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    Summary
    EudraCT Number:2015-004990-34
    Sponsor's Protocol Code Number:MK-0431-845
    National Competent Authority:Estonia - SAM
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2016-04-06
    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 ConcernedEstonia - SAM
    A.2EudraCT number2015-004990-34
    A.3Full title of the trial
    A Phase III, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Study the Efficacy and Safety of the Continuation of Sitagliptin Compared with the Withdrawal of Sitagliptin During Initiation and Titration of Insulin Glargine (LANTUS®) in Subjects with Type 2 Diabetes Mellitus
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Randomized Sitagliptin Withdrawal Study
    A.3.2Name or abbreviated title of the trial where available
    Randomized Sitagliptin Withdrawal Study
    A.4.1Sponsor's protocol code numberMK-0431-845
    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.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc
    B.5.2Functional name of contact pointGlobal Clinical Trials Operations
    B.5.3 Address:
    B.5.3.1Street AddressOne Merck Drive, P.O. Box 100
    B.5.3.2Town/ cityWhitehouse Station, NJ
    B.5.3.3Post code08889-0100
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1732594 3046
    B.5.5Fax number+1732594 1880
    B.5.6E-mailravi_shankar3@merck.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 Yes
    D.2.1.1.1Trade name Januvia
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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.3.2Product code MK-0431
    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 INNSitagliptin Phosphate
    D.3.9.2Current sponsor codeMK-0431
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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
    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 (T2DM)
    E.1.1.1Medical condition in easily understood language
    Type 2 Diabetes Mellitus (T2DM)
    E.1.1.2Therapeutic area Diseases [C] - Nutritional and Metabolic Diseases [C18]
    MedDRA Classification
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    In subjects with T2DM with inadequate glycemic control on metformin and sitagliptin, who initiate and titrate insulin glargine (LANTUS®), to assess the effect of continuing sitagliptin relative to withdrawing sitagliptin on: (1) HbA1c (A1C) after 30 weeks; (2) the event rate of documented symptomatic hypoglycemia with blood glucose < or = 70 mg/dL (< or = 3.9 mmol/L) over 30 weeks; (3) general safety and tolerability over 30 weeks.
    E.2.2Secondary objectives of the trial
    In subjects with T2DM with inadequate glycemic control on metformin and sitagliptin, who initiate and titrate insulin glargine (LANTUS®), to assess the effect of continuing sitagliptin relative to withdrawing sitagliptin on: 1) the incidence of the following over 30 weeks: a) documented symptomatic hypoglycemia with blood glucose (BG) < or =70 mg/dL; b) documented hypoglycemia with BG < or =70 mg/dL; c) documented symptomatic hypoglycemia with BG <56 mg/dL; d) documented hypoglycemia with BG <56 mg/dL; 2) the event rate of the following over 30 weeks: a) documented symptomatic hypoglycemia with BG <56 mg/dL; b) documented hypoglycemia with BG < or =70 mg/dL ; c) documented hypoglycemia with BG <56 mg/dL; 3) the daily dose of insulin after 30 weeks; 4) the proportion of subjects with A1C <7.0% after 30 weeks; 5) the proportion of subjects with A1C <7.0% after 30 weeks without any event of documented hypoglycemia with BG < or =70 mg/dL ; 6) fasting plasma glucose after 30 weeks.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Merck will conduct Future Biomedical Research on DNA (blood) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The
    objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is
    to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time.
    E.3Principal inclusion criteria
    In order to be eligible for participation in this trial, the subject must: (1) have T2DM and be > or = 18 years of age on the day of signing ICF; (2) be on one of the following treatment regimens: (a) stable dose of sitagliptin (100 mg/day) and metformin IR or XR (> or = 1500 mg/day) either co-administered or as a FDC for > or = 12 weeks with A1C between 7.5% and 11.0%, inclusive; (b) stable dose of metformin IR or XR (> or = 1500 mg/day) and another DPP-4 inhibitor (at maximum labeled dose), other than sitagliptin, either co-administered or as a FDC, for > or = 12 weeks with A1C between 7.5% and 11.0%, inclusive; (c) stable dose of sitagliptin (100 mg/day) and metformin IR or XR (> or = 1500 mg/day) either co-administered or as a FDC, and a sulfonylurea for > or = 12 weeks OR stable dose of metformin IR or XR (> or = 1500 mg/day) and a sulfonylurea administered as a FDC and sitagliptin (100 mg/day) with A1C between 7.0% and 10.0%, inclusive; (d) stable dose of metformin IR or XR (> or = 1500 mg/day) and another DPP-4 inhibitor (at maximum labeled dose), other than sitagliptin, either co-administered or as a FDC, and a sulfonylurea for > or = 12 weeks OR stable dose of metformin IR or XR (> or = 1500 mg/day) and a sulfonylurea administered as a FDC and another DPP-4 inhibitor other than sitagliptin with A1C between 7.0% and 10.0%, inclusive; (e) stable dose of metformin IR or XR (> or = 1500 mg/day) and a sulfonylurea either co-administered or as a FDC for > or = 12 weeks with A1C between 7.5% and 11.0% (> or = 58 mmol/mol and < or = 97 mmol/mol), inclusive. (3) At Visit 3, have an A1C of 7.5% to 11.0%.
