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Coronary Artery DiseasePhase 4AddHope2NCT01595789

The Effect of Liraglutide on the Treatment of Coronary Artery Disease and Type 2 Diabetes

A Phase 4 study testing Liraglutide in people with Coronary Artery Disease and Diabetes Mellitus, Type 2, run by Haugaard, Steen Bendix, M.D., DMSc at 1 site in Denmark.

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 investigate the effect of combined glucagon-like-peptide-1 (GLP-1) analogue and metformin therapy on glucose metabolic and cardiovascular endpoints compared to metformin monotherapy in patients with coronary artery disease (CAD) and newly diagnosed type 2 diabetes (T2D). Read more about this study

Who is it for?
Ages 18 to 85 years
What is being tested?
Liraglutide
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
41 participants
Where
1 siteDenmark
Study dates
May 2012to Jul 2015
Phase
Phase 4
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 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Stable CAD documented by one of the following:
  • Previous MI (a minimum of 6 weeks after an acute MI)
  • Previous coronary revascularization
  • CAD confirmed by an abnormal coronary angiography (CAG) or CT-angiography showing stenosis > 50% of any major coronary arteries.
  • Body mass index (BMI) >/= 25,0 kg/m2
  • Age >/= 18 years and </= 85 years
Show all 11Show fewer
  • Type 2 diabetes diagnosed by one of the following criteria:
  • HbA1c >/= 6.5%
  • HbA1c < 6.5 % and fasting plasma glucose >/= 7.0 mmol/l (confirmed)
  • HbA1c < 6.5 % and a 2 h plasma glucose value during OGTT >/= 11.1 mmol/l
  • The data for glucose metabolism are accepted provided that they have been obtained within 24 months prior to inclusion of the patient. The glucose metabolic categories are defined by ADA and WHO criteria.

Who cannot join

  • Type 1 diabetes mellitus defined as C-peptide < 450 pM
  • Previously diagnosed diabetes mellitus for more than 24 months prior to the screening procedure for this trial, except from gestational diabetes
  • Use of more than 2 types of oral antidiabetic medication and/or use of parenteral antidiabetic medication in the period of 3 months prior to the screening visit. It is accepted that the patient continues his usual antidiabetic medication after the screening visit but antidiabetic medication must be discontinued 2 weeks prior to the baseline visit.
  • Significant heart disease (NYHA > 2; Ejection Fraction < 40% and unstable angina pectoris) and known severe valve disease
  • Documented atrial fibrillation or atrial flutter within 6 weeks previous to the screening. Paroxysmal atrial fibrillation is accepted if sinus rhythm is achieved at the screening.
  • Uncontrolled arterial hypertension (> 180/100 mmHg) at the time of screening
Show all 25Show fewer
  • Liver (transaminases greater than x 2 the upper normal level) or renal diseases (eGFR < 60 ml/min)
  • Amylase greater than x 3 the upper reference value
  • Any chronic medical condition to unduly increase risk for the potential enrollee as judged by study investigators
  • Dysregulated myxedema or hyperthyroid condition defined by a value of TSH < 0,1 and > 10,0 milli U/L
  • Anemia (< 85% of lower normal limit), leucopenia (< 85% of lower normal limit), or thrombocytopenia (< 85% of lower normal limit)
  • Pregnancy or failure to comply with contraception planning within two years, or breastfeeding
  • Abuse of alcohol or drugs, or any other co-existing condition that would make patients unsuitable to participate in the study, as judged by the investigators
  • Use of immunosuppressive therapy in the preceding 12 months
  • Chronic pancreatitis or previous acute pancreatitis
  • Known or suspected hypersensitivity to trial product(s) or related products
  • Treatment with oral glucocorticoids, calcineurin inhibitors, or dipeptidyl peptidase 4 (DPP4) inhibitors, or other GLP-1 mimetics (e.g. exenatide), which in the Investigator's opinion could interfere with glucose metabolism
  • Cancer (except basal cell skin cancer or squamous cell skin cancer) or any other clinically significant disorder, which in the Investigator's opinion could interfere with the results of the trail
  • Inflammatory bowel disease
  • Previous bowel resection
  • Clinical signs of diabetic gastroparesis
  • Plasma calcium-ion >/= 1,45 mmol/L
  • Plasma calcitonin >/= 50 ng/L
  • Subjects with personal or family history of medullary thyroid carcinoma or a personal history of multiple endocrine neoplasia type 2
  • Refusal to sign informed consent.

