E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Diabetes Mellitus, Type 2 |
Diabete mellito di tpo 2 |
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E.1.1.1 | Medical condition in easily understood language |
Diabetes Mellitus, Type 2 |
Diabete mellito di tpo 2 |
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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 | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045242 |
E.1.2 | Term | Type II diabetes mellitus |
E.1.2 | System Organ Class | 100000004861 |
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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 compare the effect on glycaemic control of treatment with once weekly insulin 287 using 2 different switch approaches versus once daily insulin glargine U100 both in combination with metformin ± DPP4 inhibitors (DPP4i) in basal insulin analogue treated T2DM subjects. |
Confrontare l’effetto sul controllo glicemico del trattamento con insulina 287 una volta a settimana usando due diversi approcci di passaggio in confronto all’insulina glargine U100 una volta al giorno entrambe in combinazione con metformina ± DPP4i in soggetti affetti da DMT2 trattati con analoghi dell’insulina basale |
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E.2.2 | Secondary objectives of the trial |
To compare the safety and tolerability of once weekly insulin 287 using 2 different switch approaches versus once daily insulin glargine U100 both in combination with metformin ± DPP4i in basal insulin analogue treated T2DM subjects. |
Confrontare la sicurezza e la tollerabilità dell’insulina 287 una volta a settimana usando 2 diversi approcci di passaggio in confronto all’insulina glargine U100 una volta al giorno entrambe in combinazione con metformina ± DPP4i in soggetti affetti da DMT2 trattati con analoghi dell’insulina basale |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial. 2. Male or female, aged 18-75 years (both inclusive) at the time of signing informed consent. 3. Diagnosed with type 2 diabetes mellitus = 180 days prior to the day of screening. 4. HbA1c of 7.0-10.0% (53.0-85.8 mmol/mol) (both inclusive) as assessed by central laboratory. 5. Treated with once daily or twice daily basal insulin analogue (insulin degludec, insulin detemir, insulin glargine U100 or U300, total daily dose of 10-50 U, both inclusive) = 90 days prior to the day of screening. 6. Stable daily dose(s) for 90 days prior to the day of screening of any of the following antidiabetic drug(s) or combination regime(s): Any metformin formulations = 1500 mg or maximum tolerated or effective dose (as documented in subjects medical records) Any metformin formulations = 1500 mg or maximum tolerated or effective dose with DPP4i = half of the maximum approved dose according to local label or maximum tolerated or effective dose (as documented in subjects medical records) 7. Body mass index (BMI) = 40.0 kg/m2 |
1. Modulo di consenso informato ottenuto prima di qualsiasi attività correlata alla sperimentazione. Per attività correlate alla sperimentazione si intende qualunque procedura svolta all’interno dello studio, incluse le attività necessarie a stabilire l’idoneità a partecipare. 2. Soggetti di sesso maschile o femminile, di età compresa tra 18-75 anni (estremi compresi) al momento della firma del modulo di consenso informato. 3. Soggetti che hanno ricevuto diagnosi di diabete mellito di tipo 2 =180 giorni prima del giorno dello screening. 4. Con valori di HbA1c compresi tra 7,0-10,0% (53,0-85,8 mmol/mol) (estremi compresi) secondo valutazione del laboratorio centrale. 5. Soggetti trattati con analoghi dell’insulina basale una volta o due volte al giorno (insulina degludec, insulina detemir, insulina glargine U100 o U300, con dose giornaliera totale di 10-50 U, estremi compresi) =90 giorni prima del giorno dello screening. 6. Dose/i giornaliera/e stabile/i di uno qualsiasi dei seguenti farmaci antidiabetici o regimi combinati nei 90 giorni precedenti il giorno dello screening: qualsiasi formulazione di metformina =1.500 mg o dose massima tollerata o efficace (documentata nella cartella clinica del soggetto); qualsiasi formulazione di metformina =1.500 mg o dose massima tollerata o efficace con DPP4i = metà della dose massima approvata secondo l’etichetta locale o dose massima tollerata o efficace (documentata nella cartella clinica del soggetto). 7. Indice di massa corporea (Body mass index, BMI) =40,0 kg/m2. |
