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A Preliminary Study of the Efficacy and Safety of MK-8521 for Type 2 Diabetes (MK-8521-004)

Primary Purpose

Type II Diabetes Mellitus

Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
MK-8521
Placebo
Liraglutide
Metformin
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type II Diabetes Mellitus

Eligibility Criteria

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

Inclusion Criteria:

  • Have T2DM in accordance with American Diabetes Association guidelines
  • Be on metformin monotherapy (>-1000 mg/day: metformin IR or metformin XR) for at least 12 weeks prior to study start with a hemoglobin A1C (A1C) >-7.5 and <-10.5% OR Be on dual therapy with metformin (>-1000 mg/day: dose stable for at least 4 weeks prior to study start) with an A1C of >-7.0% and <-10.0% and a second AHA and be willing to washout the second AHA. Allowable AHAs are dipeptidyl peptidase 4 (DPP-4 inhibitors), alpha-glucosidase inhibitors, sulfonylureas, and glinides.
  • Have a body mass index (BMI) ≥23 kg/m^2 and ≤40 kg/m^2
  • Is a female who is not of reproductive potential, or is a female of reproductive potential who agrees to avoid becoming pregnant: while receiving study drug and for 14 days after the last dose of study drug

Exclusion Criteria:

  • Have a history of type 1 diabetes or a history of diabetic ketoacidosis
  • Has a history of other specific types of diabetes (e.g., genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical-induced, and post-organ transplant)
  • Has been treated with any gut-derived incretin hormone glucagon-like peptide 1 (GLP-1) receptor agonist (e.g. Byetta™, Victoza™ or investigational agents) within the last 6 months or has had GLP-1 receptor agonist discontinued due to gastrointestinal intolerance or lack of efficacy. Note: treatment with a GLP-1 receptor agonist that was discontinued >6 months prior to study start is not an exclusion if the GLP-1 receptor agonist was discontinued for reasons other than gastrointestinal intolerance or lack of efficacy.
  • Has a history of clinically significant gastrointestinal disorder (including diabetic gastroparesis; irritable bowel disease; recurrent episodes of nausea, vomiting, diarrhea and abdominal pain)
  • Has a history of clinically significant and active, immunological, respiratory, genitourinary or major neurological (including stroke, transient ischemic attack and chronic seizures) abnormalities or diseases
  • Has a history of cardiovascular disease (including diabetic cardiomyopathy) or significant cardiac condition (including a history of myocardial infarction, stable or unstable angina, arterial revascularization, pathologic, symptomatic or sustained tachyarrhythmia [e.g. atrial fibrillation, sustained supraventricular tachycardia, symptomatic non-sustained supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, Wolf-Parkinson-White syndrome, congenital long QT syndrome, etc.]) or heart failure
  • Has a family history of medullary carcinoma of the thyroid or multiple endocrine neoplasm type-2 syndrome
  • Has active diabetic proliferative retinopathy or a history of maculopathy
  • Has human immunodeficiency virus (HIV)
  • Has a medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic hepatitis B or C (assessed by medical history), primary biliary cirrhosis, or active symptomatic gallbladder disease
  • Is on a weight loss medication or has undergone bariatric surgery
  • Has a history of acute or chronic pancreatitis of any etiology
  • Had an event of severe hypoglycemia with neuroglycopenia in the past 12 months
  • Has a positive urine pregnancy test
  • Is pregnant or breast-feeding, or is planning to conceive during the trial, including 14 days following the last dose of investigational product
  • Routinely consumes >1 alcoholic drinks per day or >7 alcoholic drinks per week or engages in binge drinking
  • Routinely consumes ≥480mg /day caffeine in caffeinated beverages (1 cup of coffee contains approximately 120 mg of caffeine
  • Is taking a beta blocker or medications with sympathomimetic activity (e.g. pseudoephedrine, phenylpropanolamine, etc.)
  • Is currently a user of nicotine or nicotine containing products or does not agree to refrain from using nicotine during the trial, including 14 days following the last dose of investigational product
  • Is currently a user of any illicit drugs (including any marijuana use) or has a history of drug (including alcohol) abuse within approximately 5 years
  • has other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or blinded investigational product administration

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Placebo Comparator

    Active Comparator

    Arm Label

    MK-8521 300 μg

    MK-8521 180 μg

    Placebo

    Liraglutide 1.8 mg

    Arm Description

    Participants receive double-blind MK-8521 300 μg daily (QD), subcutaneously, over 12 weeks.

