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Safety Study of TAK-559 in Treating Subjects With Type 2 Diabetes Mellitus

Primary Purpose

Diabetes Mellitus

Status
Terminated
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
TAK-559
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus focused on measuring Glucose Metabolism Disorder, Dysmetabolic Syndrome, Type II Diabetes, Diabetes Mellitus, Lipoatrophic, Dyslipidemia, Drug Therapy.

Eligibility Criteria

25 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Required sponsor approval if older than 80 years.
  • Had either:

    • Successfully completed Protocol 01-03-TL-559-016, or
    • Participated in either Protocol 01-02-TL-559-013, 01-02-TL-559-014, 01-04-TL-559-028, or 01-04-TL-559-029 and either

      • completed the study
      • prematurely terminated from the study due to the HbA1c withdrawal criterion after at least 12 weeks of treatment, or
      • in the opinion of the investigator, demonstrated a lack of efficacy after at least 16 weeks of treatment and was withdrawn from the study.
  • A female subject of childbearing potential who was sexually active agreed to use adequate contraception, and was neither pregnant nor lactating from Screening throughout the duration of the study.
  • Were willing to continue following an individualized weight maintenance diet during the study period.
  • Had evidence of insulin secretory capacity, as demonstrated by a fasting C-peptide concentration of greater than or equal to 1.5 ng/mL (0.50 nmol/L) at the prior visit of Protocol 013, 014, 016, 028, or 029.
  • Were willing to perform daily self-monitoring blood glucose tests.
  • Were in good health at Enrollment, as determined by a physician at the final visit of Protocol 013, 014, 016, 028, or 029 (ie, via medical history and physical examination), other than having type 2 diabetes mellitus and New York Heart Association Classification I or II congestive heart failure.
  • Had clinical laboratory evaluations (including clinical chemistry, hematology, and complete urinalysis after fasting for at least 8 hours) within the normal reference range for the testing laboratory, unless the results were deemed not clinically significant by the investigator or sponsor, at the prior visit of Protocol 013, 014, 016, 028, or 029.
  • Had a normal thyroid-stimulating hormone level of less than 5.5 uIU/mL (5.5 mIU/L) and greater than or equal to 0.35 uIU/mL (0.35 mIU/L) at the prior visit of Protocol 013, 014, 016, 028, or 029.

Exclusion Criteria:

  • Had significant cardiovascular disease, including, but not limited to, New York Heart Association Classification III or IV CHF at Enrollment.
  • Had a planned surgical or catheter intervention for coronary angioplasty within 12 months after the Enrollment Visit.
  • Had a systolic blood pressure greater than 140 mm Hg or a diastolic blood pressure greater than 95 mm Hg at Enrollment.
  • Had symptomatic orthostatic hypotension or systolic blood pressure less than 90 mm Hg at Enrollment.
  • Had a history of a clinically significant abnormal electrocardiogram or experienced any cardiovascular event including, but not limited to, myocardial infarction, coronary angioplasty or bypass graft, unstable angina pectoris, transient ischemic attacks, or documented cerebrovascular accident during Protocol 013, 014, 016, 028, or 029.
  • Had a creatine phosphokinase value above 3 times the upper limit of normal at the prior visit of Protocol 013, 014, 016, 028, or 029.
  • Had a triglyceride level greater than 500 mg/dL (5.6 nmol/L) at the prior visit of Protocol 013, 014, 016, 028, or 029.
  • Had an alanine aminotransferase or aspartate aminotransferase level above 3 times the upper limit of normal, active liver disease, or jaundice at any time during Protocol 013, 014, 016, 028, or 029.
  • Had donated and/or received any blood products within 3 months prior to Enrollment.
  • Had used illicit drugs or abused alcohol during participation in Protocol 013, 014, 016, 028, or 029.
  • Had experienced another illness occurring at the same time requiring hospitalization during the occurring at the same time 3 weeks before the Enrollment Visit.
  • Had experienced any other serious disease or condition during participation in Protocol 013, 014, 016, 028, or 029 that might have affected life expectancy or made it difficult to successfully manage and follow the patient according to the protocol.
  • Was required to take or intended to continue taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfered with the evaluation of the study medication, including:

