A Study to Assess the Efficacy and Safety of Ipragliflozin in Subjects With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin (IMPRESSION)
Primary Purpose
Type 2 Diabetes Mellitus
Status
Completed
Phase
Phase 3
Locations
Russian Federation
Study Type
Interventional
Intervention
Ipragliflozin L-proline
Metformin
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Type 2 Diabetes Mellitus focused on measuring Type 2 Diabetes Mellitus, ASP1941, Ipragliflozin
Eligibility Criteria
Inclusion Criteria:
- Subject has been diagnosed with type 2 diabetes mellitus at least 12 weeks before visit 1.
- Subject has been on a stable dose and a daily dose regimen of metformin ≥ 1500 mg for at least 12 weeks prior to visit 1.
- Subject has HbA1c ≥ 7.5% and ≤ 11.0% at visit 1.
- Subject has been on a stable diet and exercise program for at least 12 weeks prior to visit 1 and is willing to maintain this program for the duration of the treatment period.
- Subject has a body mass index (BMI) of 20 to 45 kg/m2, inclusive, at visit 1.
- Subjects are allowed to continue taking their medication for concomitant diseases (including over-the-counter products), provided they have been on a stable dose for a minimum of 30 days prior to visit 1.
Female subjects must either:
Be of non-childbearing potential:
- postmenopausal (defined as at least 1 year without any menses) prior to screening, or
- documented as surgically sterile
Or, if of childbearing potential,
- Agree not to try to become pregnant during the study and for 28 days after the final study drug administration
- And have a negative serum pregnancy test at visit 1
- And, if heterosexually active, agree to consistently use 2 forms of highly effective birth control (at least 1 of which must be a barrier method) starting at screening, throughout the study period and for 28 days after the final study drug administration.
- Female subjects must agree not to breastfeed starting at screening, throughout the study period and for 28 days after the final study drug administration.
- Female subjects must not donate ova starting at screening, throughout the study period and for 28 days after the final study drug administration.
- Male subjects and their female spouse/partners who are of childbearing potential must be using highly effective contraception consisting of 2 forms of birth control (at least 1 of which must be a barrier method) starting at screening and continue throughout the study period.
- Male subjects must not donate sperm starting at screening and throughout the study period.
Exclusion Criteria:
- Subject has type 1 diabetes mellitus.
- Subject has received any medication for glycemic control, with the exception of metformin, (e.g., oral antidiabetic drugs, insulin, etc.) within 12 weeks prior to visit 1.
- Subject is currently receiving an excluded medication or has received insulin within 12 weeks prior to visit 1 or during the screening period.
- Subject has a history of stroke, unstable angina, myocardial infarction, any vascular intervention or heart failure (New York Heart Association Class III-IV;) within 12 weeks prior to visit 1.
- Subject has had a malignancy in the last 5 years, except for adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix.
- Subject has a history of diabetic coma or precoma.
- Subject has a history of ketoacidosis or lactic acidosis.
- History of drinking more than 21 units of alcohol per week (1 unit = 10 g pure alcohol = 250 mL of beer [5%] or 35 mL of spirits [35%] or 100 mL of wine [12%]) (> 14 units of alcohol for female subjects) or history of drugs abuse (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, and opiates) within 3 months prior to visit 1.
- Subject is known to have hepatitis or be a carrier of hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody or is known to be positive for human immunodeficiency virus (HIV)-1 and/or HIV-2.
- Subject has a severe infection, has serious trauma, or is a perioperative subject.
- Subject has symptomatic urinary tract infection or genital infection at visit 1 and/or just prior to randomization at visit 3.
- Subject has uncontrolled severe hypertension (or subject whose systolic blood pressure is > 180 mmHg or diastolic blood pressure of > 110 mmHg measured in a sitting position after 5 minutes of rest at visit 1).
- Subject has an alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) > 2 x the upper limit of normal (ULN) range or has a total bilirubin > 1.5 x ULN at visit 1.
- Subject has a urinary microalbumin/creatinine ratio ≥ 300 mg/g at visit 1.
- Subject has estimated glomerular filtration rate (GFR) value of < 60 mL/min/1.73 m2 at visit 1 (using the Modification of Diet in Renal Disease [MDRD] calculation).
- Subject has known or suspected hypersensitivity to ipragliflozin or any components of the formulations used or a history of allergy for Sodium-glucose cotransporter (SGLT)2 inhibitors.
- Subject has previously received ipragliflozin or other SGLT2 inhibitors.
- Subject is concurrently participating in another drug study or has received an investigational drug within 30 days or the limit set by national law, whichever is longer, prior to visit 1 or plans to receive another investigational drug during the study.
- Female subject who is currently pregnant or lactating
- Male or female subject who does not use appropriate contraception during the study.