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Copenhagen University Hospital, Bispebjerg

    Copenhagen, Bispebjerg, 2400

Other trials in Denmark

About this study

Official title: Adding Liraglutide to the Backbone Therapy of Biguanide in Patients With Coronary Artery Disease and Newly Diagnosed Type-2 Diabetes

The purpose of this study is to investigate the effect of combined glucagon-like-peptide-1 (GLP-1) analogue and metformin therapy on glucose metabolic and cardiovascular endpoints compared to metformin monotherapy in patients with coronary artery disease (CAD) and newly diagnosed type 2 diabetes (T2D).

It is hypothesized that GLP-1 analogue added to backbone therapy of metformin in CAD patients with T2D will improve beta-cell function, left ventricular ejection fraction (LVEF), heart rate variability and lower 24h blood pressure among other selected endpoints.

The present study on CAD patients with newly diagnosed T2D will address these selected endpoints during an investigator initiated, randomized, double blind, crossover, placebo-controlled 12 + 12 weeks intervention study with a 2 week wash-out period.

Read the detailed description

The total study period for each patient will be 26 weeks (12 plus 12 weeks of intervention with a 2 week wash-out period).

The endpoints will be evaluated at baseline (week 0), at week 12, at week 14 (following 2 weeks of wash-out) and finally at week 26.

Being tested
Liraglutide, Placebo
Keywords
Coronary Artery Disease, Diabetes Mellitus, Left ventricular ejection fraction, Beta-cell function
Medical subject headings
Coronary Artery Disease, Diabetes Mellitus, Type 2, Diabetes Mellitus

What participants receive

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

  • LiraglutideDrug

    Also called Brand name: Victoza, Active substance: liraglutide, EMA Product number: EMEA/H/C/001026, ATC Code: A10BX07

    Liraglutide injection pen is administered by the participant once daily by subcutaneous injection. It is given independent of meals. The starting dose is 0.6 mg. After 2 weeks the dose will be increased to 1.2 mg. The dose will be further increased after 4 weeks to 1.8 mg. After a total of 12 weeks of treatment, a wash-out period of 2 weeks follows. Subsequently, the participant will be crossed over to a second period of 12 weeks of treatment with placebo.

  • PlaceboDrug

    Volume-matched placebo injection pen is administered by the participant once daily by subcutaneous injection. It is given independent of meals. The starting dose is 0.6 mg volume-matched placebo. After 2 weeks the dose will be increased to 1.2 mg. The dose will be further increased after 4 weeks to 1.8 mg. After a total of 12 weeks of treatment, a wash-out period of 2 weeks follows. Subsequently, the participant will be crossed over to a second period of 12 weeks of treatment with liraglutide.

Study groups in NCT01595789
Study groupRoleWhat they receive
Placebo + metforminPlacebo comparatorNot described
Receives: Drug: Placebo
Liraglutide + metforminActive comparatorNot described
Receives: Drug: Liraglutide

What is being measured

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

  1. Beta-cell function

    Beta-cell function (disposition index) as measured during an intravenous glucose tolerance test (By Bergman Minimal Model)

    Measured: after 12 weeks of intervention

  2. LVEF

    Changes in LVEF assessed by dobutamine stress echocardiography

    Measured: after 12 weeks of intervention

Secondary outcomes (10)
  1. Glucagon, incretin, glucose, NEFA, insulin and C-peptide response during meal test

    Measured: Baseline (week 0), week 12, week 14, week 26

  2. Insulin sensitivity (Si), acute insulin and C-peptide response to intravenous glucose (AIRg, ACRg), glucose clearance (Kg), glucose effectiveness (Sg) and hepatic extraction of insulin (HEXi)

    Insulin sensitivity (Si), acute insulin and C-peptide response to intravenous glucose (AIRg, ACRg), glucose clearance (Kg), glucose effectiveness (Sg) and hepatic extraction of insulin (HEXi) derived from a standard frequent sampling intravenous glucose tolerance test (FSIGT, Minimal model)

    Measured: Baseline (week 0), week 12, week 14, week 26

  3. CRP, TNF-alfa and IL-6 in plasma and gene expression of IL6 and TNF-alfa in subcutaneous fat

    Measured: Baseline (week 0), week 12, week 14, week 26

  4. Non esterified fatty acids (NEFA)

    NEFA during FSIGT by use of NEFA minimal model

    Measured: Baseline (week 0), week 12, week 14, week 26

  5. Heart rate variability (HRV)

    HRV i.e. SDNN (standard deviation of all normal RR interval) assessed during HOLTER monitoring

    Measured: Baseline (week 0), week 12, week 14, week 26

  6. Maximal velocity of the myocardium in systole (s´) and in diastole (e´)

    Maximal velocity of the myocardium in systole (s´) and in diastole (e´) during the dobutamine stress test