    • insulin (for patients who participated in Protocol 01-02-TL-559-013, 01-02-TL-559-014, 01-04-TL-559-028, and 01-04-TL-559-029)
    • prescription-strength niacin
    • fibric acid derivatives
    • systemic corticosteroids
    • warfarin
    • rifampin
    • nicotinic acid
    • St. John's Wort
    • thiazolidinediones
    • peroxisome proliferator-activated receptor agonists other than the study drug.
  • Had experienced persistent unexplained microscopic or macroscopic hematuria or developed cancer of the bladder while participating in Protocol 013, 014, 016, 028, or 029.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    TAK-559 32 mg QD

    Arm Description

    Outcomes

    Primary Outcome Measures

    Change from baseline in clinical laboratory hematology tests.
    Change from baseline in clinical laboratory chemistry tests.
    Blood pressure measurements.
    Pulse measurements.
    Body weight.
    Physical examinations.
    12-lead electrocardiogram.
    Adverse event occurrence.

    Secondary Outcome Measures

    Change from baseline in glycosylated hemoglobin.
    Change from baseline in fasting plasma glucose.
    Change from baseline in fasting insulin.
    Change from baseline in fasting C-peptide.
    Change from baseline in triglycerides.
    Change from baseline in total cholesterol.
    Change from baseline in high-density lipoprotein.
    Change from baseline in low-density lipoprotein.
    Change from baseline in very-low-density lipoprotein.
    Change from baseline in low-density lipoprotein fractionation.
    Change from baseline in intermediate-density lipoprotein size.
    Change from baseline in large low-density lipoprotein size.
    Change from baseline in small low-density lipoprotein size.
    Change from baseline in medium-small low-density lipoprotein size.
    Change from baseline in very-small low-density lipoprotein size.
    Change from baseline in mean low-density lipoprotein size.
    Change from baseline in apolipoproteins A1 and B.
    Change from baseline in atherosclerosis marker plasminogen activator inhibitor 1.
    Change from baseline in atherosclerosis marker fibrinogen.
    Change from baseline in inflammation marker Interleukin-6.
    Change from baseline in inflammation marker C-reactive protein.

    Full Information

    First Posted
    September 26, 2008
    Last Updated
    November 8, 2012
    Sponsor
    Takeda
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00762112
    Brief Title
    Safety Study of TAK-559 in Treating Subjects With Type 2 Diabetes Mellitus
    Official Title
    A Long-Term, Open-Label, Phase 3a Safety Study of Oral TAK-559 (32 mg QD) in the Treatment of Patients With Type 2 Diabetes Mellitus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2012
    Overall Recruitment Status
    Terminated
    Why Stopped
    Hepatic safety signal identified.
    Study Start Date
    November 2003 (undefined)
    Primary Completion Date
    December 2004 (Actual)
    Study Completion Date
    December 2004 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Takeda

