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Safety and Efficacy of Bexagliflozin Compared to Placebo as Add-on Therapy to Metformin in Type 2 Diabetes Subjects

Primary Purpose

Type2 Diabetes Mellitus

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Bexagliflozin tablets, 20 mg
Bexagliflozin tablets, placebo
Bexagliflozin tablets, 20 mg
Sponsored by
Theracos
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type2 Diabetes Mellitus

Eligibility Criteria

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

The subjects were required to meet the following criteria at the time of enrollment to be eligible for the study:

  1. Had been age ≥ 20 years at screening. Women of childbearing potential were required to have tested negative for pregnancy and have agreed to abstinence or contraception for the duration of the study to avoid any possible pregnancy. Females who were surgically sterile (hysterectomy, oophorectomy) or postmenopausal (absence of menses greater than 12 months) were eligible if they had tested negative for pregnancy at screening.
  2. a) Had a history of T2DM with an HbA1c level of ≥ 7.5% and ≤ 10.5% at screening, or b) Had a history of T2DM with an HbA1c level of >10.5% and ≤ 12.0% at screening
  3. Had been prescribed a stable dose of metformin (≥1500 mg per day in the US or ≥ 1000 mg per day in Japan) as their sole anti-diabetic medication
  4. Had a body mass index (BMI) ≤ 45 kg m-2
  5. Had been able to comprehend and willing to provide written informed consent in accordance with institutional and regulatory guidelines
  6. Had no recent changes to their medications for hypertension or hyperlipidemia (if applicable)
  7. Had the ability to regularly self-administer medication, as evidenced by consumption of all, or at worst one less than all, doses of run-in medication prior to randomization

Subjects who met any of the following criteria were to be excluded from the study:

  1. Had a diagnosis of type 1 diabetes mellitus or maturity-onset diabetes of the young
  2. Were pregnant or breastfeeding
  3. Had one or more hemoglobin alleles that affect HbA1c measurement
  4. Had a history of genitourinary tract infection (e.g., UTI, GMI, vaginitis, balanitis) within 6 weeks of screening or a history of ≥ 3 genitourinary infections requiring treatment within 6 months of screening
  5. Had an estimated glomerular filtration rate (eGFR), as calculated by the modification of diet in renal disease study equation (MDRD), < 60 mL min-1 per 1.73 m2
  6. Had a sitting systolic blood pressure >180 mmHg or a sitting diastolic blood pressure > 110 mmHg at screening
  7. Had exposure to hypoglycemic agent(s) other than metformin during the 8 weeks prior to screening
  8. Had a history of illicit drug use or alcohol abuse in the past 2 years
  9. Had a life expectancy < 2 years
  10. Had a diagnosis of New York Heart Association (NYHA) Class IV heart failure within 3 months of screening
  11. Had experienced an MI, unstable angina, stroke, or hospitalization for heart failure within 3 months of screening
  12. Had exposure to an investigational drug within 30 days
  13. Had a previous exposure to bexagliflozin or EGT0001474
  14. Had a history of SGLT2 inhibitor treatment
  15. Were participating in another interventional trial
  16. Were not able to comply with the study scheduled visits
  17. Had any condition, disease, disorder, or clinically relevant abnormality that, in the opinion of the primary investigator, would jeopardize the subject's appropriate participation in this study or obscure the effects of treatment
  18. Had an alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 2.5 × ULN or total bilirubin ≥ 1.5 × ULN at screening

Sites / Locations

  • Clinical Research Site 1232
  • Clinical Research Site 1378
  • Clinical Research Site 1269
  • Clinical Research Site 1363
  • Clinical Research Site 1381
  • Clinical Research Site 1375
  • Clinical Research Site 1365
  • Clinical Research Site 1382
  • Clinical Research Site 1372
  • Clinical Research Site 1362
  • Clinical Research Site 1373
  • Clinical Research Site 1376
  • Clinical Research Site 1366
  • Clinical Research Site 1294
  • Clinical Research Site 1374
  • Clinical Research Site 1370
  • Clinical Research Site 1009
  • Clinical Research Site 1037
  • Clinical Research Site 1286
  • Clinical Research Site 1275
  • Clinical Research Site 1368
  • Clinical Research Site 1019
  • Clinical Research Site 1379
  • Clinical Research Site 1369
  • Clinical Research Site 1371
  • Clinical Research Site 1360
  • Clinical Research Site 6048
  • Clinical Research Site 6050
  • Clinical Research Site 6041
  • Clinical Research Site 6029
  • Clinical Research Site 6051
  • Clinical Research Site 6020
  • Clinical Research Site 6055
  • Clinical Research Site 6046
  • Clinical Research Site 6033
  • Clinical Research Site 6013
  • Clinical Research Site 6052
  • Clinical Research Site 6053
  • Clinical Research Site 6040
  • Clinical Research Site 6043
  • Clinical Research Site 6015
  • Clinical Research Site 6045
  • Clinical Research Site 6047