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E.4 | Principal exclusion criteria |
1. Known or suspected hypersensitivity to trial product(s) or related products. 2. Previous participation in this trial. Participation is defined as signed informed consent. 3. Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using an adequate contraceptive method. For Czech Republic and Germany, please see country specific requirements in Appendix 10. 4. Participation in any clinical trial of an approved or non-approved investigational medicinal product within 90 days before screening. 5. Any disorder, except for conditions associated with type 2 diabetes mellitus, which in the investigator’s opinion might jeopardise subject’s safety or compliance with the protocol. 6. Any episodes of diabetic ketoacidosis within the past 90 days prior to the day of screening and between screening and randomisation. 7. Known hypoglycaemic unawareness as indicated by the Investigator according to Clarke’s questionnaire question 8.1 8. Recurrent severe hypoglycaemic episodes within the last year as judged by the Investigator. 9. Myocardial infarction, stroke, hospitalisation for unstable angina pectoris or transient ischaemic attack within 180 days prior to the day of screening and between screening and randomisation. 10. Presently classified as being in New York Heart Association (NYHA) Class IV. 11. Planned coronary, carotid or peripheral artery revascularisation, between screening and randomisation. 12. Renal impairment measured as estimated Glomerular Filtration Rate (eGFR) value of eGFR <60 ml/min/1.73 m2 as defined by KDIGO 2012.13 13. Impaired liver function, defined as Alanine Aminotransferase (ALT) = 2.5 times or Bilirubin >1.5 times upper normal limit at screening 14. Inadequately treated blood pressure defined as Grade 3 hypertension or higher (Systolic =180 mmHg or diastolic =110 mmHg) at screening. 15. Treatment with any medication for the indication of diabetes or obesity other than stated in the inclusion criteria within the past 90 days prior to the day of screening. 16. Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days prior to screening or in the period between screening and randomisation. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination. 17. Presence or history of malignant neoplasms within 5 years prior to the day of screening. Basal and squamous cell skin cancer and any carcinoma in-situ are allowed |
1. Ipersensibilità nota o sospetta al/ai prodotto/i sperimentale/i o ai prodotti correlati. 2. Precedente partecipazione a questa sperimentazione. La partecipazione è definita come modulo di consenso informato firmato. 3. Soggetto di sesso femminile che sia in gravidanza, in allattamento o intenda iniziare una gravidanza o in età fertile e che non utilizzi misure contraccettive adeguate. 4. Partecipazione a qualsiasi sperimentazione clinica di un prodotto medicinale sperimentale approvato o non approvato nei 90 giorni precedenti allo screening. 5. Qualsiasi disturbo, eccetto le condizioni associate al diabete mellito di tipo 2, che, a giudizio dello sperimentatore, potrebbe mettere a rischio la sicurezza del soggetto o la conformità al protocollo. 6. Qualsiasi episodio di chetoacidosi diabetica negli ultimi 90 giorni precedenti il giorno dello screening e tra lo screening e la randomizzazione. 7. Inconsapevolezza di ipoglicemia nota, come indicato dallo sperimentatore in base alla domanda 8 del questionario di Clarke.1 8. Gravi episodi ipoglicemici ricorrenti nell’ultimo anno, secondo il giudizio dello sperimentatore. 9. Infarto del miocardio, ictus o ricovero in ospedale per angina instabile o attacco ischemico transitorio nei 180 giorni precedenti il giorno dello screening e tra lo screening e la randomizzazione. 10. Soggetti attualmente classificati nella Classe IV secondo la New York Heart Association (NYHA). 11. Prevista rivascolarizzazione arteriosa periferica, carotidea o coronarica tra lo screening e la randomizzazione. 12. Insufficienza renale misurata in termini di velocità di filtrazione glomerulare stimata (estimated Glomerular Filtration Rate, eGFR) con un valore eGFR <60 ml/min/1,73 m2 definito secondo la classificazione KDIGO 2012.