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Does Dapagliflozin Provide Additional Health Benefits To Dietary Counseling For Weight Loss?

Primary Purpose

Weight Loss

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Dapagliflozin Tablet
Placebo Tablet
Sponsored by
Christopher Bell
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Weight Loss

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Provision of informed consent prior to any study specific procedures.
  • Aged 18-65 years.
  • No known Type 2 Diabetes
  • Body mass index greater than or equal to 27.5 kg/m^2
  • Limited exercise participation (maximum of 3/week regularly scheduled activity sessions of < 30 minutes during the previous month).
  • Completion of a screening visit consisting of medical history, physical examination, and 12-lead electrocardiogram and blood pressure assessment at rest and during incremental exercise to volitional exhaustion (Note: Subjects with abnormal screening values may be eligible if the results are not clinically significant, as judged by the investigator or medical monitor)
  • Agree to abide by the study schedule and dietary restrictions and to return for the required assessments
  • Women of childbearing potential must have negative pregnancy test and be using acceptable contraception

Exclusion Criteria:

  • Evidence of clinically significant cardiovascular, respiratory, renal, hepatic, pulmonary, gastrointestinal, haematological, neurological, psychiatric, or other disease that may interfere with the objectives of the study or the safety of the subject, as judged by the investigator in agreement with the sponsor or medical monitor, have been hospitalized in the past 2 years as a result of these conditions, or are receiving pharmacological treatment for these conditions.
  • Use of prescription drugs (see exceptions listed below) or herbal preparations in the 2 weeks before study commencement. Prior use of medication or herbal preparations in the 4 weeks before study commencement that are intended for weight-loss and/or sold/marketed as weight-loss products or may alter metabolism. Permitted Prescription Drugs: Birth Control, Less than a 7 day short course of antibiotics. Note: Rifampicin is not permitted. Other medicines, such as those for gastroesophageal reflux disease, depression, and Over The Counter analgesics and allergy medications,may be allowed, but will be approved on a case-by-case basis.
  • Is currently enrolled in another clinical study for another investigational drug or has taken any other investigational drug within 30 days before the screening visit.
  • Habitual and/or recent use (within 2 years) of tobacco.
  • Being considered unsuitable for participation in this trial for any reason, as judged by the investigator or medical monitor.
  • History of serious hypersensitivity reaction to Dapagliflozin.
  • Severe renal impairment, end-stage renal disease, or dialysis.
  • Pregnant or breastfeeding individual.
  • Severe hepatic insufficiency and/or significant abnormal liver function defined as aspartate aminotransferase (AST) >3x upper limit of normal and/or alanine aminotransferase (ALT) >3x upper limit of normal.
  • Total bilirubin >2.0 mg/dL (34.2 umol/L).
  • Positive serologic evidence of current infectious liver disease including Hepatitis B viral antibody immunoglobulin M, Hepatitis B surface antigen and Hepatitis C virus antibody.
  • Estimated Glomerular Filtration Rate <60 mL/min/1.73 m^2 (calculated by Cockcroft-Gault formula).
  • History of bladder cancer.
  • Recent cardiovascular events in a patient, including any of the following: acute coronary syndrome within 2 months prior to enrolment; hospitalization for unstable angina or acute myocardial infarction within 2 months prior to enrolment; acute stroke or trans-ischemic attack within two months prior to enrolment; less than two months post coronary artery revascularization; congestive heart failure defined as New York Heart Association class IV, unstable or acute congestive heart failure. Note: eligible patients with congestive heart failure, especially those who are on diuretic therapy, should have careful monitoring of their volume status throughout the study.
  • Blood pressure at enrolment: Systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg.
  • Blood pressure at randomization: Systolic blood pressure ≥165 mmHg and/or diastolic blood pressure ≥100 mmHg
  • Individuals who, in the judgment of the medical monitor, may be at risk for dehydration.
  • Individuals with a history of fragility fracture, or bone mineral density values reflective of risk for fracture (DEXA Z-score <or= to -2 in pre-menopausal women, and men <50, and T-score <or= to -1) will not be permitted to participate.

Sites / Locations

  • Colorado State University, Dept. of Health and Exercise Science

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Dapagliflozin with dietary counseling

Placebo with dietary counseling

Arm Description

Daily oral administration of dapagliflozin tablet with dietary counseling to promote weight loss.

Daily oral administration of placebo tablet with dietary counseling to promote weight loss.