    Participants receive double-blind MK-8521 180 μg QD, subcutaneously, over 12 weeks.

    Participants receive matching double-blind placebo, QD over 12 weeks.

    Participants receive open-label 1.8 mg of liraglutide, QD, subcutaneously, over 12 weeks.

    Outcomes

    Primary Outcome Measures

    Change From Baseline in Hemoglobin A1C (A1C) at Week 12
    A1C is the percentage of hemoglobin that has glucose bound to it and is a blood marker used to report average blood glucose levels over prolonged periods of time. A1C is reported as a percentage (%). This change from baseline reflects the Week 12 A1C minus the Week 0 A1C.
    Number of Participants With an Adverse Event (AE)
    An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
    Number of Participants Who Discontinued Study Treatment Due to an AE
    An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
    Number of Participants With an AE of Symptomatic Hypoglycemia
    An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study. Hypoglycemia episodes are those with glucose values ≤70 mg/dL (3.9 mmol/L). Symptomatic hypoglycemia episodes were episodes with clinical symptoms reported by the investigator as hypoglycemia and classified as adverse events.
    Change From Baseline in Heart Rate at Week 12
    This change from baseline reflects the Week 12 heart rate minus the Week 0 heart rate.

    Secondary Outcome Measures

    Change From Baseline in Body Weight at Week 12
    This change from baseline reflects the Week 12 body weight minus the Week 0 body weight.
    Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12
    This change from baseline reflects the Week 12 FPG minus the Week 0 FPG.
    Change From Baseline in Fasting Low Density Lipoprotein (LDL) Cholesterol at Week 12
    This change from baseline reflects the Week 12 fasting LDL cholesterol minus the Week 0 fasting LDL cholesterol.
    Change From Baseline in Fasting High Density Lipoprotein (HDL) Cholesterol at Week 12
    This change from baseline reflects the Week 12 fasting HDL cholesterol minus the Week 0 fasting HDL cholesterol.
    Change From Baseline in Fasting Triglycerides at Week 12
    This change from baseline reflects the Week 12 fasting triglycerides minus the Week 0 fasting triglycerides.
    Change From Baseline in Systolic Blood Pressure (SBP) at Week 12
    This change from baseline reflects the Week 12 SBP minus the Week 0 SBP.
    Change From Baseline in Diastolic Blood Pressure (DBP) at Week 12
    This change from baseline reflects the Week 12 DBP minus the Week 0 DBP.

