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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT03199053




Registration number
NCT03199053
Ethics application status
Date submitted
22/06/2017
Date registered
26/06/2017
Date last updated
17/04/2024

Titles & IDs
Public title
Study to Evaluate Safety and Efficacy of Dapagliflozin and Saxagliptin in Patients With Type 2 Diabetes Mellitus (T2DM) Aged 10 to Below 18 Years Old
Scientific title
A 26 Week, Multicenter, Randomized, Placebo-Controlled, Double-Blind, Parallel Group, Phase 3 Trial With a 26 Week Safety Extension Period Evaluating the Safety and Efficacy of Dapagliflozin 5 and 10 mg, and Saxagliptin 2.5 and 5 mg in Pediatric Patients With Type 2 Diabetes Mellitus Who Are Between 10 and Below 18 Years of Age
Secondary ID [1] 0 0
2015-005042-66
Secondary ID [2] 0 0
D1680C00019
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Diabetes Mellitus, Type 2 0 0
Condition category
Condition code
Metabolic and Endocrine 0 0 0 0
Diabetes

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Dapagliflozin
Treatment: Drugs - Saxagliptin
Treatment: Drugs - Placebo

Experimental: Low dose Dapagliflozin - Oral route. Start with a low dose of dapagliflozin administered once daily and remain on the low dose regardless of your HbA1c at week 12.

Experimental: Low dose/high dose Dapagliflozin - Oral route. Start with a low dose of Dapagliflozin administered once daily and up titrate to the high dose Dapagliflozin administered once daily if HbA1c >= 7% at week 12

Experimental: Low dose Saxagliptin - Oral route. Start with a low dose of saxagliptin administered once daily and remain on the low dose regardless of your HbA1c at week 12

Experimental: Low dose/high dose Saxagliptin - Oral route. Start with a low dose of saxagliptin administered once daily and up titrate to the high dose if HbA1c >= 7% at week 12

Placebo Comparator: Placebo arm - Oral route. Placebo tablets administered for 52 weeks


Treatment: Drugs: Dapagliflozin
Tablets, Oral, 5mg , Once daily Tablets, Oral, 10mg, Once daily

Treatment: Drugs: Saxagliptin
Tablets, Oral, 2.5mg Once daily Tablets, Oral, 5mg, Once daily

Treatment: Drugs: Placebo
Matching placebo to dapagliflozin 5mg and 10 mg/saxagliptin 2.5 mg and 5 mg, Tablets, oral, Once daily

Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Dapagliflozin Versus Placebo: Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [1] 0 0
Baseline and Week 26
Primary outcome [2] 0 0
Saxagliptin Versus Placebo: Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [2] 0 0
Baseline and Week 26
Secondary outcome [1] 0 0
Dapagliflozin Low-dose/High-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [1] 0 0
Baseline and Week 26
Secondary outcome [2] 0 0
Saxagliptin Low-dose/High-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [2] 0 0
Baseline and Week 26
Secondary outcome [3] 0 0
Dapagliflozin Low-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [3] 0 0
Baseline and Week 26
Secondary outcome [4] 0 0
Saxagliptin Low-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [4] 0 0
Baseline and Week 26
Secondary outcome [5] 0 0
Dapagliflozin Versus Placebo: Adjusted Mean Change From Baseline in Fasting Plasma Glucose (FPG) at Week 26
Timepoint [5] 0 0
Baseline and Week 26
Secondary outcome [6] 0 0
Saxagliptin Versus Placebo: Adjusted Mean Change From Baseline in FPG at Week 26
Timepoint [6] 0 0
Baseline and Week 26
Secondary outcome [7] 0 0
Dapagliflozin Low-dose/High-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in FPG at Week 26
Timepoint [7] 0 0
Baseline and Week 26
Secondary outcome [8] 0 0
Saxagliptin Low-dose/High-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in FPG at Week 26
Timepoint [8] 0 0
Baseline and Week 26
Secondary outcome [9] 0 0
Dapagliflozin Low-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in FPG at Week 26
Timepoint [9] 0 0
Baseline and Week 26
Secondary outcome [10] 0 0
Saxagliptin Low-dose Versus Placebo (Weighted): Adjusted Mean Change From Baseline in FPG at Week 26
Timepoint [10] 0 0
Baseline and Week 26
Secondary outcome [11] 0 0
Percentage of Participants With Baseline HbA1c = 7% Who Achieved HbA1c < 7% at Week 26
Timepoint [11] 0 0
Baseline and Week 26
Secondary outcome [12] 0 0
Low-dose/High-dose Versus Placebo (Weighted): Percentage of Participants With Baseline HbA1c = 7% Who Achieved HbA1c < 7% at Week 26
Timepoint [12] 0 0
Baseline and Week 26
Secondary outcome [13] 0 0
Low-dose Versus Placebo (Weighted): Percentage of Participants With Baseline HbA1c = 7% Who Achieved HbA1c < 7% at Week 26
Timepoint [13] 0 0
Baseline and Week 26
Secondary outcome [14] 0 0
Low-dose Versus Uptitration to the High Dose: Adjusted Mean Change From Baseline in HbA1c at Week 26
Timepoint [14] 0 0
Baseline and Week 26
Secondary outcome [15] 0 0
Low-dose Versus Uptitration to the High Dose: Adjusted Mean Change From Baseline in FPG at Week 26
Timepoint [15] 0 0
Baseline and Week 26
Secondary outcome [16] 0 0
Dapagliflozin Low-dose Versus Uptitration to the High Dose: Percentage of Participants With Baseline HbA1c = 7% Who Achieved HbA1c < 7% at Week 26
Timepoint [16] 0 0
Baseline and Week 26
Secondary outcome [17] 0 0
Saxagliptin Low-dose Versus Uptitration to the High Dose: Percentage of Participants With Baseline HbA1c = 7% Who Achieved HbA1c < 7% at Week 26
Timepoint [17] 0 0
Baseline and Week 26

Eligibility
Key inclusion criteria
- Signed Written Informed Consent

- Target Population

- Previously diagnosed with Type 2 Diabetes Mellitus by World Health Organization/ADA
criteria

- HbA1c between 6.5% and 10.5% obtained at screening.

- Currently on diet and exercise and stable dose of at least 1000 mg metformin (IR or
XR) for a minimum of 8 weeks, or stable dose of insulin for a minimum of 8 weeks, or a
stable combination of at least 1000 mg metformin (IR or XR) and insulin for a minimum
of 8 weeks prior to randomization. For those children on insulin, investigators will
confirm that attempts at removing insulin from the subject's therapeutic regimen had
been previously made but had not been successful.

- Age and Reproductive Status

- Male and female patients eligible if 10 years of age, up to but not including 18 years
of age at the time of enrollment/screening. At least 30% of total subjects will be
between the ages of 10 and 14 years and at least one third, but no more than two
thirds, female subjects.

- Women of childbearing potential must have a negative pregnancy test within 24 hours
prior to the start of study drug.

- Women must not be breastfeeding.

- Women of childbearing potential must agree to follow instructions for method(s) of
contraception for the duration of treatment with study drugs: saxagliptin, and
dapagliflozin, plus 5 half-lives of study drugs or 30 days (whichever is longer), plus
30 days (duration of ovulatory cycle) for a total of 60 days post treatment
completion.
Minimum age
10 Years
Maximum age
18 Years
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
- Target Disease Exceptions

- Presence of Type 1 diabetes, as demonstrated by Preexisting diagnosis of Type 1
diabetes,

- Previous diagnosis of monogenic etiology of Type 2 diabetes

- Diabetes ketoacidosis (DKA) within 6 months of screening

- Current use of the following medications for the treatment of diabetes, or use within
the specified timeframe prior to screening for the main study:

- Eight weeks: sulfonylureas, alpha glucosidase inhibitors, metiglinide, oral or
injectable incretins or incretin mimetics, other antidiabetes medications not
otherwise specified.

