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Effect of Cycloset on Glycemic Control When Added to Glucagon-like Peptide 1 (GLP-1) Analogue Therapy

Primary Purpose

Type 2 Diabetes

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Cycloset
Sponsored by
The University of Texas Health Science Center at San Antonio
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes focused on measuring Type 2 Diabetes, T2DM, Cycloset, Glycemic Control, GLP-1

Eligibility Criteria

30 Years - 69 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Type 2 diabetes male or female subjects between the ages of 30 and 70 years of age, inclusive, at Screening
  • BMI = 24-40 kg/m2
  • HbA1c = 7.5-10.0%
  • Stable body weight (±3-4lbs) over the preceding 3 months
  • Subjects currently receiving a stable dose of exenatide (2mg/week) or liraglutide (1.2-1.8 mg/day) for at least 90 days prior to determination of baseline HbA1C and eligibility for enrollment in the study protocol.
  • Subjects with a daytime feeding/night time sleeping schedule
  • Subjects with no evidence of major organ system disease as determined by physical exam, history, and screening laboratory data
  • Women must be of non-childbearing potential as defined by one of the following:
  • Women >45 and < 60 years of age at Screening, who have been amenorrheic for at least 2 years
  • Women who have had a documented hysterectomy and/or bilateral oophorectomy
  • Women > 60 years of age
  • Females of childbearing potential with a negative pregnancy test at Screening and Treatment visits, using one of the following forms of contraception for the duration of participation in the study (i.e., until Follow-up 7-14 days post last dose): Oral contraceptive, Injectable progesterone, subdermal implant, spermicidal foam/gel/film/cream/suppository, diaphragm with spermicide, copper or hormonal containing IUD (intrauterine device), sterile male partner vasectomized > 6 month pre-dosing
  • Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study
  • Subjects must be willing and able to comply with scheduled visits, treatment, laboratory tests and study procedures.

Exclusion Criteria:

  • Recent (i.e., within three (3) months prior to Screening) evidence or medical history of unstable concurrent disease such as: documented evidence or history of clinically significant hematological, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, immunological, or clinically significant neurological disease.
  • No history of T2DM
  • BMI of less 24 and greater 40 kg/m2
  • Unstable body weight (change of greater than ±3-4lbs over the preceding 3 months
  • Subjects not currently receiving exenatide or liraglutide
  • Subjects participating in an excessively heavy exercise program
  • Subject with a feeding/sleeping schedule different from a daytime feeding/night time sleeping schedule
  • Subjects taking medications known to alter glucose metabolism (with the exception of metformin and/or pioglitazone) or which effect brain neuro synaptic function are excluded.
  • Subjects with evidence of major organ system disease as determined by physical exam, history, and screening laboratory data
  • Pregnant subjects or subjects unwilling to use birth control during their study enrollment
  • Blood donation of approximately 1 pint (500 mL) within 8 weeks prior to Screening 12. Subjects that are allergic to bromocriptine or any of the other ingredients in Cycloset, or take ergot medicines, breastfeeding or have history of syncope or Type 1 diabetes mellitus
  • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results that, in the judgment of the investigator, would make the subject inappropriate for entry into this study subjects of reproductive potential

Sites / Locations

  • University of Texas Health Science Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Cycloset

Arm Description

Drug - Cycloset Cycloset 2.4 -3.2 mg/day Other Names: Bromocriptine Mesylate Quick Release

Outcomes

Primary Outcome Measures

HbA1C
The objective of this study is to examine the effect of the addition of Cycloset on glycemic control in inadequately controlled (HbA1c 7.5-10.0) T2DM (type 2 diabetes mellitus) patients who are already on Bydureon (exenatide once weekly) or Victoza (liraglutide ) as part of their standard care. An additional co-primary objective of the study is to examine the effect of Cycloset on postprandial glucose metabolism.
Glucose Metabolism During Mixed Meal Tolerance Test
The objective of this study is to examine the effect of the addition of Cycloset on glycemic control in inadequately controlled (HbA1c 7.5-10.0) T2DM patients who are already on Bydureon (exenatide once weekly) or Victoza (liraglutide ) as part of their standard care.

Secondary Outcome Measures

Endothelial Function,
To assess the potential beneficial effect of Cycloset on endothelial function. This is measured by using pulse pressure.
Body Composition
To assess the potential beneficial effect of Cycloset on body weight composition.
Percentage Body Fat
To assess the potential beneficial effect of Cycloset on body fat content
Blood Pressure
To assess the potential beneficial effect of Cycloset on blood pressure.
Mean Arterial Blood Pressure
To assess the potential beneficial effect of Cycloset on change in mean arterial blood pressure
Arterial Stiffness (AS)
To assess the potential beneficial effect of Cycloset on arterial stiffness. Arterial stiffness is calculated by the measurement of pulse pressure, where Pulse pressure = SBP - DBP (Where SBP is systolic blood pressure and DBP is diastolic blood pressure) The calculated value is used as a predictor of cardiovascular disease. Higher values indicate that cardiovascular disease is more likely.