    Measured: Baseline (week 0), week 12, week 14, week 26

  7. Changes in exercise tolerance test variables: Total exercise duration (sec), time to limiting angina (sec) and time to 1 mm ST-segment depression (sec)

    Changes in exercise tolerance test variables: Total exercise duration (sec), time to limiting angina (sec) and time to 1 mm ST-segment depression (sec)

    Measured: Baseline (week 0), week 12, week 14, week 26

  8. ST-depression and ectopic activity

    ST-depression and ectopic activity assessed during 24h HOLTER monitoring

    Measured: Baseline (week 0), week 12, week 14, week 26

  9. Diurnal blood pressure

    Measured: Baseline (week 0), week 12, week 14, week 26

  10. Diastolic heart function (E/E*)

    Diastolic heart function (E/E*) in rest and during stress

    Measured: Baseline (week 0), week 12, week 14, week 26

Timeline

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

  1. First posted10 May 2012 (estimated)
  2. Study startMay 2012
  3. Primary completionOct 2014
  4. Study completionJul 2015

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01595789
Sponsor's protocol ID
BBHAH-2011430
Other IDs
2011-005405-78
Acronym
AddHope2
Status last verified
Mar 2017
First submitted
8 May 2012
Last updated
7 Mar 2017
Results posted
No
Data monitoring committee
Yes

Publications

  • Kumarathurai P, Sajadieh A, Anholm C, Kristiansen OP, Haugaard SB, Nielsen OW. Effects of liraglutide on diastolic function parameters in patients with type 2 diabetes and coronary artery disease: a randomized crossover study. Cardiovasc Diabetol. 2021 Jan 7;20(1):12. doi: 10.1186/s12933-020-01205-2.

    PubMed 33413428
  • Anholm C, Kumarathurai P, Jurs A, Pedersen LR, Nielsen OW, Kristiansen OP, Fenger M, Holst JJ, Madsbad S, Sajadieh A, Haugaard SB. Liraglutide improves the beta-cell function without increasing insulin secretion during a mixed meal in patients, who exhibit well-controlled type 2 diabetes and coronary artery disease. Diabetol Metab Syndr. 2019 May 31;11:42. doi: 10.1186/s13098-019-0438-6. eCollection 2019.

    PubMed 31164926
  • Kumarathurai P, Anholm C, Fabricius-Bjerre A, Nielsen OW, Kristiansen O, Madsbad S, Haugaard SB, Sajadieh A. Effects of the glucagon-like peptide-1 receptor agonist liraglutide on 24-h ambulatory blood pressure in patients with type 2 diabetes and stable coronary artery disease: a randomized, double-blind, placebo-controlled, crossover study. J Hypertens. 2017 May;35(5):1070-1078. doi: 10.1097/HJH.0000000000001275.

    PubMed 28129251
  • Kumarathurai P, Anholm C, Larsen BS, Olsen RH, Madsbad S, Kristiansen O, Nielsen OW, Haugaard SB, Sajadieh A. Effects of Liraglutide on Heart Rate and Heart Rate Variability: A Randomized, Double-Blind, Placebo-Controlled Crossover Study. Diabetes Care. 2017 Jan;40(1):117-124. doi: 10.2337/dc16-1580. Epub 2016 Oct 19.

    PubMed 27797930
  • Kumarathurai P, Anholm C, Nielsen OW, Kristiansen OP, Molvig J, Madsbad S, Haugaard SB, Sajadieh A. Effects of the glucagon-like peptide-1 receptor agonist liraglutide on systolic function in patients with coronary artery disease and type 2 diabetes: a randomized double-blind placebo-controlled crossover study. Cardiovasc Diabetol. 2016 Jul 26;15(1):105. doi: 10.1186/s12933-016-0425-2.

    PubMed 27455835
  • Anholm C, Kumarathurai P, Klit MS, Kristiansen OP, Nielsen OW, Ladelund S, Madsbad S, Sajadieh A, Haugaard SB; AddHope2 Trial Study Group. Adding liraglutide to the backbone therapy of biguanide in patients with coronary artery disease and newly diagnosed type-2 diabetes (the AddHope2 study): a randomised controlled study protocol. BMJ Open. 2014 Jul 16;4(7):e005942. doi: 10.1136/bmjopen-2014-005942.

    PubMed 25031198

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Liraglutide in people with Coronary Artery Disease and Diabetes Mellitus, Type 2, run by Haugaard, Steen Bendix, M.D., DMSc at 1 site in Denmark.

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 11 inclusion and 25 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 7 Mar 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

Beta-cell function (time frame: after 12 weeks of intervention). The study lists 2 primary outcomes in all. 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 NCT01595789, which also lists 6 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 7 Mar 2017.

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