- Sixteen weeks: thiazolidinediones, DPP-4 inhibitors (with no reported medication
related AEs related to DPP-4 inhibitors), sodium glucose cotransporter-2 (SGLT-2)
inhibitors (with no reported medication related AEs related to SGLT-2 inhibitors)

- Initiation or discontinuation of prescription or non-prescription weight loss drugs
within 8 weeks of screening. Use of prescription or non-prescription weight loss drugs
must be stable during the study.

- Medical History and Concurrent Diseases

- Pregnant, positive serum pregnancy test, planning to become pregnant during the
clinical trials, or breastfeeding

- History of unstable or rapidly progressive renal disease

- History of unresolved vesico-ureteral reflux

- History of or current, acute or chronic pancreatitis

- History of hemoglobinopathy, with the exception of sickle cell trait or thalassemia
minor; or chronic or recurrent hemolysis

- Malignancy within 5 years of the screening visit (with the exception of treated basal
cell or treated squamous cell carcinoma)

- Replacement or chronic systemic corticosteroid therapy, defined as any dose of
systemic corticosteroid taken for > 4 weeks within 3 months prior to the Day 1 visit

- Physical and Laboratory Test Findings

- Abnormal renal function,

- An abnormal thyroid-stimulating hormone (TSH) value at enrollment will be further
evaluated for free T4. Subjects with abnormal free T4 values will be excluded.

- Hematuria (confirmed by microscopy at screening) with no explanation as judged by the
Investigator up to randomization.

- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2× upper limit of
normal (ULN), or clinically significant hepatic disease.

- Serum total bilirubin (TB) > 2x ULN unless exclusively caused by Gilbert's syndrome

- Positive serologic evidence of current infectious liver disease including anti
hepatitis A virus (HAV) (IgM), hepatitis B surface antigen (HBsAg), or anti hepatitis
C virus (HCV). Patients who have isolated positive anti-hepatitis B surface antibodies
may be included.

- Anemia of any etiology

- Volume-depleted subjects.

- Allergies and Adverse Drug Reaction

- Known allergy, sensitivity or contraindication to any study drug or its
excipient/vehicle

- Other Exclusion Criteria

- Subject is currently abusing alcohol or other drugs or has done so within the last 6
months prior to the screening visit.

- Prisoners or subjects who are involuntarily incarcerated. (Note: under certain
specific circumstances a person who has been imprisoned may be included or permitted
to continue as a subject. Strict conditions apply and Sponsor/designee approval is
required.)

- Subjects who are compulsorily detained for treatment of either a psychiatric or
physical (e.g., infectious disease) illness.

- Psychiatric or cognitive disorder that will, in the opinion of investigators, limit
the subject's ability to comply with the study medications and monitoring.

- Subjects who have contraindications to therapy as outlined in the saxagliptin and
dapagliflozin Investigator Brochure or local package inserts.

- Participation and receiving IP in another clinical study during the prior 3 months

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Research Site - Blacktown
Recruitment postcode(s) [1] 0 0
2148 - Blacktown
Recruitment outside Australia
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United States of America
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California
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Connecticut
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Georgia
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Idaho
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United States of America
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New Jersey
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United States of America
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Tennessee
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Texas
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United States of America
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Virginia
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Argentina
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Buenos Aires
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Caba
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Ciudad de Buenos Aires
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Hat Yai
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Aydin
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Bursa
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Istanbul
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Manisa
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Ukraine
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Dnipro
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Ukraine
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Kyiv
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Ukraine
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Vinnytsia
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United Kingdom
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Birmingham
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London
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Middlesborough
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United Kingdom
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Nottingham

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
AstraZeneca
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The primary objective of this study is to determine if there will be a greater mean reduction
from baseline in glycated hemoglobin (HbA1c) achieved after 26 weeks of oral double-blind
add-on therapy of dapagliflozin or saxagliptin compared to placebo in paediatric T2DM
patients with HbA1c levels of 6.5 to 10.5% on diet and exercise and metformin, insulin, or
metformin plus insulin.
Trial website
https://clinicaltrials.gov/ct2/show/NCT03199053
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
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Phone 0 0
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Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT03199053