Clinical Trial Results:
A Double-blind, Randomized, Phase IV, Mechanistic, Placebo-controlled, Cross-over, Single-center Study to Evaluate the Effects of 5 Weeks Dapagliflozin Treatment on Insulin Sensitivity in Skeletal Muscle in Type 2 Diabetes Mellitus Patients
Summary
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EudraCT number |
2016-003991-27 |
Trial protocol |
NL |
Global end of trial date |
04 Nov 2019
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Results information
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Results version number |
v1(current) |
This version publication date |
18 Nov 2020
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First version publication date |
18 Nov 2020
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
D1690C00047
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT03338855 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
AstraZeneca
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Sponsor organisation address |
Pepparedsleden 1, Mölndal, Sweden, SE-431 83
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Public contact |
Global Clinical Lead, AstraZeneca, +1 8772409479, information.center@astrazeneca.com
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Scientific contact |
Global Clinical Lead, AstraZeneca, +1 8772409479, information.center@astrazeneca.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
04 Nov 2019
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
04 Nov 2019
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To investigate if dapagliflozin improves skeletal muscle insulin sensitivity expressed as corrected glucose disposal rate (cGDR) in comparison with placebo after 5-week double-blind treatment. Insulin sensitivity was determined using a 2-step euglycemic hyperinsulinemic clamp (EHC) procedure.
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Protection of trial subjects |
This study was performed in accordance with the ethical principles that have their origin in the Declaration of Helsinki and that are consistent with International Council for Harmonisation /Good Clinical Practice, applicable regulatory requirements and the AstraZeneca policy on Bioethics.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
05 Mar 2018
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Netherlands: 26
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Worldwide total number of subjects |
26
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EEA total number of subjects |
26
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
16
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From 65 to 84 years |
10
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85 years and over |
0
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Recruitment
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Recruitment details |
This was a double-blind, randomized, placebo-controlled, cross-over Phase IV mechanistic study which was conducted in 1 study center in the Netherlands between 05 March 2018 and 04 November 2019. | |||||||||||||||||||||
Pre-assignment
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Screening details |
Eligible patients with Type 2 diabetes mellitus were randomized to a specific double-blind treatment sequence (either dapagliflozin then placebo or placebo then dapagliflozin). Each of the 2 treatment periods had a maximum duration of 40 days, separated by a wash-out period of 6 to 8 weeks. | |||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||||||||||||||
Roles blinded |
Subject, Investigator, Carer, Data analyst, Assessor | |||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Dapagliflozin 10 mg then Placebo | |||||||||||||||||||||
Arm description |
Patients received an oral dose of 10 milligrams (mg) dapagliflozin, once daily for 5 weeks. After a wash-out period of 6 to 8 weeks, matched placebo tablets were taken orally, once daily for 5 weeks. | |||||||||||||||||||||
Arm type |
Experimental and Placebo | |||||||||||||||||||||
Investigational medicinal product name |
Dapagliflozin
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Investigational medicinal product code |
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Other name |
Forxiga®, Farxiga®
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Pharmaceutical forms |
Film-coated tablet
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Routes of administration |
Oral use
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Dosage and administration details |
One tablet was to be taken orally once daily in the morning and at approximately the same time of day during the treatment period.
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Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Film-coated tablet
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Routes of administration |
Oral use
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Dosage and administration details |
One tablet was to be taken orally once daily in the morning and at approximately the same time of day during the treatment period.
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Arm title
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Placebo then Dapagliflozin 10 mg | |||||||||||||||||||||
Arm description |
Patients received placebo tablets (matched to dapagliflozin) taken orally, once daily for 5 weeks. After a wash-out period of 6 to 8 weeks, patients received an oral dose of 10 mg dapagliflozin, once daily for 5 weeks. | |||||||||||||||||||||
Arm type |
Experimental and Placebo | |||||||||||||||||||||
Investigational medicinal product name |
Dapagliflozin
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Investigational medicinal product code |
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Other name |
Forxiga®, Farxiga®
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Pharmaceutical forms |
Film-coated tablet
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Routes of administration |
Oral use
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Dosage and administration details |
One tablet was to be taken orally once daily in the morning and at approximately the same time of day during the treatment period.
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Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Film-coated tablet
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Routes of administration |
Oral use
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Dosage and administration details |
One tablet was to be taken orally once daily in the morning and at approximately the same time of day during the treatment period.
