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 | 19.0 |
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 the noninferiority in the efficacy of Toujeo® to Tresiba® in glycated hemoglobin (HbA1c) change. |
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E.2.2 | Secondary objectives of the trial |
-To assess the effects of the insulin Toujeo® in comparison with insulin Tresiba® on:
-Change in Fasting plasma glucose (FPG);
-Change in Fasting self-monitored plasma glucose (SMPG) and 4-point SMPG and 8-point SMPG profile;
-Percentage of patients reaching HbA1c targets <7% or ≤6.5%;
-Percentage of patients reaching HbA1c targets <7% or ≤6.5% without severe and/or confirmed hypoglycemia
-Percentage of patients requiring rescue therapy.
-To assess the frequency of occurrence and diurnal distribution of hypoglycemia by American Diabetes Association (ADA) category of hypoglycemia.
-To assess the safety in each treatment group.
-To assess the treatment effects in each treatment group on Patient Reported Outcomes (PRO).
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Adult patients with type 2 diabetes mellitus (T2DM) inadequately controlled with OADs therapy with/without GLP-1 receptor agonist at stable dose for at least 3 months.
-Signed written informed consent.
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E.4 | Principal exclusion criteria |
-Age <18 years.
-HbA1c <7.5% or >10.5% (at screening visit).
-Body mass index (BMI) <25 kg/m^2 or >40 kg/m^2.
-History of T2DM for less than 1 year before screening.
-Less than 6 months before screening on OADs treatment and GLP-1 receptor agonist (if taken).
-Current or previous insulin use except for a maximum of 8 consecutive days or totally 15 days (eg, acute illness, surgery) during the last year prior to screening.
-Initiation of new glucose-lowering medications and/or weight loss drug in the last 3 months before screening visit.
-Patient receiving only noninsulin antihyperglycemic drugs not approved for combination with insulin according to local labelling/local treatment guideline.
-History of hypoglycemia unawareness or repeated episodes of severe hypoglycemia or metabolic acidosis, including hospitalization for diabetic ketoacidosis during the last 12 months prior to screening.
-Unstable proliferative diabetic retinopathy or any other rapidly progressive diabetic retinopathy or macular edema likely to require treatment (eg, laser, surgical treatment, or injectable drugs) during the study period.
-End stage renal disease.
-Any acute or chronic condition that in the opinion of Investigator would affect the patient safety, compliance, or study results.
-Any contraindication to use of Toujeo® or Tresiba® as defined in the national product label, hypersensitivity to Toujeo® or Tresiba® active ingredients or one of the excipients.
-Pregnant or breast-feeding women
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E.5 End points |
E.5.1 | Primary end point(s) |
Change from baseline in HbA1c |
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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/ Change from baseline in HbA1c
2/ Change in FPG from Baseline
3/ Change in fasting self-monitoring plasma glucose (SMPG) from baseline
4/ Change in 4-point and 8-point SMPG profiles per time-point from Baseline
5/ Change of mean 24-hour plasma glucose from baseline
6/ Change in variability of fasting SMPG and 24-hour plasma glucose from Baseline
7/ Percentage (%) of patients reaching target HbA1c <7% and ≤6.5%
8/ Percentage (%) of patients reaching target HbA1c <7% and ≤6.5% without severe and/or confirmed hypoglycemia
9/ Percentage (%) of patients with sulphonylurea or meglitinide dose reduction due to hypoglycemia
10/ Percentage of patients requiring a rescue therapy
11/ Change in basal insulin dose (U and U/kg body weight) from Baseline
12/ Assessment of hypoglycemia event (ADA category)
13/ Percentage (%) of patients experiencing adverse events
14/ Change in Patient Report Outcomes scores
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1/ Baseline to Week 12
2-3-4-5-6-7-8-11-14 / Baseline to Week 12 and Week 24
9-10-12-13 / Baseline to Week 24 |
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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) | Yes |
E.8.2.2 | Placebo | No |
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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 73 |
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 |
Bulgaria |
Croatia |
Czech Republic |
Denmark |
France |
Greece |
Hungary |
Israel |
Italy |
Romania |
Serbia |
Slovakia |
Slovenia |
Sweden |
Switzerland |
United Kingdom |
United States |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |