E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Type 2 Diabetes |
Diabetes tipo 2 |
|
E.1.1.1 | Medical condition in easily understood language |
Type 2 Diabetes |
Diabetes tipo 2 |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
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 evaluate the effect of treatment with liraglutide versus placebo on forced expiratory volume in one second (FEV1) in patients with type 2 diabetes mellitus |
Evaluar el efecto del tratamiento con liraglutida frente a placebo sobre el volumen espiratorio forzado en el primer segundo (FEV1) en pacientes con diabetes mellitus tipo 2 |
|
E.2.2 | Secondary objectives of the trial |
- To evaluate the effect of treatment with liraglutide versus placebo on various other related respiratory function parameters - To evaluate the effect of treatment with liraglutide versus placebo on respiratory parameters during sleep - To evaluate the effect of treatment with liraglutide versus placebo on serum proteins A and D of pulmonary surfactant |
- Evaluar el efecto del tratamiento con liraglutida frente a placebo sobre otros parámetros relacionados con la función respiratoria distintos a FEV1 - Evaluar el efecto del tratamiento con liraglutida frente a placebo sobre los parámetros respiratorios durante el sueño. - Evaluar el efecto del tratamiento con liraglutida frente a placebo sobre los niveles séricos de las proteínas A y D del surfactante pulmonar |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Signed informed consent. Subjects between 40 and 65 years old. Diagnosis of type 2 diabetes mellitus with more than 5 years of evolution of disease. Metformin ( alone or in combination with sulfonylurea and / or insulin and / or tiazolidinendionas ) at a stable dose for at least the past 3 months. HbA1c ? 7,0 y ? 9,0 %. BMI between 30 and 40 kg / m2. No pulmonary disease (COPD, asthma, fibrosis, etc) known. Baseline FEV1 decline of equal or greater than 10% in the percentage of the theoretical value. Chest radiography without significant changes in the lung parenchyma . |
Pacientes que firman el consentimiento informado para participar en el estudio Edad entre 40 y 65 años. Diagnóstico de diabetes mellitus tipo 2 con más de 5 años de evolución de enfermedad. Tratamiento con metformina (en monoterapia o en combinación con sulfonilureas y/o insulina y/o tiazolidinendionas) a una dosis estable durante al menos los 3 meses anteriores. HbA1c ? 7,0 y ? 9,0 %. Índice de masa corporal entre 30 y 40 Kg/m2. Sin patología pulmonar (EPOC, asma, fibrosis, etc) conocida. Descenso basal del FEV1 igual o superior al 10 % en el porcentaje del valor teórico. Radiografía de tórax sin alteraciones significativas en el parénquima pulmonar. |
|
E.4 | Principal exclusion criteria |
Type 1 diabetes mellitus Treatment with inhibitors of dipeptidyl peptidase 4 glitazones and / or SGLT2 inhibitors. Active and former smokers for less than five years ago smoking. Chronic obstructive pulmonary disease. Respiratory sleep disorders that require treatment with CPAP (continuous positive pressure in the airway). Asthma treatment with bronchodilators. Previous bariatric surgery. Cardiovascular disease, heart failure and / or stroke. Pathology of the chest wall. Serum creatinine> 1.7 mg / dl. Abnormal results in liver function test (ALT / AST greater than twice the upper limit of normal). History of acute or chronic pancreatitis. Personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia (MEN ) type 2. Active neoplasms or neoplastic patients considered disease-free history from less than 5 years ago. Women of childbearing age who are pregnant (positive pregnancy test within 14 days before the start of treatment) or intend to get pregnant. Lactating women. Women of childbearing potential not using adequate contraception (such as oral contraceptives, intrauterine device or barrier method of birth control along with spermicide or surgical sterilization) or unwilling to use during the study (as required by local laws or practices). |
