Clinical Trial Results:
A Randomized, Double-blind, Placebo Controlled, 2-arm, Parallel-group, 26-week, Multicenter Study to Evaluate the Efficacy, Safety, and Tolerability of Canagliflozin in the Treatment of Subjects with Type 2 Diabetes Mellitus with Inadequate Glycemic Control on Metformin and Sitagliptin Therapy
Summary
|
|
EudraCT number |
2013-004819-40 |
Trial protocol |
DE |
Global end of trial date |
11 Sep 2015
|
Results information
|
|
Results version number |
v1(current) |
This version publication date |
25 Aug 2016
|
First version publication date |
25 Aug 2016
|
Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
|
|||
Trial identification
|
|||
Sponsor protocol code |
28431754DIA4004
|
||
Additional study identifiers
|
|||
ISRCTN number |
- | ||
US NCT number |
NCT02025907 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
|
|||
Sponsor organisation name |
Janssen Research & Development, LLC
|
||
Sponsor organisation address |
Turnhoutseweg 30, BEERSE, Belgium, 2340
|
||
Public contact |
Clinical Registry Group, Janssen Research & Development, LLC, ClinicalTrialsEU@its.jnj.com
|
||
Scientific contact |
Clinical Registry Group, Janssen Research & Development, LLC, ClinicalTrialsEU@its.jnj.com
|
||
Paediatric regulatory details
|
|||
Is trial part of an agreed paediatric investigation plan (PIP) |
No
|
||
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 |
11 Sep 2015
|
||
Is this the analysis of the primary completion data? |
No
|
||
Global end of trial reached? |
Yes
|
||
Global end of trial date |
11 Sep 2015
|
||
Was the trial ended prematurely? |
No
|
||
General information about the trial
|
|||
Main objective of the trial |
The main objectives were to assess the effect of canagliflozin relative to placebo on glycosylated hemoglobin (HbA1c) and to assess the safety and tolerability of canagliflozin.
|
||
Protection of trial subjects |
The safety assessments included the clinical laboratory tests (hematology, serum chemistry, FPG, and urinalysis), fasting lipid, electrocardiogram (ECG), vital signs, hypoglycemic episodes, fasting self-monitored blood glucose (SMBG) and physical examinations. Adverse events (AEs) were assessed throughout the study.
|
||
Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
21 Feb 2014
|
||
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 |
Australia: 35
|
||
Country: Number of subjects enrolled |
Canada: 39
|
||
Country: Number of subjects enrolled |
France: 16
|
||
Country: Number of subjects enrolled |
Germany: 29
|
||
Country: Number of subjects enrolled |
United States: 94
|
||
Worldwide total number of subjects |
213
|
||
EEA total number of subjects |
45
|
||
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) |
0
|
||
Adolescents (12-17 years) |
0
|
||
Adults (18-64 years) |
161
|
||
From 65 to 84 years |
52
|
||
85 years and over |
0
|
|
|||||||||||||||||||||||||||||||
Recruitment
|
|||||||||||||||||||||||||||||||
Recruitment details |
- | ||||||||||||||||||||||||||||||
Pre-assignment
|
|||||||||||||||||||||||||||||||
Screening details |
Total of 390 subjects screened, out of that 218 subjects were randomly assigned in 1:1 ratio to canagliflozin or placebo treatment. However, One subject was randomized twice (once to placebo and once to canagliflozin) was excluded from the safety analysis set, therefore 216 of the 218 randomized subjects were included in the analyses. | ||||||||||||||||||||||||||||||
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 |
Subject, Investigator | ||||||||||||||||||||||||||||||
Arms
|
|||||||||||||||||||||||||||||||
Are arms mutually exclusive |
Yes
|
||||||||||||||||||||||||||||||
Arm title
|
Placebo | ||||||||||||||||||||||||||||||
Arm description |
Subjects administered with placebo (inactive medication) once daily for 26 weeks. | ||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
|
||||||||||||||||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||||||||||||||||
Other name |
|||||||||||||||||||||||||||||||
Pharmaceutical forms |
Capsule
|
||||||||||||||||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||||||||||||||||
Dosage and administration details |
Subjects administered with matching placebo to canagliflozin orally, once daily for 26 weeks.
|
||||||||||||||||||||||||||||||
Arm title
|
Canagliflozin | ||||||||||||||||||||||||||||||
Arm description |
Subjects administered canagliflozin (JNJ-28431754) 100 milligram (mg) titratable to 300 mg once daily for 26 weeks. | ||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Canagliflozin
|
||||||||||||||||||||||||||||||
Investigational medicinal product code |
|||||||||||||||||||||||||||||||
Other name |
|||||||||||||||||||||||||||||||
Pharmaceutical forms |
Capsule
|
||||||||||||||||||||||||||||||
Routes of administration |
Oral use
|
||||||||||||||||||||||||||||||
Dosage and administration details |
Subjects administered with canagliflozin orally, once daily for 26 weeks.
