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DiabetesPhase 3NCT01880736

A Trial Investigating the Efficacy and Safety of Flexible vs. Fixed Dosing and Simple vs. Stepwise Titration With Once Daily (OD) Insulin Degludec in Inadequately Treated Subjects With Type 2 Diabetes

A Phase 3 study testing insulin degludec in people with Diabetes and Diabetes Mellitus, Type 2, run by Novo Nordisk A/S at 40 sites in Japan.

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

This trial is conducted in Asia. The aim of the trial is to investigate the efficacy and safety of flexible versus fixed dosing and simple versus stepwise titration with OD insulin degludec in inadequately treated subjects with type 2 diabetes. Read more about this study

Who is it for?
Ages 20 years and older
Conditions the study is for
Diabetes, Diabetes Mellitus, Type 2
What is being tested?
insulin degludec
Could I receive a placebo?
No, everyone receives an active treatment
How many people
458 participants
Where
40 sitesJapan
Study dates
Jun 2013to Apr 2014
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 20 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Current treatment with IGlar (insulin glargine) with or without OADs (oral antidiabetic drug). All antidiabetic treatments should have been on-going for at least 12 weeks prior to randomisation, and doses of OADs should have been stable in this period of time. - Please note that a maximum of 3 OADs are allowed during this trial: metformin, sulphonylurea (SU)/glinides, dipeptidyl peptidase 4 (DPP-IV) inhibitors, alfa-glucosidaseinhibitors or pioglitazone.
  • Diagnosis of T2DM (type 2 diabetes mellitus) at the discretion of the investigator for at least 26 weeks prior to visit 1 (Screening visit)
  • HbA1c 7.0-9.5% (both inclusive) by central laboratory analysis
  • Body mass index (BMI) equal to or below 35 kg/m^2

Who cannot join

  • Any chronic disorder or severe disease which, in the opinion of the Investigator might jeopardise subject's safety or compliance with the protocol
  • Stroke; decompensated heart failure New York Heart Association (NYHA) class III or IV; myocardial infarction; unstable angina pectoris; or coronary arterial bypass graft or angioplasty; all within the last 26 weeks prior to Visit 1 (Screening visit)
  • Impaired renal function, defined as serum-creatinine higher than or equal to 1.4 mg/dL for males and higher than or equal to 1.3 mg/dL for females
  • Current or past (within the last 5 years) malignant neoplasms (except basal cell and squamous cell skin carcinoma)
  • Treatment with glucose-lowering agent(s) other than stated in the inclusion criteria in a period of 12 weeks prior to randomisation

Trial locations and contacts

40 sites in 1 country.