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Baseline characteristics reporting groups
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Reporting group title |
Dapagliflozin 10 mg then Placebo
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Reporting group description |
Patients received an oral dose of 10 milligrams (mg) dapagliflozin, once daily for 5 weeks. After a wash-out period of 6 to 8 weeks, matched placebo tablets were taken orally, once daily for 5 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo then Dapagliflozin 10 mg
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Reporting group description |
Patients received placebo tablets (matched to dapagliflozin) taken orally, once daily for 5 weeks. After a wash-out period of 6 to 8 weeks, patients received an oral dose of 10 mg dapagliflozin, once daily for 5 weeks. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Dapagliflozin 10 mg then Placebo
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Reporting group description |
Patients received an oral dose of 10 milligrams (mg) dapagliflozin, once daily for 5 weeks. After a wash-out period of 6 to 8 weeks, matched placebo tablets were taken orally, once daily for 5 weeks. | ||
Reporting group title |
Placebo then Dapagliflozin 10 mg
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Reporting group description |
Patients received placebo tablets (matched to dapagliflozin) taken orally, once daily for 5 weeks. After a wash-out period of 6 to 8 weeks, patients received an oral dose of 10 mg dapagliflozin, once daily for 5 weeks. | ||
Subject analysis set title |
Dapagliflozin 10 mg
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Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
Patients received an oral dose of 10 mg dapagliflozin, once daily for 5 weeks in either Treatment Period 1 or Treatment Period 2.
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Subject analysis set title |
Placebo
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Subject analysis set type |
Intention-to-treat | ||
Subject analysis set description |
Patients received an oral dose of placebo, once daily for 5 weeks in either Treatment Period 1 or Treatment Period 2.
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End point title |
Corrected Glucose Disposal Rate (cGDR) Measured as Change in Rate of Disposal (Delta RD) Basal vs High Insulin After 5 Weeks of Treatment | ||||||||||||
End point description |
Skeletal muscle insulin sensitivity was measured as cGDR (referred to as delta RD [basal vs high insulin]) using a 2-step 5.5 hour EHC procedure in combination with infusion of D-glucose (6,6-D2) glucose. Delta RD (basal vs high insulin) was corrected for urinary glucose excretion and measured at the end of Treatment Periods 1 and 2.
The evaluable analysis set (clamp) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the clamp method were excluded.
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End point type |
Primary
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End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
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Statistical analysis title |
Treatment Difference | ||||||||||||
Statistical analysis description |
Comparison of delta RD (basal vs high insulin) between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
44
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Analysis specification |
Pre-specified
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Analysis type |
superiority [1] | ||||||||||||
P-value |
= 0.3047 [2] | ||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||
Parameter type |
Least Square (LS) Mean Difference | ||||||||||||
Point estimate |
-1.068
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-3.183 | ||||||||||||
upper limit |
1.047 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
1.014
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Notes [1] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [2] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
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End point title |
Change in Endogenous Glucose Production (EGP) After 5 Weeks of Treatment | ||||||||||||||||||
End point description |
A 2 step 5.5 hour EHC in combination with infusion of 6,6-D2 glucose was used to determine rates of EGP at the end of Treatment Periods 1 and 2. Results of the change in EGP are presented as delta EGP (basal vs low insulin and basal vs high insulin). The evaluable analysis set (clamp) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the clamp method were excluded.
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End point type |
Other pre-specified
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End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
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Statistical analysis title |
Treatment Difference | ||||||||||||||||||
Statistical analysis description |
Comparison of delta EGP (basal vs low insulin) between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
44
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Analysis specification |
Pre-specified
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Analysis type |
superiority [3] | ||||||||||||||||||
P-value |
= 0.0036 [4] | ||||||||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||||||||
Point estimate |
-1.705
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Confidence interval |
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level |
95% | ||||||||||||||||||
sides |
2-sided
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lower limit |
-2.784 | ||||||||||||||||||
upper limit |
-0.625 | ||||||||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.517
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Notes [3] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [4] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
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Statistical analysis title |
Treatment Difference | ||||||||||||||||||
Statistical analysis description |
Comparison of delta EGP (basal vs high insulin) between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
44
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Analysis specification |
Pre-specified
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Analysis type |
superiority [5] | ||||||||||||||||||
P-value |
< 0.0001 [6] | ||||||||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||||||||
Point estimate |
-2.292
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Confidence interval |
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level |
95% | ||||||||||||||||||
sides |
2-sided
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lower limit |
-3.146 | ||||||||||||||||||
upper limit |
-1.438 | ||||||||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.409
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Notes [5] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [6] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
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End point title |
Change in Respiratory Exchange Ratio (RER) from Fasted State to Insulin Stimulated State After 5 Weeks of Treatment | ||||||||||||
End point description |
During the indirect calorimetry of the EHC test, respiratory gas exchange was measured using open air circuit respirometry with an automated ventilated hood system. Metabolic flexibility was determined by the change in RER from fasted state to insulin stimulated state at the end of Treatment Periods 1 and 2 and results are presented as delta RER (basal vs high insulin). The evaluable analysis set (indirect calorimetry) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the indirect calorimetry method were excluded.