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Placebo Comparator

Experimental

Arm Label

Bexagliflozin tablets, 20 mg; Double-Blind

Bexagliflozin tablets, Placebo; Double Blind

Bexagliflozin Tablets, 20 mg; High Glycemic Group

Arm Description

Outcomes

Primary Outcome Measures

Change From Baseline in HbA1c at Week 24 for Double-blind Group
HbA1c was obtained at baseline and at Week 24. The model-adjusted change from baseline was calculated using mixed-effects repeated measures analysis.
Change From Baseline in HbA1c at Week 24 for High Glycemic Group
The change in HbA1c from baseline at Week 24 in High Glycemic Group was calculated by subtracting the mean HbA1c at baseline from the mean HbA1c at Week 24

Secondary Outcome Measures

Change From Baseline in Fasting Plasma Glucose (FPG) at Week 24 for Double-blind Group
FPG was obtained at baseline and at Week 24. The model-adjusted change from baseline was calculated using mixed-effects repeated measures analysis.
Change From Baseline in Fasting Plasma Glucose (FPG) at Week 24 for High Glycemic Group
The change in FPG from baseline at Week 24 for High Glycemic Group was calculated by subtracting the mean FPG at baseline from the mean FPG at Week 24
Change From Baseline in Systolic Blood Pressure (SBP) at Week 24
Changes from baseline at Week 24 in SBP for the double-blind group and high glycemic group
Proportion of Subjects Achieving HbA1c < 7% Over Time for Double-blind Group
The proportion of subjects who achieved HbA1c < 7% at 6, 12, 18 and 24 weeks were calculated based on the number of subjects with a value at each time point for each group. The model-adjusted proportion was calculated based on a logistic analysis using Generalized Estimating Equation (GEE) logistic regression that includes country, treatment, visit, treatment-by-visit interaction and the baseline HbA1c value as a fixed effect covariate. An unstructured correlation structure will be used, or autoregressive if the model with the unstructured structure does not converge.
Proportion of Subjects Achieving HbA1c < 7% Over Time for High Glycemic Group
The proportion of subjects who achieved HbA1c < 7% at 6, 12, 18 and 24 weeks were calculated based on the number of subjects with a value at each time point for each group.
Change in Body Mass From Baseline to Week 24 in Subjects With a BMI ≥ 25 kg/m2 for Double-blind Group
Changes in body mass from baseline to week 24 was calculated based on LS means for both bexagliflozin and placebo groups.
Change in Body Mass From Baseline to Week 24 in Subjects With a BMI ≥ 25 kg/m2 for High Glycemic Group
The change in body mass from baseline at week 24 for High Glycemic group was calculated by subtracting the mean body mass at baseline from the mean body mass at week 24
Change From Baseline in HbA1c Over Time in Double-blind Treatment Group
The change from baseline in HbA1c at 6, 12, 18 and 24 weeks was calculated based on the number of subjects with a value at each time point for each group. The model-adjusted change from baseline was calculated based on a mixed-effects repeated measures analysis that includes country, treatment, visit, treatment-by-visit interaction and the baseline HbA1c value as a fixed effect covariate.
Change in HbA1c Over Time Among Subjects Who Have Baseline HbA1c of > 10.5% and ≤ 12.0%
The change from baseline in HbA1c at 6, 12, 18 and 24 weeks was calculated based on the number of subjects with a value at each time point in High Glycemic Group.

