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Safety and Efficacy of EndoBarrier in Subjects With Type 2 Diabetes Who Are Obese (ENDO)

Primary Purpose

Type 2 Diabetes, Obesity

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
EndoBarrier
Sham Procedure
Sponsored by
GI Dynamics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes focused on measuring glycemic control, type 2 diabetes, device, obese

Eligibility Criteria

21 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males/females aged ≥ 21 years and ≤ 65 years
  • Diagnosis of Type 2 Diabetes for ≤ 20 years
  • Obese individuals (BMI ≥ 30 kg/m2 and ≤ 55 kg/m2)
  • Stable doses (at least 3 months) of up to two anti-T2DM medications (MET, SU, DPP-4i or TZD)
  • Glycemic state: HbA1c at screening ≥ 7.5% and ≤ 10.0%.
  • Subjects willing to comply with study requirements
  • Subjects who have signed an informed consent form

Exclusion Criteria:

  • Diagnosis of type 1 diabetes mellitus or having any history of ketoacidosis
  • C-peptide < 1.0 ng/mL
  • Triglyceride level > 400 mg/dL
  • Vitamin D deficiency (<20 ng/mL)
  • Male subjects with serum Creatinine >1.5 mg/dl or female subjects with Creatinine >1.4 mg/dL
  • Uncorrectable bleeding diathesis, platelet dysfunction, thrombocytopenia with platelet count less than 100,000/microliter, or known coagulopathy
  • Height < 5 feet (152.4 cm)
  • Current alcohol or drug addiction
  • Symptomatic kidney stones or gallstones within 6 months prior to randomization
  • Chronic pancreatitis or acute pancreatitis within 12 months of randomization
  • Diagnosis of osteoporosis or currently taking bisphosphonates or teriparatide
  • Diagnosis of an autoimmune connective tissue disorder (e.g., lupus erythematosus, scleroderma)
  • Active gastroesophageal reflux disease [GERD] uncontrolled with a Proton Pump Inhibitor (PPI)
  • Thyroid disease unless controlled with medication
  • Currently taking Non-Steroidal Anti-Inflammatory Drugs [NSAIDs] (e.g., aspirin, ibuprofen, etc.) within 10 days prior to randomization and/or there is a need or expected use of these agents during the trial 12 months post index procedure
  • Currently taking prescription antithrombotic therapy (e.g., anticoagulant or antiplatelet agent) within 10 days prior to randomization and/or there is a need or expected need to use during the trial 12 months post index procedure
  • Currently taking systemic corticosteroids, drugs known to affect GI motility, prescription/over-the-counter weight loss medications, or medications known to cause significant weight gain or weight loss within 30 days prior to randomization and/or there is a need or expected need to use these medications during the trial 12 months post index procedure
  • Medication for type 2 diabetes other than MET, SU, DPP-4i, and TZD (e.g., GLP1 or insulin) within 3 months of screening
  • Chronic use of narcotics, opiates, benzodiazepines, or other addictive tranquilizers
  • Allergy or hypersensitivity to ceftriaxone, cephalosporins, penicillin, or any equivalent antibiotics
  • Active Helicobacter pylori infection (Note: Subjects may be eligible after undergoing 2 weeks of antibiotic treatment without re-screening)
  • Previous GI surgery or abnormal GI anatomical finding that could preclude the ability to place the EndoBarrier device, liner or affect the function of the liner
  • Abnormal pathologies or conditions of the gastrointestinal tract, including current ulcers or Crohn's disease, history of atresias or untreated stenoses, current upper gastrointestinal bleeding conditions within 3 months of randomization
  • Any condition or major illness that places the subject at undue risk by participating in the study
  • Poor dentition not allowing complete chewing of food
  • Enrolled in another investigational study within 3 months of screening for this study (Enrollment in observational studies is permitted)
  • Residing in a location without ready access to study site medical resources
  • Documented weight loss of >10 pounds anytime during the 3 months preceding randomization
  • Positive stool guaiac at time of screening

Sites / Locations

  • University of Alabama at Birmingham
  • Mayo Clinic Arizona
  • Little Rock Diagnostic Center (LRDC)
  • Cedars-Sinai Medical Center
  • Stanford University School of Medicine
  • University of Colorado/ Anschutz Health & Wellness Center
  • Emory University
  • Northwestern University
  • Kentucky Research Group
  • Tulane University Health Sciences Center
  • MedStar Health Research Institute
  • Massachusetts General Hospital
  • Boston Medical Center
  • University of Michigan
  • Mayo Clinic Minnesota
  • Washington University
  • Billings Clinic
  • Beth Israel Medical Center
  • University of North Carolina
  • Cleveland Clinic
  • Legacy Research Institute
  • Endocrinology Consultants of East Tennessee & Gastrointestinal Associates
  • Dallas Diabetes
  • UT Southwestern Medical Center
  • The Methodist Hospital Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

Device (EndoBarrier)

Sham Procedure

Arm Description

Device for glycemic control

sham procedure

Outcomes

Primary Outcome Measures

Primary Efficacy Endpoint: Improvement in HbA1c
Mean Change in HbA1c from Baseline to 12 Months in the mITT population with Bayesian Imputation
Primary Safety Endpoint: Early Device Removal Due to Device-Related SAE
Of the 161 subjects for whom data were available at 12 Months, 19 (11.8%) subjects experienced device-related SAEs that required an early device removal.

