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Ertugliflozin vs. Glimepiride in Type 2 Diabetes Mellitus (T2DM) Participants on Metformin (MK-8835-002)

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Ertugliflozin 5 mg
Ertugliflozin 10 mg
Glimerpiride
Placebo to Ertugliflozin
Placebo to Glimepiride
Metformin
Sitagliptin
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes Mellitus

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of T2DM in accordance to American Diabetes Association guidelines
  • On metformin monotherapy or metformin in combination with a single allowable anti-hyperglycemic agent (AHA), DPP-4 inhibitors, meglitinides and AGIs are listed as allowable AHAs along with sulfonylureas prior to study participation.
  • Body Mass Index (BMI) ≥18.0 kg/m^2
  • Male or female not of reproductive potential
  • If a female of reproductive potential, agree to remain abstinent or to use (or have their partner use) 2 acceptable combinations of birth control while participating in the trial and for 14 days after the last use of study drug.

Exclusion Criteria:

  • History or presence of type 1 diabetes mellitus or a history of ketoacidosis
  • History of other specific types of diabetes (eg, genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical-induced, and post-organ transplant).
  • A known hypersensitivity or intolerance to any sodium-glucose co-transporter 2 (SGLT2) inhibitor
  • Use of the following prohibited therapeutic agents within 12 weeks of study participation: insulin, injectable anti-hyperglycemic agents, pioglitazone or rosiglitazone, another SGLT2 inhibitor, bromocriptine (Cycloset®), colesevelam (Welchol®), and any other non-approved anti-hyperglycemic therapy
  • Known hypersensitivity or intolerance to metformin or glimepiride
  • On a weight-loss program or medication or medication associated with weight changes and is not weight-stable (>=5% change in body weight in the last 6 months)
  • History of bariatric surgery less than 12 months prior to study participation
  • History of myocardial infarction, unstable angina, arterial revascularization, stroke, transient ischemic attack, or New York Heart Association (NYHA) functional class III-IV heart failure within 3 months of study participation
  • Active, obstructive uropathy or an indwelling urinary catheter
  • A history of malignancy ≤5 years prior to study participation, except for adequately treated basal or squamous cell skin cancer or in situ cervical cancer
  • Known history of Human Immunodeficiency Virus (HIV)
  • Blood dyscrasias or any disorders causing hemolysis or unstable red blood cells
  • A medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic active hepatitis B or C (assessed by medical history), primary biliary cirrhosis, or symptomatic gallbladder disease
  • Any clinically significant malabsorption condition
  • Being treated for hyperthyroidism, or on thyroid replacement therapy that has not been at a stable dose for at least 6 weeks prior to study participation
  • Previous randomization in a study with ertugliflozin
  • Participation in other studies involving investigational drug(s) within 30 days of study participation and/or during the pre-randomization period
  • A surgical procedure within 6 weeks prior to study participation or planned major surgery during the trial
  • A positive urine pregnancy test
  • Pregnant or breast-feeding, or expecting to conceive during the trial, including 14 days following the last dose of study drug
  • Undergoing hormonal therapy in preparation to donate eggs during the period of the trial, including 14 days following the last dose of study drug
  • Consumption of more than 2 alcoholic drinks per day or engages in binge drinking
  • Donation of blood or blood products within 6 weeks of study participation or plans to donate blood or blood products at any time during the trial

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Active Comparator

    Arm Label

    Ertugliflozin 5 mg

    Ertugliflozin 15 mg

    Glimepiride up to 8 mg

    Arm Description

    Ertugliflozin 5 mg once daily (QD) from Day 1 to Week 104

    Ertugliflozin 15 mg QD from Day 1 to Week 104

    Glimepiride to a maximum of 8 mg QD from Day 1 to Week 104

    Outcomes

    Primary Outcome Measures

    Change From Baseline in Hemoglobin A1C (A1C) at Week 52: Excluding Rescue Approach
    A1C is blood marker used to report average blood glucose levels over prolonged periods of time and is reported as a percentage (%). A1C represents the percentage of glycated hemoglobin. This change from baseline reflects the Week 52 A1C minus the Week 0 A1C. A negative number indicates a reduction in A1C level. Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication. The primary study objective was the MK-8835 15 mg vs. glimepiride comparison; the MK-8835 5mg vs glimerpiride comparison was a secondary study objective.
    Percentage of Participants Experiencing An Adverse Event (AE) Up to Week 106
    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.
    Percentage of Participants Discontinuing Study Treatment Due to an AE Up to Week 104
    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.