Outcomes

Primary Outcome Measures

Change From Baseline in Insulin Sensitivity at Week 12 Via Oral Glucose Tolerance Test
Insulin sensitivity was estimated by measuring circulating insulin concentrations after a 12 hour fast and after ingesting 75 g of glucose. Insulin was measured 0, 30, 60, 90 and 120 minutes after glucose ingestion. Time point 0 minutes is reported below.
Change From Baseline in Blood Pressure at Week 12
Blood pressure was measured with an automatic machine at baseline. Numbers are reported as systolic/diastolic
Change From Baseline in Perception of Satiety at Week 12
Participants answered a satiety questionnaire before liquid meal primer, immediately post liquid meal primer, 60 minutes post liquid primer, immediately post breakfast buffet, 60 minutes, 120 minutes and 180 minutes post breakfast buffet. Responses how full do you feel right now? for 60 minutes post liquid meal primer ingestion are reported below. This was determined by using a visual analog scale. The left side of the analog scale represents a null answer (e.g. How full do you feel right now)? Answer 0: Not full at all. The right side of the line represented the strongest answer in the opposite direction (e.g. How full to you feel right now)? Answer 100: Extremely full. The length of the line is 100 mm, thus the scale ranges for all answers were 0-100. All values are reported as values between 0 and 100. If the answers to the fullness questions increased, this represented a decreased desire to eat.
Change From Baseline in Perception of Hunger at Week 12
Participants answered a hunger questionnaire before liquid meal primer, immediately post liquid meal primer, 60 minutes post liquid primer, immediately post breakfast buffet, 60 minutes, 120 minutes and 180 minutes post breakfast buffet. Responses to how hungry do you feel right now? for 60 minutes post liquid meal primer ingestion are reported below. This was determined by using a visual analog scale. The left side of the analog scale represents a null answer (e.g. How hungry do you feel right now? Answer 0: Not hungry at all. The right side of the line represented the strongest answer in the opposite direction (e.g. How full to you feel right now)? Answer 100: Extremely hungry. The length of the line is 100 mm, thus the scale ranges for all answers were 0-100. All values are reported as values between 0 and 100. If the answers to the fullness questions increased, this represented an increased desire to eat.
Change From Baseline in Marker of Inflammation (High Sensitive C-reactive Protein) at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Marker of Inflammation (Tumor Necrosis Factor Alpha) at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Marker of Inflammation (Interleukin 6) at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Hunger Hormone Ghrelin at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Hunger Hormone Peptide Tyrosine Tyrosine at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Maker of Oxidative Stress (Oxidized Low Density Lipoprotein) at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Maker of Oxidative Stress (Low Density Thiobarbituric Acid Reactive Substances) at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Satiety Hormone Leptin at Week 12
Will be analyzed using a commercially available biochemical assay.
Change From Baseline in Satiety Hormone Insulin at Week 12
Will be analyzed using a commercially available biochemical assay.

Secondary Outcome Measures

Full Information

First Posted
June 6, 2017
Last Updated
January 31, 2020
Sponsor
Christopher Bell
Collaborators
AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT03180489
Brief Title
Does Dapagliflozin Provide Additional Health Benefits To Dietary Counseling For Weight Loss?
Official Title
Does Dapagliflozin Provide Additional Health Benefits To Dietary Counseling For Weight Loss?
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
May 3, 2017 (Actual)
Primary Completion Date
December 21, 2018 (Actual)
Study Completion Date
December 21, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Christopher Bell
Collaborators
AstraZeneca

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Dapagliflozin is a medicine to treat diabetes. Its mechanism of action is via sodium-glucose co-transporter 2 (SGLT2) inhibition. In adults with diabetes, use of sodium-glucose co-transporter 2 inhibitors is associated with moderate weight (fat) loss, in addition to other health benefits, including decreased blood pressure, decreased inflammation, and decreased oxidative stress. It is unclear as to whether these health benefits are due to SGLT2 inhibition per se, or as a secondary effect of weight loss. We wish to compare the health benefits of dietary counseling for weight loss with and without concomitant use of an SGLT2 inhibitor.
Detailed Description
This is a randomized, prospective, placebo-controlled, double blind, repeated measures study. 50 overweight/obese adults (body mas index > 27.5 kg/m2) will be recruited for participation and randomly assigned to one of two 12 week treatments: (1) daily oral administration of Dapagliflozin with dietary counseling to promote weight loss; or, (2) daily oral administration of a placebo with dietary counseling to promote weight loss.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Weight Loss