    E.4Principal exclusion criteria
    The subject must be excluded from participating in the trial if the subject: (1) has been treated with any AHA other than protocol-specified agents (i.e., other than metformin, DPP-4 inhibitor, or sulfonylurea agent) within the prior 12 weeks; (2) has a history of 2 or more episodes of hypoglycemia resulting in seizure, coma, or loss of consciousness, OR subject has had recurrent (> or = 3 times per week) episodes of hypoglycemia over the past 8 weeks; (3) has a history of type 1 diabetes mellitus (T1DM) or ketoacidosis, or has a history of latent autoimmune diabetes of adults (LADA), or subject is assessed by the investigator as possibly having T1DM or LADA confirmed with a C-peptide <0.7 ng/mL (<0.23 nmol/L), or has a history of other specific types of diabetes; (4) has a history of intolerance or hypersensitivity to sitagliptin, insulin, or metformin or any contraindication to sitagliptin, insulin, or metformin based upon the label of the country of the investigational site; (5) is currently participating, or has participated, in a study in which the subject received an investigational compound or used an investigational device within the prior 12 weeks of signing informed consent or is not willing to refrain from participating in another study; (6) is currently on or likely to require treatment with a prohibited medication (see Section 5.5.2 of protocol). Example: is on, or likely to require treatment with more than 14 consecutive days or repeated courses of pharmacologic doses of corticosteroids; (8) is pregnant or breast-feeding; (9) has an exclusionary laboratory value as listed in the protocol; (10) At Visit 4, has a site fasting fingerstick glucose of <130 mg/dL (7.2 mmol/L) or >270 mg/dL (15.0 mmol/L).
    E.5 End points
    E.5.1Primary end point(s)
    (1) Change from baseline in A1C at Week 30; (2) Event rate of documented symptomatic hypoglycemia with blood glucose < or = 70 mg/dL (< or = 3.9 mmol/L) over 30 weeks.
    E.5.1.1Timepoint(s) of evaluation of this end point
    30 weeks
    E.5.2Secondary end point(s)
    1) Event rate of documented symptomatic hypoglycemia with blood glucose <56 mg/dL (< or = 3.1 mmol/L) over 30 weeks; (2) Incidence of each of the following over 30 weeks: (a) documented symptomatic hypoglycemia with blood glucose < or = 70 mg/dL (< or = 3.9 mmol/L); (b) documented hypoglycemia with blood glucose < or = 70 mg/dL (< or = 3.9 mmol/L); (c) documented symptomatic hypoglycemia with blood glucose <56 mg/dL (< or = 3.1 mmol/L); (d) documented hypoglycemia with blood glucose <56 mg/dL (< or = 3.1 mmol/L); (3) Change from baseline in total daily insulin dose at Week 30; (4) Event rate of each of the following over 30 weeks: (a) documented hypoglycemia with blood glucose < or = 70 mg/dL (< or = 3.9 mmol/L); (b) documented hypoglycemia with blood glucose <56 mg/dL (< or = 3.1 mmol/L); (5) Proportion of subjects at A1C goal <7.0% (<53 mmol/mol) at Week 30; (6) Proportion of subjects at A1C goal <7.0% (<53 mmol/mol) at Week 30 with no documented hypoglycemia with blood glucose < or = 70 mg/dL (< or = 3.9 mmol/L); (7) Change from baseline in FPG at Week 30.
    E.5.2.1Timepoint(s) of evaluation of this end point
    30 weeks
    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 Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    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 trial2
    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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA53
    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
    Australia
    Canada
    Czech Republic
    Denmark
    Estonia
    France
    Germany
    Hungary
    Israel
    Korea, Republic of
    Latvia
    Philippines
    Poland
    Puerto Rico
    Romania
    Russian Federation
    Spain
    Turkey
    United States
    E.8.7Trial 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
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months10
    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: 560
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 140
    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 state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 300
    F.4.2.2In the whole clinical trial 700
    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)
    A subject who completes the study or prematurely discontinues will be treated according to standard practice. A subject who prematurely discontinues treatment with blinded study drug but who continues to participate in the trial of study medication by providing follow-up information can receive medical and diabetes management by the physician/investigator. This subject may initiate any other therapy as needed. Procurement of other AHAs, including background AHA, is the subject responsibility
    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 Decision2016-05-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-04-14
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2018-01-30
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