    Secondary Outcome Measures

    Percentage of Participants With an Adverse Event of Symptomatic Hypoglycemia Up to Week 52: Excluding Rescue Approach
    Symptomatic hypoglycemia was an event with clinical symptoms reported by the investigator as hypoglycemia (biochemical documentation not required). Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication.
    Change From Baseline in Body Weight at Week 52 Excluding Rescue Approach
    This change from baseline reflects the Week 52 body weight minus the Week 0 body weight. Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication.
    Change From Baseline in Sitting Systolic Blood Pressure (SBP) at Week 52 Excluding Rescue Approach
    This change from baseline reflects the Week 52 SBP minus the Week 0 SBP. Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication.

    Full Information

    First Posted
    November 25, 2013
    Last Updated
    March 25, 2019
    Sponsor
    Merck Sharp & Dohme LLC
    Collaborators
    Pfizer
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01999218
    Brief Title
    Ertugliflozin vs. Glimepiride in Type 2 Diabetes Mellitus (T2DM) Participants on Metformin (MK-8835-002)
    Official Title
    A Phase III, Multicenter, Randomized, Double-Blind, Active-Comparator-Controlled Clinical Trial to Study the Safety and Efficacy of the Addition of Ertugliflozin (MK-8835/PF-04971729) Compared With the Addition of Glimepiride in Subjects With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Metformin
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2019
    Overall Recruitment Status
    Completed
    Study Start Date
    December 16, 2013 (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
    Collaborators
    Pfizer

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This study will evaluate the efficacy and safety of the addition of ertugliflozin (MK-8835/PF-04971729) compared with the addition of glimepiride in participants with T2DM who have inadequate glycemic control on metformin. The primary hypothesis of this study is that after 52 weeks, the change from baseline in hemoglobin A1c (A1C) in participants treated with the addition of ertugliflozin 15 mg once daily is non-inferior compared with that in participants treated with the addition of glimepiride.
    Detailed Description
    The duration of the trial will be up to approximately 122 weeks. This will include a 1-week screening period, an up to 13-week wash-off/titration/dose stabilization period, a 2-week placebo run-in period, a 104-week double-blind, active comparator-controlled treatment period, and a post-treatment telephone contact 14 days after the last dose of study drug.

    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
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    1326 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Ertugliflozin 5 mg
    Arm Type
    Experimental
    Arm Description
    Ertugliflozin 5 mg once daily (QD) from Day 1 to Week 104
    Arm Title
    Ertugliflozin 15 mg
    Arm Type
    Experimental
    Arm Description
    Ertugliflozin 15 mg QD from Day 1 to Week 104
    Arm Title
    Glimepiride up to 8 mg
    Arm Type
    Active Comparator
    Arm Description
    Glimepiride to a maximum of 8 mg QD from Day 1 to Week 104
    Intervention Type
    Drug
    Intervention Name(s)
    Ertugliflozin 5 mg
    Other Intervention Name(s)
    MK-8835
    Intervention Description
    Ertugliflozin, 5 mg, oral, once daily, from Day 1 to Week 104
    Intervention Type
    Drug
    Intervention Name(s)
    Ertugliflozin 10 mg
    Other Intervention Name(s)
    MK-8355
    Intervention Description
    Ertugliflozin, 10 mg, oral, once daily from Day 1 to Week 104.
    Intervention Type
    Drug
    Intervention Name(s)
    Glimerpiride
    Intervention Description
    Glimepiride, oral tablets, initiated at 1 mg daily and titrated up to the maximum approved dose (8 mg daily based on the local country label) or maximum tolerated dose
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo to Ertugliflozin
    Intervention Description
    Matching placebo to ertugliflozin, 5 mg and/or 10 mg, oral, once daily, from Day 1 to Week 104
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo to Glimepiride
    Intervention Description
    Matching placebo to glimepiride, 1 mg or 2 mg, oral, once daily, from Day 1 to Week 104.
    Intervention Type
    Drug
    Intervention Name(s)
    Metformin
    Intervention Description
    Participants are to remain on their stable doses of metformin (oral, >=1500 mg/day) while receiving blinded investigational product during the double-blind treatment period. Participants on metformin <1500 at screening are up-titrated to >= 1500 daily.
    Intervention Type
    Drug
    Intervention Name(s)
    Sitagliptin
    Intervention Description
    Open label, oral, once daily, rescue medication as required.
    Primary Outcome Measure Information:
    Title
    Change From Baseline in Hemoglobin A1C (A1C) at Week 52: Excluding Rescue Approach
    Description
    A1C is blood marker used to report average blood glucose levels over prolonged periods of time and is reported as a percentage (%). A1C represents the percentage of glycated hemoglobin. This change from baseline reflects the Week 52 A1C minus the Week 0 A1C. A negative number indicates a reduction in A1C level. Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication. The primary study objective was the MK-8835 15 mg vs. glimepiride comparison; the MK-8835 5mg vs glimerpiride comparison was a secondary study objective.
    Time Frame
    Baseline and Week 52
    Title
    Percentage of Participants Experiencing An Adverse Event (AE) Up to Week 106
    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 106
    Title
    Percentage of Participants Discontinuing Study Treatment Due to an AE Up to Week 104
    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 104
    Secondary Outcome Measure Information:
    Title
    Percentage of Participants With an Adverse Event of Symptomatic Hypoglycemia Up to Week 52: Excluding Rescue Approach
    Description
    Symptomatic hypoglycemia was an event with clinical symptoms reported by the investigator as hypoglycemia (biochemical documentation not required). Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication.
    Time Frame
    Up to Week 52
    Title
    Change From Baseline in Body Weight at Week 52 Excluding Rescue Approach
    Description
    This change from baseline reflects the Week 52 body weight minus the Week 0 body weight. Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication.
    Time Frame
    Baseline and Week 52
    Title
    Change From Baseline in Sitting Systolic Blood Pressure (SBP) at Week 52 Excluding Rescue Approach
    Description
    This change from baseline reflects the Week 52 SBP minus the Week 0 SBP. Participants who met glycemic rescue criteria received open-label sitagliptin glycemic rescue medication.
    Time Frame
    Baseline and Week 52

