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Safety and Efficacy of Bexagliflozin Compared to Sitagliptin as Add-on Therapy to Metformin in Type 2 Diabetes Subjects

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Bexagliflozin
Sitagliptin
Placebo for sitagliptin
Placebo for bexagliflozin
Sponsored by
Theracos
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes Mellitus

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Each subject was required to meet the following criteria at the time of enrollment to be eligible for the study:

  1. To have been male or female adults ≥ 18 years of age.
  2. To have been negative on the urine pregnancy test and agreed to abstain from coitus or use contraception during the entire study if a subject was female of childbearing potential.
  3. To have had a diagnosis of T2DM with HbA1c levels between 7.0% and 11% (inclusive) at the time of screening.
  4. To have been treated with a stable dose of ≥ 1500 mg/day metformin only along with diet and exercise counseling for at least 8 weeks at the time of screening.
  5. To have had a BMI ≤ 45 kg per m2 at the time of screening.
  6. To have been taking stable doses of treatment for dyslipidemia and/or hypertension for 30 days if applicable.
  7. To have been willing and able to return for all clinic visits and to complete all study-required procedures.
  8. To have adhered to the investigational product administration requirements as evidenced by missing no more than 1 day of run-in medications.

Potential subjects who exhibited any of the following characteristics were to be excluded from the study:

  1. Diagnosis of type 1 diabetes mellitus or maturity-onset diabetes of the young (MODY)
  2. Hemoglobinopathy that affected HbA1c measurement
  3. Any contraindication to the safe use of DPP-4 therapy or sitagliptin, including known hypersensitivity reaction
  4. History of pancreatitis
  5. Genitourinary tract infection within 6 weeks of screening or history of ≥ 3 genitourinary infections requiring treatment within 6 months from the time of screening
  6. Cancer, active or in remission, for < 3 years
  7. History of alcohol or illicit drug abuse in the past 2 years
  8. Triglycerides > 500 mg dL-1 at Visit V1
  9. Evidence of abnormal liver function tests (total bilirubin or alkaline phosphatase > 1.5 x upper limit of normal (ULN) with the exception of isolated Gilbert's syndrome); or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 x ULN
  10. Estimated GFR, as calculated by the modification of diet in renal disease study equation (MDRD), < 60 mL min-1 per 1.73 m2 at the time of screening.
  11. Uncontrolled hypertension (SBP > 160 mm Hg or diastolic BP > 95 mm Hg) at Visit V1
  12. Life expectancy < 2 years
  13. History of MI, unstable angina, stroke or hospitalization for heart failure within 3 months at the time of screening
  14. History of treatment with an investigational drug within 30 days or within 7 half-lives of the investigational drug, whichever is longer
  15. Previous treatment with bexagliflozin or EGT0001474 study drug
  16. Currently or within 3 months of taking any SGLT2 inhibitor
  17. Currently participating in another interventional trial
  18. Prior renal transplantation or evidence of nephrotic syndrome (defined as a urine albumin-to-creatinine ratio (UACR) > 1500 mg g-1 at the time of screening).
  19. Any condition, disease, disorder or clinically relevant abnormality that could have jeopardized the subject's appropriate participation in this study or obscure the effects of treatment
  20. Female subjects who were pregnant or nursing
  21. Two or more consecutive SMBG measures ≥ 250 mg dL-1 (13.9 mmol L-1) prior to randomization accompanied by clinical signs or symptoms of hyperglycemia prior to randomization, including weight loss, blurred vision, increased thirst increased urination, or fatigue