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study was to determine the long-term safety of TAK-559, once daily (QD), in subjects with Type 2 Diabetes.
    Detailed Description
    Insulin is a primary regulator of blood glucose concentrations. A subnormal response to circulating insulin levels at target tissues leads to a decrease in insulin-mediated glucose uptake. Insulin resistance is associated with normal to high insulin levels and is often accompanied by dyslipidemia, a disruption in lipid metabolism resulting in increased triglycerides and low-density lipoprotein levels as well as decreased high-density lipoprotein levels in patients with type 2 diabetes mellitus. In the early stages of insulin resistance, a compensatory mechanism of increased insulin secretion by the pancreas maintains normal to near-normal glucose levels. Once the pancreas fails to maintain the increased insulin output, overt type 2 diabetes mellitus occurs. Insulin also plays an important role in the metabolism of fat and proteins and exerts its influence at the peroxisome proliferator-activated receptor level. Peroxisome proliferator-activated receptor -alpha receptors are expressed predominantly in skeletal muscle, adipose tissue, heart, liver, kidney, gut, macrophages, and vascular tissue, and play a key role in energy storage, glucose homeostasis, and vascular biology. Thus, as insulin activates peroxisome proliferator-activated receptor-alpha receptors, this results in the cellular uptake of glucose. Peroxisome proliferator-activated receptor receptors are ligand-activated transcription elements that regulate gene expression necessary for metabolism. For this reason, peroxisome proliferator-activated receptors play a pivotal role in glucose homeostasis, adipocyte differentiation, and lipid storage. The genes predominantly targeted by transcription activity of activated peroxisome proliferator-activated receptor-alpha receptors are those that mediate fatty acid uptake, fatty acid oxidation, and lipoprotein metabolism. As such, peroxisome proliferator-activated receptor-alpha agonists have their greatest effect on lipid metabolism and vascular biology. TAK-559 is a novel oxyiminoalkanoic acid under investigation for use as an oral agent in the treatment of patients with type 2 diabetes mellitus. TAK-559 has partial peroxisome proliferator-activated receptor-alpha agonist activity, potent peroxisome proliferator-activated receptor-alpha activity, and modest peroxisome proliferator-activated receptor-gamma activity at high concentrations in nonclinical models.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Diabetes Mellitus
    Keywords
    Glucose Metabolism Disorder, Dysmetabolic Syndrome, Type II Diabetes, Diabetes Mellitus, Lipoatrophic, Dyslipidemia, Drug Therapy.

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    316 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    TAK-559 32 mg QD
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    TAK-559
    Intervention Description
    TAK-559 32 mg, tablets, orally, once daily for up to 24 months.
    Primary Outcome Measure Information:
    Title
    Change from baseline in clinical laboratory hematology tests.
    Time Frame
    Week 2 and Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in clinical laboratory chemistry tests.
    Time Frame
    Week 2 and Months 6, 12, 18, and Final Visit
    Title
    Blood pressure measurements.
    Time Frame
    All visits.
    Title
    Pulse measurements.
    Time Frame
    All visits.
    Title
    Body weight.
    Time Frame
    All visits.
    Title
    Physical examinations.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    12-lead electrocardiogram.
    Time Frame
    Months 6, 12, and Final Visit
    Title
    Adverse event occurrence.
    Time Frame
    All visits or at occurrence
    Secondary Outcome Measure Information:
    Title
    Change from baseline in glycosylated hemoglobin.
    Time Frame
    Months 3, 6, 9, 12, 15, 18, 21, and Final Visit
    Title
    Change from baseline in fasting plasma glucose.
    Time Frame
    All visits.
    Title
    Change from baseline in fasting insulin.
    Time Frame
    Months 3, 6, 9, 12, 15, 18, 21, and Final Visit
    Title
    Change from baseline in fasting C-peptide.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in triglycerides.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in total cholesterol.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in high-density lipoprotein.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in low-density lipoprotein.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in very-low-density lipoprotein.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in low-density lipoprotein fractionation.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in intermediate-density lipoprotein size.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in large low-density lipoprotein size.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in small low-density lipoprotein size.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in medium-small low-density lipoprotein size.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in very-small low-density lipoprotein size.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in mean low-density lipoprotein size.
    Time Frame
    Months 6, 12, 18, and Final Visit
    Title
    Change from baseline in apolipoproteins A1 and B.
    Time Frame
    Months 12 and Final Visit
    Title
    Change from baseline in atherosclerosis marker plasminogen activator inhibitor 1.
    Time Frame
    Months 6, 12, and Final Visit
    Title
    Change from baseline in atherosclerosis marker fibrinogen.
    Time Frame
    Months 6, 12, and Final Visit
    Title
    Change from baseline in inflammation marker Interleukin-6.
    Time Frame
    Months 6, 12, and Final Visit
    Title
    Change from baseline in inflammation marker C-reactive protein.
    Time Frame
    Months 6, 12, and Final Visit