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Diagnosis of T2DM in accordance to American Diabetes Association guidelines On metformin monotherapy or metformin in combination with a single allowable anti-hyperglycemic agent (AHA), DPP-4 inhibitors, meglitinides and AGIs are listed as allowable AHAs along with sulfonylureas prior to study participation. Body Mass Index (BMI) ≥18.0 kg/m^2 Male or female not of reproductive potential If a female of reproductive potential, agree to remain abstinent or to use (or have their partner use) 2 acceptable combinations of birth control while participating in the trial and for 14 days after the last use of study drug. Exclusion Criteria: History or presence of type 1 diabetes mellitus or a history of ketoacidosis History of other specific types of diabetes (eg, genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical-induced, and post-organ transplant). A known hypersensitivity or intolerance to any sodium-glucose co-transporter 2 (SGLT2) inhibitor Use of the following prohibited therapeutic agents within 12 weeks of study participation: insulin, injectable anti-hyperglycemic agents, pioglitazone or rosiglitazone, another SGLT2 inhibitor, bromocriptine (Cycloset®), colesevelam (Welchol®), and any other non-approved anti-hyperglycemic therapy Known hypersensitivity or intolerance to metformin or glimepiride On a weight-loss program or medication or medication associated with weight changes and is not weight-stable (>=5% change in body weight in the last 6 months) History of bariatric surgery less than 12 months prior to study participation History of myocardial infarction, unstable angina, arterial revascularization, stroke, transient ischemic attack, or New York Heart Association (NYHA) functional class III-IV heart failure within 3 months of study participation Active, obstructive uropathy or an indwelling urinary catheter A history of malignancy ≤5 years prior to study participation, except for adequately treated basal or squamous cell skin cancer or in situ cervical cancer Known history of Human Immunodeficiency Virus (HIV) Blood dyscrasias or any disorders causing hemolysis or unstable red blood cells A medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic active hepatitis B or C (assessed by medical history), primary biliary cirrhosis, or symptomatic gallbladder disease Any clinically significant malabsorption condition Being treated for hyperthyroidism, or on thyroid replacement therapy that has not been at a stable dose for at least 6 weeks prior to study participation Previous randomization in a study with ertugliflozin Participation in other studies involving investigational drug(s) within 30 days of study participation and/or during the pre-randomization period A surgical procedure within 6 weeks prior to study participation or planned major surgery during the trial A positive urine pregnancy test Pregnant or breast-feeding, or expecting to conceive during the trial, including 14 days following the last dose of study drug Undergoing hormonal therapy in preparation to donate eggs during the period of the trial, including 14 days following the last dose of study drug Consumption of more than 2 alcoholic drinks per day or engages in binge drinking Donation of blood or blood products within 6 weeks of study participation or plans to donate blood or blood products at any time during the trial
    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