* 13. Funzionalità epatica ridotta, definita come alanina aminotransferasi (ALT) =2,5 volte o bilirubina >1,5 volte il limite superiore di normalità allo screening. 14. Ipertensione inadeguatamente trattata allo screening, definita come ipertensione di Classe 3 o superiore (pressione arteriosa sistolica =180 mmHg e/o pressione arteriosa diastolica =110 mmHg) allo screening. 15. Trattamento con qualsiasi farmaco indicato per il diabete o l’obesità, diverso da quelli stabiliti nei criteri di inclusione, nel periodo dei 90 giorni precedenti al giorno dello screening. 16. Retinopatia o maculopatia diabetica non controllata o potenzialmente instabile, verificata mediante esame del fondo oculare eseguito negli ultimi 90 giorni precedenti lo screening o nell’intervallo di tempo compreso tra lo screening e la randomizzazione. La dilatazione farmacologica della pupilla è un requisito, a meno che non venga usata una fotocamera digitale specifica per un esame del fondo oculare senza dilatazione della pupilla. 17. Presenza o anamnesi di neoplasie maligne nei 5 anni precedenti al giorno dello screening. Sono consentiti il carcinoma cutaneo a cellule squamose e a cellule basali e qualsiasi carcinoma in situ |
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E.5 End points |
E.5.1 | Primary end point(s) |
Time in target range 3.9–10.0 mmol/L (70-180 mg/dL) measured using continuous glucose monitoring (CGM) |
Tempo trascorso nell’intervallo target di 3,9-10,0 mmol/l (70-180 mg/dl) misurato usando il CGM |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Last 2 weeks of treatment (week 15 and 16) |
Ultime 2 settimane di trattamento (Settimane 15 e 16) |
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E.5.2 | Secondary end point(s) |
1. Change in HbA1c 2. Change in fasting plasma glucose (FPG) 3. Change in body weight 4. Weekly insulin dose 5. Number of treatment emergent adverse events (TEAEs) 6. Number of severe hypoglycaemic episodes (level 3) 7. Number of clinically significant hypoglycaemic episodes (level 2) (below 3.0 mmol/L (54 mg/dL), confirmed by BG meter) or severe hypoglycaemic episodes (level 3) 8. Number of hypoglycaemic alert episodes (level 1) (equal to or above 3.0 and below 3.9 mmol/L (equal to or above 54 and below 70 mg/dL), confirmed by BG meter) |
1. Variazione nell’emoglobina glicata (HbA1c) 2. Variazione nella glicemia plasmatica a digiuno (Fasting Plasma Glucose, FPG) 3. Variazione nel peso corporeo 4. Dose settimanale di insulina 5. Numero degli eventi avversi emergenti dal trattamento (Treatment Emergent Adverse Events, TEAE) 6. Numero di episodi ipoglicemici gravi (livello 3) 7. Numero di episodi ipoglicemici clinicamente significativi (livello 2) (<3.0 mmol/l [54 mg/dl], confermato mediante glucometro) o episodi ipoglicemici gravi (livello 3) 8. Numero di episodi di allerta ipoglicemica (livello 1) (da =3,0 a <3,9 mmol/l [da =54 a <70 mg/dl], confermato mediante glucometro) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-3.From baseline week 0 (V2) to week 16 (V18) 4. During the last 2 weeks of treatment (week 15 and 16) 5. From baseline week 0 (V2) to week 21 (V20) 6 -8 From baseline week 0 (V2) to week 16 (V18) |
1-3 Dalla Settimana basale 0 (V2) alla Settimana 16 (V18) 4 Ultime due settimane di trattamento (settimana 15 e 16) 5 Dalla Settimana basale 0 (V2) alla Settimana 21 (V20) 6-8 Dalla Settimana basale 0 (V2) alla Settimana 16 (V18) |
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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 | 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 | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability |
Tollerabilità |
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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 | 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 | 3 |
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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 16 |
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 | Information not present in EudraCT |
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 |
Canada |
United States |
European Union |
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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 | 0 |
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 years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 8 |
E.8.9.2 | In all countries concerned by the trial days | 14 |