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Dapagliflozin + Saxagliptin in a Basal-bolus Insulin Treatment (DapaSaxaBBIT)

Primary Purpose

Type 2 Diabetes

Status
Terminated
Phase
Phase 4
Locations
Germany
Study Type
Interventional
Intervention
Dapagliflozin 10 mg + Saxagliptin 5 mg
Placebo 1 10 mg + Placebo 2 5 mg
Sponsored by
University Hospital Tuebingen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Type 2 diabetes
  • Age 18 - 75 years
  • Anti-GAD antibodies negative (Glutamic Acid Decarboxylase)
  • C-peptide levels ≥ 1.5 ng/mL
  • Fasting blood glucose > 126 mg/dl
  • HbA1c 8.0 - 10.5 %
  • BMI 25.0 - 45.0 kg/m2
  • Previous therapy with BBIT (basal insulin and at least once daily bolus insulin)

Exclusion Criteria:

  • Use of any oral antidiabetic treatment except for metformin (i.e., sulphonylureas, DPP-IV inhibitors, thiazolidinediones, SGLT-2 inhibitors (Sodium dependent glucose transporter) or GLP-1 analogues (glucagone like peptide) within the last three months prior to Screening
  • Repeated episodes of severe hypoglycaemia within the last six months prior to Screening
  • History of diabetic ketoacidosis, precoma diabetica, or diabetic coma
  • Treatment with any other investigational drug within the last three months before Screening
  • Acute infections within the last four weeks prior to Screening
  • Recurrent urogenital infections
  • History of pancreatitis
  • Anamnestic history of hypersensitivity to the study drugs or to drugs with similar chemical structures
  • History of severe or multiple allergies
  • Concomitant participation in other clinical trials
  • Type 1 diabetes
  • Cardiovascular disease Clinically relevant ventricular tachycardia or ventricular fibrillation, 3rd degree AV block or Torsades de Pointes or treatment with antiarrhythmic drugs. Percutaneous coronary intervention within the past 6 months. Any of the following within the past 6 months: myocardial infarction (MI), coronary artery bypass surgery; unstable angina; or stroke.

Uncontrolled unstable angina pectoris or history of pericarditis, myocarditis, endocarditis. Congestive heart failure NYHA (New York Heart Association) class III or IV. Increased risk of thromboembolism, e.g. subjects with a history of deep leg vein thrombosis or family history of deep leg vein thrombosis, as judged by the Investigator.

  • Malignancy including leukemia and lymphoma within the last 5y.
  • Liver disease such as cirrhosis or chronic active hepatitis.
  • Significant renal dysfunction (see also exclusion criteria laboratory abnormalities).
  • State after kidney transplantation
  • Endocrine disease:

Acromegaly or treatment with growth hormone or similar drugs. Chronic oral or parenteral corticosteroid treatment (>7 consecutive days of treatment) within 8 weeks; thyroid hormone replacement is allowed if the dosage has been stable for at least 3 months and the TSH is within normal limits

•Any of the following significant laboratory abnormalities: eGFR (as calculated by the MDRD equation) < 60 ml/min at Screening Fasting triglycerides >700 mg/dl (>7.9 mmol/l)

  • Systolic blood pressure outside the range of 100-160 mmHg or diastolic blood pressure above 95 mmHg at Screening
  • History of active substance abuse (including alcohol > 40g/day) within the past 2 years.
  • Pregnancy or childbearing potential without adequate contraception
  • Present therapy with systemic steroids
  • Presence of psychiatric disorder or intake of anti-depressive or anti-psychotic agents with the exception of benzodiazepines and SSRIs/SNRI´s (selective serotonin reuptake inhibitor)
  • Potentially unreliable subjects, and those judged by the investigator to be unsuitable for the study.
  • Contraindications for Magnetic resonance (MR) scanning such as persons with cardiac pacemaker and implants out of metal or claustrophobia

