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Assessing the Effect of Met DR on Plasma Glucose and PK in Subjects With T2DM

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Met DR
Sponsored by
Elcelyx Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Type 2 Diabetes Mellitus

Eligibility Criteria

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

Inclusion Criteria:

  1. 18 to 70 (inclusive) years old at Visit 1 (Screening)
  2. Was diagnosed with type 2 diabetes mellitus with

    • HbA1c between 6.0 to 9.5% (inclusive) for subjects managing their diabetes with:

      i. Diet and exercise alone, or ii. A stable regimen (minimum of 2 months at Visit 1) of metformin alone, or iii. A stable regimen (minimum of 2 months at Visit 1) of DPP-4 inhibitor alone OR

    • HbA1c between 6.0 to 8.5% (inclusive) for subjects managing their diabetes with a stable (minimum of 2 months at Visit 1) combination regimen of metformin and DPP-4 inhibitors
  3. Had normal renal function with an estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m^2 based on the Modification of Diet in Renal Disease (MDRD) equation
  4. Body mass index (BMI) of 25.0 to 40.0 kg/m^2 (inclusive) at Screening
  5. Male, or if female and met all of the following criteria:

    • Not breastfeeding
    • Negative pregnancy test result (human chorionic gonadotropin, beta subunit) at Visit 1 (Screening) (not applicable to hysterectomized females)
    • Surgically sterile, postmenopausal, or if of childbearing potential, practiced and was willing to continue to practice appropriate birth control during the entire duration of the study
  6. Had a physical examination with no clinically significant abnormalities as judged by the investigator
  7. Ability to understand and willingness to adhere to protocol requirements
  8. If on chronic thyroid pharmacologic therapy, the dose must have been stable for at least 3 months prior to Visit 1 (Screening), and must have thyroid-stimulating hormone (TSH) test result in normal range at Visit 1 (Screening)

Exclusion Criteria:

  1. Had a clinically significant medical condition that could potentially affect study participation and/or personal well-being, as judged by the investigator, including but not limited to the following conditions:

    • Hepatic disease
    • Renal disease
    • Gastrointestinal disease
    • Endocrine disorder except diabetes
    • Cardiovascular disease
    • Central nervous system diseases
    • Psychiatric or neurological disorders
    • Organ transplantation
    • Chronic or acute infection
    • Orthostatic hypotension, fainting spells or blackouts
    • Allergy or hypersensitivity
  2. Had any chronic disease requiring medication that was adjusted in the past 90 days (subjects could take acute intermittent over-the-counter medications such as Tylenol, if needed)
  3. Had any drug treatment that affects gastric pH (prescription or over-the-counter), including any antacids or medications such as Rolaids or Pepcid within 2 days of Visit 1 (Screening)
  4. Had major surgery of any kind within 6 months of Visit 1 (Screening)
  5. Had received a blood transfusion within 6 months of Visit 1 (Screening)
  6. Had a history of >5 kg weight change within 3 months of Visit 1 (Screening)
  7. Had clinical laboratory test (clinical chemistry, hematology, or urinalysis) abnormalities other than those expected in subjects with type 2 diabetes and judged by the investigator to be clinically significant at Visit 1 (Screening)
  8. Had a physical, psychological, or historical finding that, in the investigator's opinion, would make the subject unsuitable for the study
  9. Abused drugs or alcohol or had a history of abuse that in the investigator's opinion would cause the individual to be noncompliant with study procedures
  10. Had donated blood within 3 months of the date of the first dose of randomized study medication, or was planning to donate blood during the study
  11. Used insulin within 3 months of Visit 1 (Screening)
  12. Had received GLP-1 receptor agonists and/or thiazolidinedione treatment within 6 months of Visit 1 (Screening)
  13. Had known intolerance to metformin
  14. Had received any investigational drug within 2 months (or five half-lives of the investigational drug, whichever was greater) of Visit 1 (Screening)
  15. Had known allergies or hypersensitivity to any component of study treatment
  16. Was employed by Elcelyx Therapeutics, Inc. (that is an employee, temporary contract worker, or designee of the company)
  17. Smoked more than 10 cigarettes per day, 3 cigars per day, 3 pipes per day, used more than 1 can of smokeless tobacco per week, or used a combination of tobacco products that approximate nicotine doses equivalent to 10 cigarettes per day

