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A Double-Blind, Randomized, Active-Comparator (Metformin) Controlled, Clinical Trial to Study the Efficacy and Safety of the Strategy to Start Patients With Type 2 Diabetes Mellitus on Janumet™ Compared to Metformin

Primary Purpose

Diabetes Type 2

Status
Unknown status
Phase
Phase 3
Locations
Israel
Study Type
Interventional
Intervention
Metformin 1500 mg daily
Metformin + Janufer (Janumet)
Sponsored by
Meir Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Type 2 focused on measuring DM 2, Metformin, Januvia, Community setting, newly diagnosed diadetics, or diabetes patients not treated during the last year

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • All laboratory measurements are to be performed after an overnight fast ≥ 10 hours in duration. Patients with laboratory screening values/findings not meeting protocol inclusion criteria may, at the discretion of the investigator, have one repeat determination performed. If the repeat value satisfies the criterion they may continue in the screening process. Only the laboratory test not meeting inclusion should be repeated (not the entire panel).

Exclusion Criteria:

Glucose Metabolism and Therapy Criteria

  • Patient has a history of type 1 diabetes mellitus or history of ketoacidosis. Patients Requiring Specific Treatments
  • Patient has symptomatic hyperglycemia requiring immediate initiation of insulin therapy.
  • Patient has a history of intolerance or hypersensitivity to metformin or sitagliptin or has any contraindication to use metformin.

Concomitant Disease of Organs and Systems

  • Patient has a medical history of active liver disease (excluding hepatic steatosis).
  • Patient has severe active peripheral vascular disease (e.g., manifested by claudication with minimal activity, a non-healing ischemic ulcer, or disease which is likely to require intervention such as with bypass or angioplasty).
  • Patient has unstable or acute congestive heart failure.
  • Patient has a history of malignancy without documentation of remission/cure. Other Criteria
  • Patient is pregnant, has a positive urine pregnancy test at Visit 1, is expecting to conceive within the projected duration of the study, or is breast feeding.

Exclusion Criteria Based on Lab Abnormalities

  • Patient has increased serum-creatinine and/or decreased estimated creatinine clearance.
  • If screening labs are repeated, the last laboratory draw/result should be used for inclusion.§ Either elevated Creatinine or decreased estimated creatinine clearance lead to exclusion of the patient.
  • Patients whose serum creatinine does not meet the exclusion criteria, but whose estimated creatinine clearance is <60 mL/min but ≥50 mL/min, may have a measured creatinine clearance (i.e., based upon a 24-hour urine collection). These patients may be eligible if their measured creatinine clearance is ≥60 mL/min.

At Visit 2

  • Patient has a site fingerstick glucose <130 mg/dL (7.2 mmol/L) or >320 mg/dL (17.8 mmol/L).

Note: If the patient meets this exclusion criterion AND the investigator believes that the value does not reflect the patient's recent glycemic control based upon recent SBGM values and/or the Visit 1 FPG value, the patient should not be excluded at this time. The current visit should be changed to an "Unscheduled visit" and the patient should be rescheduled for Visit 2. If, at the rescheduled Visit 2, the patient meets this exclusion criterion, the patient MUST be excluded.

  • Patient has a positive urine pregnancy test.
  • Patient developed a new medical condition, suffered a change in status of an established medical condition, developed a laboratory abnormality, or required a new treatment or medication between Visit 1 and Visit 2 which meets any previously described study exclusion criterion.

Sites / Locations

  • Clalit Health services centerRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

a

2

Arm Description

This group will receive Metformin and placebo.

The second arm will receive Metformin and Januvia

Outcomes

Primary Outcome Measures

The efficacy and safety of community based study in diabetic patients, comparing Metformin to Metformin + Janufer.
The efficacy and safety of Metformin VS Metformin + Janufer in the community setting

Secondary Outcome Measures

Full Information

First Posted
May 21, 2008
Last Updated
March 16, 2012
Sponsor
Meir Medical Center
Collaborators
Clalit Health Services
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1. Study Identification

Unique Protocol Identification Number
NCT00684528
Brief Title
A Double-Blind, Randomized, Active-Comparator (Metformin) Controlled, Clinical Trial to Study the Efficacy and Safety of the Strategy to Start Patients With Type 2 Diabetes Mellitus on Janumet™ Compared to Metformin
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Unknown status
Study Start Date
June 2008 (undefined)
Primary Completion Date
December 2011 (Actual)
Study Completion Date
December 2012 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Meir Medical Center
Collaborators
Clalit Health Services

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Comparison between the effectiveness of one anti-diabetic drug (Metformin, To combination of this drug and additional drug (Janufer), In the community setting.
Detailed Description
This is a randomized, double-blind, active-comparator (metformin) controlled study in drug-naïve patients with T2DM who have an HbA1c ≥ 7.5%. The duration of the study is 55 weeks, which will include a 1-week screening period (Visit 1 to Visit 2) and a 54 week double-blind, active treatment period. At Visit 2/Day 1 patients who meet all enrollment criteria will be randomized in a 1:1 ratio to one of two active treatment groups: 1. JANUMET™ (fixed-dose combination sitagliptin/metformin) or 2. metformin. The starting fixed-dose combination of sitagliptin/metformin will be 50/500 mg administered twice-daily and then up-titrated to a dose of 50/1000 mg b.i.d. over 4 weeks. The starting dose of metformin will be 500 mg twice-daily and then up-titrated to a dose of 1000 mg b.i.d. over 4 weeks. Patients who can not tolerate JANUMET™ at a dose of at least 50/500 mg b.i.d. or metformin at a dose of at least 500 mg b.i.d. 6 weeks after randomization and throughout the study will be discontinued. During the double-blind treatment period patients will remain on the study medication, but investigators are allowed to add other antihyperglycemic agents to improve glycemic control as necessary. The investigator can schedule additional visits to initiate additional antihyperglycemic agents or monitor glycemic control at any time during the study period. There will be no fixed visit schedule, but 7 clinical visits are recommended. It is also recommended to perform the first visit on active treatment 6 weeks after randomization and after this visit to schedule visits every 3 months. All clinical and lab data can be obtained using the "Clalit health care information system".

