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Efficacy and Safety Study of Pioglitazone Combined With Metformin on Metabolic Syndrome in Subjects With Type 2 Diabetes (PRISMA)

Primary Purpose

Diabetes Mellitus

Status

Completed

Phase

Phase 3

Locations

Study Type

Interventional

Intervention

Pioglitazone and Metformin

Metformin

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

35 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Diagnosis of Type 2 Diabetes Mellitus.
Has glycosylated hemoglobin levels between 6.0% and 8.0%.
Treatment with metformin (2,000 to 3,000 mg daily) for at least 3 months.
Has reduced high-density lipoprotein cholesterol levels less than 40 mg/dl in males and less than 50 mg/dl in females, irrespective of treatment with statins.
Has central obesity defined as a waist circumference greater than or equal to 94 cm for men and greater than or equal to 80 cm for females.
Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.

Exclusion Criteria:

Has a diagnosis of Type 1 Diabetes Mellitus.
Required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:
- other oral antidiabetic drugs than metformin or with insulin in the 3 months preceding study entry.
- Fibrates
- Rifampicin
Has any disease with malabsorption.
Has acute or chronic pancreatitis.
Has familial polyposis coli.
Has a medical history of myocardial infarction, transient ischemic attacks or stroke in the past 6 months.
Has heart failure as defined by the New York Heart Association classification I-IV.
Has significant liver impairment, with an alanine aminotransferase level greater than 2.5 the upper limit of normal range.
Has significant renal impairment, with a serum creatinine level greater than 1.5 mg/dl for men and greater than 1.2 mg/dl for women.
Has anemia of any etiology (defined as hemoglobin levels less than 10.5 g/dL) or any other hematologic disease.
Has a diagnosis or suspicion of neoplastic disease.
History of chronic alcohol or drug abuse.
Known allergy, sensitivity or intolerance to the study drugs and their formulation ingredients.
Participation in another trial in the 3 months preceding study entry.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Pioglitazone + Metformin

Metformin

Arm Description

Outcomes

Primary Outcome Measures

Increase in High-Density Lipoprotein cholesterol levels.

Secondary Outcome Measures

The change from Baseline in Metabolic Syndrome, as defined by the International Diabetes Federation (aggregate waist circumference, fasting plasma glucose, triglycerides and high-density lipoprotein cholesterol).

The change from Baseline in Metabolic Syndrome, as defined by the International Diabetes Federation (blood pressure).

The change from Baseline in Individual Metabolic Parameters (insulin sensitivity and beta-cell function, inflammatory cytokines, adipokines, endothelial functionality).

Adverse Events.

The change from Baseline in Laboratory Parameters (hematology, chemistry and urinalysis).

Full Information

NCT ID

NCT00772174

First Posted

October 8, 2008

Last Updated

July 1, 2010

Sponsor

Takeda

1. Study Identification

Unique Protocol Identification Number

NCT00772174

Brief Title

Efficacy and Safety Study of Pioglitazone Combined With Metformin on Metabolic Syndrome in Subjects With Type 2 Diabetes

Acronym

PRISMA

Official Title

Double-blind, Randomized, Multicenter, Parallel-Group Study to Evaluate the Effects of Pioglitazone on Metabolic Syndrome in Patients With Type 2 Diabetes Treated With Metformin

Study Type

Interventional

2. Study Status

Record Verification Date

July 2010

Overall Recruitment Status

Completed

Study Start Date

January 2007 (undefined)

Primary Completion Date

February 2008 (Actual)

Study Completion Date

February 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor

Takeda

4. Oversight

Data Monitoring Committee

5. Study Description

Brief Summary

The purpose of this study was to determine the efficacy of pioglitazone taken with metformin on high-density lipoprotein cholesterol in subjects with Type 2 Diabetes.

Detailed Description

Diabetes is none of the most common, chronic diseases worldwide and affects nearly 200 million people. It is the fourth or fifth leading cause of death in developed countries, and it is expected that diabetes will reach epidemic proportions, affecting 333 million people globally by 2025. The metabolic syndrome is a cluster of the most dangerous cardiovascular risk factors and includes diabetes and pre-diabetes in addition to abdominal obesity, low high-density lipoprotein cholesterol, high triglycerides and hypertension. It is estimated that around a quarter of the world's adult population has metabolic syndrome, and are twice as likely to die and three times as likely to have a heart attack or stroke when compared to people without the syndrome. In addition, non-diabetic people with metabolic syndrome have a fivefold greater risk of developing type 2 diabetes. The clustering of cardiovascular risk factors that typifies the metabolic syndrome is now considered the driving force for a cardiovascular disease epidemic. Metabolic syndrome has been recently defined by a Consensus Conference of the International Diabetes Federation as a cluster of clinical and laboratory signs characterized by the presence of abnormal deposition of fat tissue in the abdomen and visceral districts, and at least two other clinical and laboratory abnormalities, including altered glucose metabolism or type 2 diabetes and decreased levels of high-density lipoprotein cholesterol. One of the underlying pathophysiological mechanisms of metabolic syndrome is insulin resistance, characterized by an increased glucose output from the liver, and reduced glucose uptake in the muscle and adipose tissue cells. Drugs whose mechanism of action consists of increasing insulin sensitivity in the target tissues are able to reduce the clinical manifestations and consequences of metabolic syndrome. While each individual component of metabolic syndrome confers an increased risk of cardiovascular-related complications or death, this risk is more pronounced when the syndrome itself is present. The more components of metabolic syndrome are evident, the higher is the cardiovascular mortality rate.