Full Information

First Posted
September 16, 2014
Last Updated
June 20, 2019
Sponsor
The University of Texas Health Science Center at San Antonio
Collaborators
VeroScience
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1. Study Identification

Unique Protocol Identification Number
NCT02299050
Brief Title
Effect of Cycloset on Glycemic Control When Added to Glucagon-like Peptide 1 (GLP-1) Analogue Therapy
Official Title
Effect of Cycloset on Glycemic Control in Type 2 Diabetic Patients Inadequately Controlled on GLP-1 Analogue Therapy
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
June 2014 (undefined)
Primary Completion Date
April 30, 2018 (Actual)
Study Completion Date
April 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The University of Texas Health Science Center at San Antonio
Collaborators
VeroScience

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Purpose This study will examine the effect of the addition of Cycloset upon glucose metabolism (glycemic control including post prandial glucose metabolism) in individuals with inadequately controlled (HbA1c 7.5-10.0) type 2 diabetes (T2DM) who are already on Bydureon (exenatide once weekly) or Victoza (liraglutide once daily) as part of their standard care. Both a mechanistic rationale and empirical experimental evidence implicate a beneficial interaction between bromocriptine and the incretin mimetics (GLP-1 analogs) upon postprandial hyperglycemia in insulin resistant states. One of the actions of the incretin mimetics such as the GLP-1 analogs is to stimulate postprandial beta cell insulin secretory response to plasma glucose (see drug labeling information; www.fda.gov). Thus the combination of Cycloset that is working as a post prandial insulin sensitizier with therapies that increase post prandial insulin would be expected to provide complimentary glucose lowering effects. To date, however, no such studies investigating the interactive effects of a GLP-1 analog and Bromocriptine-QR (QR=extended release) (Cycloset) have been conducted in humans. Condition - Type 2 Diabetes. Intervention - Cycloset. Phase - Phase 4 Study Type: Interventional Study Design: Treatment, Single Group Assignment, Open Label, N/A, Safety/Efficacy Study Official Title: Effect of Cycloset on Glycemic Control in Type 2 Diabetic Patients Inadequately Controlled on GLP-1 Analogue Therapy
Detailed Description
This is a single-site, prospective, cohort study that will assess the effect of Cycloset as add-on therapy in adult subjects with T2DM that is inadequately controlled (HbA1c 7.5% to 10.0%) on GLP-1 analog therapy with either exenatide (Bydureon) once weekly or liraglutide (Victoza) once daily. Entry criteria will be checked at the screening visit. All qualified subjects will undergo baseline studies including non-invasive hemodynamic testing for assessment of aortic stiffness and pulse wave velocity, assessment of body weight composition by dual-energy X-ray absorptiometry (DXA), assessment of endothelial function using the Endo-PAT device, measurement of cytokines and inflammatory biomarkers in the peripheral blood and urine, assessment of oxidative stress and inflammatory markers in white blood cells isolated from a peripheral whole blood sample, a 5-hour mixed meal tolerance test (MMT) for assessment of postprandial glucose metabolism and 24-hour ambulatory BP monitoring. Following completion of all the baseline studies as above, subjects will be started on Cycloset, 0.8 mg/day in addition to their stable dose of Bydureon (exenatide) (2mg/week) or Victoza (liraglutide) (1.2-1.8 mg/day), and the dose will be increased by 0.8 mg/day every week to a maximum of 3.2 mg/day, or as tolerated to a minimum of 2.4 mg/day. Subjects will return at months 1, 2, 3, and 4 for interim medical history, body weight, HbA1c, and FPG (Fasting plasma glucose). Postural blood pressure measurements will be obtained with the subject lying down and then after standing for 5 minutes at each of the visits. At month 4, all of the baseline studies detailed above will be repeated. All tests will be performed in the Clinical Research Center at the Texas Diabetes Institute/University of Texas Health Science Center, San Antonio.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes
Keywords
Type 2 Diabetes, T2DM, Cycloset, Glycemic Control, GLP-1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cycloset
Arm Type
Other
Arm Description
Drug - Cycloset Cycloset 2.4 -3.2 mg/day Other Names: Bromocriptine Mesylate Quick Release
Intervention Type
Drug
Intervention Name(s)
Cycloset
Other Intervention Name(s)
Bromocriptine Mesylate Quick Release
Intervention Description
Bromocriptine QR 0.8 mg tablet 0.8 mg/day with dose increased to a maximum of 3.2 mg/day or as tolerated to a minimum of 2.4 mg/day Other names: Cycloset, B-QR
Primary Outcome Measure Information:
Title
HbA1C
Description
The objective of this study is to examine the effect of the addition of Cycloset on glycemic control in inadequately controlled (HbA1c 7.5-10.0) T2DM (type 2 diabetes mellitus) patients who are already on Bydureon (exenatide once weekly) or Victoza (liraglutide ) as part of their standard care. An additional co-primary objective of the study is to examine the effect of Cycloset on postprandial glucose metabolism.
Time Frame
Change from baseline to four to five months
Title
Glucose Metabolism During Mixed Meal Tolerance Test