40 sites in 1 country

Japan40 sites
  • Novo Nordisk Investigational Site

    Chuo-ku, Tokyo, 103 0002

  • Novo Nordisk Investigational Site

    Chuo-ku, Tokyo, 103 0027

  • Novo Nordisk Investigational Site

    Fukui-shi, Fukui, 918-8503

  • Novo Nordisk Investigational Site

    Fukuoka, 812 0025

  • Novo Nordisk Investigational Site

    Gifu-shi, Gifu, 501-1194

  • Novo Nordisk Investigational Site

    Izumisano, 598 0048

  • Novo Nordisk Investigational Site

    Kagoshima-shi, Kagoshima, 890-8520

  • Novo Nordisk Investigational Site

    Kamakura-shi, 247 0056

  • Novo Nordisk Investigational Site

    Kashiwara-shi, Osaka, 582 0005

  • Novo Nordisk Investigational Site

    Katsushika-ku, Tokyo, 125 0054

  • Novo Nordisk Investigational Site

    Kawasaki-shi, Kanagawa, 216-8511

  • Novo Nordisk Investigational Site

    Kitakyushu-shi, Fukuoka, 800 0252

  • Novo Nordisk Investigational Site

    Kitakyushu-shi, Fukuoka, 807-8555

  • Novo Nordisk Investigational Site

    Kitakyusyu-shi, Fukuoka, 800-0222

  • Novo Nordisk Investigational Site

    Koriyama-shi, Fukushima, 963 8851

  • Novo Nordisk Investigational Site

    Kumamoto-shi,Kumamoto, 862 0976

  • Novo Nordisk Investigational Site

    Mito-shi, Ibaraki, 310-0845

  • Novo Nordisk Investigational Site

    Miyazaki, 880 0034

  • Novo Nordisk Investigational Site

    Naka-shi, Ibaraki, 311 0113

  • Novo Nordisk Investigational Site

    Niigata-shi, Niigata, 951-8520

  • Novo Nordisk Investigational Site

    Nishinomiya-shi, Hyogo, 663-8501

  • Novo Nordisk Investigational Site

    Ōita, 870 0039

  • Novo Nordisk Investigational Site

    Okawa-shi, Fukuoka, 831 0016

  • Novo Nordisk Investigational Site

    Osaka-shi, Osaka, 532 0003

  • Novo Nordisk Investigational Site

    Oyama-shi, Tochigi, 323 0022

  • Novo Nordisk Investigational Site

    Sakaide-shi, Kagawa, 762-0031

  • Novo Nordisk Investigational Site

    Sapporo-shi, Hokkaido, 060 0062

  • Novo Nordisk Investigational Site

    Sapporo-shi, Hokkaido, 060-0001

  • Novo Nordisk Investigational Site

    Sapporo-shi, Hokkaido, 062 0007

  • Novo Nordisk Investigational Site

    Sendai, 980 0021

  • Novo Nordisk Investigational Site

    Shimotsuke-shi, Tochigi, 329 0433

  • Novo Nordisk Investigational Site

    Suita-shi, Osaka, 565-0853

  • Novo Nordisk Investigational Site

    Takatsuki-shi, Osaka, 569 1096

  • Novo Nordisk Investigational Site

    Tokyo, 103-0028

  • Novo Nordisk Investigational Site

    Tokyo, 113-8655

  • Novo Nordisk Investigational Site

    Tokyo, 123-0845

  • Novo Nordisk Investigational Site

    Tokyo, 143-8541

  • Novo Nordisk Investigational Site

    Tokyo, 144-0051

  • Novo Nordisk Investigational Site

    Tokyo, 162-8655

  • Novo Nordisk Investigational Site

    Yokkaichi-shi, Mie, 510-0829

Other trials in Japan

About this study

Official title: A Trial Investigating the Efficacy and Safety of Flexible vs. Fixed Dosing and Simple vs. Stepwise Titration With Once Daily Insulin Degludec in Inadequately Treated Subjects With Type 2 Diabetes

This trial is conducted in Asia. The aim of the trial is to investigate the efficacy and safety of flexible versus fixed dosing and simple versus stepwise titration with OD insulin degludec in inadequately treated subjects with type 2 diabetes.

Being tested
insulin degludec
Medical subject headings
Diabetes Mellitus, Diabetes Mellitus, Type 2

What participants receive

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

  • insulin degludecDrug

    Individual dose adjusted once weekly. IDeg (100 U/mL, 3 mL FlexTouch® pen PDS290) to be administered under the skin OD with the option to vary time of administration within a window of plus/minus 8 hours. A maximum of 3 pre-trial OADs are allowed during the trial at an unchanged, stable dose level and dosing frequency.

  • insulin degludecDrug

    Individual dose adjusted once weekly. IDeg (100 U/mL, 3 mL FlexTouch® pen PDS290) to be administered under the skin OD at the same time each day. A maximum of 3 pre-trial OADs are allowed during the trial at an unchanged, stable dose level and dosing frequency.

  • insulin degludecDrug

    Individual dose adjusted once weekly. IDeg (100 U/mL, 3 mL FlexTouch® pen PDS290) to be administered subcutaneously (under the skin) OD at the same time each day. A maximum of 3 pre-trial oral anti-diabetic drugs (OADs) are allowed during the trial at an unchanged, stable dose level and dosing frequency.

Study groups in NCT01880736
Study groupRoleWhat they receive
IDeg OD Flexible DoseExperimentalNot described
Receives: Drug: insulin degludec
IDeg OD Fixed DoseExperimentalNot described
Receives: Drug: insulin degludec
IDeg OD SimpleExperimentalNot described
Receives: Drug: insulin degludec
IDeg OD StepwiseExperimentalNot described
Receives: Drug: insulin degludec

What is being measured

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

  1. Change From Baseline in HbA1c (%) Glycosylated Haemoglobin)

    Changes from baseline in HbA1c values over time period of Week 0-26 were evaluated by dosing regimen (flexible vs. fixed dosing) and by titration algorithm (simple vs stepwise)

    Measured: Week 0, week 26

Secondary outcomes (8)
  1. Change From Baseline in Fasting Plasma Glucose (FPG)

    Changes from baseline in FPG values over the time period of Week 0-26 were evaluated by dosing regimen (flexible vs. fixed dosing) and by titration algorithm (simple vs stepwise).

    Measured: Week 0, week 26

  2. Responder for HbA1c (%) Based on Central Laboratory Assessment: HbA1c Below 7.0% at End of Trial

    The number of subjects who achieved the pre-defined HbA1c target (<7.0%) after 26 weeks of treatment was recorded by dosing regimen (flexible vs. fixed dosing) and by titration algorithm (simple vs stepwise).

    Measured: After 26 weeks of treatment

  3. Incidence of Treatment Emergent Adverse Events (TEAEs)

    The incidences of treatment emergent adverse events (TEAEs) over the time period of Week 0-26 were recorded by dosing regimen (flexible vs. fixed dosing); and by titration algorithm (simple vs stepwise).