- The subject is unable to adhere to the treatment regimen, protocol procedures or study requirements (including discontinuation criteria during the run-in period), in the investigator's judgment.
- Subject has an unstable medical or psychiatric illness.
Sites / Locations
- Site RU70011
- Site RU70005
- Site RU70003
- Site RU70009
- Site RU70010
- Site RU70006
- Site RU70004
- Site RU70008
- Site RU70014
- Site RU70007
- Site RU70002
- Site RU70015
- Site RU70001
- Site RU70013
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Experimental
Other
Arm Label
Metformin and placebo
Metformin and Ipragliflozin
Metformin, placebo and Ipragliflozin
Arm Description
Participants will receive daily dosage of Metformin and Placebo as single tablets.
Participants will receive daily dosage of Metformin and Ipragliflozin (2 dose strengths) as single tablets.
Participants will receive daily dosage of Metformin, placebo and Ipragliflozin (1 dose strength) as single tablets.
Outcomes
Primary Outcome Measures
Change from baseline in HbA1c with ipragliflozin once daily added on to metformin compared to placebo added on to metformin
Glycated hemoglobin (HbA1c)
Secondary Outcome Measures
Change from baseline in HbA1c in each treatment group
Change from baseline in FPG in each treatment group
Fasting plasma glucose (FPG)
Number of patients reaching a treatment goal in HbA1c of < 7.0% in each treatment group
Change in body weight in each treatment group
Change in blood pressure in each treatment group
Number of patients with AEs
Adverse Events (AEs)
Number of patients with AEs of special interest
AEs of special interest include: hypoglycemic events, dehydration/hypovolemia, urinary tract infections and genital infections
Percentage of patients reaching a treatment goal in HbA1c of < 7.0% in each treatment group
Change from baseline in PROs as measured by European Quality of Life 5 Dimensions 5 Levels [EQ-5D-5L] questionnaire
Patient-reported outcomes (PROs)
Change from baseline in PROs as measured by Audit of Diabetes Dependent Quality of Life [ADDQoL-19] questionnaire
Change from baseline in PROs as measured by Work Productivity and Activity Impairment: General Health [WPAI:GH] questionnaire
Change from baseline in PROs as measured by Diabetes Medication Satisfaction [Diab-MedSat] questionnaire
Percentage of patients with AEs
Percentage of patients with AEs of special interest
AEs of special interest include: hypoglycemic events, dehydration/hypovolemia, urinary tract infections and genital infections
Full Information
NCT ID
NCT02794792
First Posted
March 14, 2016
Last Updated
November 5, 2018
Sponsor
Astellas Pharma Europe B.V.
1. Study Identification
Unique Protocol Identification Number
NCT02794792
Brief Title
A Study to Assess the Efficacy and Safety of Ipragliflozin in Subjects With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin
Acronym
IMPRESSION
Official Title
A Phase 3, Double-blind, Randomized Study to Assess the Efficacy and Safety of Ipragliflozin in Combination With Metformin Compared to Metformin Plus Placebo in Subjects in Russia With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin
Study Type
Interventional
2. Study Status
Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
May 11, 2016 (Actual)
Primary Completion Date
March 2, 2017 (Actual)
Study Completion Date
June 20, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Europe B.V.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The main purpose of this study is to evaluate the efficacy in reducing glycated hemoglobin of ipragliflozin in combination with metformin compared with metformin plus placebo in subjects with type 2 diabetes mellitus who have inadequate glycemic control on metformin.
Detailed Description
This is a phase 3, double-blind, randomized study to assess the efficacy and safety of ipragliflozin in combination with metformin compared to metformin plus placebo in subjects in Russia with type 2 diabetes mellitus who have inadequate glycemic control on metformin. Subjects will enter a 10-day (± 3 days) screening period, followed by a 2-week single-blind placebo run-in period, followed by a 24-week randomized double-blind treatment period and a 4-week follow-up period
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes Mellitus
Keywords
Type 2 Diabetes Mellitus, ASP1941, Ipragliflozin
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
268 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Metformin and placebo
Arm Type
Active Comparator
Arm Description
Participants will receive daily dosage of Metformin and Placebo as single tablets.
Arm Title
Metformin and Ipragliflozin
Arm Type
Experimental
Arm Description
Participants will receive daily dosage of Metformin and Ipragliflozin (2 dose strengths) as single tablets.
Arm Title
Metformin, placebo and Ipragliflozin
Arm Type
Other
Arm Description
Participants will receive daily dosage of Metformin, placebo and Ipragliflozin (1 dose strength) as single tablets.