Secondary Outcome Measures

Assessment of Total Cholesterol Change at 12 Months Compared to Baseline
Percentage of Subjects Who Achieve HbA1c Less Than or Equal to 7.0% at 12 Months
LDL Change From Baseline
Triglycerides Change From Baseline
Fasting Glucose Change From Baseline
Systolic BP Change From Baseline
Diastolic BP Change From Baseline
Percentage of Subjects Who Achieve % Total Body Weight Loss Greater Than or Equal to 5% at 12 Months

Full Information

First Posted
November 13, 2012
Last Updated
December 2, 2016
Sponsor
GI Dynamics
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1. Study Identification

Unique Protocol Identification Number
NCT01728116
Brief Title
Safety and Efficacy of EndoBarrier in Subjects With Type 2 Diabetes Who Are Obese
Acronym
ENDO
Official Title
A Randomized, Multi-Center, Pivotal Efficacy and Safety Study Comparing the EndoBarrier Gastrointestinal Liner System vs. Sham for Glycemic Improvement in Inadequately Controlled Obese Type 2 Diabetic Subjects on Oral Anti-Diabetes Agents
Study Type
Interventional

2. Study Status

Record Verification Date
December 2016
Overall Recruitment Status
Terminated
Why Stopped
Higher than anticipated rate of Hepatic abscess (N=7)
Study Start Date
December 2012 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
February 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GI Dynamics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To determine if the EndoBarrier safely and effectively improves glycemic control in obese subjects with type 2 diabetes
Detailed Description
This is a randomized, double blinded, prospective study. Subjects will be evaluated and randomized to either the device or sham treatment group if they qualify for the study. A comparison of glycemic control between the two groups will be assessed as the primary outcome measurement as well as the safety profile of the device.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes, Obesity
Keywords
glycemic control, type 2 diabetes, device, obese

