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Remote And Decentralised Innovative Approaches to Clinical Trials (RADIAL) (RADIAL)

Primary Purpose

Diabetes Mellitus, Type 2

Status
Not yet recruiting
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Methodological intervention
Toujeo
Sponsored by
Mira Zuidgeest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Diabetes Mellitus, Type 2 focused on measuring decentralised clinical trial approach, proof-of-concept study

Eligibility Criteria

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

Inclusion Criteria: Participants are eligible to be included in the study only if all of the following criteria apply: Participant with T2DM diagnosed for at least 1 year before the screening visit (V1). Participant treated with a stable basal insulin regimen (i.e. type of insulin and time/frequency of the injection), for at least 3 months before the screening visit. The total daily basal insulin dose should be stable (±20%) for at least 1 month before the screening visit. Participant treated with ≥1 noninsulin antidiabetic drugs at stable dose in the 3 months before the screening visit. Signed written informed consent or e-consent depending on the arm. Participant's mental and physical status allows them to be able to perform their activities of daily living with no or minimal assistance, including the ability to administer injectable insulin and measure their blood glycaemic level. Willing and able to permit home visits (only for Part A of the study). Willing and able to comply with study drug receipt, accountability, and return processes and procedures. Access to tablet/smartphone with Bluetooth functionality. Access to internet connection that allows remote data entry and, for part B, video conferencing. Exclusion Criteria: Participants are excluded from the study if any of the following criteria apply: Age <18 years. HbA1c at screening visit: <7.0% or >10.0%. Patient not willing to self-manage insulin titration algorithm. Type 1 diabetes mellitus. Treatment with mixed insulin (premixes), short-acting insulin, fast acting insulin analogues or Toujeo® during the 3 months before the screening visit. Use of systemic glucocorticoids (excluding topical application or inhaled forms) for two weeks or more within 8 weeks prior to the time of screening. Any clinically significant abnormality identified at the time of screening, or any condition (including known substance or alcohol abuse, or psychiatric disorder) that in the opinion of the Investigator or any sub-Investigator would make implementation of the protocol or interpretation of the study results difficult or would preclude the safe participation of the participant in this study. Use of any investigational drug within 1 month or 5 half-lives, whichever is longer, prior to screening visit. Participant is the Investigator or any Subinvestigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol. Participant whom the investigator deems otherwise ineligible (e.g. unable to understand and follow instructions). Reason for ineligibility will be documented. Pregnant or breastfeeding woman at the time of screening. Woman of childbearing potential not protected by acceptable method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy (see Section 10.3). Known hypersensitivity / intolerance to insulin glargine or any of Toujeo® excipients. Participant who withdraws consent during the screening (participant who is not willing to continue or fails to return). Despite screening of the participant, enrolment is stopped at the study level.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Active Comparator

    Active Comparator

    Active Comparator

    Arm Label

    Conventional

    Hybrid

    Remote

    Arm Description

    In RADIAL, the main study intervention is a methodological intervention with patients being recruited into three arms with different level of decentralization. Additionally, participants in all arms are switching from their previously used basal insulin to Toujeo®, which is the clinical intervention, in the protocol defined as the study drug. The conventional arm is modelled after a previous clinical trial with a similar indication and intervention and aims to represent current state-of-the art clinical trial conduct.

    In RADIAL, the main study intervention is a methodological intervention with patients being recruited into three arms with different level of decentralization. Additionally, participants in all arms are switching from their previously used basal insulin to Toujeo®, which is the clinical intervention, in the protocol defined as the study drug. The hybrid trial design is defined as a trial containing conventional trial elements, such as site-based recruitment and screening visits, as well as decentralised trials elements, such as a remote follow-up period and data collection

    In RADIAL, the main study intervention is a methodological intervention with patients being recruited into three arms with different level of decentralization. Additionally, participants in all arms are switching from their previously used basal insulin to Toujeo®, which is the clinical intervention, in the protocol defined as the study drug. The remote arm is fully decentralised and aims to represent future decentralised clinical trial practice using a decentralised recruitment model, intervention period and data collection.

    Outcomes

    Primary Outcome Measures

    Enrolment rates
    Time to enrolment from Site activation until last participant enrolled
    Retention rates
    Proportion of participants completing the study period
    Diversity
    Various diversity aspects such as race, ethnicity, socioeconomic status, digital literacy, distance to health care professional, mobility.
    Participant satisfaction
    Participant satisfaction measured using a questionnaire just after V2 (baseline), V6 and V9 (EOT)
    Site staff satisfaction
    Site staff satisfaction measured using a questionnaire (after study initiation visit [SIV]), after 3 enrolled participants, after 3 participants completed Week 12 and after last patient last visit (LPLV).
    Study cost
    Absolute cost per participant using a combination of prospective and retrospective measurements
    Time of AE (Adverse Event)/ SAE (Serious Adverse Event) occurence to collection
    Time from event occurrence to collection AE/SAE in the eDiary or eCRF (electronic Case Report Form), whichever is applicable.
    Treatment adherence
    Adherence to the daily insulin injection by means of eDiary analysis in percentage of days of documented intake until participant's EOT.
    Missing data
    Proportion of missing data on the critical data points (Hb1Ac, Fasting Glucose, Participant satisfaction questionnaire)
    Query rate
    Number of queries (both manual and automatic) per participant per arm.