    Full Information

    First Posted
    July 6, 2015
    Last Updated
    August 10, 2018
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02492763
    Brief Title
    A Preliminary Study of the Efficacy and Safety of MK-8521 for Type 2 Diabetes (MK-8521-004)
    Official Title
    A Phase IIa, Multicenter, Placebo- and Active-controlled, Randomized, Double-Blind, Clinical Trial to Evaluate the Safety and Efficacy of MK-8521 Compared to Placebo in Subjects With Type 2 Diabetes Mellitus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2018
    Overall Recruitment Status
    Terminated
    Study Start Date
    July 27, 2015 (Actual)
    Primary Completion Date
    April 18, 2017 (Actual)
    Study Completion Date
    April 18, 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a multicenter randomized, double-blind, placebo- and active-controlled (liraglutide; Victoza®), parallel-group, clinical trial of MK-8521 in participants with type 2 diabetes mellitus (T2DM) with inadequate glycemic control while on a stable dose of metformin (≥1000 mg/day). The trial will include a 1-week screening period; at least an 8-week antihyperglycemic agent (AHA) washout period, if required; a 14-week blinded therapy period (which includes single-blind run-in and double-blind therapy); and a 14-day post-treatment visit, 2 weeks after the last dose of investigational product. The primary hypothesis of the trial is that MK-8521 provides greater reduction in hemoglobin A1C relative to placebo after 12 weeks of once-daily administration in participants with T2DM with inadequate glycemic control on metformin monotherapy.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    176 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    MK-8521 300 μg
    Arm Type
    Experimental
    Arm Description
    Participants receive double-blind MK-8521 300 μg daily (QD), subcutaneously, over 12 weeks.
    Arm Title
    MK-8521 180 μg
    Arm Type
    Experimental
    Arm Description
    Participants receive double-blind MK-8521 180 μg QD, subcutaneously, over 12 weeks.
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Participants receive matching double-blind placebo, QD over 12 weeks.
    Arm Title
    Liraglutide 1.8 mg
    Arm Type
    Active Comparator
    Arm Description
    Participants receive open-label 1.8 mg of liraglutide, QD, subcutaneously, over 12 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    MK-8521
    Intervention Description
    Dose strengths: 180 μg QD administered subcutaneously. A 2-step dose escalation regimen [60 μg, 120 μg] over the first 2 weeks is used to achieve the final dose up to 180 μg.); 300 μg QD administered subcutaneously (A 3-step dose escalation regimen [60 μg, 120 μg, 180 μg] over the first 3 weeks is used to achieve the final dose up to 300 μg.
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Double dummy matching placebo for the MK-8521 and placebo arms: matching placebo for MK-8521 300 μg QD administered subcutaneously; matching placebo for MK-8521 180 μg QD administered subcutaneously. A dose escalation regimen consistent with that of the MK-8521 300 μg and 180 μg arms of the study; mock escalation will be performed over the first 2 to 3 weeks.
    Intervention Type
    Drug
    Intervention Name(s)
    Liraglutide
    Other Intervention Name(s)
    Victoza®
    Intervention Description
    Dose strength: 1.8 mg QD administered subcutaneously. A 2-step dose escalation regimen (0.6 mg, 1.2 mg) over the first 2 weeks is used to achieve the final dose up to 1.8 mg.
    Intervention Type
    Drug
    Intervention Name(s)
    Metformin
    Intervention Description
    Metformin immediate release (IR) or metformin extended release (XR) administered ≥1000 mg QD as background therapy
    Primary Outcome Measure Information:
    Title
    Change From Baseline in Hemoglobin A1C (A1C) at Week 12
    Description
    A1C is the percentage of hemoglobin that has glucose bound to it and is a blood marker used to report average blood glucose levels over prolonged periods of time. A1C is reported as a percentage (%). This change from baseline reflects the Week 12 A1C minus the Week 0 A1C.
    Time Frame
    Baseline and Week 12
    Title
    Number of Participants With an Adverse Event (AE)
    Description
    An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
    Time Frame
    Up to Week 14
    Title
    Number of Participants Who Discontinued Study Treatment Due to an AE
    Description
    An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
    Time Frame
    Up to Week 12
    Title
    Number of Participants With an AE of Symptomatic Hypoglycemia
    Description
    An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study. Hypoglycemia episodes are those with glucose values ≤70 mg/dL (3.9 mmol/L). Symptomatic hypoglycemia episodes were episodes with clinical symptoms reported by the investigator as hypoglycemia and classified as adverse events.
    Time Frame
    Up to Week 14
    Title
    Change From Baseline in Heart Rate at Week 12
    Description
    This change from baseline reflects the Week 12 heart rate minus the Week 0 heart rate.
    Time Frame
    Baseline and Week 12
    Secondary Outcome Measure Information:
    Title
    Change From Baseline in Body Weight at Week 12
    Description
    This change from baseline reflects the Week 12 body weight minus the Week 0 body weight.
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12
    Description
    This change from baseline reflects the Week 12 FPG minus the Week 0 FPG.
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Fasting Low Density Lipoprotein (LDL) Cholesterol at Week 12
    Description
    This change from baseline reflects the Week 12 fasting LDL cholesterol minus the Week 0 fasting LDL cholesterol.
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Fasting High Density Lipoprotein (HDL) Cholesterol at Week 12
    Description
    This change from baseline reflects the Week 12 fasting HDL cholesterol minus the Week 0 fasting HDL cholesterol.
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Fasting Triglycerides at Week 12
    Description
    This change from baseline reflects the Week 12 fasting triglycerides minus the Week 0 fasting triglycerides.
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Systolic Blood Pressure (SBP) at Week 12
    Description
    This change from baseline reflects the Week 12 SBP minus the Week 0 SBP.
    Time Frame
    Baseline and Week 12
    Title
    Change From Baseline in Diastolic Blood Pressure (DBP) at Week 12
    Description
    This change from baseline reflects the Week 12 DBP minus the Week 0 DBP.
    Time Frame
    Baseline and Week 12