Sites / Locations

  • Clinical Research Site 1357
  • Clinical Research Site 1358
  • Clinical Research Site 1361
  • Clinical Research Site 1031
  • Clinical Research Site 1271
  • Clinical Research Site 1359
  • Clinical Research Site 1009
  • Clinical Research Site 1037
  • Clinical Research Site 1008
  • Clinical Research Site 1360
  • Clinical Research Site 3119
  • Clinical Research Site 3123
  • Clinical Research Site 3120
  • Clinical Research Site 3112
  • Clinical Research Site 3122
  • Clinical Research Site 9102
  • Clinical Research Site 9101
  • Clinical Research Site 9106
  • Clinical Research Site 9107
  • Clinical Research Site 9105
  • Clinical Research Site 9103
  • Clinical Research Site 6031
  • Clinical Research Site 6037
  • Clinical Research Site 6042
  • Clinical Research Site 6040
  • Clinical Research Site 6035
  • Clinical Research Site 6034
  • Clinical Research Site 6039
  • Clinical Research Site 6041
  • Clinical Research Site 6032
  • Clinical Research Site 6036
  • Clinical Research Site 6038
  • Clinical Research Site 6033
  • Clinical Research Site 7137
  • Clinical Research Site 7144
  • Clinical Research Site 7142
  • Clinical Research Site 7139
  • Clinical Research Site 7141
  • Clinical Research Site 7120
  • Clinical Research Site 7138
  • Clinical Research Site 7131
  • Clinical Research Site 7143
  • Clinical Research Site 7140
  • Clinical Research Site 7136
  • Clinical Research Site 7107
  • Clinical Research Site 7128
  • Clinical Research Site 9002
  • Clinical Research Site 9016
  • Clinical Research Site 9005
  • Clinical Research Site 9017
  • Clinical Research Site 9013
  • Clinical Research Site 9012
  • Clinical Research Site 9011
  • Clinical Research Site 9014
  • Clinical Research Site 9015
  • Clinical Research Site 9018

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Bexagliflozin

Sitagliptin

Arm Description

Subjects will receive a bexagliflozin tablet, 20 mg, once daily for the duration of the study. Subjects will continue taking metformin and receive placebo for sitagliptin daily for the duration of the study.

Subjects will receive a sitagliptin tablet, 100 mg, once daily for the duration of the study. Subjects will continue taking metformin and receive placebo for bexagliflozin for the duration of the study.

Outcomes

Primary Outcome Measures

Change in HbA1c From Baseline to Week 24
The primary efficacy objective is to demonstrate that bexagliflozin is non-inferior to sitagliptin by evaluating the treatment effect on hemoglobin A1c (HbA1c) reduction at week 24 in subjects whose type 2 diabetes mellitus (T2DM) is inadequately controlled by metformin.

Secondary Outcome Measures

Change in FPG From Baseline at Week 24
To evaluate the treatment effect of bexagliflozin vs. sitagliptin on the change in fasting plasma glucose (FPG) at week 24
Change in Body Weight in Subjects With Baseline BMI ≥ 25 kg/m2 at Week 24
To evaluate the treatment effect of bexagliflozin vs. sitagliptin on the change in body weight in subjects with baseline body mass index (BMI) ≥ 25 kg/m2 at week 24
Change in SBP in Subjects From Baseline at Week 24
To evaluate the treatment effect of bexagliflozin vs. sitagliptin on the change in systolic blood pressure (SBP) in subjects at week 24

Full Information

First Posted
April 11, 2017
Last Updated
June 15, 2021
Sponsor
Theracos
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1. Study Identification

Unique Protocol Identification Number
NCT03115112
Brief Title
Safety and Efficacy of Bexagliflozin Compared to Sitagliptin as Add-on Therapy to Metformin in Type 2 Diabetes Subjects
Official Title
A Phase 3, Randomized, Double-Blind, Active-Controlled Study to Evaluate the Effects of Bexagliflozin Versus Sitagliptin in Subjects With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control by Metformin
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
October 12, 2017 (Actual)
Primary Completion Date
October 31, 2018 (Actual)
Study Completion Date
October 31, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Theracos