    Secondary Outcome Measures

    Full Information

    First Posted
    March 8, 2023
    Last Updated
    June 14, 2023
    Sponsor
    Mira Zuidgeest
    Collaborators
    IMI Trials@Home consortium, Innovative Medicines Initiative, Sanofi
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05780151
    Brief Title
    Remote And Decentralised Innovative Approaches to Clinical Trials (RADIAL)
    Acronym
    RADIAL
    Official Title
    Pan-European Proof-of-concept Study Comparing Decentralised Clinical Trial (DCT) and Hybrid Approaches to Conventional Clinical Trial Approaches in Patients With Type 2 Diabetes Mellitus Treated With Toujeo®
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    June 2023 (Anticipated)
    Primary Completion Date
    July 2024 (Anticipated)
    Study Completion Date
    July 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor-Investigator
    Name of the Sponsor
    Mira Zuidgeest
    Collaborators
    IMI Trials@Home consortium, Innovative Medicines Initiative, Sanofi

    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
    Pan-European proof-of-concept study comparing Decentralised Clinical Trial (DCT) and hybrid approaches to conventional clinical trial approaches in patients with Type 2 diabetes mellitus treated with Toujeo®.
    Detailed Description
    The proposed study has been designed to compare the scientific and operational quality of fully decentralised and hybrid approaches to a conventional clinical trial approach and evaluate the feasibility of such approaches. The primary study objectives are to (1) assess potential benefits of a DCT approach on participant recruitment, retention, diversity, site and participant satisfaction, and cost and (2) to determine acceptability of a DCT approach by measuring variables related to safety oversight, treatment adherence and data quality (missing data and query rate) within the arms that have a different degree of decentralisation. The secondary study objective is to determine whether the efficacy of treatment with Toujeo® (insulin glargine 300 U/mL) is within the accepted range within the arms with different degree of decentralisation. The design is a parallel-group, open-label, multi-centre study in Europe for patients with Type 2 diabetes mellitus ( T2DM) with glycated haemoglobin (HbA1c) between 7% and 10% and treated with basal insulin as part of their glucose-lowering treatment. The study consists of 2 parts with 3 different arms. Part A has site-based recruitment followed by a 1:1 randomization into a conventional arm and a hybrid arm. Part B has decentralised recruitment, no randomization and consists of a fully remote arm. The study will enrol approximately 150 adults in each site-based arm (conventional and hybrid) and approximately 300 in the remote arm, for a total of 600 participants in approximately 5-6 countries. Both Part A and Part B will consist of a screening period (3-6 weeks), a treatment period with open-label Toujeo® (24 weeks) and a follow-up period (2-4 days after end of treatment [EOT]).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Diabetes Mellitus, Type 2
    Keywords
    decentralised clinical trial approach, proof-of-concept study

