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Diabetes MellitusPhase 3PROactiveNCT00174993

Efficacy of Pioglitazone on Macrovascular Outcome in Patients With Type 2 Diabetes

A Phase 3 study testing Pioglitazone in people with Diabetes Mellitus, run by Takeda at 19 sites in 19 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine whether pioglitazone, once daily (QD), can delay the time to death, heart attack, acute coronary syndrome, heart bypass surgery, stroke, leg bypass surgery or amputation in patients with type 2 diabetes. Read more about this study

Who is it for?
Ages 35 to 75 years
Conditions the study is for
Diabetes Mellitus
What is being tested?
Pioglitazone
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
4,373 participants
Where
19 sitesin 19 countries
Study dates
May 2001to Jan 2005
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 35 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Type 2 diabetes mellitus
  • Glycosylated hemoglobin above the upper limit of normal (ie, the local equivalent of 6.5% for)
  • Established history of macrovascular disease, defined as 1 or more of:
  • Myocardial infarction at least 6 months before entry into the study.
  • Stroke at least 6 months before entry into the study
  • Percutaneous coronary intervention or coronary artery bypass graft at least 6 months before entry into the study.
Show all 9Show fewer
  • Acute coronary syndrome at least 3 months before entry into the study.
  • Objective evidence of coronary artery disease.
  • Peripheral arterial obstructive disease

Who cannot join

  • Signs of type 1 diabetes.
  • Patients prescribed insulin as sole therapy for glycemic control of diabetes for 2 weeks or more at any time in the previous 3 months.
  • Myocardial infarction, stroke, coronary artery bypass graft, or percutaneous cardiac intervention in the 6 months prior to enrolment.
  • Acute coronary syndrome in the 3 months prior to enrolment.
  • Heart failure at entry defined as patient having a New York Heart Association functional score of II or above.
  • Had an appointment for a coronary angiogram or endovascular or surgical intervention.
Show all 19Show fewer
  • Leg ulcers, gangrene, or ischemic rest pain.
  • Had an appointment for an angiogram or endovascular or surgical intervention for leg ischemia.
  • Had undergone a major operation (defined as a surgical procedure lasting for more than 30 minutes) at any time in the previous 4 weeks.
  • Significantly impaired hepatic function, defined as alanine aminotransferase greater than 2.5 times the upper limit of normal.
  • Familial polyposis coli.
  • Required dialysis.
  • History of alcohol or drug abuse.
  • Any other intercurrent disease believed to be likely to have a significant impact on the patient's life expectancy during the course of the study (eg, cancer).
  • Patient was undergoing follow-up as part of another clinical trial or less than 3 months had elapsed since the last dose of an investigational drug or procedure.
  • Hypersensitivity to pioglitazone or other TZD.
  • Current use of pioglitazone or other TZD.
  • Patient was known to be infected with human immunodeficiency virus or was known to have viral hepatitis.
  • Women who were any of the following: pregnant, breast feeding, wished to become pregnant during the course of the study or of childbearing potential and not planning to use a reliable method of contraception throughout the study.

Trial locations and contacts

19 sites in 19 countries.

19 sites in 19 countries

Austria1 site
  • Study site

    Multiple Cities

Other trials in Austria

Belgium1 site
  • Study site

    Multiple Cities

Other trials in Belgium

Czechia1 site
  • Study site

    Multiple Cities

Other trials in Czechia

Denmark1 site
  • Study site

    Multiple Cities

Other trials in Denmark

Estonia1 site
  • Study site

    Multiple Cities

Other trials in Estonia

Finland1 site
  • Study site

    Multiple Cities

Other trials in Finland

France1 site
  • Study site

    Multiple Cities

Other trials in France

Germany1 site
  • Study site

    Multiple Cities

Other trials in Germany

Hungary1 site
  • Study site

    Multiple Cities

Other trials in Hungary

Italy1 site
  • Study site

    Multiple Cities

Other trials in Italy

Latvia1 site
  • Study site

    Multiple Cities

Other trials in Latvia

Lithuania1 site
  • Study site

    Multiple Cities

Other trials in Lithuania

Netherlands1 site
  • Study site

    Multiple Cities

Other trials in Netherlands

Norway1 site
  • Study site

    Multiple Cities

Other trials in Norway

Poland1 site
  • Study site

    Multiple Cities

Other trials in Poland

Slovakia1 site
  • Study site

    Multiple Cities

Other trials in Slovakia

Sweden1 site
  • Study site

    Multiple Cities

Other trials in Sweden

Switzerland1 site
  • Study site

    Multiple Cities

Other trials in Switzerland

United Kingdom1 site
  • Study site

    Multiple Cities

Other trials in United Kingdom

About this study

Official title: PROspective PioglitAzone Clinical Trial In MacroVascular Events: A Macrovascular Outcome Study in Type 2 Diabetic Patients Comparing Pioglitazone With Placebo in Addition to Existing Therapy

The purpose of this study is to determine whether pioglitazone, once daily (QD), can delay the time to death, heart attack, acute coronary syndrome, heart bypass surgery, stroke, leg bypass surgery or amputation in patients with type 2 diabetes.