    Measured: Weeks 0-26

  4. Number of Treatment Emergent Confirmed Hypoglycaemic Episodes (Defined as Severe Hypoglycaemia and/or a Measured Plasma Glucose (PG) Less Than 3.1 mmol/L (Less Than 56 mg/dL))

    The confirmed hypoglycaemic episodes (defined as severe hypoglycaemia and/or a measured plasma glucose (PG) less than 3.1 mmol/L [less than 56 mg/dL]) over the time period of Week 0-26 was recorded by dosing regimen (flexible vs. fixed dosing); and by titration algorithm (simple vs stepwise).

    Measured: Weeks 0-26

  5. Number of Treatment Emergent Hypoglycaemic Episodes According to the American Diabetes Association (ADA) Definition

    Number of treatment emergent hypoglycaemic episodes according to the ADA definition (classified as severe hypoglycaemia, documented hypoglycaemia, asymptomatic hypoglycaemia, probable symptomatic hypoglycaemia, relative hypoglycaemia) over the time period of Week 0-26 was recorded by dosing regimen (flexible vs. fixed dosing) and by titration algorithm (simple vs stepwise).

    Measured: Weeks 0-26

  6. Number of Treatment Emergent Confirmed Hypoglycaemic Episodes in the Maintenance Period

    The number of treatment mergent confirmed hypoglycaemic episodes in the maintenance period from Week 16 to end of trial (week 27) was recorded by dosing regimen (flexible vs. fixed dosing) and by titration algorithm (simple vs. stepwise). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes with a confirmed plasma glucose value of less than 3.1 mmol/L.

    Measured: From Week 16 to end of trial (week 27)

  7. Number of Treatment Emergent Nocturnal (00:01-05:59 am) Confirmed Hypoglycaemic Episodes

    The number of treatment emergent nocturnal (00:01-05:59 am) confirmed hypoglycaemic episodes over the time period of Week 0-26 was recorded by dosing regimen (flexible vs. fixed dosing) and by titration algorithm (simple vs stepwise). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes with a confirmed plasma glucose value of less than 3.1 mmol/L. Nocturnal hypoglycaemic episodes are defined as occurring between 00:01 and 05:59 a.m.

    Measured: Weeks 0-26

  8. Number of Treatment Emergent Nocturnal (00:01-05:59 am) Confirmed Hypoglycaemic Episodes in the Maintenance Period

    The number of treatment emergent nocturnal (00:01-05:59 am) confirmed hypoglycaemic episodes in the maintenance period from 16 weeks to end of trial (week 27) was recorded by dosing regimen (flexible vs. fixed dosing); and by titration algorithm (simple vs stepwise). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes with a confirmed plasma glucose value of less than 3.1 mmol/L. Nocturnal hypoglycaemic episodes are defined as occurring between 00:01 and 05:59 a.m.

    Measured: From week 16 to end of trial (week 27)

Timeline

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

  1. First posted19 Jun 2013 (estimated)
  2. Study startJun 2013
  3. Primary completionApr 2014
  4. Study completionApr 2014

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
None (open label)
Enrolment
458 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01880736
Sponsor's protocol ID
NN1250-4060
Other IDs
U1111-1137-0953, JapicCTI- 132164
Status last verified
Dec 2016
First submitted
14 Jun 2013
Last updated
10 Feb 2017
Data monitoring committee
No

Publications

  • Kadowaki T, Jinnouchi H, Kaku K, Herslov ML, Hyllested-Winge J, Nakamura S. Insulin degludec in a simple or stepwise titration algorithm in a Japanese population of patients with type 2 diabetes: a randomized, 26-week, treat-to-target trial. Diabetol Int. 2016 Sep 2;8(1):87-94. doi: 10.1007/s13340-016-0284-9. eCollection 2017 Mar.

    PubMed 30603311
  • Kadowaki T, Jinnouchi H, Kaku K, Herslov ML, Hyllested-Winge J, Nakamura S. Efficacy and safety of once-daily insulin degludec dosed flexibly at convenient times vs fixed dosing at the same time each day in a Japanese cohort with type 2 diabetes: A randomized, 26-week, treat-to-target trial. J Diabetes Investig. 2016 Sep;7(5):711-7. doi: 10.1111/jdi.12502. Epub 2016 Apr 1.

    PubMed 27182031

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing insulin degludec in people with Diabetes and Diabetes Mellitus, Type 2, run by Novo Nordisk A/S at 40 sites in Japan.

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 4 inclusion and 5 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 10 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 40 sites in Japan. 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. 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?

Yes. Results are posted in the registry (first posted 17 Mar 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Change From Baseline in HbA1c (%) Glycosylated Haemoglobin) (time frame: Week 0, week 26). 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 NCT01880736, which also lists 2 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 10 Feb 2017.

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