Intervention Type
Drug
Intervention Name(s)
Ipragliflozin L-proline
Other Intervention Name(s)
Suglat, ASP1941
Intervention Description
Oral
Intervention Type
Drug
Intervention Name(s)
Metformin
Other Intervention Name(s)
Riomet, Glucophage, Glumetza, Glucophage XR, Fortamet
Intervention Description
Oral
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Oral
Primary Outcome Measure Information:
Title
Change from baseline in HbA1c with ipragliflozin once daily added on to metformin compared to placebo added on to metformin
Description
Glycated hemoglobin (HbA1c)
Time Frame
Baseline and 12 weeks
Secondary Outcome Measure Information:
Title
Change from baseline in HbA1c in each treatment group
Time Frame
Baseline and 24 weeks
Title
Change from baseline in FPG in each treatment group
Description
Fasting plasma glucose (FPG)
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Number of patients reaching a treatment goal in HbA1c of < 7.0% in each treatment group
Time Frame
Up to 24 weeks
Title
Change in body weight in each treatment group
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Change in blood pressure in each treatment group
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Number of patients with AEs
Description
Adverse Events (AEs)
Time Frame
Up to 24 weeks
Title
Number of patients with AEs of special interest
Description
AEs of special interest include: hypoglycemic events, dehydration/hypovolemia, urinary tract infections and genital infections
Time Frame
Up to 24 weeks
Title
Percentage of patients reaching a treatment goal in HbA1c of < 7.0% in each treatment group
Time Frame
Up to 24 weeks
Title
Change from baseline in PROs as measured by European Quality of Life 5 Dimensions 5 Levels [EQ-5D-5L] questionnaire
Description
Patient-reported outcomes (PROs)
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Change from baseline in PROs as measured by Audit of Diabetes Dependent Quality of Life [ADDQoL-19] questionnaire
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Change from baseline in PROs as measured by Work Productivity and Activity Impairment: General Health [WPAI:GH] questionnaire
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Change from baseline in PROs as measured by Diabetes Medication Satisfaction [Diab-MedSat] questionnaire
Time Frame
Baseline, 12 weeks and 24 weeks
Title
Percentage of patients with AEs
Time Frame
Up to 24 weeks
Title
Percentage of patients with AEs of special interest
Description
AEs of special interest include: hypoglycemic events, dehydration/hypovolemia, urinary tract infections and genital infections
Time Frame
Up to 24 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject has been diagnosed with type 2 diabetes mellitus at least 12 weeks before visit 1.
Subject has been on a stable dose and a daily dose regimen of metformin ≥ 1500 mg for at least 12 weeks prior to visit 1.
Subject has HbA1c ≥ 7.5% and ≤ 11.0% at visit 1.
Subject has been on a stable diet and exercise program for at least 12 weeks prior to visit 1 and is willing to maintain this program for the duration of the treatment period.
Subject has a body mass index (BMI) of 20 to 45 kg/m2, inclusive, at visit 1.
Subjects are allowed to continue taking their medication for concomitant diseases (including over-the-counter products), provided they have been on a stable dose for a minimum of 30 days prior to visit 1.
Female subjects must either:
Be of non-childbearing potential:
postmenopausal (defined as at least 1 year without any menses) prior to screening, or
documented as surgically sterile
Or, if of childbearing potential,
Agree not to try to become pregnant during the study and for 28 days after the final study drug administration
And have a negative serum pregnancy test at visit 1
And, if heterosexually active, agree to consistently use 2 forms of highly effective birth control (at least 1 of which must be a barrier method) starting at screening, throughout the study period and for 28 days after the final study drug administration.
Female subjects must agree not to breastfeed starting at screening, throughout the study period and for 28 days after the final study drug administration.
Female subjects must not donate ova starting at screening, throughout the study period and for 28 days after the final study drug administration.
Male subjects and their female spouse/partners who are of childbearing potential must be using highly effective contraception consisting of 2 forms of birth control (at least 1 of which must be a barrier method) starting at screening and continue throughout the study period.
Male subjects must not donate sperm starting at screening and throughout the study period.
Exclusion Criteria:
Subject has type 1 diabetes mellitus.
Subject has received any medication for glycemic control, with the exception of metformin, (e.g., oral antidiabetic drugs, insulin, etc.) within 12 weeks prior to visit 1.
Subject is currently receiving an excluded medication or has received insulin within 12 weeks prior to visit 1 or during the screening period.
Subject has a history of stroke, unstable angina, myocardial infarction, any vascular intervention or heart failure (New York Heart Association Class III-IV;) within 12 weeks prior to visit 1.
Subject has had a malignancy in the last 5 years, except for adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix.
Subject has a history of diabetic coma or precoma.
Subject has a history of ketoacidosis or lactic acidosis.
History of drinking more than 21 units of alcohol per week (1 unit = 10 g pure alcohol = 250 mL of beer [5%] or 35 mL of spirits [35%] or 100 mL of wine [12%]) (> 14 units of alcohol for female subjects) or history of drugs abuse (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, and opiates) within 3 months prior to visit 1.
