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The Safety and Efficacy of MK-1293 Versus Lantus™ in Participants With Type 2 Diabetes Mellitus (MK-1293-006)

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
MK-1293
Lantus™
Prandial insulin
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 Type 2 Diabetes Mellitus (T2DM) as defined by the American Diabetes Association (ADA) or the European Association for the Study of Diabetes (EASD)
  • hemoglobin A1C of ≤11.0% and requires insulin for glycemic control
  • Body mass index (BMI) <45 kg/m^2

Exclusion Criteria:

  • History of type 1 diabetes mellitus or a history of ketoacidosis, or has type 1 diabetes confirmed with a C-peptide <0.7 ng/mL (0.23 nmol/L)
  • One or more severe hypoglycemic episodes associated with hypoglycemic seizures, comas or unconsciousness within the past 6 months
  • History of intolerance or hypersensitivity to Lantus™ or contraindication to Lantus™ or one of its excipients based on the label of the country of the investigational site
  • On a weight loss program within the last 8 weeks
  • Received injectable incretin-based therapy (e.g., Victoza™, Byetta™) within the prior 8 weeks
  • Bariatric surgery within 12 months prior to signing the informed consent
  • Likely to require treatment for ≥2 consecutive weeks or repeated courses of corticosteroids
  • Undergone a surgical procedure within 4 weeks prior to signing informed consent or has planned major surgery during the study
  • New or worsening signs or symptoms of coronary heart disease or congestive heart failure within the last 3 months
  • Presence of any of the following during the last 3 months: acute coronary syndrome, coronary artery intervention, and/or stroke or transient ischemic neurological disorder
  • Severe peripheral vascular disease
  • Systolic blood pressure ≥ 160 mm Hg or a diastolic ≥95 mm Hg and blood pressure is not considered likely to be under these limits with an adjustment in antihypertensive medication
  • Chronic myopathy or a progressive neurological or neuromuscular disorder
  • Active nephropathy
  • History of active liver disease (other than non-alcoholic hepatic steatosis), including chronic active hepatitis B or C, primary biliary cirrhosis, or symptomatic gallbladder disease
  • Human immunodeficiency virus (HIV)
  • Clinically important hematological disorder (such as aplastic anemia, myeloproliferative or myelodysplastic syndromes, thrombocytopenia)
  • History of malignancy ≤5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer, or in situ cervical cancer
  • History of melanoma, leukemia, lymphoma, or renal cell carcinoma
  • Hyperthyroidism
  • On a stable dose of thyroid hormone replacement therapy for <6 weeks
  • Uses recreational or illicit drugs or has had a recent history (within the last year) of drug or alcohol abuse or dependence
  • Pregnant or breast-feeding, or is expecting to conceive or donate eggs during the study, including 14 days following the last dose of study drug
  • Donated blood products or has had phlebotomy of >300 mL within 8 weeks of signing informed consent, or intends to donate blood products within the projected duration of the study
  • Poor mental function or any other reason to expect that the participant may have difficulty in complying with the requirements of the study
  • Clinically significant ECG abnormality which exposes the participant to risk by enrolling in the study
  • Positive urine pregnancy test
  • Participant is a night shift worker which causes difficulty complying with the overnight fast requirement and has potential for confounding the 7-point SMBG analysis
  • Participant, as assessed by the investigator, is not appropriate for or does not agree to target a fasting glucose of 70-100 mg/dL [3.9 -5.6 mmol/L]
  • Has used a formulation of glargine insulin other than Lantus™

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    MK-1293

    Lantus™

    Arm Description

    MK-1293 administered subcutaneously once daily in the evening.

    Lantus™ administered subcutaneously once daily in the evening.

    Outcomes

    Primary Outcome Measures

    Change From Baseline in Participant Hemoglobin A1C Level at Week 24
    A1C is measured as a percent. A1C is the key glycemic parameter which correlates with reduction of risk of diabetic complications.
    Percentage of Participants With Confirmed Anti-Insulin Antibodies (AIA) up to Week 24
    Percentage of participants is a cumulative percentage of participants with any confirmed AIA (including baseline) up to Week 24.

