E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10067585 |
E.1.2 | Term | Type 2 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 demonstrate non-inferiority in terms of glycemic control, measured as change in glycated hemoglobin (HbA1c), of a patient- versus a physician-managed titration algorithm, for the treatment with HOE901-U300 (Insulin Glargine U300), in patients with inadequately controlled Type 2 Diabetes Mellitus (T2DM). |
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E.2.2 | Secondary objectives of the trial |
-To evaluate the efficacy, safety, and quality of life of the two titration approaches in terms of: -Percentage of patients reaching fasting self-monitored plasma glucose (SMPG) target. -Hypoglycemic events -Change in HbA1c from baseline across subgroups of baseline HbA1c category (< 8%, ≥ 8 to <9%, ≥9 %). -Safety and tolerability. -Change in Patient-Reported Outcome (PRO) instruments (Diabetes Distress Scale and Diabetes Empowerment Scale). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Patients with T2DM as defined by World Health Organization (WHO) diagnosed for at least 1 year at the time of the screening visit, treated with ≥1 non-insulin antihyperglycemic drug(s) with or without a basal insulin, for at least 6 months. -Signed informed consent |
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E.4 | Principal exclusion criteria |
-Age <18 years old. -HbA1c at screening visit: -<7.0% or >10.0% for patients taking basal insulin. -<7.5% or >11.0% for insulin-naive patients. -Patient not willing to self-manage titration algorithm (including self-injection, SMPG). -Type 1 diabetes mellitus. -Insulin-pretreated patients not on a stable basal insulin regimen in the last 12 weeks prior to screening visit (ie, type of insulin and time/frequency of the injection); the insulin dose should be stable (±20 %) for at least 8 weeks prior to screening visit. -Change in dose of existing, or initiation of new, non-insulin antidiabetic drugs in the last 12 weeks prior to screening visit. -Treatment with an insulin other than basal insulin: mixed insulin (premixes), rapid insulin, fast acting insulin analogues in the last 6 months before screening (use ≤10 days in relation to hospitalization or an acute illness is accepted). -Use of systemic glucocorticoids (excluding topical application or inhaled forms) for two weeks or more within 8 weeks prior to the time of screening. -History of hypoglycemia unawareness. -Any clinically significant abnormality identified on physical examination, laboratory tests, or vital signs at the time of screening, or any condition (including known substance or alcohol abuse, or psychiatric disorder) that in the opinion of the Investigator or any sub-Investigator would make implementation of the protocol or interpretation of the study results difficult or would preclude the safe participation of the subject in this protocol. -Use of any investigational drug within 1 month or 5 half-lives, whichever is longer, prior to screening visit. -Patients included (or planned to be included during study duration) in Toujeo Customized Patient Solution (CPS) program or any other patient support program (PSP). -Pregnant or breast-feeding women. -Women of childbearing potential not protected by highly effective contraceptive method of birth control and/or who are unwilling or unable to be tested for pregnancy. -Known hypersensitivity/intolerance to insulin glargine or any of its excipients. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Mean change in HbA1c compared between the two titration modality arms (Patient- and Physician-managed titration) |
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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) |
1- Percentage of patients achieving targeted fasting SMPG (80-130 mg/dL[4.4 -7.2 mmol/L]) without experiencing severe and/or confirmed hypoglycemia<54 mg/dL (3.0 mmol/L) 2- Percentage of patients experiencing at least one hypoglycemia 3- Number of hypoglycemic events per patient-year during the study treatment period 4- Percentage of patients reaching targeted fasting SMPG (80-130 mg/dL [4.4 -7.2 mmol/L]) 5- Time (weeks) from to reach target fasting pre-breakfast SMPG 6- Mean change in HbA1c 7- Mean change in HbA1c across subgroups of baseline HbA1c category (< 8%, ≥ 8 to <9%, ≥9 %) 8- Mean of 7-point SMPG profile 9- Mean change by SMPG time point 10- Number of patients with adverse events 11- Mean change in FPG 12- Mean change in HOE901-U300 dose 13- Mean change in body weight 14- Mean change on the Diabetes Distress Scale (DDS) 15- Percentage of patients with high distress (average scores >3) at each occasion on the Diabetes Distress Scale (DDS) 16- Mean change on the Diabetes Empowerment Scale (DES) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Baseline to Week 12 and Week 24 1, 4, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16
Baseline to Week 24 2, 3, 5 Baseline to Week 12 6
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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 | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
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) | 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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Patient-managed titration versus Physician-managed titration of Insulin Glargin in T2DM patients |
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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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 89 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Croatia |
Czech Republic |
Denmark |
Greece |
Poland |
Slovakia |
Slovenia |
Spain |
Switzerland |
United Kingdom |
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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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
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 months | 15 |