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to investigate the effect of bexagliflozin compared to sitagliptin as an add-on therapy to metformin in lowering hemoglobin A1c (HbA1c) levels in subjects with type 2 diabetes mellitus (T2DM).
Detailed Description
This was a phase 3, multi-center, randomized, double-blind, parallel-group study to demonstrate that bexagliflozin was non-inferior to sitagliptin as add-on therapy in subjects whose T2DM was not adequately controlled by metformin treatment alone. The primary effectiveness endpoint was the change in HbA1c from baseline at week 24. At the time of screening, all subjects were to have taken metformin at a stable dose of ≥ 1500 mg per day for ≥ 8 weeks and have received diet and exercise counseling. A total of 374 eligible subjects were to be enrolled in the study. Subjects who successfully completed a 1-week run-in and who met all eligibility criteria were to be randomized in a 1:1 ratio to receive once daily double-blind treatment of either active bexagliflozin tablets with placebo sitagliptin tablets or placebo bexagliflozin tablets and active sitagliptin tablets. The study subjects were to continue receiving open-labeled metformin during the entire study at a stable dose and frequency. The treatment period was 24 weeks and was conducted in an outpatient setting. Randomization was stratified by HbA1c (≤ 8.5% vs. ˃ 8.5%) values. Symptoms and blood sugars related to the occurrence of hyperglycemia, hypoglycemic events or symptoms that could indicate ketoacidosis were to be recorded. Bexagliflozin tablets, 20 mg or placebo, and sitagliptin tablets, 100 mg or placebo, were to be taken once daily at approximately the same time each day either before or after breakfast. Background metformin was to be taken at the same dose and frequency from screening throughout the entire study. Each subject was advised to return to the clinic at weeks 6, 12, 18 and 24 for efficacy assessment and safety monitoring, including review of AEs and concomitant medication, vital signs, ECG, physical examination and blood and urine specimen collections. Subjects were to return to the clinic for a follow-up exit visit at week 26 or 2 weeks after the last dose of study drugs if subjects withdrew from the study prior to week 24.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes Mellitus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
386 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bexagliflozin
Arm Type
Active Comparator
Arm Description
Subjects will receive a bexagliflozin tablet, 20 mg, once daily for the duration of the study. Subjects will continue taking metformin and receive placebo for sitagliptin daily for the duration of the study.
Arm Title
Sitagliptin
Arm Type
Active Comparator
Arm Description
Subjects will receive a sitagliptin tablet, 100 mg, once daily for the duration of the study. Subjects will continue taking metformin and receive placebo for bexagliflozin for the duration of the study.
Intervention Type
Drug
Intervention Name(s)
Bexagliflozin
Other Intervention Name(s)
EGT0001442, EGT0001474
Intervention Description
tablets containing 20 mg bexagliflozin
Intervention Type
Drug
Intervention Name(s)
Sitagliptin
Other Intervention Name(s)
Januvia
Intervention Description
tablets containing 100 mg sitagliptin
Intervention Type
Drug
Intervention Name(s)
Placebo for sitagliptin
Intervention Description
inactive tablets to match the appearance of sitagliptin tablets
Intervention Type
Drug
Intervention Name(s)
Placebo for bexagliflozin
Intervention Description
inactive tablets to match the appearance of bexagliflozin tablets
Primary Outcome Measure Information:
Title
Change in HbA1c From Baseline to Week 24
Description
The primary efficacy objective is to demonstrate that bexagliflozin is non-inferior to sitagliptin by evaluating the treatment effect on hemoglobin A1c (HbA1c) reduction at week 24 in subjects whose type 2 diabetes mellitus (T2DM) is inadequately controlled by metformin.
Time Frame
Baseline to week 24
Secondary Outcome Measure Information:
Title
Change in FPG From Baseline at Week 24
Description
To evaluate the treatment effect of bexagliflozin vs. sitagliptin on the change in fasting plasma glucose (FPG) at week 24
Time Frame
Baseline to week 24
Title
Change in Body Weight in Subjects With Baseline BMI ≥ 25 kg/m2 at Week 24
Description
To evaluate the treatment effect of bexagliflozin vs. sitagliptin on the change in body weight in subjects with baseline body mass index (BMI) ≥ 25 kg/m2 at week 24
Time Frame
Baseline to week 24
Title