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
62 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dapagliflozin with dietary counseling
Arm Type
Experimental
Arm Description
Daily oral administration of dapagliflozin tablet with dietary counseling to promote weight loss.
Arm Title
Placebo with dietary counseling
Arm Type
Placebo Comparator
Arm Description
Daily oral administration of placebo tablet with dietary counseling to promote weight loss.
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin Tablet
Other Intervention Name(s)
Farxiga
Intervention Description
Daily oral administration of dapagliflozin with dietary counseling to promote weight loss. Dapagliflozin 5 mg tablet will begin as one tablet per day for the first 14-days. In the absence of complications, side effects, or unfavorable reactions, the dose will then increase to two tablets for the remainder of the study.
Intervention Type
Drug
Intervention Name(s)
Placebo Tablet
Intervention Description
Daily administration of placebo tablet with dietary counseling to promote weight loss. Matching placebo for dapagliflozin 5 mg tablet will begin as one tablet per day for the first 14-days. In the absence of complications, side effects, or unfavorable reactions, the dose will then increase to two tablets for the remainder of the study.
Primary Outcome Measure Information:
Title
Change From Baseline in Insulin Sensitivity at Week 12 Via Oral Glucose Tolerance Test
Description
Insulin sensitivity was estimated by measuring circulating insulin concentrations after a 12 hour fast and after ingesting 75 g of glucose. Insulin was measured 0, 30, 60, 90 and 120 minutes after glucose ingestion. Time point 0 minutes is reported below.
Time Frame
Baseline, 12 weeks
Title
Change From Baseline in Blood Pressure at Week 12
Description
Blood pressure was measured with an automatic machine at baseline. Numbers are reported as systolic/diastolic
Time Frame
Baseline, 12 weeks
Title
Change From Baseline in Perception of Satiety at Week 12
Description
Participants answered a satiety questionnaire before liquid meal primer, immediately post liquid meal primer, 60 minutes post liquid primer, immediately post breakfast buffet, 60 minutes, 120 minutes and 180 minutes post breakfast buffet. Responses how full do you feel right now? for 60 minutes post liquid meal primer ingestion are reported below. This was determined by using a visual analog scale. The left side of the analog scale represents a null answer (e.g. How full do you feel right now)? Answer 0: Not full at all. The right side of the line represented the strongest answer in the opposite direction (e.g. How full to you feel right now)? Answer 100: Extremely full. The length of the line is 100 mm, thus the scale ranges for all answers were 0-100. All values are reported as values between 0 and 100. If the answers to the fullness questions increased, this represented a decreased desire to eat.
Time Frame
Baseline, 12 weeks
Title
Change From Baseline in Perception of Hunger at Week 12
Description
Participants answered a hunger questionnaire before liquid meal primer, immediately post liquid meal primer, 60 minutes post liquid primer, immediately post breakfast buffet, 60 minutes, 120 minutes and 180 minutes post breakfast buffet. Responses to how hungry do you feel right now? for 60 minutes post liquid meal primer ingestion are reported below. This was determined by using a visual analog scale. The left side of the analog scale represents a null answer (e.g. How hungry do you feel right now? Answer 0: Not hungry at all. The right side of the line represented the strongest answer in the opposite direction (e.g. How full to you feel right now)? Answer 100: Extremely hungry. The length of the line is 100 mm, thus the scale ranges for all answers were 0-100. All values are reported as values between 0 and 100. If the answers to the fullness questions increased, this represented an increased desire to eat.
Time Frame
Baseline, 12 weeks
Title
Change From Baseline in Marker of Inflammation (High Sensitive C-reactive Protein) at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
Data not collected
Title
Change From Baseline in Marker of Inflammation (Tumor Necrosis Factor Alpha) at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
Data not collected
Title
Change From Baseline in Marker of Inflammation (Interleukin 6) at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
data not collected
Title
Change From Baseline in Hunger Hormone Ghrelin at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
data not collected
Title
Change From Baseline in Hunger Hormone Peptide Tyrosine Tyrosine at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
data not collected
Title
Change From Baseline in Maker of Oxidative Stress (Oxidized Low Density Lipoprotein) at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
Data not collected
Title
Change From Baseline in Maker of Oxidative Stress (Low Density Thiobarbituric Acid Reactive Substances) at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
Data not collected
Title
Change From Baseline in Satiety Hormone Leptin at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
Data not collected
Title
Change From Baseline in Satiety Hormone Insulin at Week 12
Description
Will be analyzed using a commercially available biochemical assay.
Time Frame
Data not collected

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Provision of informed consent prior to any study specific procedures. Aged 18-65 years. No known Type 2 Diabetes Body mass index greater than or equal to 27.5 kg/m^2 Limited exercise participation (maximum of 3/week regularly scheduled activity sessions of < 30 minutes during the previous month). Completion of a screening visit consisting of medical history, physical examination, and 12-lead electrocardiogram and blood pressure assessment at rest and during incremental exercise to volitional exhaustion (Note: Subjects with abnormal screening values may be eligible if the results are not clinically significant, as judged by the investigator or medical monitor) Agree to abide by the study schedule and dietary restrictions and to return for the required assessments Women of childbearing potential must have negative pregnancy test and be using acceptable contraception Exclusion Criteria: Evidence of clinically significant cardiovascular, respiratory, renal, hepatic, pulmonary, gastrointestinal, haematological, neurological, psychiatric, or other disease that may interfere with the objectives of the study or the safety of the subject, as judged by the investigator in agreement with the sponsor or medical monitor, have been hospitalized in the past 2 years as a result of these conditions, or are receiving pharmacological treatment for these conditions. Use of prescription drugs (see exceptions listed below) or herbal preparations in the 2 weeks before study commencement. Prior use of medication or herbal preparations in the 4 weeks before study commencement that are intended for weight-loss and/or sold/marketed as weight-loss products or may alter metabolism. Permitted Prescription Drugs: Birth Control, Less than a 7 day short course of antibiotics. Note: Rifampicin is not permitted. Other medicines, such as those for gastroesophageal reflux disease, depression, and Over The Counter analgesics and allergy medications,may be allowed, but will be approved on a case-by-case basis. Is currently enrolled in another clinical study for another investigational drug or has taken any other investigational drug within 30 days before the screening visit. Habitual and/or recent use (within 2 years) of tobacco. Being considered unsuitable for participation in this trial for any reason, as judged by the investigator or medical monitor. History of serious hypersensitivity reaction to Dapagliflozin. Severe renal impairment, end-stage renal disease, or dialysis. Pregnant or breastfeeding individual. Severe hepatic insufficiency and/or significant abnormal liver function defined as aspartate aminotransferase (AST) >3x upper limit of normal and/or alanine aminotransferase (ALT) >3x upper limit of normal. Total bilirubin >2.0 mg/dL (34.2 umol/L). Positive serologic evidence of current infectious liver disease including Hepatitis B viral antibody immunoglobulin M, Hepatitis B surface antigen and Hepatitis C virus antibody. Estimated Glomerular Filtration Rate <60 mL/min/1.73 m^2 (calculated by Cockcroft-Gault formula). History of bladder cancer. Recent cardiovascular events in a patient, including any of the following: acute coronary syndrome within 2 months prior to enrolment; hospitalization for unstable angina or acute myocardial infarction within 2 months prior to enrolment; acute stroke or trans-ischemic attack within two months prior to enrolment; less than two months post coronary artery revascularization; congestive heart failure defined as New York Heart Association class IV, unstable or acute congestive heart failure. Note: eligible patients with congestive heart failure, especially those who are on diuretic therapy, should have careful monitoring of their volume status throughout the study. Blood pressure at enrolment: Systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg. Blood pressure at randomization: Systolic blood pressure ≥165 mmHg and/or diastolic blood pressure ≥100 mmHg Individuals who, in the judgment of the medical monitor, may be at risk for dehydration. Individuals with a history of fragility fracture, or bone mineral density values reflective of risk for fracture (DEXA Z-score <or= to -2 in pre-menopausal women, and men <50, and T-score <or= to -1) will not be permitted to participate.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christopher Bell, Ph.D.
Organizational Affiliation
Colorado State University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Christopher Melby, Dr.P.H.
Organizational Affiliation
Colorado State University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Colorado State University, Dept. of Health and Exercise Science
City
Fort Collins
State/Province
Colorado
ZIP/Postal Code
80523-1582
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Does Dapagliflozin Provide Additional Health Benefits To Dietary Counseling For Weight Loss?

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