Sites / Locations

  • University Hospital Tübingen

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Verum

Placebo

Arm Description

Dapagliflozin 10 mg + Saxagliptin 5 mg, each once daily, for 24 weeks

Placebo 1 10 mg + Placebo 2 5 mg, each once daily, for 24 weeks

Outcomes

Primary Outcome Measures

Percentage of subjects achieving a HbA1c ≤ 7.5% and having a reversal from a BBIT to a BOT regimen
Percentage of subjects achieving a HbA1c ≤ 7.5% and having a reversal from a BBIT to a BOT regimen with treatment of dapagliflozin/saxagliptin or placebo

Secondary Outcome Measures

changes in HbA1c between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in hypoglycaemic events between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in fasting blood glucose between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in daily insulin dose between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in bodyweight between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in body fat content between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in body fat distribution between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in liver fat content between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in intra-nasal insulin-induced brain fMR (functional magnetic resonance) imaging results between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in blood pressure between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in the blood lipid profile between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in microalbuminuria between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in well being and disease perception between groups
treatment of dapagliflozin/saxagliptin or placebo
changes in fear of hypoglycemia between groups
treatment of dapagliflozin/saxagliptin or placebo

Full Information

First Posted
October 28, 2016
Last Updated
February 7, 2020
Sponsor
University Hospital Tuebingen
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1. Study Identification

Unique Protocol Identification Number
NCT02965443
Brief Title
Dapagliflozin + Saxagliptin in a Basal-bolus Insulin Treatment
Acronym
DapaSaxaBBIT
Official Title
Effectiveness of Dapagliflozin + Saxagliptin to Revert From a Basal-bolus Insulin Treatment (BBIT) Regimen to a Basal Supported Oral Therapy (BOT) in Patients With Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Terminated
Why Stopped
Low patient recruitment
Study Start Date
February 2, 2018 (Actual)
Primary Completion Date
February 3, 2020 (Actual)
Study Completion Date
February 3, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital Tuebingen