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Model Description
    Parallel-group, open-label, multi-centre study
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    600 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Conventional
    Arm Type
    Active Comparator
    Arm Description
    In RADIAL, the main study intervention is a methodological intervention with patients being recruited into three arms with different level of decentralization. Additionally, participants in all arms are switching from their previously used basal insulin to Toujeo®, which is the clinical intervention, in the protocol defined as the study drug. The conventional arm is modelled after a previous clinical trial with a similar indication and intervention and aims to represent current state-of-the art clinical trial conduct.
    Arm Title
    Hybrid
    Arm Type
    Active Comparator
    Arm Description
    In RADIAL, the main study intervention is a methodological intervention with patients being recruited into three arms with different level of decentralization. Additionally, participants in all arms are switching from their previously used basal insulin to Toujeo®, which is the clinical intervention, in the protocol defined as the study drug. The hybrid trial design is defined as a trial containing conventional trial elements, such as site-based recruitment and screening visits, as well as decentralised trials elements, such as a remote follow-up period and data collection
    Arm Title
    Remote
    Arm Type
    Active Comparator
    Arm Description
    In RADIAL, the main study intervention is a methodological intervention with patients being recruited into three arms with different level of decentralization. Additionally, participants in all arms are switching from their previously used basal insulin to Toujeo®, which is the clinical intervention, in the protocol defined as the study drug. The remote arm is fully decentralised and aims to represent future decentralised clinical trial practice using a decentralised recruitment model, intervention period and data collection.
    Intervention Type
    Other
    Intervention Name(s)
    Methodological intervention
    Intervention Description
    All three arms will receive the same clinical intervention but will differ in their level of decentralisation, the methodological intervention.
    Intervention Type
    Drug
    Intervention Name(s)
    Toujeo
    Other Intervention Name(s)
    insulin glargine 300 U/ml
    Intervention Description
    All participants in the study will receive Toujeo® (insulin glargine 300 U/mL). During the treatment period, Toujeo® injection will be administered once daily at the same time as the participant's previous basal insulin was injected, for participant previously treated with once daily injection. In case of previous insulin treatment administered twice a day, the time of injection of Toujeo® will have to be agreed between the physician and the participant before first administration.
    Primary Outcome Measure Information:
    Title
    Enrolment rates
    Description
    Time to enrolment from Site activation until last participant enrolled
    Time Frame
    32 weeks
    Title
    Retention rates
    Description
    Proportion of participants completing the study period
    Time Frame
    6 months
    Title
    Diversity
    Description
    Various diversity aspects such as race, ethnicity, socioeconomic status, digital literacy, distance to health care professional, mobility.
    Time Frame
    10 weeks
    Title
    Participant satisfaction
    Description
    Participant satisfaction measured using a questionnaire just after V2 (baseline), V6 and V9 (EOT)
    Time Frame
    6 months
    Title
    Site staff satisfaction
    Description
    Site staff satisfaction measured using a questionnaire (after study initiation visit [SIV]), after 3 enrolled participants, after 3 participants completed Week 12 and after last patient last visit (LPLV).
    Time Frame
    6 months
    Title
    Study cost
    Description
    Absolute cost per participant using a combination of prospective and retrospective measurements
    Time Frame
    complete trial duration
    Title
    Time of AE (Adverse Event)/ SAE (Serious Adverse Event) occurence to collection
    Description
    Time from event occurrence to collection AE/SAE in the eDiary or eCRF (electronic Case Report Form), whichever is applicable.
    Time Frame
    6 months
    Title
    Treatment adherence
    Description
    Adherence to the daily insulin injection by means of eDiary analysis in percentage of days of documented intake until participant's EOT.
    Time Frame
    6 months
    Title
    Missing data
    Description
    Proportion of missing data on the critical data points (Hb1Ac, Fasting Glucose, Participant satisfaction questionnaire)
    Time Frame
    9 months
    Title
    Query rate
    Description
    Number of queries (both manual and automatic) per participant per arm.
    Time Frame
    9 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Participants are eligible to be included in the study only if all of the following criteria apply: Participant with T2DM diagnosed for at least 1 year before the screening visit (V1). Participant treated with a stable basal insulin regimen (i.e. type of insulin and time/frequency of the injection), for at least 3 months before the screening visit. The total daily basal insulin dose should be stable (±20%) for at least 1 month before the screening visit. Participant treated with ≥1 noninsulin antidiabetic drugs at stable dose in the 3 months before the screening visit. Signed written informed consent or e-consent depending on the arm. Participant's mental and physical status allows them to be able to perform their activities of daily living with no or minimal assistance, including the ability to administer injectable insulin and measure their blood glycaemic level. Willing and able to permit home visits (only for Part A of the study). Willing and able to comply with study drug receipt, accountability, and return processes and procedures. Access to tablet/smartphone with Bluetooth functionality. Access to internet connection that allows remote data entry and, for part B, video conferencing. Exclusion Criteria: Participants are excluded from the study if any of the following criteria apply: Age <18 years. HbA1c at screening visit: <7.0% or >10.0%. Patient not willing to self-manage insulin titration algorithm. Type 1 diabetes mellitus. Treatment with mixed insulin (premixes), short-acting insulin, fast acting insulin analogues or Toujeo® during the 3 months before the screening visit. Use of systemic glucocorticoids (excluding topical application or inhaled forms) for two weeks or more within 8 weeks prior to the time of screening. Any clinically significant abnormality identified at the time of screening, or any condition (including known substance or alcohol abuse, or psychiatric disorder) that in the opinion of the Investigator or any sub-Investigator would make implementation of the protocol or interpretation of the study results difficult or would preclude the safe participation of the participant in this study. Use of any investigational drug within 1 month or 5 half-lives, whichever is longer, prior to screening visit. Participant is the Investigator or any Subinvestigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the protocol. Participant whom the investigator deems otherwise ineligible (e.g. unable to understand and follow instructions). Reason for ineligibility will be documented. Pregnant or breastfeeding woman at the time of screening. Woman of childbearing potential not protected by acceptable method(s) of birth control and/or who are unwilling or unable to be tested for pregnancy (see Section 10.3). Known hypersensitivity / intolerance to insulin glargine or any of Toujeo® excipients. Participant who withdraws consent during the screening (participant who is not willing to continue or fails to return). Despite screening of the participant, enrolment is stopped at the study level.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Bart Lagerwaard, PhD
    Phone
    0031807555555
    Email
    radial@umcutrecht.nl
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Mira GP Zuidgeest, PhD
    Organizational Affiliation
    UMC Utrecht
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Links:
    URL
    http://trialsathome.com
    Description
    Website Trials@Home project

    Learn more about this trial

    Remote And Decentralised Innovative Approaches to Clinical Trials (RADIAL)

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