Subject is known to have hepatitis or be a carrier of hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody or is known to be positive for human immunodeficiency virus (HIV)-1 and/or HIV-2.
Subject has a severe infection, has serious trauma, or is a perioperative subject.
Subject has symptomatic urinary tract infection or genital infection at visit 1 and/or just prior to randomization at visit 3.
Subject has uncontrolled severe hypertension (or subject whose systolic blood pressure is > 180 mmHg or diastolic blood pressure of > 110 mmHg measured in a sitting position after 5 minutes of rest at visit 1).
Subject has an alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) > 2 x the upper limit of normal (ULN) range or has a total bilirubin > 1.5 x ULN at visit 1.
Subject has a urinary microalbumin/creatinine ratio ≥ 300 mg/g at visit 1.
Subject has estimated glomerular filtration rate (GFR) value of < 60 mL/min/1.73 m2 at visit 1 (using the Modification of Diet in Renal Disease [MDRD] calculation).
Subject has known or suspected hypersensitivity to ipragliflozin or any components of the formulations used or a history of allergy for Sodium-glucose cotransporter (SGLT)2 inhibitors.
Subject has previously received ipragliflozin or other SGLT2 inhibitors.
Subject is concurrently participating in another drug study or has received an investigational drug within 30 days or the limit set by national law, whichever is longer, prior to visit 1 or plans to receive another investigational drug during the study.
Female subject who is currently pregnant or lactating
Male or female subject who does not use appropriate contraception during the study.
The subject is unable to adhere to the treatment regimen, protocol procedures or study requirements (including discontinuation criteria during the run-in period), in the investigator's judgment.
Subject has an unstable medical or psychiatric illness.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Monitor
Organizational Affiliation
Astellas Pharma Europe B.V.
Official's Role
Study Director
Facility Information:
Facility Name
Site RU70011
City
Moscow
ZIP/Postal Code
117036
Country
Russian Federation
Facility Name
Site RU70005
City
Moscow
ZIP/Postal Code
119034
Country
Russian Federation
Facility Name
Site RU70003
City
Moscow
ZIP/Postal Code
121374
Country
Russian Federation
Facility Name
Site RU70009
City
Moscow
ZIP/Postal Code
125315
Country
Russian Federation
Facility Name
Site RU70010
City
Nizhniy Novgorod
ZIP/Postal Code
603018
Country
Russian Federation
Facility Name
Site RU70006
City
Samara
ZIP/Postal Code
443067
Country
Russian Federation
Facility Name
Site RU70004
City
Saratov
ZIP/Postal Code
410012
Country
Russian Federation
Facility Name
Site RU70008
City
St. Petersburg
ZIP/Postal Code
191119
Country
Russian Federation
Facility Name
Site RU70014
City
St. Petersburg
ZIP/Postal Code
194354
Country
Russian Federation
Facility Name
Site RU70007
City
St. Petersburg
ZIP/Postal Code
197022
Country
Russian Federation
Facility Name
Site RU70002
City
St. Petersburg
ZIP/Postal Code
197706
Country
Russian Federation
Facility Name
Site RU70015
City
Volgograd
ZIP/Postal Code
400001
Country
Russian Federation
Facility Name
Site RU70001
City
Yaroslavl
ZIP/Postal Code
150003
Country
Russian Federation
Facility Name
Site RU70013
City
Yaroslavl
ZIP/Postal Code
150062
Country
Russian Federation
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Access to anonymized individual participant level data collected during the trial, in addition to study-related supporting documentation, is planned for trials conducted with approved product indications and formulations, as well as compounds terminated during development. Conditions and exceptions are described under the Sponsor Specific Details for Astellas on www.clinicalstudydatarequest.com.
IPD Sharing Time Frame
Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
IPD Sharing Access Criteria
Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
IPD Sharing URL
https://www.clinicalstudydatarequest.com/
Citations:
PubMed Identifier
31606880
Citation
Kashiwagi A, Shestakova MV, Ito Y, Noguchi M, Wilpshaar W, Yoshida S, Wilding JPH. Safety of Ipragliflozin in Patients with Type 2 Diabetes Mellitus: Pooled Analysis of Phase II/III/IV Clinical Trials. Diabetes Ther. 2019 Dec;10(6):2201-2217. doi: 10.1007/s13300-019-00699-8. Epub 2019 Oct 12.
Results Reference
derived
Links:
URL
https://astellasclinicalstudyresults.com/study.aspx?ID=255
Description
Link to results on the Astellas Clinical Study Results website
Learn more about this trial
A Study to Assess the Efficacy and Safety of Ipragliflozin in Subjects With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin
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