    Secondary Outcome Measures

    Change From Baseline in Participant Body Weight at Week 24
    Change from baseline in participant body weight at Week 24.
    Percentage of Participants Experiencing an Adverse Event (AE) of Hypoglycemia Up to Week 24
    Symptomatic events assessed as likely to be hypoglycemia were to be reported by investigators as adverse events of hypoglycemia; a concurrent glucose measurement was not required. Asymptomatic events with confirmed glucose levels </= 70mg/dL (</= 3.9mmol/L) could also be reported as adverse events at the discretion of the investigator.
    Percentage of Participants Experiencing an AE Over the 24-week Treatment Period
    An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the investigational product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the investigational product, is also an AE.
    Daily Basal Insulin Dose (Units) at Week 24
    The daily basal insulin dose (measured in units) for any given visit is defined as the average dose from the three most recent days preceding the visit date.
    Daily Basal Insulin Dose Per Body Weight (Units/kg) at Week 24
    Basal insulin dose per body weight was calculated as total insulin dose (units) per day divided by body weight in kilograms (kg).
    Change From Baseline in Participant Fasting Plasma Glucose (FPG) at Week 24
    Participants fasted (no food or drink except water and non-antihyperglycemic non-study medications as prescribed) for at least 8 hours prior to all study visits.
    Change From Baseline in Participant 7-Point Average of Self-Monitored Blood Glucose (SMBG) at Week 24
    7-Point Average of SMBG was defined as the mean of blood glucose measurements taken at the following 7 times: before morning meal, after morning meal, before midday meal, after midday meal, before evening meal, after evening meal or at bedtime, and between 2 AM and 4 AM.
    Percentage of Participants With Hemoglobin A1C <7% at Week 24
    Percentage of participants with A1C <7.0% (53 mmol/mol) at Week 24.
    Percentage of Participants With Hemoglobin A1C <6.5% at Week 24
    Percentage of participants with A1C <6.5% (48 mmol/mol) at Week 24.

    Full Information

    First Posted
    February 7, 2014
    Last Updated
    August 8, 2018
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02059187
    Brief Title
    The Safety and Efficacy of MK-1293 Versus Lantus™ in Participants With Type 2 Diabetes Mellitus (MK-1293-006)
    Official Title
    A Phase III Clinical Trial to Study the Safety and Efficacy of MK-1293 Compared to Lantus™ in Subjects With Type 2 Diabetes Mellitus
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    February 11, 2014 (Actual)
    Primary Completion Date
    March 11, 2015 (Actual)
    Study Completion Date
    March 11, 2015 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This 24-week study is a safety and efficacy comparison of MK-1293 and Lantus™ in participants with type 2 diabetes mellitus (T2DM). The primary hypothesis is that after 24 weeks, the mean change in hemoglobin A1c (A1C) from baseline is non-inferior (with margin of 0.4%) in participants treated with MK-1293 compared with that in participants treated with Lantus™.

