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Type 2 DiabetesPhase 3NCT02889510

Study to Assess the Efficacy of Liraglutide in Patients With Type 2 Diabetes Mellitus

A Phase 3 study testing liraglutide in people with Type 2 Diabetes, run by Lecube, Albert, M.D. at 6 sites in Spain.

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

Type 2 diabetes (T2DM) is related to reduced pulmonary function. As experimental studies with glucagon-like peptide 1 (GLP-1) have shown an increase in pulmonary surfactant secretion, and the GLP-1 receptor has been found in significant amounts in the lung, it could be hypothesized that the treatment with liraglutide… Read more about this study

Who is it for?
Ages 40 to 65 years
Conditions the study is for
Type 2 Diabetes
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
76 participants
Where
6 sitesSpain
Study dates
4 Oct 2016to 16 Dec 2019
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 40 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Signed informed consent.
  • Subjects between 40 and 65 years old. Diagnosis of type 2 diabetes mellitus with more than 5 years of evolution of disease.
  • Metformin (alone or in combination with sulfonylurea and / or insulin and / or thiazolidinediones) at a stable dose for at least the past 3 months.
  • HbA1c ≥ 7,0 y ≤ 9,0 %.
  • BMI between 30 and 40 kg / m2.
  • No pulmonary disease (COPD, asthma, fibrosis, etc) known.
  • Baseline FEV1 decline of equal or greater than 10% in the percentage of the theoretical value.
  • Chest radiography without significant changes in the lung parenchyma

Who cannot join

  • Type 1 diabetes mellitus
  • Treatment with inhibitors of dipeptidyl peptidase 4 glitazones and / or
  • SGLT2 inhibitors.
  • Active and former smokers for less than five years ago smoking.
  • Chronic obstructive pulmonary disease.
  • Respiratory sleep disorders that require treatment with continuous positive pressure in the airway.
Show all 19Show fewer
  • Asthma treatment with bronchodilators.
  • Previous bariatric surgery.
  • Cardiovascular disease, heart failure and / or stroke.
  • Pathology of the chest wall.
  • Serum creatinine> 1.7 mg / dl.
  • Abnormal results in liver function test (Alanine transaminase/ Aspartate Aminotransferase greater than twice the upper limit of normal).
  • History of acute or chronic pancreatitis.
  • Personal or family history of medullary thyroid cancer or Multiple
  • Endocrine Neoplasia (MEN ) type 2.
  • Active neoplasms or neoplastic patients considered disease-free history from less than 5 years ago.
  • Women of childbearing age who are pregnant (positive pregnancy test within 14 days before the start of treatment) or intend to get pregnant.
  • Lactating women.
  • Women of childbearing potential not using adequate contraception (such as oral contraceptives, intrauterine device or barrier method of birth control along with spermicide or surgical sterilization) or unwilling to use during the study (as required by local laws or practices).

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

Spain6 sites
  • Hospital Universitari Germans Trias i Pujol

    Badalona, Barcelona, 08916

  • Hospital Universitari Vall d´Hebrón

    Barcelona, 08035

  • Hospital Universitari Arnau de Vilanova de Lleida

    Lleida, 25198

  • Hospital Universitario Virgen de la Victoria

    Málaga, 29010

  • Clínica Universidad de Navarra

    Pamplona, Navarre, 31008

  • Hospital Universitario Virgen del Rocío

    Seville, 41013

Other trials in Spain

About this study

Official title: Multicentre Randomized Double Blind, Crossover, Placebo Controlled Clinical Trial to Evaluate the Effect of Liraglutide on Lung Function in Patients With Type 2 Diabetes Mellitus (LIRALUNG Study)

Type 2 diabetes (T2DM) is related to reduced pulmonary function. As experimental studies with glucagon-like peptide 1 (GLP-1) have shown an increase in pulmonary surfactant secretion, and the GLP-1 receptor has been found in significant amounts in the lung, it could be hypothesized that the treatment with liraglutide (a GL-1 agonist) will improve this reduced pulmonary function

Read the detailed description

There is growing evidence to suggest an association between type 2 diabetes and impaired pulmonary function. In this regard, several cross-sectional studies have appeared showing decreased indices of forced expiration, lung volume and diffusion capacity as the main lung dysfunctions detected in type 2 diabetic populations. In fact, diabetes is frequently co-morbid with chronic obstructive pulmonary disease, and data from the Atherosclerosis Risk in Communities Study showed a faster pulmonary function decline in type 2 diabetic patients than in other participants. This is important because the reduction of FEV1 has been demonstrated an independent cause of mortality in diabetic patients.