4. Oversight

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

5. Study Description

Brief Summary
To perform a study that investigates the effectiveness of adding the SGLT2 inhibitor dapagliflozin + the dipeptidyl peptidase 4 (DPP-4) inhibitor saxagliptin vs placebo to revert from a BBIT regimen to a BOT regimen in patients with type 2 diabetes.
Detailed Description
This will be a phase IV study investigating the efficacy and safety of adding the SGLT2 inhibitor dapagliflozin together wih the DPP-4 inhibitor saxagliptin to an intensified insulin treatment regimen. Because BOT is superior to BBIT in respect to the development of bodyweight, hypoglycaemia and patient satisfaction in type 2 diabetes, we hypothesize that the combined addition of the SGLT2 inhibitor dapagliflozin with the DPP-4 inhibitor saxagliptin is effective and safe to revert from a BBIT to a BOT treatment regimen.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Verum
Arm Type
Active Comparator
Arm Description
Dapagliflozin 10 mg + Saxagliptin 5 mg, each once daily, for 24 weeks
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo 1 10 mg + Placebo 2 5 mg, each once daily, for 24 weeks
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin 10 mg + Saxagliptin 5 mg
Other Intervention Name(s)
Forxiga + Onglyza
Intervention Description
24 weeks intervention with Dapagliflozin 10 mg + Saxagliptin 5 mg
Intervention Type
Drug
Intervention Name(s)
Placebo 1 10 mg + Placebo 2 5 mg
Other Intervention Name(s)
Placebo 1 + Placebo 2
Intervention Description
24 weeks intervention with Placebo 1 10 mg + Placebo 2 5 mg
Primary Outcome Measure Information:
Title
Percentage of subjects achieving a HbA1c ≤ 7.5% and having a reversal from a BBIT to a BOT regimen
Description
Percentage of subjects achieving a HbA1c ≤ 7.5% and having a reversal from a BBIT to a BOT regimen with treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
changes in HbA1c between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in hypoglycaemic events between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in fasting blood glucose between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in daily insulin dose between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in bodyweight between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in body fat content between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in body fat distribution between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in liver fat content between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in intra-nasal insulin-induced brain fMR (functional magnetic resonance) imaging results between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in blood pressure between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in the blood lipid profile between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in microalbuminuria between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in well being and disease perception between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in fear of hypoglycemia between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Other Pre-specified Outcome Measures:
Title
changes in fetuin-A levels between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in adiponectin levels between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in (Interleucin 1?ßß) IL-1ß levels between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in Il-6 levels between groups
Description
treatment of dapagliflozin/saxagliptinn or placebo
Time Frame
24 weeks
Title
differences in adverse events between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
differences in severe adverse events between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
differences in heart rate between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
differences in ECG parameters between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks
Title
changes in clinical chemistry/haematology parameters between groups
Description
treatment of dapagliflozin/saxagliptin or placebo
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Type 2 diabetes Age 18 - 75 years Anti-GAD antibodies negative (Glutamic Acid Decarboxylase) C-peptide levels ≥ 1.5 ng/mL Fasting blood glucose > 126 mg/dl HbA1c 8.0 - 10.5 % BMI 25.0 - 45.0 kg/m2 Previous therapy with BBIT (basal insulin and at least once daily bolus insulin) Exclusion Criteria: Use of any oral antidiabetic treatment except for metformin (i.e., sulphonylureas, DPP-IV inhibitors, thiazolidinediones, SGLT-2 inhibitors (Sodium dependent glucose transporter) or GLP-1 analogues (glucagone like peptide) within the last three months prior to Screening Repeated episodes of severe hypoglycaemia within the last six months prior to Screening History of diabetic ketoacidosis, precoma diabetica, or diabetic coma Treatment with any other investigational drug within the last three months before Screening Acute infections within the last four weeks prior to Screening Recurrent urogenital infections History of pancreatitis Anamnestic history of hypersensitivity to the study drugs or to drugs with similar chemical structures History of severe or multiple allergies Concomitant participation in other clinical trials Type 1 diabetes Cardiovascular disease Clinically relevant ventricular tachycardia or ventricular fibrillation, 3rd degree AV block or Torsades de Pointes or treatment with antiarrhythmic drugs. Percutaneous coronary intervention within the past 6 months. Any of the following within the past 6 months: myocardial infarction (MI), coronary artery bypass surgery; unstable angina; or stroke. Uncontrolled unstable angina pectoris or history of pericarditis, myocarditis, endocarditis. Congestive heart failure NYHA (New York Heart Association) class III or IV. Increased risk of thromboembolism, e.g. subjects with a history of deep leg vein thrombosis or family history of deep leg vein thrombosis, as judged by the Investigator. Malignancy including leukemia and lymphoma within the last 5y. Liver disease such as cirrhosis or chronic active hepatitis. Significant renal dysfunction (see also exclusion criteria laboratory abnormalities). State after kidney transplantation Endocrine disease: Acromegaly or treatment with growth hormone or similar drugs. Chronic oral or parenteral corticosteroid treatment (>7 consecutive days of treatment) within 8 weeks; thyroid hormone replacement is allowed if the dosage has been stable for at least 3 months and the TSH is within normal limits •Any of the following significant laboratory abnormalities: eGFR (as calculated by the MDRD equation) < 60 ml/min at Screening Fasting triglycerides >700 mg/dl (>7.9 mmol/l) Systolic blood pressure outside the range of 100-160 mmHg or diastolic blood pressure above 95 mmHg at Screening History of active substance abuse (including alcohol > 40g/day) within the past 2 years. Pregnancy or childbearing potential without adequate contraception Present therapy with systemic steroids Presence of psychiatric disorder or intake of anti-depressive or anti-psychotic agents with the exception of benzodiazepines and SSRIs/SNRI´s (selective serotonin reuptake inhibitor) Potentially unreliable subjects, and those judged by the investigator to be unsuitable for the study. Contraindications for Magnetic resonance (MR) scanning such as persons with cardiac pacemaker and implants out of metal or claustrophobia
Facility Information:
Facility Name
University Hospital Tübingen
City
Tübingen
ZIP/Postal Code
72076
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

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Dapagliflozin + Saxagliptin in a Basal-bolus Insulin Treatment

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