Full Information

First Posted
August 21, 2017
Last Updated
July 6, 2021
Sponsor
Theracos
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1. Study Identification

Unique Protocol Identification Number
NCT03259789
Brief Title
Safety and Efficacy of Bexagliflozin Compared to Placebo as Add-on Therapy to Metformin in Type 2 Diabetes Subjects
Official Title
A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate Bexagliflozin in Subjects With Type 2 Diabetes Mellitus Who Are Not Adequately Controlled by Metformin Alone
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
November 28, 2017 (Actual)
Primary Completion Date
January 23, 2019 (Actual)
Study Completion Date
January 23, 2019 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to investigate the effect of bexagliflozin compared to placebo as an add-on therapy to metformin in lowering hemoglobin A1c (HbA1c) levels in subjects with type 2 diabetes mellitus (T2DM).
Detailed Description
Approximately 300 subjects with inadequately controlled T2DM on metformin were to be recruited from the United States and Japan. Subjects were randomly assigned to receive bexagliflozin tablets, 20 mg, or bexagliflozin tablets, placebo, in a ratio of 1:1 once daily for 24 weeks. Subjects were to continue taking metformin for the duration of the study. The study also enrolled 50 subjects with extremely poorly controlled T2DM on metformin to receive open-label bexagliflozin tablets, 20 mg, for 24 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type2 Diabetes Mellitus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
351 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bexagliflozin tablets, 20 mg; Double-Blind
Arm Type
Active Comparator
Arm Title
Bexagliflozin tablets, Placebo; Double Blind
Arm Type
Placebo Comparator
Arm Title
Bexagliflozin Tablets, 20 mg; High Glycemic Group
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Bexagliflozin tablets, 20 mg
Other Intervention Name(s)
EGT0001442, EGT0001474
Intervention Description
Each subject will receive bexagliflozin, 20 mg once daily for the duration of the study.
Intervention Type
Drug
Intervention Name(s)
Bexagliflozin tablets, placebo
Intervention Description
Each subject will receive placebo (inactive tablet) once daily for the duration of the study.
Intervention Type
Drug
Intervention Name(s)
Bexagliflozin tablets, 20 mg
Other Intervention Name(s)
EGT0001442, EGT0001474
Intervention Description
Each subject will receive bexagliflozin, 20 mg once daily for the duration of the study.
Primary Outcome Measure Information:
Title
Change From Baseline in HbA1c at Week 24 for Double-blind Group
Description
HbA1c was obtained at baseline and at Week 24. The model-adjusted change from baseline was calculated using mixed-effects repeated measures analysis.
Time Frame
Baseline to week 24
Title
Change From Baseline in HbA1c at Week 24 for High Glycemic Group
Description
The change in HbA1c from baseline at Week 24 in High Glycemic Group was calculated by subtracting the mean HbA1c at baseline from the mean HbA1c at Week 24
Time Frame
Baseline to week 24
Secondary Outcome Measure Information:
Title
Change From Baseline in Fasting Plasma Glucose (FPG) at Week 24 for Double-blind Group
Description
FPG was obtained at baseline and at Week 24. The model-adjusted change from baseline was calculated using mixed-effects repeated measures analysis.
Time Frame
Baseline, up to 24 weeks
Title
Change From Baseline in Fasting Plasma Glucose (FPG) at Week 24 for High Glycemic Group
Description
The change in FPG from baseline at Week 24 for High Glycemic Group was calculated by subtracting the mean FPG at baseline from the mean FPG at Week 24
Time Frame
Baseline, up to 24 weeks
Title
Change From Baseline in Systolic Blood Pressure (SBP) at Week 24
Description
Changes from baseline at Week 24 in SBP for the double-blind group and high glycemic group
Time Frame
Baseline to week 24
Title
Proportion of Subjects Achieving HbA1c < 7% Over Time for Double-blind Group
Description
The proportion of subjects who achieved HbA1c < 7% at 6, 12, 18 and 24 weeks were calculated based on the number of subjects with a value at each time point for each group. The model-adjusted proportion was calculated based on a logistic analysis using Generalized Estimating Equation (GEE) logistic regression that includes country, treatment, visit, treatment-by-visit interaction and the baseline HbA1c value as a fixed effect covariate. An unstructured correlation structure will be used, or autoregressive if the model with the unstructured structure does not converge.
Time Frame
Baseline, up to 24 weeks
Title
Proportion of Subjects Achieving HbA1c < 7% Over Time for High Glycemic Group
Description
The proportion of subjects who achieved HbA1c < 7% at 6, 12, 18 and 24 weeks were calculated based on the number of subjects with a value at each time point for each group.
Time Frame
Baseline, up to 24 weeks