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
325 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Device (EndoBarrier)
Arm Type
Experimental
Arm Description
Device for glycemic control
Arm Title
Sham Procedure
Arm Type
Sham Comparator
Arm Description
sham procedure
Intervention Type
Device
Intervention Name(s)
EndoBarrier
Other Intervention Name(s)
Duodenal-jejunal bypass liner (DJBL)
Intervention Description
Endoscopically-delivered and removable device comprised of an anchor that is placed in the duodenal bulb and a 60 cm long impermeable liner that passes distal from the anchor point
Intervention Type
Procedure
Intervention Name(s)
Sham Procedure
Intervention Description
Endoscopic evaluation but no device placement
Primary Outcome Measure Information:
Title
Primary Efficacy Endpoint: Improvement in HbA1c
Description
Mean Change in HbA1c from Baseline to 12 Months in the mITT population with Bayesian Imputation
Time Frame
Baseline and12 months
Title
Primary Safety Endpoint: Early Device Removal Due to Device-Related SAE
Description
Of the 161 subjects for whom data were available at 12 Months, 19 (11.8%) subjects experienced device-related SAEs that required an early device removal.
Time Frame
Baseline and 12 Months
Secondary Outcome Measure Information:
Title
Assessment of Total Cholesterol Change at 12 Months Compared to Baseline
Time Frame
Baseline and 12 Months
Title
Percentage of Subjects Who Achieve HbA1c Less Than or Equal to 7.0% at 12 Months
Time Frame
Baseline and 12 Months
Title
LDL Change From Baseline
Time Frame
Baseline and 12 Months
Title
Triglycerides Change From Baseline
Time Frame
Baseline and 12 Months
Title
Fasting Glucose Change From Baseline
Time Frame
Baseline and 12 Months
Title
Systolic BP Change From Baseline
Time Frame
Baseline and 12 Months
Title
Diastolic BP Change From Baseline
Time Frame
Baseline and 12 Months
Title
Percentage of Subjects Who Achieve % Total Body Weight Loss Greater Than or Equal to 5% at 12 Months
Time Frame
Baseline and 12 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males/females aged ≥ 21 years and ≤ 65 years Diagnosis of Type 2 Diabetes for ≤ 20 years Obese individuals (BMI ≥ 30 kg/m2 and ≤ 55 kg/m2) Stable doses (at least 3 months) of up to two anti-T2DM medications (MET, SU, DPP-4i or TZD) Glycemic state: HbA1c at screening ≥ 7.5% and ≤ 10.0%. Subjects willing to comply with study requirements Subjects who have signed an informed consent form Exclusion Criteria: Diagnosis of type 1 diabetes mellitus or having any history of ketoacidosis C-peptide < 1.0 ng/mL Triglyceride level > 400 mg/dL Vitamin D deficiency (<20 ng/mL) Male subjects with serum Creatinine >1.5 mg/dl or female subjects with Creatinine >1.4 mg/dL Uncorrectable bleeding diathesis, platelet dysfunction, thrombocytopenia with platelet count less than 100,000/microliter, or known coagulopathy Height < 5 feet (152.4 cm) Current alcohol or drug addiction Symptomatic kidney stones or gallstones within 6 months prior to randomization Chronic pancreatitis or acute pancreatitis within 12 months of randomization Diagnosis of osteoporosis or currently taking bisphosphonates or teriparatide Diagnosis of an autoimmune connective tissue disorder (e.g., lupus erythematosus, scleroderma) Active gastroesophageal reflux disease [GERD] uncontrolled with a Proton Pump Inhibitor (PPI) Thyroid disease unless controlled with medication Currently taking Non-Steroidal Anti-Inflammatory Drugs [NSAIDs] (e.g., aspirin, ibuprofen, etc.) within 10 days prior to randomization and/or there is a need or expected use of these agents during the trial 12 months post index procedure Currently taking prescription antithrombotic therapy (e.g., anticoagulant or antiplatelet agent) within 10 days prior to randomization and/or there is a need or expected need to use during the trial 12 months post index procedure Currently taking systemic corticosteroids, drugs known to affect GI motility, prescription/over-the-counter weight loss medications, or medications known to cause significant weight gain or weight loss within 30 days prior to randomization and/or there is a need or expected need to use these medications during the trial 12 months post index procedure Medication for type 2 diabetes other than MET, SU, DPP-4i, and TZD (e.g., GLP1 or insulin) within 3 months of screening Chronic use of narcotics, opiates, benzodiazepines, or other addictive tranquilizers Allergy or hypersensitivity to ceftriaxone, cephalosporins, penicillin, or any equivalent antibiotics Active Helicobacter pylori infection (Note: Subjects may be eligible after undergoing 2 weeks of antibiotic treatment without re-screening) Previous GI surgery or abnormal GI anatomical finding that could preclude the ability to place the EndoBarrier device, liner or affect the function of the liner Abnormal pathologies or conditions of the gastrointestinal tract, including current ulcers or Crohn's disease, history of atresias or untreated stenoses, current upper gastrointestinal bleeding conditions within 3 months of randomization Any condition or major illness that places the subject at undue risk by participating in the study Poor dentition not allowing complete chewing of food Enrolled in another investigational study within 3 months of screening for this study (Enrollment in observational studies is permitted) Residing in a location without ready access to study site medical resources Documented weight loss of >10 pounds anytime during the 3 months preceding randomization Positive stool guaiac at time of screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lee M Kaplan, MD, PhD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Keith Gersin, MD
Organizational Affiliation
Carolinas Medical Center
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Mayo Clinic Arizona
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85259
Country
United States
Facility Name
Little Rock Diagnostic Center (LRDC)
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
University of Colorado/ Anschutz Health & Wellness Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Emory University
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30303
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60208
Country
United States
Facility Name
Kentucky Research Group
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40218
Country
United States
Facility Name
Tulane University Health Sciences Center
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112-2699
Country
United States
Facility Name
MedStar Health Research Institute
City
Hyattsville
State/Province
Maryland
ZIP/Postal Code
20782
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Boston Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Mayo Clinic Minnesota
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Washington University
City
St Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Billings Clinic
City
Billings
State/Province
Montana
ZIP/Postal Code
59101
Country
United States
Facility Name
Beth Israel Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
University of North Carolina
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Legacy Research Institute
City
Portland
State/Province
Oregon
ZIP/Postal Code
97232
Country
United States
Facility Name
Endocrinology Consultants of East Tennessee & Gastrointestinal Associates
City
Knoxville
State/Province
Tennessee
ZIP/Postal Code
37909
Country
United States
Facility Name
Dallas Diabetes
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390-7170
Country
United States
Facility Name
The Methodist Hospital Research Institute
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
Links:
URL
http://www.gidynamics.com/
Description
GI Dynamics website

Learn more about this trial

Safety and Efficacy of EndoBarrier in Subjects With Type 2 Diabetes Who Are Obese

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