    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
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    531 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    MK-1293
    Arm Type
    Experimental
    Arm Description
    MK-1293 administered subcutaneously once daily in the evening.
    Arm Title
    Lantus™
    Arm Type
    Active Comparator
    Arm Description
    Lantus™ administered subcutaneously once daily in the evening.
    Intervention Type
    Drug
    Intervention Name(s)
    MK-1293
    Intervention Description
    MK-1293 (insulin glargine) 100 units/mL administered subcutaneously once daily for 24 weeks. Participants not taking insulin at study entry will initiate MK-1293 at 10 units daily. Participants taking insulin will initiate MK-1293 at an appropriate dose based on prior insulin dosing. After initiation, the dose will be titrated to the suggested target for fasting finger stick glucose. MK-1293 dosing once daily at times other than bedtime will be permitted for participants with a previously established dosing time.
    Intervention Type
    Drug
    Intervention Name(s)
    Lantus™
    Other Intervention Name(s)
    Insulin glargine [rDNA origin]
    Intervention Description
    Lantus™ (insulin glargine [rDNA origin]) 100 units/mL administered subcutaneously once daily for 24 weeks. Participants not taking insulin at study entry will initiate Lantus™ at 10 units daily. Participants taking insulin will initiate Lantus™ at an appropriate dose based on prior insulin dosing. After initiation, the dose will be titrated to the suggested target for fasting finger stick glucose. Lantus™ dosing once daily at times other than bedtime will be permitted for participants with a previously established dosing time.
    Intervention Type
    Drug
    Intervention Name(s)
    Prandial insulin
    Intervention Description
    Participants taking prandial insulin will continue their current prandial insulin regimen during the insulin glargine titration. After the insulin glargine titration phase, the prandial insulin may be adjusted if the investigator determines it to be necessary for glucose control.
    Primary Outcome Measure Information:
    Title
    Change From Baseline in Participant Hemoglobin A1C Level at Week 24
    Description
    A1C is measured as a percent. A1C is the key glycemic parameter which correlates with reduction of risk of diabetic complications.
    Time Frame
    Baseline and Week 24
    Title
    Percentage of Participants With Confirmed Anti-Insulin Antibodies (AIA) up to Week 24
    Description
    Percentage of participants is a cumulative percentage of participants with any confirmed AIA (including baseline) up to Week 24.
    Time Frame
    Up to 24 weeks
    Secondary Outcome Measure Information:
    Title
    Change From Baseline in Participant Body Weight at Week 24
    Description
    Change from baseline in participant body weight at Week 24.
    Time Frame
    Baseline and Week 24
    Title
    Percentage of Participants Experiencing an Adverse Event (AE) of Hypoglycemia Up to Week 24
    Description
    Symptomatic events assessed as likely to be hypoglycemia were to be reported by investigators as adverse events of hypoglycemia; a concurrent glucose measurement was not required. Asymptomatic events with confirmed glucose levels </= 70mg/dL (</= 3.9mmol/L) could also be reported as adverse events at the discretion of the investigator.
    Time Frame
    Up to 24 weeks
    Title
    Percentage of Participants Experiencing an AE Over the 24-week Treatment Period
    Description
    An AE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the investigational product, whether or not considered related to the use of the product. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a preexisting condition which is temporally associated with the use of the investigational product, is also an AE.
    Time Frame
    Up to 24 weeks
    Title
    Daily Basal Insulin Dose (Units) at Week 24
    Description
    The daily basal insulin dose (measured in units) for any given visit is defined as the average dose from the three most recent days preceding the visit date.
    Time Frame
    Week 24
    Title
    Daily Basal Insulin Dose Per Body Weight (Units/kg) at Week 24
    Description
    Basal insulin dose per body weight was calculated as total insulin dose (units) per day divided by body weight in kilograms (kg).
    Time Frame
    Week 24
    Title
    Change From Baseline in Participant Fasting Plasma Glucose (FPG) at Week 24
    Description
    Participants fasted (no food or drink except water and non-antihyperglycemic non-study medications as prescribed) for at least 8 hours prior to all study visits.
    Time Frame
    Baseline and Week 24
    Title
    Change From Baseline in Participant 7-Point Average of Self-Monitored Blood Glucose (SMBG) at Week 24
    Description
    7-Point Average of SMBG was defined as the mean of blood glucose measurements taken at the following 7 times: before morning meal, after morning meal, before midday meal, after midday meal, before evening meal, after evening meal or at bedtime, and between 2 AM and 4 AM.
    Time Frame
    Baseline and Week 24
    Title
    Percentage of Participants With Hemoglobin A1C <7% at Week 24
    Description
    Percentage of participants with A1C <7.0% (53 mmol/mol) at Week 24.
    Time Frame
    Week 24
    Title
    Percentage of Participants With Hemoglobin A1C <6.5% at Week 24
    Description
    Percentage of participants with A1C <6.5% (48 mmol/mol) at Week 24.
    Time Frame
    Week 24