Interestingly, lung function measures start to decrease several years before the diagnosis of diabetes. In this regard an investigation found that insulin resistance is an independent determinant of pulmonary function in non-diabetic morbidly obese women. In addition, the results suggest that the metabolic pathways related to insulin resistance are crucial in initiating lung abnormalities in type 2 diabetic patients.

The reasons for the association between respiratory disease and diabetes are unclear. However, the relationship between type 2 diabetes and muscle strength, the impairment in lung elastic properties, and the presence of a low-grade chronic inflammation state are involved. In supporting these findings, thickening of the alveolar epithelia and pulmonary capillary basal lamina, fibrosis, centrilobular emphysema, and pulmonary microangiopathy have been detected in autopsies of diabetic patients. In addition, defects in the bronchiolar surfactant layer, which is involved in maintaining airway stability and diameter, may also be considered a contributing factor to the impairment of airway calibre regulation in diabetic patients. When the alveolocapillary barrier is damaged, surfactant proteins leak into the bloodstream. A recent population-based random sample study has described how increased circulating levels of surfactant protein A, the major surfactant-associated protein, were associated with altered glucose tolerance and insulin resistance. Therefore, surfactant defects in diabetic individuals may also lead to an increase in airway resistance and to a reduction in ventilatory patterns as observed in our studies. In addition, as experimental studies have shown that glucagon-like peptide 1 plays a role in the stimulation of surfactant production, its underlying deficit in type 2 diabetes could also enhance the airway resistance observed in these patients. However, the beneficial effects on pulmonary function using incretin-based therapies remain to be elucidated.

Clinical trial study hypothesis is that treatment with an incretin mimetic such as liraglutide may ameliorate lung function parameters in type 2 diabetics patients, independently of weight reduction. This hypothesis is based on the following factors:

  1. - There is growing evidence to suggest an association between type 2 diabetes and impaired pulmonary function.
  2. - In patients with type 2 diabetes, the incretin effect is severely reduced or absent, contributing to the reduced lung function parameters observed in type 2 diabetic patients.
  3. - GLP-1 stimulates surfactant production in "in vitro" studies and, in consequence, the increase in surfactant production induced by liraglutide could be the main factor involved in the respiratory improvement.
Conditions
Type 2 Diabetes
Being tested
liraglutide, placebo
Keywords
diabetes, liraglutide, lung function
Medical subject headings
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

    7-week subcutaneous liraglutide once daily

  • placeboDrug

    7-week subcutaneous placebo once daily

Study groups in NCT02889510
Study groupRoleWhat they receive
liraglutideOther7-week subcutaneous liraglutide treatment once daily
Receives: Drug: liraglutide
placeboOther7-week subcutaneous placebo treatment once daily.
Receives: Drug: placebo

What is being measured

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

  1. Changes From Baseline on Measurements of Respiratory Function Defined by Forced Expiratory Volume in 1 Second (FEV1)

    Changes from baseline on measurements of respiratory function defined by forced expiratory volume in 1 second (FEV1).

    Mean difference between 7 weeks after treatment visit and baseline visit is registered.

    Measured: 7 weeks

Secondary outcomes (7)
  1. Changes From Baseline on Measurements of Respiratory Function Defined by Forced Vital Capacity (FVC)

    Changes from baseline on measurements of respiratory function defined by forced vital capacity (FVC).

    Mean difference between 7 weeks after treatment visit and baseline visit is registered.

    Measured: 7 weeks

  2. Changes From Baseline in Serum Levels of Surfactant A and D Protein

    Changes from baseline in serum levels of surfactant A and D protein. Values for surfactant A or D protein after 7 treatment weeks (liraglutide or placebo) are registered.

    Measured: 7 weeks

  3. Changes From Baseline on Measurements of Respiratory Function Defined by Maximum Mid-expiratory Flow (FEF25-75)

    Changes from baseline on measurements of respiratory function defined by Maximum mid-expiratory flow (FEF25-75).

    Mean difference between 7 weeks after treatment visit and baseline visit is registered.

    Measured: 7 weeks

  4. Changes From Baseline on Measurements of Respiratory Function Defined by Forced Expiratory Volume in 1 Second/Forced Vital Capacity (FEV1/FVC)

    Changes from baseline on measurements of respiratory function defined by forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC).

    Mean difference between 7 weeks after treatment visit and baseline visit is registered.

    Measured: 7 weeks

  5. Changes From Baseline on Measurements of Respiratory Function Defined by Residual Volume (RV)

    Changes from baseline on measurements of respiratory function defined by residual volume (RV).

    Measured: 7 weeks

  6. Changes From Baseline on Measurements of Respiratory Function Defined by Total Lung Capacity (TLC)

    Changes from baseline on measurements of respiratory function defined by Total lung capacity (TLC).

