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

About this trial
This is an interventional treatment trial for Type 2 Diabetes Mellitus
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™
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
NCT ID
NCT02059187
First Posted
February 7, 2014
Last Updated
August 8, 2018
Sponsor
Merck Sharp & Dohme LLC
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
Learn more about this trial
The Safety and Efficacy of MK-1293 Versus Lantus™ in Participants With Type 2 Diabetes Mellitus (MK-1293-006)
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