Title
Change in Body Mass From Baseline to Week 24 in Subjects With a BMI ≥ 25 kg/m2 for Double-blind Group
Description
Changes in body mass from baseline to week 24 was calculated based on LS means for both bexagliflozin and placebo groups.
Time Frame
Baseline to week 24
Title
Change in Body Mass From Baseline to Week 24 in Subjects With a BMI ≥ 25 kg/m2 for High Glycemic Group
Description
The change in body mass from baseline at week 24 for High Glycemic group was calculated by subtracting the mean body mass at baseline from the mean body mass at week 24
Time Frame
Baseline to week 24
Title
Change From Baseline in HbA1c Over Time in Double-blind Treatment Group
Description
The change from baseline in HbA1c at 6, 12, 18 and 24 weeks was calculated based on the number of subjects with a value at each time point for each group. The model-adjusted change from baseline was calculated based on a mixed-effects repeated measures analysis that includes country, treatment, visit, treatment-by-visit interaction and the baseline HbA1c value as a fixed effect covariate.
Time Frame
Baseline, up to 24 weeks
Title
Change in HbA1c Over Time Among Subjects Who Have Baseline HbA1c of > 10.5% and ≤ 12.0%
Description
The change from baseline in HbA1c at 6, 12, 18 and 24 weeks was calculated based on the number of subjects with a value at each time point in High Glycemic Group.
Time Frame
Baseline, up to 24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
The subjects were required to meet the following criteria at the time of enrollment to be eligible for the study: Had been age ≥ 20 years at screening. Women of childbearing potential were required to have tested negative for pregnancy and have agreed to abstinence or contraception for the duration of the study to avoid any possible pregnancy. Females who were surgically sterile (hysterectomy, oophorectomy) or postmenopausal (absence of menses greater than 12 months) were eligible if they had tested negative for pregnancy at screening. a) Had a history of T2DM with an HbA1c level of ≥ 7.5% and ≤ 10.5% at screening, or b) Had a history of T2DM with an HbA1c level of >10.5% and ≤ 12.0% at screening Had been prescribed a stable dose of metformin (≥1500 mg per day in the US or ≥ 1000 mg per day in Japan) as their sole anti-diabetic medication Had a body mass index (BMI) ≤ 45 kg m-2 Had been able to comprehend and willing to provide written informed consent in accordance with institutional and regulatory guidelines Had no recent changes to their medications for hypertension or hyperlipidemia (if applicable) Had the ability to regularly self-administer medication, as evidenced by consumption of all, or at worst one less than all, doses of run-in medication prior to randomization Subjects who met any of the following criteria were to be excluded from the study: Had a diagnosis of type 1 diabetes mellitus or maturity-onset diabetes of the young Were pregnant or breastfeeding Had one or more hemoglobin alleles that affect HbA1c measurement Had a history of genitourinary tract infection (e.g., UTI, GMI, vaginitis, balanitis) within 6 weeks of screening or a history of ≥ 3 genitourinary infections requiring treatment within 6 months of screening Had an estimated glomerular filtration rate (eGFR), as calculated by the modification of diet in renal disease study equation (MDRD), < 60 mL min-1 per 1.73 m2 Had a sitting systolic blood pressure >180 mmHg or a sitting diastolic blood pressure > 110 mmHg at screening Had exposure to hypoglycemic agent(s) other than metformin during the 8 weeks prior to screening Had a history of illicit drug use or alcohol abuse in the past 2 years Had a life expectancy < 2 years Had a diagnosis of New York Heart Association (NYHA) Class IV heart failure within 3 months of screening Had experienced an MI, unstable angina, stroke, or hospitalization for heart failure within 3 months of screening Had exposure to an investigational drug within 30 days Had a previous exposure to bexagliflozin or EGT0001474 Had a history of SGLT2 inhibitor treatment Were participating in another interventional trial Were not able to comply with the study scheduled visits Had any condition, disease, disorder, or clinically relevant abnormality that, in the opinion of the primary investigator, would jeopardize the subject's appropriate participation in this study or obscure the effects of treatment Had an alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 2.5 × ULN or total bilirubin ≥ 1.5 × ULN at screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
J, Paul Lock, M.D.
Organizational Affiliation
Theracos
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Research Site 1232
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35205
Country
United States
Facility Name
Clinical Research Site 1378
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35242
Country
United States
Facility Name
Clinical Research Site 1269
City