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Type 2
Keywords
DM 2, Metformin, Januvia, Community setting, newly diagnosed diadetics, or diabetes patients not treated during the last year

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
1000 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
a
Arm Type
Active Comparator
Arm Description
This group will receive Metformin and placebo.
Arm Title
2
Arm Type
Experimental
Arm Description
The second arm will receive Metformin and Januvia
Intervention Type
Drug
Intervention Name(s)
Metformin 1500 mg daily
Intervention Description
500 mg thrice daily
Intervention Type
Drug
Intervention Name(s)
Metformin + Janufer (Janumet)
Intervention Description
Titration up to 1500/150 mg daily
Primary Outcome Measure Information:
Title
The efficacy and safety of community based study in diabetic patients, comparing Metformin to Metformin + Janufer.
Time Frame
54 weeks
Title
The efficacy and safety of Metformin VS Metformin + Janufer in the community setting
Time Frame
2010

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All laboratory measurements are to be performed after an overnight fast ≥ 10 hours in duration. Patients with laboratory screening values/findings not meeting protocol inclusion criteria may, at the discretion of the investigator, have one repeat determination performed. If the repeat value satisfies the criterion they may continue in the screening process. Only the laboratory test not meeting inclusion should be repeated (not the entire panel). Exclusion Criteria: Glucose Metabolism and Therapy Criteria Patient has a history of type 1 diabetes mellitus or history of ketoacidosis. Patients Requiring Specific Treatments Patient has symptomatic hyperglycemia requiring immediate initiation of insulin therapy. Patient has a history of intolerance or hypersensitivity to metformin or sitagliptin or has any contraindication to use metformin. Concomitant Disease of Organs and Systems Patient has a medical history of active liver disease (excluding hepatic steatosis). Patient has severe active peripheral vascular disease (e.g., manifested by claudication with minimal activity, a non-healing ischemic ulcer, or disease which is likely to require intervention such as with bypass or angioplasty). Patient has unstable or acute congestive heart failure. Patient has a history of malignancy without documentation of remission/cure. Other Criteria Patient is pregnant, has a positive urine pregnancy test at Visit 1, is expecting to conceive within the projected duration of the study, or is breast feeding. Exclusion Criteria Based on Lab Abnormalities Patient has increased serum-creatinine and/or decreased estimated creatinine clearance. If screening labs are repeated, the last laboratory draw/result should be used for inclusion.§ Either elevated Creatinine or decreased estimated creatinine clearance lead to exclusion of the patient. Patients whose serum creatinine does not meet the exclusion criteria, but whose estimated creatinine clearance is <60 mL/min but ≥50 mL/min, may have a measured creatinine clearance (i.e., based upon a 24-hour urine collection). These patients may be eligible if their measured creatinine clearance is ≥60 mL/min. At Visit 2 Patient has a site fingerstick glucose <130 mg/dL (7.2 mmol/L) or >320 mg/dL (17.8 mmol/L). Note: If the patient meets this exclusion criterion AND the investigator believes that the value does not reflect the patient's recent glycemic control based upon recent SBGM values and/or the Visit 1 FPG value, the patient should not be excluded at this time. The current visit should be changed to an "Unscheduled visit" and the patient should be rescheduled for Visit 2. If, at the rescheduled Visit 2, the patient meets this exclusion criterion, the patient MUST be excluded. Patient has a positive urine pregnancy test. Patient developed a new medical condition, suffered a change in status of an established medical condition, developed a laboratory abnormality, or required a new treatment or medication between Visit 1 and Visit 2 which meets any previously described study exclusion criterion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Niky Liberman, MD
Phone
972-3692-3316
Email
nikyli@clalit.org.il
First Name & Middle Initial & Last Name or Official Title & Degree
Lotan Shilo, MD
Phone
972-9747-2170
Email
shilolo@clalit.org.il
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joel Zinger, MD
Organizational Affiliation
clali health organization
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clalit Health services center
City
Tel Aviv
ZIP/Postal Code
62098
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zinger
Phone
972-5062-63652
First Name & Middle Initial & Last Name & Degree
Zinger Joel, MD

12. IPD Sharing Statement

Citations:
PubMed Identifier
18353996
Citation
Mistry GC, Maes AL, Lasseter KC, Davies MJ, Gottesdiener KM, Wagner JA, Herman GA. Effect of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on blood pressure in nondiabetic patients with mild to moderate hypertension. J Clin Pharmacol. 2008 May;48(5):592-8. doi: 10.1177/0091270008316885. Epub 2008 Mar 19.
Results Reference
background
PubMed Identifier
18201203
Citation
Scott R, Loeys T, Davies MJ, Engel SS; Sitagliptin Study 801 Group. Efficacy and safety of sitagliptin when added to ongoing metformin therapy in patients with type 2 diabetes. Diabetes Obes Metab. 2008 Sep;10(10):959-69. doi: 10.1111/j.1463-1326.2007.00839.x. Epub 2008 Jan 14.
Results Reference
result

Learn more about this trial

A Double-Blind, Randomized, Active-Comparator (Metformin) Controlled, Clinical Trial to Study the Efficacy and Safety of the Strategy to Start Patients With Type 2 Diabetes Mellitus on Janumet™ Compared to Metformin

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