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Effects of Dapagliflozin 10 mg on Insulin Resistance in Patients With Type 2 Diabetes Mellitus (DERISC)

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 4
Locations
Finland
Study Type
Interventional
Intervention
Dapagliflozin
Placebo
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes Mellitus focused on measuring Diabetes Mellitus, Dapagliflozin, Placebo, Insulin resistance, Insulin sensitivity

Eligibility Criteria

35 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Main Inclusion Criteria:

  1. Provision of signed informed consent prior to any study specific procedures.
  2. Female or male aged 35 to 70 years inclusive with suitable veins for cannulation or repeated venipuncture
  3. Type 2 Diabetes mellitus defined as HbA1c of ≥ 6.5% and ≤ 10.5%.
  4. Stable (≥ 3 months) T2D treatment with metformin and/or metformin+dipeptidyl peptidase-4 inhibitors (DPP-IV)
  5. Body mass index (BMI) ≤ 40 kg/m2.
  6. Female subjects must be of non-childbearing potential, meeting at least one of the following criteria:

    1. Hysterectomized females
    2. Postmenopausal women, defined as women who have not had a menstrual period within 1 year

Main Exclusion Criteria:

  1. Any condition that is contraindicated with MRI such as, but not limited to, having a pacemaker or claustrophobia.
  2. Volume depleted patients. Patients at risk for volume depletion due to co-existing conditions or concomitant medications, such as loop diuretics should have careful monitoring of their volume status.
  3. Recent Cardiovascular Events in a patient:

    • Acute Coronary Syndrome (ACS) within 2 months prior to enrolment
    • Hospitalization for unstable angina or acute myocardial infarction within 2 months prior to enrolment
    • Acute Stroke or Transient Ischemic Attack (TIA) within two months prior to enrolment
    • Less than two months post coronary artery revascularization
  4. Congestive heart failure defined as New York Heart Association (NYHA) class IV, unstable or acute congestive heart failure.
  5. Blood pressure at enrolment: Systolic BP ≥165 mm Hg and/or diastolic BP ≥100 mm Hg
  6. Any clinically significant illness, medical or surgical procedure or trauma within 4 weeks of the first administration of the investigational product.
  7. On insulin, GLP-1 or other oral antidiabetic drug treatment (metformin or both metformin and DPP-IV allowed) or using other medications known to affect glucose metabolism.
  8. Any clinically significant abnormalities in physical examination, Electrocardiography (ECG) or clinical chemistry results as judged by the investigator. The following specific exclusion criteria apply to the selected Clinical Chemistry results:

    1. Creatinine clearance <60mL/min (estimated with Cockroft-Gault formula).
    2. Severe hepatic insufficiency and/or significant abnormal liver function defined as aspartate aminotransferase (AST) >3x upper limit of normal (ULN) and/or alanine aminotransferase (ALT) >3x ULN.
    3. Total bilirubin (TB) >2.0 mg/dL (34.2 µmol/L).
  9. Body weight loss greater than 5% within 3 months prior to Visit 1.
  10. Previous PET scan
  11. History of or presence of (as found at Visit 1) any clinically significant disease, disorder or condition which, in the opinion of the investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study.

Sites / Locations

  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Dapagliflozin

Placebo

Arm Description

Dapagliflozin Once Daily 10 mg

Matching placebo for Dapagliflozin Once Daily 10 mg

Outcomes

Primary Outcome Measures

Adjusted Change From Baseline in Skeletal Muscle Insulin-stimulated Gluocose Uptake
Adjusted change from baseline in skeletal muscle insulin-stimulated gluocose uptake (umol/min/kg)

Secondary Outcome Measures

Adjusted Change in Adipose Tissue Insulin-stimulated Glucose Uptake
Change in adipose tissue insulin-stimulated glucose uptake assessed by hyperglycemic-euglycemic clamp using F-FDG PET
Adjusted Change in Liver Insulin-stimulated Glucose Uptake From Baseline to Week 8
Adjusted change in liver insulin-stimulated glucose uptake assessed by hyperglycemic-euglycemic clamp using F-FDG PET

Full Information

First Posted
April 22, 2015
Last Updated
July 24, 2017
Sponsor
AstraZeneca
Collaborators
Antaros Medical, Bioventure Hub, 43183 Mölndal, Sweden
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1. Study Identification

Unique Protocol Identification Number
NCT02426541
Brief Title
Effects of Dapagliflozin 10 mg on Insulin Resistance in Patients With Type 2 Diabetes Mellitus
Acronym
DERISC
Official Title
An 8-week, Single Centre, Randomized, Parallel-group, Double-blind, Placebo Controlled Phase IV Study to Evaluate Dapagliflozin 10 mg Once Daily Effects on Insulin Resistance in Subjects With Type 2 Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Completed
Study Start Date
March 23, 2015 (Actual)
Primary Completion Date
April 28, 2016 (Actual)
Study Completion Date
April 28, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca
Collaborators
Antaros Medical, Bioventure Hub, 43183 Mölndal, Sweden