Foley
State/Province
Alabama
ZIP/Postal Code
36535
Country
United States
Facility Name
Clinical Research Site 1363
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72209
Country
United States
Facility Name
Clinical Research Site 1381
City
Anaheim
State/Province
California
ZIP/Postal Code
92805
Country
United States
Facility Name
Clinical Research Site 1375
City
North Hollywood
State/Province
California
ZIP/Postal Code
91606
Country
United States
Facility Name
Clinical Research Site 1365
City
Norwalk
State/Province
California
ZIP/Postal Code
90650
Country
United States
Facility Name
Clinical Research Site 1382
City
Norwalk
State/Province
Connecticut
ZIP/Postal Code
06851
Country
United States
Facility Name
Clinical Research Site 1372
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33024
Country
United States
Facility Name
Clinical Research Site 1362
City
Palm Springs
State/Province
Florida
ZIP/Postal Code
33461
Country
United States
Facility Name
Clinical Research Site 1373
City
Pembroke Pines
State/Province
Florida
ZIP/Postal Code
33026
Country
United States
Facility Name
Clinical Research Site 1376
City
Nampa
State/Province
Idaho
ZIP/Postal Code
83686
Country
United States
Facility Name
Clinical Research Site 1366
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60602
Country
United States
Facility Name
Clinical Research Site 1294
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70124
Country
United States
Facility Name
Clinical Research Site 1374
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63117
Country
United States
Facility Name
Clinical Research Site 1370
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89104
Country
United States
Facility Name
Clinical Research Site 1009
City
Berlin
State/Province
New Jersey
ZIP/Postal Code
08009
Country
United States
Facility Name
Clinical Research Site 1037
City
Trenton
State/Province
New Jersey
ZIP/Postal Code
08611
Country
United States
Facility Name
Clinical Research Site 1286
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87102
Country
United States
Facility Name
Clinical Research Site 1275
City
Bronx
State/Province
New York
ZIP/Postal Code
10455
Country
United States
Facility Name
Clinical Research Site 1368
City
New York
State/Province
New York
ZIP/Postal Code
10036
Country
United States
Facility Name
Clinical Research Site 1019
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Clinical Research Site 1379
City
Gonzales
State/Province
Texas
ZIP/Postal Code
78629
Country
United States
Facility Name
Clinical Research Site 1369
City
Houston
State/Province
Texas
ZIP/Postal Code
77051
Country
United States
Facility Name
Clinical Research Site 1371
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78209
Country
United States
Facility Name
Clinical Research Site 1360
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78258
Country
United States
Facility Name
Clinical Research Site 6048
City
Nagoya
State/Province
Aichi
ZIP/Postal Code
456-0058
Country
Japan
Facility Name
Clinical Research Site 6050
City
Sapporo
State/Province
Hokkaido
ZIP/Postal Code
003-0023
Country
Japan
Facility Name
Clinical Research Site 6041
City
Koga
State/Province
Ibaraki
ZIP/Postal Code
306-0232
Country
Japan
Facility Name
Clinical Research Site 6029
City
Atsugi
State/Province
Kanagawa
ZIP/Postal Code
243-0035
Country
Japan
Facility Name
Clinical Research Site 6051
City
Kamakura
State/Province
Kanagawa
ZIP/Postal Code
547-0055
Country
Japan
Facility Name
Clinical Research Site 6020
City
Yokohama
State/Province
Kanagawa
ZIP/Postal Code
221-080
Country
Japan
Facility Name
Clinical Research Site 6055
City
Tokyo
State/Province
Meguro
ZIP/Postal Code
153-0053
Country
Japan
Facility Name
Clinical Research Site 6046
City
Higashiosaka
State/Province
Osaka
ZIP/Postal Code
577-0803
Country
Japan
Facility Name
Clinical Research Site 6033
City
Kashiwara
State/Province
Osaka
ZIP/Postal Code
582-0005
Country
Japan
Facility Name
Clinical Research Site 6013
City
Toyonaka
State/Province
Osaka
ZIP/Postal Code
560-0082
Country
Japan
Facility Name
Clinical Research Site 6052
City
Kawaguchi
State/Province
Saitama
ZIP/Postal Code
332-0012
Country
Japan
Facility Name
Clinical Research Site 6053
City
Shimotsuke
State/Province
Tochigi
ZIP/Postal Code
329-0433
Country
Japan
Facility Name
Clinical Research Site 6040
City
Fukuoka
ZIP/Postal Code
819-0006
Country
Japan
Facility Name
Clinical Research Site 6043
City
Kyoto
ZIP/Postal Code
600-8898
Country
Japan
Facility Name
Clinical Research Site 6015
City
Osaka
ZIP/Postal Code
536-0008
Country
Japan
Facility Name
Clinical Research Site 6045
City
Tokyo
ZIP/Postal Code
108-0075
Country
Japan
Facility Name
Clinical Research Site 6047
City
Tokyo
ZIP/Postal Code
166-0003
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Efficacy of Bexagliflozin Compared to Placebo as Add-on Therapy to Metformin in Type 2 Diabetes Subjects

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