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 show superiority of the 3 dulaglutide doses, including the two higher doses (4.5 mg and 3.0 mg) and the approved 1.5 mg dose to placebo in change in HbA1c. |
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E.2.2 | Secondary objectives of the trial |
To determine if the two higher doses of Trulicity are effective and safe.
Efficacy: To compare each dulaglutide arm (4.5 mg, 3.0 mg, 1.5 mg) to the placebo arm at 18 weeks for secondary efficacy parameters.
Safety: To compare each dulaglutide arm (4.5 mg, 3.0 mg, 1.5 mg) to the placebo arm for selected safety parameters at 18 weeks.
PK/PD: To characterize the pharmacokinetics (PK) of dulaglutide and establish the relationships between dose/exposure and key safety and efficacy measures. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Have had T2D for ≥6 months according to the World Health Organization (WHO) classification;
Have HbA1c of 7.0% to 10.0%, inclusive;
Have been treated with stable doses of metformin for at least 3 months (dose of ≥1500 mg/day) and the maximum-approved dose per country-specific label; lower doses will be allowed only with documented GI intolerability in the required dose range;
Have had stable body weight for at least 3 months; body weight will be considered stable if it has not changed more than 5% in the past 3 months;
Agree not to initiate a diet and/or exercise program during the study with the intent of reducing body weight other than the lifestyle and dietary measures for diabetes treatment;
Have a body mass index (BMI) ≥25 kg/m2;
In the investigator’s opinion, are well motivated, capable, and willing to:
[a] self-inject treatment;
[b] perform fingerstick plasma glucose (PG) monitoring at least once daily and up to 6 times per day once weekly throughout the trial;
[c] maintain a study diary as required for this protocol.
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E.4 | Principal exclusion criteria |
[13] have type 1 diabetes (T1D);
[14] have been treated with any excluded medication within 3 months prior to screening and/or between study entry and randomization; excluded glucocorticoids must not have been used for ≥14 days within 1 month prior to Visit;
[15] have used any glucose-lowering medication other than metformin 3 months prior to study entry or during screening/lead-in period or have used any GLP-1 RAs at any time in the past. Short-term use of insulin for acute conditions is allowed (≤14 days);
[16] have a condition that is a contraindication for use of the GLP-1 RA class or metformin;
[17] have a history of ≥1 episode of ketoacidosis or hyperosmolar state/coma;
[18] have had ≥1 episode of severe hypoglycemia and/or ≥1 episode of hypoglycemia unawareness within the 6 months;
[19] have had any of the following CV conditions: acute myocardial infarction (MI), New York Heart Association (NYHA) Class III or Class IV heart failure, or cerebrovascular accident (stroke);
[20] have a known clinically significant gastric emptying abnormality (eg, severe diabetic gastroparesis or gastric outlet obstruction) or have undergone gastric bypass (bariatric) surgery or restrictive bariatric surgery (eg, Lap-Band®);
[21] have acute or chronic hepatitis, signs and symptoms of any other liver disease other than nonalcoholic fatty liver disease (NAFLD), or alanine aminotransferase (ALT) level >2.5 times the upper limit of the reference range, as determined by the central laboratory at study entry; patients with NAFLD are eligible for participation in this trial;
[22] have had chronic or acute pancreatitis any time prior to study entry;
[23] have an estimated glomerular filtration rate (eGFR) <45 mL/min/1.73m2, calculated by the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation, as determined by the central laboratory
[24] have a personal or family history of medullary thyroid carcinoma (MTC) or personal history of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2);
[25] have serum calcitonin ≥20 pg/mL, as determined by the central laboratory at study entry;
[26] have evidence of significant, active autoimmune abnormality (eg, lupus, rheumatoid arthritis);
[27] have a history of active or untreated malignancy, or are in remission from a clinically significant malignancy (other than basal or squamous cell skin cancer, in situ carcinomas of the cervix, or in situ prostate cancer) during the past 5 years;
[28] any serious disease or other condition (e.g, known drug or alcohol abuse) which, in the opinion of the investigator, would pose a significant risk to the patient or interfere with the interpretation of safety, efficacy, or PD data;
[29] have any hematologic condition that may interfere with HbA1c measurement (eg, hemolytic anemias, sickle-cell disease);
[30] are investigator site personnel directly affiliated with this study and/or their immediate families (immediate family is defined as a spouse, parent, child, or sibling, whether biological or legally adopted);
[31] are currently enrolled in any other clinical trial involving an investigational product or any other type of medical research judged not to be scientifically or medically compatible with this study;
[32] are Lilly employees;
[33] have participated, within the last 30 days in a clinical trial involving an investigational product. If the previous investigational product has a long half-life, 3 months or 5 half-lives (whichever is longer) should have passed;
[34] have previously completed or withdrawn from this study or any other study investigating dulaglutide; |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change in HbA1c from baseline |
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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) |
• Proportion of patients achieving HbA1c target of <7.0%
• The change in fasting serum glucose (FSG; central laboratory) from baseline
• The change in body weight from baseline
• Treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs)
• Discontinuation of study drug due to adverse events (AEs)
• Incidence and rate of hypoglycemia (severe, total, documented symptomatic, and nocturnal)
• PK parameters (eg, Cmax, AUC)
• Pharmacodynamic evaluations will include HbA1c, FSG, body weight, QTcF interval, and heart rate
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• 18 weeks
• Baseline and 18 weeks
• Baseline and 18 weeks
• Baseline through 18 weeks
• 18 weeks
• 18 weeks
• Week 0 through week 22
• Week 0 through week 22
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
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 | 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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 4 |
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 | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
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 |
Czech Republic |
Mexico |
Poland |
Romania |
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 | |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | 14 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 14 |