|
||||||||||||||||||||||||||||||
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Baseline characteristics reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects administered with placebo (inactive medication) once daily for 26 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Canagliflozin
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects administered canagliflozin (JNJ-28431754) 100 milligram (mg) titratable to 300 mg once daily for 26 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
End points reporting groups
|
|||
Reporting group title |
Placebo
|
||
Reporting group description |
Subjects administered with placebo (inactive medication) once daily for 26 weeks. | ||
Reporting group title |
Canagliflozin
|
||
Reporting group description |
Subjects administered canagliflozin (JNJ-28431754) 100 milligram (mg) titratable to 300 mg once daily for 26 weeks. |
|
|||||||||||||
End point title |
Change From Baseline in Glycosylated Haemoglobin (HbA1c) at Week 26 | ||||||||||||
End point description |
The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) from baseline at Week 26 was compared between the different treatment groups. mITT population included all randomized subjects who received at least 1 dose of double blind study drug. A total of 3 subjects were excluded from the mITT population due to potential misconduct and GCP compliance issues. Here, ‘N’ (number of subjects analyzed) signifies those subjects who were evaluable for this outcome measure.
|
||||||||||||
End point type |
Primary
|
||||||||||||
End point timeframe |
Baseline and Week 26
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Comparison groups |
Placebo v Canagliflozin
|
||||||||||||
Number of subjects included in analysis |
193
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
Mixed Model for Repeated Measures (MMRM) | ||||||||||||
Parameter type |
Least Square (LS) Mean Difference | ||||||||||||
Point estimate |
-0.89
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-1.193 | ||||||||||||
upper limit |
-0.592 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
0.152
|
|
|||||||||||||
End point title |
Change From Baseline in Fasting Plasma Glucose (FPG) at Week 26 | ||||||||||||
End point description |
The change in fasting plasma glucose from baseline at Week 26 was compared between the different treatment groups. mITT population included all randomized subjects who received at least 1 dose of double blind study drug. A total of 3 subjects were excluded from the mITT population due to potential misconduct and GCP compliance issues. Here, ‘N’ (number of subjects analyzed) signifies those subjects who were evaluable for this outcome measure.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and Week 26
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Comparison groups |
Placebo v Canagliflozin
|
||||||||||||
Number of subjects included in analysis |
207
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
MMRM | ||||||||||||
Parameter type |
LS Mean difference | ||||||||||||
Point estimate |
-1.5
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-2.235 | ||||||||||||
upper limit |
-0.772 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
0.371
|
|
|||||||||||||
End point title |
Percent Change From Baseline in Body Weight at Week 26 | ||||||||||||
End point description |
The percentage change in body weight from baseline to Week 26 was compared between the different treatment groups. mITT population included all randomized subjects who received at least 1 dose of double blind study drug. A total of 3 subjects were excluded from the mITT population due to potential misconduct and GCP compliance issues. Here, ‘N’ (number of subjects analyzed) signifies those subjects who were evaluable for this outcome measure.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and Week 26
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Comparison groups |
Placebo v Canagliflozin
|
||||||||||||
Number of subjects included in analysis |
207
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
MMRM | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
-1.75
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-2.659 | ||||||||||||
upper limit |
-0.851 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
0.459
|
|
|||||||||||||
End point title |
Percentage of Subjects With HbA1c Less Than (<) 7.0 Percent at Week 26 | ||||||||||||
End point description |
The percentage of participants achieved HbA1c less than 7 percent at Week 26 was compared between the different treatment groups. mITT population included all randomized subjects who received at least 1 dose of double blind study drug. A total of 3 subjects were excluded from the mITT population due to potential misconduct and GCP compliance issues. Here, ‘N’ (number of subjects analyzed) signifies those subjects who were evaluable for this outcome measure.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Week 26
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Comparison groups |
Placebo v Canagliflozin
|
||||||||||||
Number of subjects included in analysis |
178
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority | ||||||||||||
P-value |
= 0.001 | ||||||||||||
Method |
Generalized linear MMRM | ||||||||||||
Parameter type |
Odds ratio (OR) | ||||||||||||
Point estimate |
4.53
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
1.89 | ||||||||||||
upper limit |
10.86 |
|
|||||||||||||
End point title |
Change From Baseline in Systolic Blood Pressure (SBP) at Week 26 | ||||||||||||
End point description |
The change in systolic blood pressure from baseline at Week 26 was compared between the different treatment groups. mITT population included all randomized subjects who received at least 1 dose of double blind study drug. A total of 3 subjects were excluded from the mITT population due to potential misconduct and GCP compliance issues. Here, ‘N’ (number of subjects analyzed) signifies those subjects who were evaluable for this outcome measure.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and Week 26
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Statistical analysis 1 | ||||||||||||
Comparison groups |
Placebo v Canagliflozin
|
||||||||||||
Number of subjects included in analysis |
207
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
MMRM | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
-5.85
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-8.786 | ||||||||||||
upper limit |
-2.914 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
1.489
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
Baseline to follow up (Approximately 31 Weeks)
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse event reporting additional description |
Safety population included all randomized subjects who received at least 1 dose of double blind study drug.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
18.0
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting groups
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Canagliflozin
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects administered canagliflozin (JNJ28431754) 100 milligram (mg) titratable to 300 mg once daily for 26 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects administered with placebo (inactive medication) once daily for 26 Weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Frequency threshold for reporting non-serious adverse events: 2% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
||
07 Feb 2014 |
The overall reason for the second amendment was to include PRO instruments to assess the subjects satisfaction with their health and their degree of diabetes-related distress. |
||
18 Sep 2014 |
The overall reason for the third amendment was to lower the maximally or near-maximally effective dose of metformin to greater than or equal to (>=) 1,500 milligram per day (mg/day), to remove the prohibition of past use of SGLT2 inhibitors and to clarify the limitations of prior use of other SGLT2 inhibitors. |
||
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. | |||
None reported |