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Active Comparator

    Experimental

    Experimental

    Arm Label

    500 mg Met DR BID

    1000 mg Met DR qAM

    1000 mg Met DR qPM

    Arm Description

    Two doses of 500 mg metformin delayed-release

    One dose of 1000 mg metformin delayed-release in the morning

    One dose of 1000 mg metformin delayed-release in the evening

    Outcomes

    Primary Outcome Measures

    AUC (0-24) of Plasma Metformin
    AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    Cmax of Plasma Metformin
    Cmax = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    AUC (0-24) of Plasma Glucose
    AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    Rmax (0-24) of Plasma Glucose
    Rmax (0-24) = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.

    Secondary Outcome Measures

    Full Information

    First Posted
    March 4, 2013
    Last Updated
    October 19, 2016
    Sponsor
    Elcelyx Therapeutics, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01804842
    Brief Title
    Assessing the Effect of Met DR on Plasma Glucose and PK in Subjects With T2DM
    Official Title
    A Randomized, Crossover Study Assessing the Effect of EFB0027 on Plasma Glucose and Pharmacokinetics in Subjects With Type 2 Diabetes Mellitus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2016
    Overall Recruitment Status
    Completed
    Study Start Date
    December 2012 (undefined)
    Primary Completion Date
    April 2013 (Actual)
    Study Completion Date
    April 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Elcelyx Therapeutics, Inc.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study compared the effects of delayed-release metformin (Met DR, EFB0027) administered once daily in the morning (qAM), administered once daily in the evening (qPM), and administered twice daily (BID) on circulating glucose concentrations and metformin pharmacokinetics (PK) in subjects with type 2 diabetes mellitus (T2DM).

