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    Clinical Trial Results:
    Effect of Saxagliptin in Addition to Dapagliflozin and Metformin on Insulin Resistance, Islet Cell Dysfunction, and Metabolic Control in Subjects with Type 2 Diabetes Mellitus on Previous Metformin Treatment

    Summary
    EudraCT number
    2014-003788-39
    Trial protocol
    DE  
    Global end of trial date
    15 Aug 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    26 May 2022
    First version publication date
    26 May 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ESR-14-10231
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02304081
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Profil Mainz GmbH & Co KG
    Sponsor organisation address
    Rheinstr. 4c, Mainz, Germany, 55116
    Public contact
    Prof. Dr. Thomas Forst, Profil Mainz GmbH & Co KG, thomas.forst@profil.com
    Scientific contact
    Prof. Dr. Thomas Forst, Profil Mainz GmbH & Co KG, thomas.forst@profil.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
    30 Dec 2016
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    15 Aug 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Aug 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate alpha- and beta-cell function during combination treatment with dapagliflozin plus saxagliptin compared to dapagliflozin alone in subjects with T2DM on stable metformin background therapy
    Protection of trial subjects
    Both drugs have been approved for single and combination treatment in the population defined by the eligibility criteria of this trial. Therefore, no specific risks are expected. Trial-related risks are mainly associated with venous blood sampling and insertion of intravenous catheters for the clamp experiment. Blood sampling and the insertion of intravenous catheters will be performed with all caution by trained investigators or study nurses.
    Background therapy
    Stable metformin background therapy
    Evidence for comparator
    -
    Actual start date of recruitment
    27 Jan 2015
    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
    Germany: 25
    Worldwide total number of subjects
    25
    EEA total number of subjects
    25
    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)
    12
    From 65 to 84 years
    13
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recruitment from the own database; advertisement on homepage

    Pre-assignment
    Screening details
    1. Subjects with Diabetes mellitus type 2 2. HbA1c 7.0%–9.9%, both inclusive 3. Treatment with metformin for at least six months (daily dose 1500 – 3000 mg) 4. Age 30–75 years, both inclusive 5. BMI 25–35 kg/m^2, both inclusive

    Period 1
    Period 1 title
    Overall trial (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
    Dapagliflozin/Saxagliptin arm
    Arm description
    Saxagliptin as add on to Dapagliflozin
    Arm type
    Experimental

    Investigational medicinal product name
    Dapagliflozin (Forxiga)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    10 mg per day for up to 34 days

    Investigational medicinal product name
    Saxagliptin (Onglyza)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    5 mg per day for up to 34 days

    Arm title
    Dapagliflozin/Placebo arm
    Arm description
    Dapagliflozin + Placebo to compare to Dapagliflozin/Saxagliptin treatment
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo to match Saxagliptin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo to match Saxagliptin; administration for up to 34 days

    Investigational medicinal product name
    Dapagliflozin (Forxiga)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    10 mg per day for up to 34 days

    Number of subjects in period 1
    Dapagliflozin/Saxagliptin arm Dapagliflozin/Placebo arm
    Started
    12
    13
    Completed
    12
    12
    Not completed
    0
    1
         Physician decision
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Dapagliflozin/Saxagliptin arm
    Reporting group description
    Saxagliptin as add on to Dapagliflozin

    Reporting group title
    Dapagliflozin/Placebo arm
    Reporting group description
    Dapagliflozin + Placebo to compare to Dapagliflozin/Saxagliptin treatment

    Reporting group values
    Dapagliflozin/Saxagliptin arm Dapagliflozin/Placebo arm Total
    Number of subjects
    12 13 25
    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)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    5 7 12
        From 65-84 years
    7 6 13
        85 years and over
    0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63.5 ( 8.45 ) 63.2 ( 5.96 ) -
    Gender categorical
    Units: Subjects
        Female
    0 6 6
        Male
    12 7 19
    Weight
    Units: kg
        arithmetic mean (standard deviation)
    91.29 ( 9.882 ) 87.78 ( 10.124 ) -
    Height
    Units: meter
        arithmetic mean (standard deviation)
    1.750 ( 0.0374 ) 1.707 ( 0.0824 ) -
    BMI
    Units: kg/m²
        arithmetic mean (standard deviation)
    29.78 ( 2.915 ) 30.12 ( 2.895 ) -
    Waist Circumference
    Units: cm
        arithmetic mean (standard deviation)
    106.0 ( 10.90 ) 105.7 ( 6.26 ) -
    Hip Circumference
    Units: cm
        arithmetic mean (standard deviation)
    100.8 ( 5.87 ) 105.2 ( 7.78 ) -
    HbA1c
    Units: percent
        arithmetic mean (standard deviation)
    8.03 ( 0.610 ) 8.03 ( 0.711 ) -
    Diabetes Duration
    Units: years
        arithmetic mean (standard deviation)
    10.6 ( 5.20 ) 7.1 ( 3.80 ) -

    End points

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    End points reporting groups
    Reporting group title
    Dapagliflozin/Saxagliptin arm
    Reporting group description
    Saxagliptin as add on to Dapagliflozin

    Reporting group title
    Dapagliflozin/Placebo arm
    Reporting group description
    Dapagliflozin + Placebo to compare to Dapagliflozin/Saxagliptin treatment

    Primary: Glucagon / insulin ratio

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    End point title
    Glucagon / insulin ratio
    End point description
    Glucagon / insulin ratio during hyperglycaemic clamp phase
    End point type
    Primary
    End point timeframe
    during hyperglycaemic clamp phase
    End point values
    Dapagliflozin/Saxagliptin arm Dapagliflozin/Placebo arm
    Number of subjects analysed
    12
    12
    Units: pmol/mU
        arithmetic mean (standard deviation)
    -0.38 ( 0.412 )
    -0.05 ( 0.373 )
    Statistical analysis title
    Primary Endpoint
    Comparison groups
    Dapagliflozin/Saxagliptin arm v Dapagliflozin/Placebo arm
    Number of subjects included in analysis
    24
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0404
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Overall trial
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    -

    Serious adverse events
    Overall trial
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 25 (0.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Overall trial
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    11 / 25 (44.00%)
    Injury, poisoning and procedural complications
    Catheter site haematoma
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Periorbital haematoma
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 25 (12.00%)
         occurrences all number
    3
    Intercostal neuralgia
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Immune system disorders
    Seasonal allergy
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Eye disorders
    Eye swelling
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    2 / 25 (8.00%)
         occurrences all number
    2
    Epigastric discomfort
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Sinusitis
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Hyperhidrosis
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1
    Psychiatric disorders
    Sleep disorder
         subjects affected / exposed
    2 / 25 (8.00%)
         occurrences all number
    3
    Renal and urinary disorders
    Pollakiuria
         subjects affected / exposed
    2 / 25 (8.00%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    2
    Infections and infestations
    Genital infection fungal
         subjects affected / exposed
    1 / 25 (4.00%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Nov 2014
    The originally submitted trial protocol (Version 1.0, dated 21 Oct 2014) was updated in response to objections made by the IEC. This updated version was submitted to the Competent Authority as substantial Amendment 1: • Inclusion criterion 1 and 3 were modified (extension of stable metformin therapy from 3 to 6 months and removal of the restriction that T2DM could have been diagnosed only within 3 months prior to screening) • Withdrawal criteria 5 and 6 were added to be able to withdraw subjects with severe hypoglycaemia or any other severe complication during the clamp procedure • Due to safety objections subjects were not released immediately after the clamp but kept for another 4 hours post-clamp for stabilization and control of blood glucose values.

    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
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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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