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an 8-week, single centre, randomized, parallel-group, double-blind, placebo-controlled Phase IV study to evaluate the effect of dapagliflozin on tissue specific insulin sensitivity in patients with Type 2 diabetes mellitus

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes Mellitus
Keywords
Diabetes Mellitus, Dapagliflozin, Placebo, Insulin resistance, Insulin sensitivity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
55 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dapagliflozin
Arm Type
Experimental
Arm Description
Dapagliflozin Once Daily 10 mg
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo for Dapagliflozin Once Daily 10 mg
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin
Other Intervention Name(s)
Forxiga, Farxiga
Intervention Description
Dapagliflozin 10 mg Tablets, Oral, Once Daily, 8 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo to Dapagliflozin 10 mg Tablets, Oral, Once Daily, 8 weeks
Primary Outcome Measure Information:
Title
Adjusted Change From Baseline in Skeletal Muscle Insulin-stimulated Gluocose Uptake
Description
Adjusted change from baseline in skeletal muscle insulin-stimulated gluocose uptake (umol/min/kg)
Time Frame
From baseline to Week 8
Secondary Outcome Measure Information:
Title
Adjusted Change in Adipose Tissue Insulin-stimulated Glucose Uptake
Description
Change in adipose tissue insulin-stimulated glucose uptake assessed by hyperglycemic-euglycemic clamp using F-FDG PET
Time Frame
Baseline to Week 8
Title
Adjusted Change in Liver Insulin-stimulated Glucose Uptake From Baseline to Week 8
Description
Adjusted change in liver insulin-stimulated glucose uptake assessed by hyperglycemic-euglycemic clamp using F-FDG PET
Time Frame
Baseline to Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
35 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Provision of signed informed consent prior to any study specific procedures. Female or male aged 35 to 70 years inclusive with suitable veins for cannulation or repeated venipuncture Type 2 Diabetes mellitus defined as HbA1c of ≥ 6.5% and ≤ 10.5%. Stable (≥ 3 months) T2D treatment with metformin and/or metformin+dipeptidyl peptidase-4 inhibitors (DPP-IV) Body mass index (BMI) ≤ 40 kg/m2. Female subjects must be of non-childbearing potential, meeting at least one of the following criteria: Hysterectomized females Postmenopausal women, defined as women who have not had a menstrual period within 1 year Main Exclusion Criteria: Any condition that is contraindicated with MRI such as, but not limited to, having a pacemaker or claustrophobia. Volume depleted patients. Patients at risk for volume depletion due to co-existing conditions or concomitant medications, such as loop diuretics should have careful monitoring of their volume status. Recent Cardiovascular Events in a patient: Acute Coronary Syndrome (ACS) within 2 months prior to enrolment Hospitalization for unstable angina or acute myocardial infarction within 2 months prior to enrolment Acute Stroke or Transient Ischemic Attack (TIA) within two months prior to enrolment Less than two months post coronary artery revascularization Congestive heart failure defined as New York Heart Association (NYHA) class IV, unstable or acute congestive heart failure. Blood pressure at enrolment: Systolic BP ≥165 mm Hg and/or diastolic BP ≥100 mm Hg Any clinically significant illness, medical or surgical procedure or trauma within 4 weeks of the first administration of the investigational product. On insulin, GLP-1 or other oral antidiabetic drug treatment (metformin or both metformin and DPP-IV allowed) or using other medications known to affect glucose metabolism. Any clinically significant abnormalities in physical examination, Electrocardiography (ECG) or clinical chemistry results as judged by the investigator. The following specific exclusion criteria apply to the selected Clinical Chemistry results: Creatinine clearance <60mL/min (estimated with Cockroft-Gault formula). Severe hepatic insufficiency and/or significant abnormal liver function defined as aspartate aminotransferase (AST) >3x upper limit of normal (ULN) and/or alanine aminotransferase (ALT) >3x ULN. Total bilirubin (TB) >2.0 mg/dL (34.2 µmol/L). Body weight loss greater than 5% within 3 months prior to Visit 1. Previous PET scan History of or presence of (as found at Visit 1) any clinically significant disease, disorder or condition which, in the opinion of the investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pirjo Nuutila, MD, PhD, Professor
Organizational Affiliation
Turku PET Centre, Turku, Finland
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site
City
Turku
Country
Finland

12. IPD Sharing Statement

Citations:
PubMed Identifier
30885955
Citation
Latva-Rasku A, Honka MJ, Kullberg J, Mononen N, Lehtimaki T, Saltevo J, Kirjavainen AK, Saunavaara V, Iozzo P, Johansson L, Oscarsson J, Hannukainen JC, Nuutila P. The SGLT2 Inhibitor Dapagliflozin Reduces Liver Fat but Does Not Affect Tissue Insulin Sensitivity: A Randomized, Double-Blind, Placebo-Controlled Study With 8-Week Treatment in Type 2 Diabetes Patients. Diabetes Care. 2019 May;42(5):931-937. doi: 10.2337/dc18-1569. Epub 2019 Mar 18.
Results Reference
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Effects of Dapagliflozin 10 mg on Insulin Resistance in Patients With Type 2 Diabetes Mellitus

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