.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2014-01-27
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2014-01-08
    P. End of Trial
    P.End of Trial StatusCompleted
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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