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End point type |
Other pre-specified
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End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
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Statistical analysis title |
Treatment Difference | ||||||||||||
Statistical analysis description |
Comparison of delta RER (basal vs high insulin) between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
42
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Analysis specification |
Pre-specified
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Analysis type |
superiority [7] | ||||||||||||
P-value |
= 0.1842 [8] | ||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
0.012
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.006 | ||||||||||||
upper limit |
0.03 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.009
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Notes [7] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [8] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
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End point title |
24-Hour RER After 5 Weeks of Treatment | ||||||||||||
End point description |
RER was measured before and after meals over a 24-hour period. The evaluable analysis set (chamber) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the chamber method were excluded.
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End point type |
Other pre-specified
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End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
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Statistical analysis title |
Treatment Difference | ||||||||||||
Statistical analysis description |
Comparison of 24-hour RER between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
48
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Analysis specification |
Pre-specified
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Analysis type |
superiority [9] | ||||||||||||
P-value |
= 0.0001 [10] | ||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
-0.023
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Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.033 | ||||||||||||
upper limit |
-0.013 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.005
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Notes [9] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [10] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
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End point title |
24-Hour Energy Expenditure After 5 Weeks of Treatment | ||||||||||||
End point description |
Whole body energy expenditure was measured over a 24-hour period. The evaluable analysis set (chamber) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the chamber method were excluded.
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End point type |
Other pre-specified
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End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
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Statistical analysis title |
Treatment Difference | ||||||||||||
Statistical analysis description |
Comparison of energy expenditure between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
48
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Analysis specification |
Pre-specified
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Analysis type |
superiority [11] | ||||||||||||
P-value |
= 0.1095 [12] | ||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
-0.109
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Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.245 | ||||||||||||
upper limit |
0.027 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.065
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Notes [11] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [12] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
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End point title |
Body Composition (Fat Mass and Lean Mass) After 5 Weeks of Treatment | ||||||||||||||||||
End point description |
On Day 6, 7 or 8 of the end of treatment visit in both treatment periods, a Dual-energy X-ray absorptiometry (DEXA) scan was used to determine body composition. The evaluable analysis set (DEXA) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with procedure specific protocol deviations regarding the DEXA method were excluded.
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End point type |
Other pre-specified
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End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
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Statistical analysis title |
Treatment Difference | ||||||||||||||||||
Statistical analysis description |
Comparison of fat mass between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
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Comparison groups |
Dapagliflozin 10 mg v Placebo
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Number of subjects included in analysis |
48
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Analysis specification |
Pre-specified
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Analysis type |
superiority [13] | ||||||||||||||||||
P-value |
= 0.6005 [14] | ||||||||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||||||||
Point estimate |
-246.7
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Confidence interval |
|||||||||||||||||||
level |
95% | ||||||||||||||||||
sides |
2-sided
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lower limit |
-1209.5 | ||||||||||||||||||
upper limit |
716.2 | ||||||||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||||||||
Dispersion value |
464.3
|
||||||||||||||||||
Notes [13] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [14] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
|||||||||||||||||||
Statistical analysis title |
Treatment Difference | ||||||||||||||||||
Statistical analysis description |
Comparison of lean mass between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
|
||||||||||||||||||
Comparison groups |
Dapagliflozin 10 mg v Placebo
|
||||||||||||||||||
Number of subjects included in analysis |
48
|
||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||
Analysis type |
superiority [15] | ||||||||||||||||||
P-value |
= 0.0376 [16] | ||||||||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||||||||
Point estimate |
-666.5
|
||||||||||||||||||
Confidence interval |
|||||||||||||||||||
level |
95% | ||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||
lower limit |
-1291 | ||||||||||||||||||
upper limit |
-41.9 | ||||||||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||||||||
Dispersion value |
301.1
|
||||||||||||||||||
Notes [15] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [16] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
|
|||||||||||||
End point title |
Body Composition (Total Mass) After 5 Weeks of Treatment | ||||||||||||
End point description |
On Day 6, 7 or 8 of the end of treatment visit in both treatment periods a DEXA scan was used to determine body composition. The evaluable analysis set (DEXA) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the DEXA method were excluded.
|
||||||||||||
End point type |
Other pre-specified
|
||||||||||||
End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Treatment Difference | ||||||||||||
Statistical analysis description |
Comparison of total mass between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
|
||||||||||||
Comparison groups |
Dapagliflozin 10 mg v Placebo
|
||||||||||||
Number of subjects included in analysis |
48
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority [17] | ||||||||||||
P-value |
= 0.0003 [18] | ||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
-1.256
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-1.854 | ||||||||||||
upper limit |
-0.657 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
0.289
|
||||||||||||
Notes [17] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [18] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
|
|||||||||||||
End point title |
Fibroblast Growth Factor 21 (FGF21) Area Under the Curve (AUC) in Plasma After 5 Weeks of Treatment | ||||||||||||
End point description |
From the end of Day 1 until the morning of Day 3 of the end of each treatment visit, the patients stayed in the metabolic chamber (36 hours). During this stay FGF21 was measured in plasma before and after meals and before bed-time to determine the AUC (last 24 hours). The evaluable analysis set (chamber) was a subset of the randomized analysis set, consisting of patients who received at least 1 dose of any investigational product. Any patients with important procedure specific protocol deviations regarding the chamber method were excluded.