    http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    30760125
    Citation
    Hollander P, Hill J, Johnson J, Wei Jiang Z, Golm G, Huyck S, Terra SG, Mancuso JP, Engel SS, Lauring B, Liu J. Results of VERTIS SU extension study: safety and efficacy of ertugliflozin treatment over 104 weeks compared to glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin. Curr Med Res Opin. 2019 Aug;35(8):1335-1343. doi: 10.1080/03007995.2019.1583450. Epub 2019 Mar 25.
    Results Reference
    result
    PubMed Identifier
    32648108
    Citation
    Gallo S, Calle RA, Terra SG, Pong A, Tarasenko L, Raji A. Effects of Ertugliflozin on Liver Enzymes in Patients with Type 2 Diabetes: A Post-Hoc Pooled Analysis of Phase 3 Trials. Diabetes Ther. 2020 Aug;11(8):1849-1860. doi: 10.1007/s13300-020-00867-1. Epub 2020 Jul 9.
    Results Reference
    derived
    PubMed Identifier
    32372382
    Citation
    Patel S, Hickman A, Frederich R, Johnson S, Huyck S, Mancuso JP, Gantz I, Terra SG. Safety of Ertugliflozin in Patients with Type 2 Diabetes Mellitus: Pooled Analysis of Seven Phase 3 Randomized Controlled Trials. Diabetes Ther. 2020 Jun;11(6):1347-1367. doi: 10.1007/s13300-020-00803-3. Epub 2020 May 5.
    Results Reference
    derived
    PubMed Identifier
    32324082
    Citation
    Liu J, Tarasenko L, Pong A, Huyck S, Wu L, Patel S, Hickman A, Mancuso JP, Gantz I, Terra SG. Efficacy and safety of ertugliflozin across racial groups in patients with type 2 diabetes mellitus. Curr Med Res Opin. 2020 Aug;36(8):1277-1284. doi: 10.1080/03007995.2020.1760228. Epub 2020 May 13.
    Results Reference
    derived
    PubMed Identifier
    32324065
    Citation
    Liu J, Tarasenko L, Pong A, Huyck S, Patel S, Hickman A, Mancuso JP, Ellison MC, Gantz I, Terra SG. Efficacy and safety of ertugliflozin in Hispanic/Latino patients with type 2 diabetes mellitus. Curr Med Res Opin. 2020 Jul;36(7):1097-1106. doi: 10.1080/03007995.2020.1760227. Epub 2020 May 13.
    Results Reference
    derived
    PubMed Identifier
    32236732
    Citation
    Cherney DZI, Heerspink HJL, Frederich R, Maldonado M, Liu J, Pong A, Xu ZJ, Patel S, Hickman A, Mancuso JP, Gantz I, Terra SG. Effects of ertugliflozin on renal function over 104 weeks of treatment: a post hoc analysis of two randomised controlled trials. Diabetologia. 2020 Jun;63(6):1128-1140. doi: 10.1007/s00125-020-05133-4. Epub 2020 Mar 31.
    Results Reference
    derived
    PubMed Identifier
    31797522
    Citation
    Liu J, Patel S, Cater NB, Wu L, Huyck S, Terra SG, Hickman A, Darekar A, Pong A, Gantz I. Efficacy and safety of ertugliflozin in East/Southeast Asian patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2020 Apr;22(4):574-582. doi: 10.1111/dom.13931. Epub 2020 Jan 3.
    Results Reference
    derived
    PubMed Identifier
    29282633
    Citation
    Hollander P, Liu J, Hill J, Johnson J, Jiang ZW, Golm G, Huyck S, Terra SG, Mancuso JP, Engel SS, Lauring B. Ertugliflozin Compared with Glimepiride in Patients with Type 2 Diabetes Mellitus Inadequately Controlled on Metformin: The VERTIS SU Randomized Study. Diabetes Ther. 2018 Feb;9(1):193-207. doi: 10.1007/s13300-017-0354-4. Epub 2017 Dec 27.
    Results Reference
    derived

    Learn more about this trial

    Ertugliflozin vs. Glimepiride in Type 2 Diabetes Mellitus (T2DM) Participants on Metformin (MK-8835-002)

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