Read the detailed description

Diabetes mellitus is one of the most common non-communicable diseases worldwide. More than 22 million persons have been diagnosed with diabetes in the European region of the International Diabetes Federation. Complications of diabetes involving both microvascular and macrovascular systems contribute to increased disability and reduced life expectancy. Damage to the coronary, cerebral (brain), and peripheral vascular beds as a consequence of diabetes is responsible for the increased macrovascular illness and death associated with the disease.

Insulin resistance is common to the genesis of both atherosclerosis and type 2 diabetes mellitus. In diabetes, insulin resistance is coupled to receptor dysfunction. In atherosclerosis, insulin resistance may have both direct effects on the cardiovascular system as well as indirect effects provoked by imbalances in blood glucose, lipids, clotting factors, endothelial function, and other factors. Considerable indirect evidence suggests that peroxisome proliferator-activated receptor agonists may favorably influence macrovascular outcome, either through modification of risk factors (such as blood lipids) or through effects on the vessel wall.

Pioglitazone, a thiazolidinedione compound discovered by Takeda Pharmaceutical Company, Ltd, functions as a peroxisome proliferator-activated receptor agonist as its mode of action.

This study is designed to assess whether pioglitazone in combination with other medications administered for glycemic management of type 2 diabetes might reduce the incidence of macrovascular events associated with this disease compared with placebo. Individuals who participate in this study will provide written informed consent and will be required to commit to screening and randomization visits and approximately 17 additional visits (1 every 2 months for the first year and every 3 months thereafter) at the study center. Study participation is anticipated to be about 40 months (or approximately 3 years and 4 months). Multiple procedures will occur at each visit which may include fasting, blood collection, physical examinations and electrocardiograms.

Being tested
Pioglitazone, Placebo
Keywords
Glucose Metabolism Disorder, Dysmetabolic Syndrome, Type II Diabetes; Diabetes Mellitus, Lipoatrophic, Dyslipidemia, Drug Therapy
Medical subject headings
Diabetes Mellitus, Glucose Metabolism Disorders, Diabetes Mellitus, Type 2, Dyslipidemias

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PioglitazoneDrug

    Also called Actos, AD4833

    Pioglitazone 15 mg to 45 mg, tablets, orally, once daily for up to 48 months.

  • PlaceboDrug

    Pioglitazone placebo-matching tablets, orally, once daily for up to 48 months

Study groups in NCT00174993
Study groupRoleWhat they receive
Pioglitazone QDExperimentalNot described
Receives: Drug: Pioglitazone
Placebo QDPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time to the Composite of All Cause Mortality, Non-Fatal Myocardial Infarction, Stroke, Acute Coronary Syndrome, Major Leg Amputation, Cardiac Intervention, Bypass Surgery or Leg Revascularization.

    Measured: At First Occurrence

Secondary outcomes (9)
  1. Time to All Cause Mortality.

    Measured: At occurrence

  2. Time to Non-Fatal Myocardial Infarction.

    Measured: At occurrence

  3. Time to Acute Coronary Syndrome.

    Measured: At occurrence

  4. Time to Cardiac Intervention (including coronary artery bypass graft or percutaneous coronary intervention).

    Measured: At occurrence

  5. Time to Stroke.

    Measured: At occurrence

  6. Time to Major Leg Amputation (above the ankle).

    Measured: At occurrence

  7. Time to Bypass Surgery

    Measured: At occurrence

  8. Time to Revascularization of the Leg.

    Measured: At occurrence

  9. Time to Cardiovascular Mortality.

    Measured: At occurrence

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Sep 2005 (estimated)
  2. Study startMay 2001
  3. Primary completionJan 2005
  4. Study completionJan 2005

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
4,373 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00174993
Sponsor's protocol ID
AD4833/EC444
Other IDs
U1111-1114-2854
Acronym
PROactive
Status last verified
Feb 2012
First submitted
9 Sep 2005
Last updated
28 Feb 2012
Results posted
No
Data monitoring committee
No

Publications

  • Bottomley JM, Palmer AJ, Williams R, Dormandy JA, Massi-Benedetti M. PROactive 03: Pioglitazone, type 2 diabetes and reducing macrovascular events - economic implications?. Br J Diabetes Vasc Dis 2006;6(Pt 2):64-69

  • Kirby,M, Heart Disease Prevention - What Place for the Glitazones. Br J Cardiol 2006;13:(1):66-70.

  • Brandle M, Goodall G, Erny-Albrecht KM, Erdmann E, Valentine WJ. Cost-effectiveness of pioglitazone in patients with type 2 diabetes and a history of macrovascular disease in a Swiss setting. Swiss Med Wkly. 2009 Mar 21;139(11-12):173-84. doi: 10.4414/smw.2009.12381.

    PubMed 19330561
  • Betteridge DJ, DeFronzo RA, Chilton RJ. PROactive: time for a critical appraisal. Eur Heart J. 2008 Apr;29(8):969-83. doi: 10.1093/eurheartj/ehn114. Epub 2008 Mar 28.

    PubMed 18375395
  • Scherbaum WA, Goodall G, Erny-Albrecht KM, Massi-Benedetti M, Erdmann E, Valentine WJ. Cost-effectiveness of pioglitazone in type 2 diabetes patients with a history of macrovascular disease: a German perspective. Cost Eff Resour Alloc. 2009 May 5;7:9. doi: 10.1186/1478-7547-7-9.

    PubMed 19416529
  • van Troostenburg de Bruyn AR, Dormandy J. Risk of thiazolidinedione-associated fracture should be appropriately assessed. Arch Intern Med. 2010 Jan 25;170(2):209-10. doi: 10.1001/archinternmed.2009.487. No abstract available.

    PubMed 20101019
  • Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, Skene AM, Tan MH, Lefebvre PJ, Murray GD, Standl E, Wilcox RG, Wilhelmsen L, Betteridge J, Birkeland K, Golay A, Heine RJ, Koranyi L, Laakso M, Mokan M, Norkus A, Pirags V, Podar T, Scheen A, Scherbaum W, Schernthaner G, Schmitz O, Skrha J, Smith U, Taton J; PROactive Investigators. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005 Oct 8;366(9493):1279-89. doi: 10.1016/S0140-6736(05)67528-9.

    PubMed 16214598
  • Schneider CA, Ferrannini E, Defronzo R, Schernthaner G, Yates J, Erdmann E. Effect of pioglitazone on cardiovascular outcome in diabetes and chronic kidney disease. J Am Soc Nephrol. 2008 Jan;19(1):182-7. doi: 10.1681/ASN.2007060678. Epub 2007 Dec 5.

    PubMed 18057215
  • Ryden L, Thrainsdottir I, Swedberg K. Adjudication of serious heart failure in patients from PROactive. Lancet. 2007 Jan 20;369(9557):189-90. doi: 10.1016/S0140-6736(07)60106-8. No abstract available.

    PubMed 17240282
  • Erdmann E, Dormandy J, Wilcox R, Massi-Benedetti M, Charbonnel B. PROactive 07: pioglitazone in the treatment of type 2 diabetes: results of the PROactive study. Vasc Health Risk Manag. 2007;3(4):355-70.

    PubMed 17969365
  • Erdmann E, Dormandy JA. The Effect of Pioglitazone on Recurrent Myocardial Infarction in 2445 Patients with Type 2 Diabetes and Preexisting Myocardial Infarction - Data from the PROactive Study. Circulation 2005;112:(21):3364-3364

  • Erdmann E, Dormandy JA, Charbonnel B, Massi-Benedetti M, Moules IK, Skene AM; PROactive Investigators. The effect of pioglitazone on recurrent myocardial infarction in 2,445 patients with type 2 diabetes and previous myocardial infarction: results from the PROactive (PROactive 05) Study. J Am Coll Cardiol. 2007 May 1;49(17):1772-80. doi: 10.1016/j.jacc.2006.12.048. Epub 2007 Apr 16.

    PubMed 17466227
  • Valentine WJ, Bottomley JM, Palmer AJ, Brandle M, Foos V, Williams R, Dormandy JA, Yates J, Tan MH, Massi-Benedetti M; PROactive Study Group. PROactive 06: cost-effectiveness of pioglitazone in Type 2 diabetes in the UK. Diabet Med. 2007 Sep;24(9):982-1002. doi: 10.1111/j.1464-5491.2007.02188.x. Epub 2007 Jun 25.

    PubMed 17593245
  • Wilcox R, Bousser MG, Betteridge DJ, Schernthaner G, Pirags V, Kupfer S, Dormandy J; PROactive Investigators. Effects of pioglitazone in patients with type 2 diabetes with or without previous stroke: results from PROactive (PROspective pioglitAzone Clinical Trial In macroVascular Events 04). Stroke. 2007 Mar;38(3):865-73. doi: 10.1161/01.STR.0000257974.06317.49. Epub 2007 Feb 8.

    PubMed 17290029
  • Erdmann E, Charbonnel B, Wilcox RG, Skene AM, Massi-Benedetti M, Yates J, Tan M, Spanheimer R, Standl E, Dormandy JA; PROactive Investigators. Pioglitazone use and heart failure in patients with type 2 diabetes and preexisting cardiovascular disease: data from the PROactive study (PROactive 08). Diabetes Care. 2007 Nov;30(11):2773-8. doi: 10.2337/dc07-0717. Epub 2007 Jul 31.

    PubMed 17666462

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Pioglitazone in people with Diabetes Mellitus, run by Takeda at 19 sites in 19 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Feb 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Austria, Belgium, Czechia, Denmark, Estonia and 14 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time to the Composite of All Cause Mortality, Non-Fatal Myocardial Infarction, Stroke, Acute Coronary Syndrome, Major Leg Amputation, Cardiac Intervention, Bypass Surgery or Leg Revascularization. (time frame: At First Occurrence). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00174993, which also lists 30 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Feb 2012.

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