|
||||||||||||
End point type |
Other pre-specified
|
||||||||||||
End point timeframe |
At end (Week 5) of Treatment Periods 1 and 2
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Treatment Difference | ||||||||||||
Statistical analysis description |
Comparison of FGF21 AUC between dapagliflozin and placebo after 5 weeks of treatment was performed using a random effects analysis of variance model.
|
||||||||||||
Comparison groups |
Dapagliflozin 10 mg v Placebo
|
||||||||||||
Number of subjects included in analysis |
42
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
superiority [19] | ||||||||||||
P-value |
= 0.1555 [20] | ||||||||||||
Method |
Linear Mixed Effects Model | ||||||||||||
Parameter type |
LS Mean Difference | ||||||||||||
Point estimate |
-244.301
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-590.002 | ||||||||||||
upper limit |
101.401 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
165.168
|
||||||||||||
Notes [19] - As this is a cross-over study and subject analysis sets are not mutually exclusive, the given automatically calculated number in the statistical analysis reflects the number of data points rather than number of subjects. [20] - A linear mixed model with treatment group, treatment sequence, and period as fixed effects and patient as random effect. |
|
||||||||||||||||
Adverse events information [1]
|
||||||||||||||||
Timeframe for reporting adverse events |
Adverse events (AEs) were reported for an overall time frame up to a maximum of 19 weeks (including both 5-week treatment periods, 6-8 weeks wash-out and 5-10 days safety follow-up
after last dose of study drug).
|
|||||||||||||||
Adverse event reporting additional description |
In this study, collection of AE data was limited to the collection of serious AEs, discontinuation of investigational product due to an AE and potential diabetic ketoacidosis events only. The safety analysis set consisted of all patients who received at least 1 dose of study drug.
|
|||||||||||||||
Assessment type |
Systematic | |||||||||||||||
Dictionary used for adverse event reporting
|
||||||||||||||||
Dictionary name |
MedDRA | |||||||||||||||
Dictionary version |
22.0
|
|||||||||||||||
Reporting groups
|
||||||||||||||||
Reporting group title |
Dapagliflozin 10mg
|
|||||||||||||||
Reporting group description |
Patients received an oral dose of 10mg dapagliflozin, once daily for 5 weeks. | |||||||||||||||
Reporting group title |
Placebo
|
|||||||||||||||
Reporting group description |
Patients received placebo tablets (matched to dapagliflozin) taken orally, once daily for 5 weeks. | |||||||||||||||
|
||||||||||||||||
Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||
|
||||||||||||||||
Notes [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported. Justification: There were no non serious adverse events above the 5% threshold in either reporting group. |
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
||
04 Dec 2017 |
Exclusion criterion added to exclude patients who did not want to be informed about unexpected medical findings or did not wish their physician to be informed about coincidental findings. Laboratory safety assessments updated to include serum/plasma potassium. The section entitled “Storage and destruction of Biological Samples” was updated to clarify length of time biological samples were to be retained. Sample size estimation also updated to provide more details of assumptions made and specify software used. |
||
20 Jun 2018 |
Exploratory objectives updated to include assessment of effect of dapagliflozin on citrate synthase activity in muscle biopsy. New exploratory objective added to investigate the effect of dapagliflozin on body weight, body mass index (BMI), and systolic and diastolic blood pressure. Inclusion criteria updated to specify that eligible patients could be on a stable dose of dipeptidyl peptidase IV inhibitor treatment for at least 3 months and also to specify patients should have a BMI of ≤ 38 kg/m2. Criteria for withdrawal updated to permit rescreening of patients. The section entitled “Study termination” was added. Biomarker assessments updated to include amino acids in addition to acetylcarnitine. Sample size estimation updated to specify screen failure rate, to ensure enough evaluable patients evenly distributed across the treatment sequences. |
||
13 Aug 2018 |
The section entitled “Study termination” was removed. |
||
12 Sep 2018 |
Implemented a pre-screening telephone call prior to Visit 1 to explain the study and ask the patients some questions relating to inclusion and exclusion criteria to verify eligibility. Included provision of a lifestyle card to the patient at Visit 2 to inform them of lifestyle advice to be adhered to during the study. |
||
Interruptions (globally) |
|||
Were there any global interruptions to the trial? No | |||
Limitations and caveats |
|||
Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |