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Efficacy of Pioglitazone in Participants With Inadequately Controlled Type 2 Diabetes Mellitus Treated With Stable Triple Oral Therapy (ADD)

Primary Purpose

Type II Diabetes Mellitus

Status
Completed
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Pioglitazone
Metformin
Sulfonylurea
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type II Diabetes Mellitus focused on measuring Drug therapy

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

Participants meeting the following criteria will be considered for inclusion in the study:

  1. Institutional Review Board (IRB)-approved written informed consent form (ICF) must be obtained from the participant or legally authorized representative prior to any trial related procedure (including withdrawal of prohibited medication, if applicable).
  2. Participants with a history of clinical diagnosis of established type 2 diabetes mellitus defined by the American Diabetes Association (ADA) criteria 2012.
  3. Male or female between 18 and 80 years of age.
  4. Participants with stable triple oral therapy of metformin + sulfonylurea + pioglitazone (ACTOS) 15 mg or ACTOSMET(Pioglitazone 15mg/Metformin 850mg) and sulfonylurea for at least 12 weeks at the screening visit.
  5. Participants with glycosylated hemoglobin (HbA1c) ≥7.0% at the screening visit.
  6. Participants with C-peptide ≥1.0 ng/mL at the screening visit.
  7. Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from screening throughout the duration of the study, up to 30 days after the last dose of the study medication.

Exclusion Criteria

Participants meeting any of the following criteria will be excluded from enrollment:

  1. Participants with type 1 diabetes mellitus or secondary forms of diabetes.
  2. Participants who have been treated with insulin for ≥7 days within 3 months prior to the screening visit.
  3. Participants with a history of bladder cancer or participants with active bladder cancer.
  4. Participants with a history of acute diabetic complications such as diabetic ketoacidosis.
  5. Participants with a history of acute or chronic metabolic acidosis, including diabetic ketoacidosis.
  6. Participants with unstable or rapidly progressive diabetic retinopathy, nephropathy (estimated glomerular filtration rate [eGFR] <60mL/min/1.73m2).
  7. Participants with cardiac insufficiency (e.g., a myocardial infarction, a coronary angioplasty or bypass graft, unstable angina, transient ischemic attacks, or a documented cerebrovascular accident within 6 months prior to the screening visit).
  8. Participants with cardiac failure or history of cardiac failure (New York Heart Association [NYHA] Stages 3 to 4).
  9. Participants with a serum alanine transaminase (ALT) level ≥2.5 times the upper limit of normal (ULN), active liver disease, or jaundice.
  10. Participants taking concomitant gemfibrozil or other strong cytochrome P450 (CYP)2C8 inhibitors.
  11. Participants with a history of recurrent or severe hypoglycemia.
  12. Participants with a history of any hemoglobinopathy (such as hemolytic anemias or sickle cell disease) that may affect determination of HbA1c.
  13. Participants with uninvestigated microscopic hematuria
  14. Participants with genetic problems such as galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption, since the study drug contains lactose.
  15. Participants with any other condition judged by the Investigator as unsuitable for the study.
  16. Participants who have used any investigational or experimental drugs or devices within 60 days of the screening visit.
  17. Lactating or pregnant female. A positive pregnancy test before the first administration of investigational medicinal product (IMP) or breastfeeding.
  18. Male participants planning to father during clinical trial conduct or within 3 months after the last planned dose of the IMP.
  19. Participants were previously enrolled into the current clinical trial.
  20. The participants participated in the active treatment phase of another clinical trial where a persisting pharmacodynamic effect of the IMP of that clinical trial cannot be excluded.
  21. Participants are considered unable or unwilling to co-operate adequately, i.e., to follow clinical trial procedures after Investigator has adequately instructed (e.g., language difficulties, etc.) or participants are anticipated not to be available for scheduled clinical trial visits/procedures.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Pioglitazone 15 mg (Double-Blind)

Pioglitazone 30 mg (Double-Blind)

Pioglitazone 30 mg (Open-Label)

Arm Description

Pioglitazone 15 mg tablets, orally, once daily, and metformin and sulfonylurea administered according to the prescribing information of the approved Korean label, for up to 24 weeks.

Pioglitazone 30 mg tablets, orally, once daily, and metformin and sulfonylurea administered according to the prescribing information of the approved Korean label, for up to 24 weeks.

Pioglitazone 30 mg tablets, orally, once daily, and metformin and sulfonylurea administered according to the prescribing information of the approved Korean label, for up to 24 weeks.

Outcomes

Primary Outcome Measures

Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 24
The change from baseline in glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) at Week 24. A negative change from baseline indicates improvement.

Secondary Outcome Measures

Change From Baseline in Fasting Plasma Glucose at Week 24
The change between the value of fasting serum glucose collected at Week 24 and fasting serum glucose collected at baseline. A negative change from baseline indicates improvement.

Full Information

First Posted
October 24, 2013
Last Updated
August 13, 2018
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT01972724
Brief Title
Efficacy of Pioglitazone in Participants With Inadequately Controlled Type 2 Diabetes Mellitus Treated With Stable Triple Oral Therapy
Acronym
ADD
Official Title
A 24-Week, Open Label, Phase IV Trial to Evaluate the Efficacy of Pioglitazone 30 mg in Patients With Inadequately Controlled Type 2 Diabetes Mellitus Treated With Stable Triple Oral Therapy of Metformin, Sulfonylurea, and Pioglitazone 15 Mg (ADD Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
December 16, 2013 (Actual)
Primary Completion Date
October 17, 2016 (Actual)
Study Completion Date
October 17, 2016 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy of pioglitazone 30 mg on glycemic control when used in participants with inadequately controlled type 2 diabetes mellitus treated with stable combinations of metformin and sulfonylurea.
Detailed Description
The drug being tested in this study is called pioglitazone. Pioglitazone is being tested to treat glycemic control in adults with inadequately controlled type 2 diabetes mellitus. This study will look at glycemic control in people who take triple oral therapy of metformin, sulfonylurea, and pioglitazone 15 mg. The study will enroll approximately 114 patients. All participants will be asked to take one pioglitazone tablet at the same time each day throughout the study as well as continuing their previous dose of metformin and sulfonylurea. This multi-center trial will be conducted in Korea. The overall time to participate in this study is up to 25 weeks. Participants will make 4 visits to the hospital or endocrinologist's office, and will be contacted by telephone 7 days after last dose of study drug for a follow-up assessment.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
114 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pioglitazone 15 mg (Double-Blind)
Arm Type
Experimental
Arm Description
Pioglitazone 15 mg tablets, orally, once daily, and metformin and sulfonylurea administered according to the prescribing information of the approved Korean label, for up to 24 weeks.
Arm Title
Pioglitazone 30 mg (Double-Blind)
Arm Type
Experimental
Arm Description
Pioglitazone 30 mg tablets, orally, once daily, and metformin and sulfonylurea administered according to the prescribing information of the approved Korean label, for up to 24 weeks.
Arm Title
Pioglitazone 30 mg (Open-Label)
Arm Type
Experimental
Arm Description
Pioglitazone 30 mg tablets, orally, once daily, and metformin and sulfonylurea administered according to the prescribing information of the approved Korean label, for up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Pioglitazone
Other Intervention Name(s)
ACTOS
Intervention Description
Pioglitazone tablets
Intervention Type
Drug
Intervention Name(s)
Metformin
Intervention Description
Metformin as prescribed in clinical practice
Intervention Type
Drug
Intervention Name(s)
Sulfonylurea
Intervention Description
Sulfonylurea as prescribed in clinical practice
Primary Outcome Measure Information:
Title
Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 24
Description
The change from baseline in glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) at Week 24. A negative change from baseline indicates improvement.
Time Frame
Baseline and Week 24
Secondary Outcome Measure Information:
Title
Change From Baseline in Fasting Plasma Glucose at Week 24
Description
The change between the value of fasting serum glucose collected at Week 24 and fasting serum glucose collected at baseline. A negative change from baseline indicates improvement.
Time Frame
Baseline and Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Participants meeting the following criteria will be considered for inclusion in the study: Institutional Review Board (IRB)-approved written informed consent form (ICF) must be obtained from the participant or legally authorized representative prior to any trial related procedure (including withdrawal of prohibited medication, if applicable). Participants with a history of clinical diagnosis of established type 2 diabetes mellitus defined by the American Diabetes Association (ADA) criteria 2012. Male or female between 18 and 80 years of age. Participants with stable triple oral therapy of metformin + sulfonylurea + pioglitazone (ACTOS) 15 mg or ACTOSMET(Pioglitazone 15mg/Metformin 850mg) and sulfonylurea for at least 12 weeks at the screening visit. Participants with glycosylated hemoglobin (HbA1c) ≥7.0% at the screening visit. Participants with C-peptide ≥1.0 ng/mL at the screening visit. Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from screening throughout the duration of the study, up to 30 days after the last dose of the study medication. Exclusion Criteria Participants meeting any of the following criteria will be excluded from enrollment: Participants with type 1 diabetes mellitus or secondary forms of diabetes. Participants who have been treated with insulin for ≥7 days within 3 months prior to the screening visit. Participants with a history of bladder cancer or participants with active bladder cancer. Participants with a history of acute diabetic complications such as diabetic ketoacidosis. Participants with a history of acute or chronic metabolic acidosis, including diabetic ketoacidosis. Participants with unstable or rapidly progressive diabetic retinopathy, nephropathy (estimated glomerular filtration rate [eGFR] <60mL/min/1.73m2). Participants with cardiac insufficiency (e.g., a myocardial infarction, a coronary angioplasty or bypass graft, unstable angina, transient ischemic attacks, or a documented cerebrovascular accident within 6 months prior to the screening visit). Participants with cardiac failure or history of cardiac failure (New York Heart Association [NYHA] Stages 3 to 4). Participants with a serum alanine transaminase (ALT) level ≥2.5 times the upper limit of normal (ULN), active liver disease, or jaundice. Participants taking concomitant gemfibrozil or other strong cytochrome P450 (CYP)2C8 inhibitors. Participants with a history of recurrent or severe hypoglycemia. Participants with a history of any hemoglobinopathy (such as hemolytic anemias or sickle cell disease) that may affect determination of HbA1c. Participants with uninvestigated microscopic hematuria Participants with genetic problems such as galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption, since the study drug contains lactose. Participants with any other condition judged by the Investigator as unsuitable for the study. Participants who have used any investigational or experimental drugs or devices within 60 days of the screening visit. Lactating or pregnant female. A positive pregnancy test before the first administration of investigational medicinal product (IMP) or breastfeeding. Male participants planning to father during clinical trial conduct or within 3 months after the last planned dose of the IMP. Participants were previously enrolled into the current clinical trial. The participants participated in the active treatment phase of another clinical trial where a persisting pharmacodynamic effect of the IMP of that clinical trial cannot be excluded. Participants are considered unable or unwilling to co-operate adequately, i.e., to follow clinical trial procedures after Investigator has adequately instructed (e.g., language difficulties, etc.) or participants are anticipated not to be available for scheduled clinical trial visits/procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Chagwon
Country
Korea, Republic of
City
Daegu
Country
Korea, Republic of
City
Daejeon
Country
Korea, Republic of
City
Gwangju
Country
Korea, Republic of
City
Gyeonggi-do
Country
Korea, Republic of
City
Jeonju
Country
Korea, Republic of
City
Seoul
Country
Korea, Republic of
City
Ulsan
Country
Korea, Republic of
City
Wonju
Country
Korea, Republic of

12. IPD Sharing Statement

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Efficacy of Pioglitazone in Participants With Inadequately Controlled Type 2 Diabetes Mellitus Treated With Stable Triple Oral Therapy

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