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    25 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Required sponsor approval if older than 80 years. Had either: Successfully completed Protocol 01-03-TL-559-016, or Participated in either Protocol 01-02-TL-559-013, 01-02-TL-559-014, 01-04-TL-559-028, or 01-04-TL-559-029 and either completed the study prematurely terminated from the study due to the HbA1c withdrawal criterion after at least 12 weeks of treatment, or in the opinion of the investigator, demonstrated a lack of efficacy after at least 16 weeks of treatment and was withdrawn from the study. A female subject of childbearing potential who was sexually active agreed to use adequate contraception, and was neither pregnant nor lactating from Screening throughout the duration of the study. Were willing to continue following an individualized weight maintenance diet during the study period. Had evidence of insulin secretory capacity, as demonstrated by a fasting C-peptide concentration of greater than or equal to 1.5 ng/mL (0.50 nmol/L) at the prior visit of Protocol 013, 014, 016, 028, or 029. Were willing to perform daily self-monitoring blood glucose tests. Were in good health at Enrollment, as determined by a physician at the final visit of Protocol 013, 014, 016, 028, or 029 (ie, via medical history and physical examination), other than having type 2 diabetes mellitus and New York Heart Association Classification I or II congestive heart failure. Had clinical laboratory evaluations (including clinical chemistry, hematology, and complete urinalysis after fasting for at least 8 hours) within the normal reference range for the testing laboratory, unless the results were deemed not clinically significant by the investigator or sponsor, at the prior visit of Protocol 013, 014, 016, 028, or 029. Had a normal thyroid-stimulating hormone level of less than 5.5 uIU/mL (5.5 mIU/L) and greater than or equal to 0.35 uIU/mL (0.35 mIU/L) at the prior visit of Protocol 013, 014, 016, 028, or 029. Exclusion Criteria: Had significant cardiovascular disease, including, but not limited to, New York Heart Association Classification III or IV CHF at Enrollment. Had a planned surgical or catheter intervention for coronary angioplasty within 12 months after the Enrollment Visit. Had a systolic blood pressure greater than 140 mm Hg or a diastolic blood pressure greater than 95 mm Hg at Enrollment. Had symptomatic orthostatic hypotension or systolic blood pressure less than 90 mm Hg at Enrollment. Had a history of a clinically significant abnormal electrocardiogram or experienced any cardiovascular event including, but not limited to, myocardial infarction, coronary angioplasty or bypass graft, unstable angina pectoris, transient ischemic attacks, or documented cerebrovascular accident during Protocol 013, 014, 016, 028, or 029. Had a creatine phosphokinase value above 3 times the upper limit of normal at the prior visit of Protocol 013, 014, 016, 028, or 029. Had a triglyceride level greater than 500 mg/dL (5.6 nmol/L) at the prior visit of Protocol 013, 014, 016, 028, or 029. Had an alanine aminotransferase or aspartate aminotransferase level above 3 times the upper limit of normal, active liver disease, or jaundice at any time during Protocol 013, 014, 016, 028, or 029. Had donated and/or received any blood products within 3 months prior to Enrollment. Had used illicit drugs or abused alcohol during participation in Protocol 013, 014, 016, 028, or 029. Had experienced another illness occurring at the same time requiring hospitalization during the occurring at the same time 3 weeks before the Enrollment Visit. Had experienced any other serious disease or condition during participation in Protocol 013, 014, 016, 028, or 029 that might have affected life expectancy or made it difficult to successfully manage and follow the patient according to the protocol. Was required to take or intended to continue taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfered with the evaluation of the study medication, including: insulin (for patients who participated in Protocol 01-02-TL-559-013, 01-02-TL-559-014, 01-04-TL-559-028, and 01-04-TL-559-029) prescription-strength niacin fibric acid derivatives systemic corticosteroids warfarin rifampin nicotinic acid St. John's Wort thiazolidinediones peroxisome proliferator-activated receptor agonists other than the study drug. Had experienced persistent unexplained microscopic or macroscopic hematuria or developed cancer of the bladder while participating in Protocol 013, 014, 016, 028, or 029.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    VP Biological Sciences
    Organizational Affiliation
    Takeda
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Safety Study of TAK-559 in Treating Subjects With Type 2 Diabetes Mellitus

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