    Measured: 7 weeks

  7. Changes From Baseline on Measurements of Respiratory Function Defined by Residual Functional Capacity (RFC)

    Changes from baseline on measurements of respiratory function defined by Residual functional capacity (RFC) are registered.

    However, this parameter was not determined in patients due to an error in the programm used.

    Measured: 7 weeks

Timeline

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

  1. First posted5 Sep 2016 (estimated)
  2. Study start4 Oct 2016
  3. Primary completion18 Nov 2019
  4. Study completion16 Dec 2019

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
Crossover
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02889510
Sponsor's protocol ID
LIRALUNG
Status last verified
Jan 2021
First submitted
25 Aug 2016
Last updated
26 Feb 2021
Data monitoring committee
No
Individual data sharing
No

Publications

  • Davis TM, Knuiman M, Kendall P, Vu H, Davis WA. Reduced pulmonary function and its associations in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Res Clin Pract. 2000 Oct;50(2):153-9. doi: 10.1016/s0168-8227(00)00166-2.

    PubMed 10960726
  • Yeh HC, Punjabi NM, Wang NY, Pankow JS, Duncan BB, Cox CE, Selvin E, Brancati FL. Cross-sectional and prospective study of lung function in adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study. Diabetes Care. 2008 Apr;31(4):741-6. doi: 10.2337/dc07-1464. Epub 2007 Dec 4.

    PubMed 18056886
  • Vara E, Arias-Diaz J, Garcia C, Balibrea JL, Blazquez E. Glucagon-like peptide-1(7-36) amide stimulates surfactant secretion in human type II pneumocytes. Am J Respir Crit Care Med. 2001 Mar;163(4):840-6. doi: 10.1164/ajrccm.163.4.9912132.

    PubMed 11282754
  • Lecube A, Sampol G, Munoz X, Lloberes P, Hernandez C, Simo R. Insulin resistance is related to impaired lung function in morbidly obese women: a case-control study. Diabetes Metab Res Rev. 2010 Nov;26(8):639-45. doi: 10.1002/dmrr.1131. Epub 2010 Sep 29.

    PubMed 20882512
  • Lecube A, Sampol G, Munoz X, Hernandez C, Mesa J, Simo R. Type 2 diabetes impairs pulmonary function in morbidly obese women: a case-control study. Diabetologia. 2010 Jun;53(6):1210-6. doi: 10.1007/s00125-010-1700-5. Epub 2010 Mar 9.

    PubMed 20217039
  • Lecube A, Sampol G, Lloberes P, Romero O, Mesa J, Hernandez C, Simo R. Diabetes is an independent risk factor for severe nocturnal hypoxemia in obese patients. A case-control study. PLoS One. 2009;4(3):e4692. doi: 10.1371/journal.pone.0004692. Epub 2009 Mar 5.

    PubMed 19262746
  • Fernandez-Real JM, Chico B, Shiratori M, Nara Y, Takahashi H, Ricart W. Circulating surfactant protein A (SP-A), a marker of lung injury, is associated with insulin resistance. Diabetes Care. 2008 May;31(5):958-63. doi: 10.2337/dc07-2173. Epub 2008 Feb 19.

    PubMed 18285549
  • Mannino DM, Thorn D, Swensen A, Holguin F. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J. 2008 Oct;32(4):962-9. doi: 10.1183/09031936.00012408. Epub 2008 Jun 25.

    PubMed 18579551
  • Davis WA, Knuiman M, Kendall P, Grange V, Davis TM; Fremantle Diabetes Study. Glycemic exposure is associated with reduced pulmonary function in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care. 2004 Mar;27(3):752-7. doi: 10.2337/diacare.27.3.752.

    PubMed 14988297
  • Nicolaie T, Zavoianu C, Nuta P. Pulmonary involvement in diabetes mellitus. Rom J Intern Med. 2003;41(4):365-74.

    PubMed 15526520
  • Lopez-Cano C, Ciudin A, Sanchez E, Tinahones FJ, Barbe F, Dalmases M, Garcia-Ramirez M, Soto A, Gaeta AM, Pellitero S, Marti R, Hernandez C, Simo R, Lecube A. Liraglutide Improves Forced Vital Capacity in Individuals With Type 2 Diabetes: Data From the Randomized Crossover LIRALUNG Study. Diabetes. 2022 Feb 1;71(2):315-320. doi: 10.2337/db21-0688.

    PubMed 34737187

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing liraglutide in people with Type 2 Diabetes, run by Lecube, Albert, M.D. at 6 sites in Spain.

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 8 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 26 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Spain. 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 26 Feb 2021). 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?

Changes From Baseline on Measurements of Respiratory Function Defined by Forced Expiratory Volume in 1 Second (FEV1) (time frame: 7 weeks). 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 NCT02889510, which also lists 11 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 26 Feb 2021.

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