Diabetes mellitus tipo 1. Tratamiento con inhibidores de dipeptidil peptidasa 4, glitazonas y/o inhibidores de SGLT2. Fumadores activos y ex fumadores desde hace menos de 5 años. Enfermedad obstructiva pulmonar crónica. Trastornos respiratorios del sueño que precisen de tratamiento con CPAP (presión positiva continua en la vía aérea). Asma en tratamiento con broncodilatadores. Cirugía bariátrica previa. Enfermedad cardiovascular, insuficiencia cardiaca y/o ictus. Patología de la pared torácica. Creatinina sérica > 1,7 mg/dl. Resultado anormal en la prueba de función hepática (valores de ALT/AST mayores de dos veces el límite superior de la normalidad). Antecedentes de pancreatitis aguda o crónica. Antecedentes personales o familiares de cáncer medular tiroideo o Neoplasia Endocrina Múltiple (MEN) tipo 2. Neoplasias activas o pacientes con antecedente neoplásico considerado libre de enfermedad desde hace menos de 5 años. Mujeres en edad fértil que están embarazadas (test de embarazo positivo en los 14 días antes del inicio del tratamiento) o que desean quedarse embarazadas. Mujeres en periodo de lactancia. Mujeres en edad fértil que no utilizan métodos anticonceptivos adecuados (como anticonceptivos orales, dispositivo intrauterino o método de barrera anticonceptivo junto con espermicida o esterilización quirúrgica) o no estén dispuestos a utilizarlos durante el estudio (según lo requieren las leyes o prácticas locales). |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Forced expiratory volume in one second (FEV1) |
Volumen espiratorio forzado en el primer segundo (FEV1) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Basal / screening visit Visit during the treatment period in weeks 11 and 18 l |
Visita basal/screening Visita durante el periodo de tratamiento en las semanas 11 y 18 |
|
E.5.2 | Secondary end point(s) |
Other parameters derived from spirometry: - Forced vital capacity (FVC,) - Maximum average expiratory flow (FEF 25-75) - FEV1 / FVC
Parameters derived from measurements of static lung volumes: - Residual volume (RV) - Total lung capacity (TLC) - Residual functional capacity (RFC, its acronym in English)
Transfer factor of the lung for carbon monoxide (DLCO)
6-minute walk test
Parameters of an unassisted home respiratory polygraphy: - Apnea-hypopnea index - Percentage of accumulated time with oxygen saturation less than 90% (TA90).
Serum surfactant protein A and D in serum. |
Otros parámetros derivados de la espirometría forzada: - Capacidad vital forzada (FVC, de sus siglas en inglés) - Flujos espiratorios medio máximo (FEF25-75) - Cociente FEV1/FVC
Parámetros derivados de las mediciones de volúmenes pulmonares estáticos: - Volumen residual (RV, de sus siglas en inglés) - Capacidad pulmonar total (TLC, de sus siglas en inglés) - Capacidad funcional residual (RFC, de sus siglas en inglés)
Factor de transferencia del pulmón para monóxido de carbono (TLCO, de sus siglas en inglés)
Datos de la prueba de marcha de 6 minutos
Parámetros de una poligrafía respiratoria domiciliaria no asistida: - Índice de apnea-hipopnea - Porcentaje de tiempo acumulado con saturaciones de oxígeno menores de 90% (TA90).
Niveles séricos de la proteína surfactante A y D en suero. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Basal / screening visit Visit during the treatment period in weeks 2, 7, 13 and 18 Visit end of treatment or early withdrawal |
Visita basal/screening Visita durante el periodo de tratamiento en las semanas 2, 7, 13, 13 y 18 Visita final de tratamiento o de abandono prematuro |
|
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 | Yes |
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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
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 | No |
E.8.1.6 | Cross over | Yes |
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
| 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 | 6 |
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
|
Visit end of treatment or early withdrawal |
Visita final de tratamiento o de abandono prematuro |
|
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 | 11 |
E.8.9.1 | In the Member State concerned days | |
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 | 11 |