Change in SBP in Subjects From Baseline at Week 24
Description
To evaluate the treatment effect of bexagliflozin vs. sitagliptin on the change in systolic blood pressure (SBP) in subjects at week 24
Time Frame
Baseline to week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Each subject was required to meet the following criteria at the time of enrollment to be eligible for the study: To have been male or female adults ≥ 18 years of age. To have been negative on the urine pregnancy test and agreed to abstain from coitus or use contraception during the entire study if a subject was female of childbearing potential. To have had a diagnosis of T2DM with HbA1c levels between 7.0% and 11% (inclusive) at the time of screening. To have been treated with a stable dose of ≥ 1500 mg/day metformin only along with diet and exercise counseling for at least 8 weeks at the time of screening. To have had a BMI ≤ 45 kg per m2 at the time of screening. To have been taking stable doses of treatment for dyslipidemia and/or hypertension for 30 days if applicable. To have been willing and able to return for all clinic visits and to complete all study-required procedures. To have adhered to the investigational product administration requirements as evidenced by missing no more than 1 day of run-in medications. Potential subjects who exhibited any of the following characteristics were to be excluded from the study: Diagnosis of type 1 diabetes mellitus or maturity-onset diabetes of the young (MODY) Hemoglobinopathy that affected HbA1c measurement Any contraindication to the safe use of DPP-4 therapy or sitagliptin, including known hypersensitivity reaction History of pancreatitis Genitourinary tract infection within 6 weeks of screening or history of ≥ 3 genitourinary infections requiring treatment within 6 months from the time of screening Cancer, active or in remission, for < 3 years History of alcohol or illicit drug abuse in the past 2 years Triglycerides > 500 mg dL-1 at Visit V1 Evidence of abnormal liver function tests (total bilirubin or alkaline phosphatase > 1.5 x upper limit of normal (ULN) with the exception of isolated Gilbert's syndrome); or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 x ULN Estimated GFR, as calculated by the modification of diet in renal disease study equation (MDRD), < 60 mL min-1 per 1.73 m2 at the time of screening. Uncontrolled hypertension (SBP > 160 mm Hg or diastolic BP > 95 mm Hg) at Visit V1 Life expectancy < 2 years History of MI, unstable angina, stroke or hospitalization for heart failure within 3 months at the time of screening History of treatment with an investigational drug within 30 days or within 7 half-lives of the investigational drug, whichever is longer Previous treatment with bexagliflozin or EGT0001474 study drug Currently or within 3 months of taking any SGLT2 inhibitor Currently participating in another interventional trial Prior renal transplantation or evidence of nephrotic syndrome (defined as a urine albumin-to-creatinine ratio (UACR) > 1500 mg g-1 at the time of screening). Any condition, disease, disorder or clinically relevant abnormality that could have jeopardized the subject's appropriate participation in this study or obscure the effects of treatment Female subjects who were pregnant or nursing Two or more consecutive SMBG measures ≥ 250 mg dL-1 (13.9 mmol L-1) prior to randomization accompanied by clinical signs or symptoms of hyperglycemia prior to randomization, including weight loss, blurred vision, increased thirst increased urination, or fatigue
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
J. Paul Lock, MD
Organizational Affiliation
Theracos Sub, LLC
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Research Site 1357
City
Lincoln
State/Province
California
ZIP/Postal Code
95648
Country
United States
Facility Name
Clinical Research Site 1358
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Clinical Research Site 1361
City
San Dimas
State/Province
California
ZIP/Postal Code
91773
Country
United States
Facility Name
Clinical Research Site 1031
City
Port Orange
State/Province
Florida
ZIP/Postal Code
32127
Country
United States
Facility Name
Clinical Research Site 1271
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Clinical Research Site 1359
City
Topeka
State/Province
Kansas
ZIP/Postal Code
66606
Country
United States
Facility Name
Clinical Research Site 1009
City
Berlin
State/Province
New Jersey
ZIP/Postal Code
08009
Country
United States
Facility Name
Clinical Research Site 1037
City
Trenton
State/Province
New Jersey
ZIP/Postal Code
08611