    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
    Basic Science
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Crossover Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    26 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    500 mg Met DR BID
    Arm Type
    Active Comparator
    Arm Description
    Two doses of 500 mg metformin delayed-release
    Arm Title
    1000 mg Met DR qAM
    Arm Type
    Experimental
    Arm Description
    One dose of 1000 mg metformin delayed-release in the morning
    Arm Title
    1000 mg Met DR qPM
    Arm Type
    Experimental
    Arm Description
    One dose of 1000 mg metformin delayed-release in the evening
    Intervention Type
    Drug
    Intervention Name(s)
    Met DR
    Other Intervention Name(s)
    EFB0027
    Intervention Description
    metformin delayed-release tablets
    Primary Outcome Measure Information:
    Title
    AUC (0-24) of Plasma Metformin
    Description
    AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    Time Frame
    Times points to create the AUC (0-24) were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner.
    Title
    Cmax of Plasma Metformin
    Description
    Cmax = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    Time Frame
    Times points to determine Cmax were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner.
    Title
    AUC (0-24) of Plasma Glucose
    Description
    AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    Time Frame
    Times points to create the AUC (0-24) were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.75, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 18.5, 19, 19.5, 20, 21, 22, 23, and 24 hours relative to the time of the standardized dinner.
    Title
    Rmax (0-24) of Plasma Glucose
    Description
    Rmax (0-24) = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C.
    Time Frame
    Times points to determine Rmax were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.75, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 18.5, 19, 19.5, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: 18 to 70 (inclusive) years old at Visit 1 (Screening) Was diagnosed with type 2 diabetes mellitus with HbA1c between 6.0 to 9.5% (inclusive) for subjects managing their diabetes with: i. Diet and exercise alone, or ii. A stable regimen (minimum of 2 months at Visit 1) of metformin alone, or iii. A stable regimen (minimum of 2 months at Visit 1) of DPP-4 inhibitor alone OR HbA1c between 6.0 to 8.5% (inclusive) for subjects managing their diabetes with a stable (minimum of 2 months at Visit 1) combination regimen of metformin and DPP-4 inhibitors Had normal renal function with an estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m^2 based on the Modification of Diet in Renal Disease (MDRD) equation Body mass index (BMI) of 25.0 to 40.0 kg/m^2 (inclusive) at Screening Male, or if female and met all of the following criteria: Not breastfeeding Negative pregnancy test result (human chorionic gonadotropin, beta subunit) at Visit 1 (Screening) (not applicable to hysterectomized females) Surgically sterile, postmenopausal, or if of childbearing potential, practiced and was willing to continue to practice appropriate birth control during the entire duration of the study Had a physical examination with no clinically significant abnormalities as judged by the investigator Ability to understand and willingness to adhere to protocol requirements If on chronic thyroid pharmacologic therapy, the dose must have been stable for at least 3 months prior to Visit 1 (Screening), and must have thyroid-stimulating hormone (TSH) test result in normal range at Visit 1 (Screening) Exclusion Criteria: Had a clinically significant medical condition that could potentially affect study participation and/or personal well-being, as judged by the investigator, including but not limited to the following conditions: Hepatic disease Renal disease Gastrointestinal disease Endocrine disorder except diabetes Cardiovascular disease Central nervous system diseases Psychiatric or neurological disorders Organ transplantation Chronic or acute infection Orthostatic hypotension, fainting spells or blackouts Allergy or hypersensitivity Had any chronic disease requiring medication that was adjusted in the past 90 days (subjects could take acute intermittent over-the-counter medications such as Tylenol, if needed) Had any drug treatment that affects gastric pH (prescription or over-the-counter), including any antacids or medications such as Rolaids or Pepcid within 2 days of Visit 1 (Screening) Had major surgery of any kind within 6 months of Visit 1 (Screening) Had received a blood transfusion within 6 months of Visit 1 (Screening) Had a history of >5 kg weight change within 3 months of Visit 1 (Screening) Had clinical laboratory test (clinical chemistry, hematology, or urinalysis) abnormalities other than those expected in subjects with type 2 diabetes and judged by the investigator to be clinically significant at Visit 1 (Screening) Had a physical, psychological, or historical finding that, in the investigator's opinion, would make the subject unsuitable for the study Abused drugs or alcohol or had a history of abuse that in the investigator's opinion would cause the individual to be noncompliant with study procedures Had donated blood within 3 months of the date of the first dose of randomized study medication, or was planning to donate blood during the study Used insulin within 3 months of Visit 1 (Screening) Had received GLP-1 receptor agonists and/or thiazolidinedione treatment within 6 months of Visit 1 (Screening) Had known intolerance to metformin Had received any investigational drug within 2 months (or five half-lives of the investigational drug, whichever was greater) of Visit 1 (Screening) Had known allergies or hypersensitivity to any component of study treatment Was employed by Elcelyx Therapeutics, Inc. (that is an employee, temporary contract worker, or designee of the company) Smoked more than 10 cigarettes per day, 3 cigars per day, 3 pipes per day, used more than 1 can of smokeless tobacco per week, or used a combination of tobacco products that approximate nicotine doses equivalent to 10 cigarettes per day
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Danielle Armas, MD
    Organizational Affiliation
    Celerion
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    26285584
    Citation
    Buse JB, DeFronzo RA, Rosenstock J, Kim T, Burns C, Skare S, Baron A, Fineman M. The Primary Glucose-Lowering Effect of Metformin Resides in the Gut, Not the Circulation: Results From Short-term Pharmacokinetic and 12-Week Dose-Ranging Studies. Diabetes Care. 2016 Feb;39(2):198-205. doi: 10.2337/dc15-0488. Epub 2015 Aug 18.
    Results Reference
    background
    PubMed Identifier
    27216492
    Citation
    DeFronzo RA, Buse JB, Kim T, Burns C, Skare S, Baron A, Fineman M. Once-daily delayed-release metformin lowers plasma glucose and enhances fasting and postprandial GLP-1 and PYY: results from two randomised trials. Diabetologia. 2016 Aug;59(8):1645-54. doi: 10.1007/s00125-016-3992-6. Epub 2016 May 23.
    Results Reference
    background

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    Assessing the Effect of Met DR on Plasma Glucose and PK in Subjects With T2DM

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