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Diagnosis of Type 2 Diabetes Mellitus (T2DM) as defined by the American Diabetes Association (ADA) or the European Association for the Study of Diabetes (EASD) hemoglobin A1C of ≤11.0% and requires insulin for glycemic control Body mass index (BMI) <45 kg/m^2 Exclusion Criteria: History of type 1 diabetes mellitus or a history of ketoacidosis, or has type 1 diabetes confirmed with a C-peptide <0.7 ng/mL (0.23 nmol/L) One or more severe hypoglycemic episodes associated with hypoglycemic seizures, comas or unconsciousness within the past 6 months History of intolerance or hypersensitivity to Lantus™ or contraindication to Lantus™ or one of its excipients based on the label of the country of the investigational site On a weight loss program within the last 8 weeks Received injectable incretin-based therapy (e.g., Victoza™, Byetta™) within the prior 8 weeks Bariatric surgery within 12 months prior to signing the informed consent Likely to require treatment for ≥2 consecutive weeks or repeated courses of corticosteroids Undergone a surgical procedure within 4 weeks prior to signing informed consent or has planned major surgery during the study New or worsening signs or symptoms of coronary heart disease or congestive heart failure within the last 3 months Presence of any of the following during the last 3 months: acute coronary syndrome, coronary artery intervention, and/or stroke or transient ischemic neurological disorder Severe peripheral vascular disease Systolic blood pressure ≥ 160 mm Hg or a diastolic ≥95 mm Hg and blood pressure is not considered likely to be under these limits with an adjustment in antihypertensive medication Chronic myopathy or a progressive neurological or neuromuscular disorder Active nephropathy History of active liver disease (other than non-alcoholic hepatic steatosis), including chronic active hepatitis B or C, primary biliary cirrhosis, or symptomatic gallbladder disease Human immunodeficiency virus (HIV) Clinically important hematological disorder (such as aplastic anemia, myeloproliferative or myelodysplastic syndromes, thrombocytopenia) History of malignancy ≤5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer, or in situ cervical cancer History of melanoma, leukemia, lymphoma, or renal cell carcinoma Hyperthyroidism On a stable dose of thyroid hormone replacement therapy for <6 weeks Uses recreational or illicit drugs or has had a recent history (within the last year) of drug or alcohol abuse or dependence Pregnant or breast-feeding, or is expecting to conceive or donate eggs during the study, including 14 days following the last dose of study drug Donated blood products or has had phlebotomy of >300 mL within 8 weeks of signing informed consent, or intends to donate blood products within the projected duration of the study Poor mental function or any other reason to expect that the participant may have difficulty in complying with the requirements of the study Clinically significant ECG abnormality which exposes the participant to risk by enrolling in the study Positive urine pregnancy test Participant is a night shift worker which causes difficulty complying with the overnight fast requirement and has potential for confounding the 7-point SMBG analysis Participant, as assessed by the investigator, is not appropriate for or does not agree to target a fasting glucose of 70-100 mg/dL [3.9 -5.6 mmol/L] Has used a formulation of glargine insulin other than Lantus™
    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
    https://www.merck.com/clinical-trials/pdf/ProcedureAccessClinicalTrialData.pdf
    IPD Sharing URL
    http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    29761615
    Citation
    Hollander PA, Carofano WL, Lam RLH, Golm GT, Eldor R, Crutchlow MF, Marcos MC, Rendell MS, Home PD, Gallwitz B, Rosenstock J. Efficacy and safety of MK-1293 insulin glargine compared with originator insulin glargine (Lantus) in type 2 diabetes: A randomized, open-label clinical trial. Diabetes Obes Metab. 2018 Sep;20(9):2229-2237. doi: 10.1111/dom.13363. Epub 2018 Jun 10.
    Results Reference
    derived

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    The Safety and Efficacy of MK-1293 Versus Lantus™ in Participants With Type 2 Diabetes Mellitus (MK-1293-006)

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