Country
United States
Facility Name
Clinical Research Site 1008
City
Munroe Falls
State/Province
Ohio
ZIP/Postal Code
44262
Country
United States
Facility Name
Clinical Research Site 1360
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78258
Country
United States
Facility Name
Clinical Research Site 3119
City
Hodonín
ZIP/Postal Code
695 00
Country
Czechia
Facility Name
Clinical Research Site 3123
City
Mladá Boleslav
ZIP/Postal Code
293 01
Country
Czechia
Facility Name
Clinical Research Site 3120
City
Olomouc
ZIP/Postal Code
779 00
Country
Czechia
Facility Name
Clinical Research Site 3112
City
Praha
ZIP/Postal Code
181 00
Country
Czechia
Facility Name
Clinical Research Site 3122
City
Prostějov
ZIP/Postal Code
796 01
Country
Czechia
Facility Name
Clinical Research Site 9102
City
Balatonfüred
Country
Hungary
Facility Name
Clinical Research Site 9101
City
Balatongyörök
Country
Hungary
Facility Name
Clinical Research Site 9106
City
Budapest
Country
Hungary
Facility Name
Clinical Research Site 9107
City
Szeged
Country
Hungary
Facility Name
Clinical Research Site 9105
City
Zalaegerszeg
Country
Hungary
Facility Name
Clinical Research Site 9103
City
Zamardi
Country
Hungary
Facility Name
Clinical Research Site 6031
City
Chiba
ZIP/Postal Code
260-0804
Country
Japan
Facility Name
Clinical Research Site 6037
City
Chiba
ZIP/Postal Code
272-8516
Country
Japan
Facility Name
Clinical Research Site 6042
City
Chiba
ZIP/Postal Code
277-0825
Country
Japan
Facility Name
Clinical Research Site 6040
City
Fukuoka
ZIP/Postal Code
819-0006
Country
Japan
Facility Name
Clinical Research Site 6035
City
Fukuoka
ZIP/Postal Code
819-0168
Country
Japan
Facility Name
Clinical Research Site 6034
City
Ibaraki
ZIP/Postal Code
300-0835
Country
Japan
Facility Name
Clinical Research Site 6039
City
Ibaraki
ZIP/Postal Code
300-1207
Country
Japan
Facility Name
Clinical Research Site 6041
City
Ibaraki
ZIP/Postal Code
306-0232
Country
Japan
Facility Name
Clinical Research Site 6032
City
Ibaraki
ZIP/Postal Code
310-0826
Country
Japan
Facility Name
Clinical Research Site 6036
City
Shizuoka
ZIP/Postal Code
424-0855
Country
Japan
Facility Name
Clinical Research Site 6038
City
Tochigi
ZIP/Postal Code
323-0022
Country
Japan
Facility Name
Clinical Research Site 6033
City
Ōsaka
ZIP/Postal Code
582-0005
Country
Japan
Facility Name
Clinical Research Site 7137
City
Gdańsk
ZIP/Postal Code
80-858
Country
Poland
Facility Name
Clinical Research Site 7144
City
Kraków
ZIP/Postal Code
30-015
Country
Poland
Facility Name
Clinical Research Site 7142
City
Kraków
ZIP/Postal Code
31-209
Country
Poland
Facility Name
Clinical Research Site 7139
City
Kraków
ZIP/Postal Code
31-261
Country
Poland
Facility Name
Clinical Research Site 7141
City
Kraków
ZIP/Postal Code
31-530
Country
Poland
Facility Name
Clinical Research Site 7120
City
Lublin
ZIP/Postal Code
20-362
Country
Poland
Facility Name
Clinical Research Site 7138
City
Lublin
ZIP/Postal Code
20-538
Country
Poland
Facility Name
Clinical Research Site 7131
City
Olsztyn
ZIP/Postal Code
10-117
Country
Poland
Facility Name
Clinical Research Site 7143
City
Poznań
ZIP/Postal Code
60-819
Country
Poland
Facility Name
Clinical Research Site 7140
City
Poznań
ZIP/Postal Code
60-821
Country
Poland
Facility Name
Clinical Research Site 7136
City
Poznań
ZIP/Postal Code
61-655
Country
Poland
Facility Name
Clinical Research Site 7107
City
Puławy
ZIP/Postal Code
24-100
Country
Poland
Facility Name
Clinical Research Site 7128
City
Toruń
ZIP/Postal Code
87-100
Country
Poland
Facility Name
Clinical Research Site 9002
City
Alicante
ZIP/Postal Code
03004
Country
Spain
Facility Name
Clinical Research Site 9016
City
Almería
ZIP/Postal Code
04001
Country
Spain
Facility Name
Clinical Research Site 9005
City
Alzira
ZIP/Postal Code
46600
Country
Spain
Facility Name
Clinical Research Site 9017
City
Barcelona
ZIP/Postal Code
08023
Country
Spain
Facility Name
Clinical Research Site 9013
City
Barcelona
ZIP/Postal Code
08500
Country
Spain
Facility Name
Clinical Research Site 9012
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Clinical Research Site 9011
City
Sevilla
ZIP/Postal Code
41009
Country
Spain
Facility Name
Clinical Research Site 9014
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Facility Name
Clinical Research Site 9015
City
Sevilla
Country
Spain
Facility Name
Clinical Research Site 9018
City
Valencia
ZIP/Postal Code
46010
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety and Efficacy of Bexagliflozin Compared to Sitagliptin as Add-on Therapy to Metformin in Type 2 Diabetes Subjects

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