    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: Have T2DM in accordance with American Diabetes Association guidelines Be on metformin monotherapy (>-1000 mg/day: metformin IR or metformin XR) for at least 12 weeks prior to study start with a hemoglobin A1C (A1C) >-7.5 and <-10.5% OR Be on dual therapy with metformin (>-1000 mg/day: dose stable for at least 4 weeks prior to study start) with an A1C of >-7.0% and <-10.0% and a second AHA and be willing to washout the second AHA. Allowable AHAs are dipeptidyl peptidase 4 (DPP-4 inhibitors), alpha-glucosidase inhibitors, sulfonylureas, and glinides. Have a body mass index (BMI) ≥23 kg/m^2 and ≤40 kg/m^2 Is a female who is not of reproductive potential, or is a female of reproductive potential who agrees to avoid becoming pregnant: while receiving study drug and for 14 days after the last dose of study drug Exclusion Criteria: Have a history of type 1 diabetes or a history of diabetic ketoacidosis Has a history of other specific types of diabetes (e.g., genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical-induced, and post-organ transplant) Has been treated with any gut-derived incretin hormone glucagon-like peptide 1 (GLP-1) receptor agonist (e.g. Byetta™, Victoza™ or investigational agents) within the last 6 months or has had GLP-1 receptor agonist discontinued due to gastrointestinal intolerance or lack of efficacy. Note: treatment with a GLP-1 receptor agonist that was discontinued >6 months prior to study start is not an exclusion if the GLP-1 receptor agonist was discontinued for reasons other than gastrointestinal intolerance or lack of efficacy. Has a history of clinically significant gastrointestinal disorder (including diabetic gastroparesis; irritable bowel disease; recurrent episodes of nausea, vomiting, diarrhea and abdominal pain) Has a history of clinically significant and active, immunological, respiratory, genitourinary or major neurological (including stroke, transient ischemic attack and chronic seizures) abnormalities or diseases Has a history of cardiovascular disease (including diabetic cardiomyopathy) or significant cardiac condition (including a history of myocardial infarction, stable or unstable angina, arterial revascularization, pathologic, symptomatic or sustained tachyarrhythmia [e.g. atrial fibrillation, sustained supraventricular tachycardia, symptomatic non-sustained supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, Wolf-Parkinson-White syndrome, congenital long QT syndrome, etc.]) or heart failure Has a family history of medullary carcinoma of the thyroid or multiple endocrine neoplasm type-2 syndrome Has active diabetic proliferative retinopathy or a history of maculopathy Has human immunodeficiency virus (HIV) Has a medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic hepatitis B or C (assessed by medical history), primary biliary cirrhosis, or active symptomatic gallbladder disease Is on a weight loss medication or has undergone bariatric surgery Has a history of acute or chronic pancreatitis of any etiology Had an event of severe hypoglycemia with neuroglycopenia in the past 12 months Has a positive urine pregnancy test Is pregnant or breast-feeding, or is planning to conceive during the trial, including 14 days following the last dose of investigational product Routinely consumes >1 alcoholic drinks per day or >7 alcoholic drinks per week or engages in binge drinking Routinely consumes ≥480mg /day caffeine in caffeinated beverages (1 cup of coffee contains approximately 120 mg of caffeine Is taking a beta blocker or medications with sympathomimetic activity (e.g. pseudoephedrine, phenylpropanolamine, etc.) Is currently a user of nicotine or nicotine containing products or does not agree to refrain from using nicotine during the trial, including 14 days following the last dose of investigational product Is currently a user of any illicit drugs (including any marijuana use) or has a history of drug (including alcohol) abuse within approximately 5 years has other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or blinded investigational product administration
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php

    Learn more about this trial

    A Preliminary Study of the Efficacy and Safety of MK-8521 for Type 2 Diabetes (MK-8521-004)

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