Description
The objective of this study is to examine the effect of the addition of Cycloset on glycemic control in inadequately controlled (HbA1c 7.5-10.0) T2DM patients who are already on Bydureon (exenatide once weekly) or Victoza (liraglutide ) as part of their standard care.
Time Frame
Change from baseline to four to five months
Secondary Outcome Measure Information:
Title
Endothelial Function,
Description
To assess the potential beneficial effect of Cycloset on endothelial function. This is measured by using pulse pressure.
Time Frame
Change from baseline to four to five months
Title
Body Composition
Description
To assess the potential beneficial effect of Cycloset on body weight composition.
Time Frame
Change from baseline to four to five months
Title
Percentage Body Fat
Description
To assess the potential beneficial effect of Cycloset on body fat content
Time Frame
Change from baseline to four to five months
Title
Blood Pressure
Description
To assess the potential beneficial effect of Cycloset on blood pressure.
Time Frame
Change from baseline to four to five months
Title
Mean Arterial Blood Pressure
Description
To assess the potential beneficial effect of Cycloset on change in mean arterial blood pressure
Time Frame
Change from baseline to four to five months
Title
Arterial Stiffness (AS)
Description
To assess the potential beneficial effect of Cycloset on arterial stiffness. Arterial stiffness is calculated by the measurement of pulse pressure, where Pulse pressure = SBP - DBP (Where SBP is systolic blood pressure and DBP is diastolic blood pressure) The calculated value is used as a predictor of cardiovascular disease. Higher values indicate that cardiovascular disease is more likely.
Time Frame
Change from baseline to four to five months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
69 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Type 2 diabetes male or female subjects between the ages of 30 and 70 years of age, inclusive, at Screening BMI = 24-40 kg/m2 HbA1c = 7.5-10.0% Stable body weight (±3-4lbs) over the preceding 3 months Subjects currently receiving a stable dose of exenatide (2mg/week) or liraglutide (1.2-1.8 mg/day) for at least 90 days prior to determination of baseline HbA1C and eligibility for enrollment in the study protocol. Subjects with a daytime feeding/night time sleeping schedule Subjects with no evidence of major organ system disease as determined by physical exam, history, and screening laboratory data Women must be of non-childbearing potential as defined by one of the following: Women >45 and < 60 years of age at Screening, who have been amenorrheic for at least 2 years Women who have had a documented hysterectomy and/or bilateral oophorectomy Women > 60 years of age Females of childbearing potential with a negative pregnancy test at Screening and Treatment visits, using one of the following forms of contraception for the duration of participation in the study (i.e., until Follow-up 7-14 days post last dose): Oral contraceptive, Injectable progesterone, subdermal implant, spermicidal foam/gel/film/cream/suppository, diaphragm with spermicide, copper or hormonal containing IUD (intrauterine device), sterile male partner vasectomized > 6 month pre-dosing Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study Subjects must be willing and able to comply with scheduled visits, treatment, laboratory tests and study procedures. Exclusion Criteria: Recent (i.e., within three (3) months prior to Screening) evidence or medical history of unstable concurrent disease such as: documented evidence or history of clinically significant hematological, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, immunological, or clinically significant neurological disease. No history of T2DM BMI of less 24 and greater 40 kg/m2 Unstable body weight (change of greater than ±3-4lbs over the preceding 3 months Subjects not currently receiving exenatide or liraglutide Subjects participating in an excessively heavy exercise program Subject with a feeding/sleeping schedule different from a daytime feeding/night time sleeping schedule Subjects taking medications known to alter glucose metabolism (with the exception of metformin and/or pioglitazone) or which effect brain neuro synaptic function are excluded. Subjects with evidence of major organ system disease as determined by physical exam, history, and screening laboratory data Pregnant subjects or subjects unwilling to use birth control during their study enrollment Blood donation of approximately 1 pint (500 mL) within 8 weeks prior to Screening 12. Subjects that are allergic to bromocriptine or any of the other ingredients in Cycloset, or take ergot medicines, breastfeeding or have history of syncope or Type 1 diabetes mellitus Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results that, in the judgment of the investigator, would make the subject inappropriate for entry into this study subjects of reproductive potential
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ralph A DeFronzo, MD
Organizational Affiliation
The University of Texas Health Science Center at San Antonio
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Texas Health Science Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Effect of Cycloset on Glycemic Control When Added to Glucagon-like Peptide 1 (GLP-1) Analogue Therapy

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