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

Parallel Assignment

Masking

ParticipantCare ProviderInvestigatorOutcomes Assessor

Allocation

Randomized

Enrollment

418 (Actual)

8. Arms, Groups, and Interventions

Arm Title

Pioglitazone + Metformin

Arm Type

Experimental

Arm Title

Metformin

Arm Type

Active Comparator

Intervention Type

Drug

Intervention Name(s)

Pioglitazone and Metformin

Other Intervention Name(s)

ACTOS®, AD4833

Intervention Description

Pioglitazone 15 mg, tablets, orally, two-times daily and metformin stable dose, orally, three-times daily for 4 weeks; then increased to pioglitazone 15 mg, tablets, orally, three-times daily and metformin stable dose, orally, three-times daily for up to 20 weeks.

Intervention Type

Drug

Intervention Name(s)

Metformin

Intervention Description

Pioglitazone placebo-matching tablets, orally, two-times daily and metformin stable dose, orally, three-times daily for 4 weeks; then increased to pioglitazone placebo-matching tablets, orally, three-times daily and metformin stable dose, orally, three-times daily for up to 20 weeks.

Primary Outcome Measure Information:

Title

Increase in High-Density Lipoprotein cholesterol levels.

Time Frame

Final Visit.

Secondary Outcome Measure Information:

Title

Time Frame

Weeks: 8 and 24.

Title

The change from Baseline in Metabolic Syndrome, as defined by the International Diabetes Federation (blood pressure).

Time Frame

At all Visits.

Title

The change from Baseline in Individual Metabolic Parameters (insulin sensitivity and beta-cell function, inflammatory cytokines, adipokines, endothelial functionality).

Time Frame

Weeks: 8 and 24.

Title

Adverse Events.

Time Frame

At all Visits.

Title

The change from Baseline in Laboratory Parameters (hematology, chemistry and urinalysis).

Time Frame

Weeks: 8 and 24.

10. Eligibility

Sex

All

Minimum Age & Unit of Time

35 Years

Maximum Age & Unit of Time

75 Years

Accepts Healthy Volunteers

Eligibility Criteria

Inclusion Criteria: Diagnosis of Type 2 Diabetes Mellitus. Has glycosylated hemoglobin levels between 6.0% and 8.0%. Treatment with metformin (2,000 to 3,000 mg daily) for at least 3 months. Has reduced high-density lipoprotein cholesterol levels less than 40 mg/dl in males and less than 50 mg/dl in females, irrespective of treatment with statins. Has central obesity defined as a waist circumference greater than or equal to 94 cm for men and greater than or equal to 80 cm for females. Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study. Exclusion Criteria: Has a diagnosis of Type 1 Diabetes Mellitus. Required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including: other oral antidiabetic drugs than metformin or with insulin in the 3 months preceding study entry. Fibrates Rifampicin Has any disease with malabsorption. Has acute or chronic pancreatitis. Has familial polyposis coli. Has a medical history of myocardial infarction, transient ischemic attacks or stroke in the past 6 months. Has heart failure as defined by the New York Heart Association classification I-IV. Has significant liver impairment, with an alanine aminotransferase level greater than 2.5 the upper limit of normal range. Has significant renal impairment, with a serum creatinine level greater than 1.5 mg/dl for men and greater than 1.2 mg/dl for women. Has anemia of any etiology (defined as hemoglobin levels less than 10.5 g/dL) or any other hematologic disease. Has a diagnosis or suspicion of neoplastic disease. History of chronic alcohol or drug abuse. Known allergy, sensitivity or intolerance to the study drugs and their formulation ingredients. Participation in another trial in the 3 months preceding study entry.

Overall Study Officials:

First Name & Middle Initial & Last Name & Degree

Medical Director

Organizational Affiliation

Takeda

Official's Role

Study Director

12. IPD Sharing Statement

Learn more about this trial

Efficacy and Safety Study of Pioglitazone Combined With Metformin on Metabolic Syndrome in Subjects With Type 2 Diabetes

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