Pharmacokinetics and Pharmacodynamics of TAK-875 in Subjects With Type 2 Diabetes
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Purpose
The purpose of this study is to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of multiple ascending-doses of TAK-875 in subjects with type 2 diabetes mellitus.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus, Type 2 |
Drug: TAK-875 |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Pharmacokinetics/Dynamics Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Basic Science |
| Official Title: | A Phase 1, Double-Blind, Randomized, Placebo-Controlled, Sequential, Multiple Ascending-Dose Study to Evaluate the Pharmacokinetics and Pharmacodynamics of TAK-875 in Subjects With Type 2 Diabetes |
- TAK-875 maximum observed plasma concentration (Cmax) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 time at which Cmax occurred (Tmax) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 area under the plasma concentration-time curve from time 0 to time tau, where tau is the length of a dosing interval AUC(0-tau) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 renal clearance (CLr) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 metabolite (M-I) Cmax [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 M-I Tmax [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 M-I AUC(0-tau) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 M-I renal clearance CLr [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 Cmax [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- TAK-875 Tmax [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- TAK-875 AUC(0-tau) [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- TAK-875 renal clearance CLr [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- M-I Tmax [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- M-I Cmax [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- M-I AUC(0-tau) [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- M-I renal clearance CLr [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- TAK-875 and M-I Cmax ratio [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- TAK-875 and M-I Cmax ratio [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- TAK-875 and M-I AUC(0-tau) ratio [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- TAK-875 and M-I AUC(0-tau) ratio [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4-hour concentration values for plasma glucose [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4- hour concentration values for insulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4- hour concentration values for proinsulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4- hour concentration values for C-peptide [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4- hour concentration values for glucagon [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4- hour concentration values for total gastric inhibitory polypeptide (GIP) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 4- hour concentration values for total glucagon-like peptide-1 (GLP-1) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24-hour concentration values for plasma glucose [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24- hour concentration values for insulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24- hour concentration values for proinsulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24- hour concentration values for C-peptide [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24- hour concentration values for glucagon [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24- hour concentration values for total gastric inhibitory polypeptide (GIP) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent changes from baseline to Day 14 in mean 24- hour concentration values for total glucagon-like peptide-1 (GLP-1) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4-hour concentration values for plasma glucose [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4- hour concentration values for insulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4- hour concentration values for proinsulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4- hour concentration values for C-peptide [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4- hour concentration values for glucagon [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4- hour concentration values for total gastric inhibitory polypeptide (GIP) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 4- hour concentration values for total glucagon-like peptide-1 (GLP-1) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24-hour concentration values for plasma glucose [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24- hour concentration values for insulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24- hour concentration values for proinsulin [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24- hour concentration values for C-peptide [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24- hour concentration values for glucagon [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24- hour concentration values for total gastric inhibitory polypeptide (GIP) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute changes from baseline to Day 14 in mean 24- hour concentration values for total glucagon-like peptide-1 (GLP-1) [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent change from baseline to 24-hours post Day 13 dose in homeostasis model assessment of ß-cell function [ Time Frame: Day 13 ] [ Designated as safety issue: No ]
- Percent change from baseline to 24-hours post Day 14 dose in homeostasis model assessment of ß-cell function [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute change from baseline to 24-hours post Day 13 dose in homeostasis model assessment of ß-cell function [ Time Frame: Day 13 ] [ Designated as safety issue: No ]
- Absolute change from baseline to 24-hours post Day 14 dose in homeostasis model assessment of ß-cell function [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Percent change from baseline to Day 14 in insulinogenic index [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
- Absolute change from baseline to Day 14 in insulinogenic index [ Time Frame: Day 14 ] [ Designated as safety issue: No ]
| Enrollment: | 60 |
| Study Start Date: | January 2009 |
| Study Completion Date: | July 2009 |
| Primary Completion Date: | July 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Drug: TAK-875
Randomized, multiple ascending-dose sequence over 14 consecutive days to include the following: TAK-875 25 mg tablets, orally TAK-875 50 mg tablets, orally TAK-875 100 mg tablets, orally TAK-875 200 mg tablets, orally TAK-875 400 mg tablets, orally TAK-875 placebo-matching tablets, orally. |
Detailed Description:
TAK-875 is being developed as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus. Nonclinical data suggest that TAK-875 stimulates insulin secretion only at elevated blood glucose levels, with the potential for low hypoglycemic side effects.
The purpose of this phase 1, multiple ascending-dose study is to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of once daily oral doses of TAK-875 for 14 days in subjects with type 2 diabetes mellitus.
Participants will be housed for a total of 8 consecutive overnight stays in the clinic, and will undergo oral glucose tolerance tests and standardized meal tests with multiple blood sampling throughout their clinic stay.
Eligibility| Ages Eligible for Study: | 18 Years to 68 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Participants with type 2 diabetes who are newly diagnosed, managed with diet and exercise alone, or taking up to 2 oral antidiabetic agents (except thiazolidinediones) and willing to discontinue the antidiabetic medication(s) 2 weeks prior to randomization.
Meets one of the following glycosylated hemoglobin criteria (diagnosis must be based on current American Diabetes Association criteria) at Screening:
- If treatment naïve, should have a glycosylated hemoglobin concentration greater than or equal to 6.5% and less than or equal to 10.0%.
- If on a single antidiabetic agent (stable dose for at least 28 days), should have a glycosylated hemoglobin greater than or equal to 6% and less than or equal to 9.5%.
- If on a combination of up to 2 antidiabetic agents (stable doses for at least 28 days), should have a glycosylated hemoglobin greater than or equal to 6% and less than or equal to 9.0%.
- Has fasting plasma glucose greater than 126 mg/dL and less than 260 mg/dL if not on any antidiabetic medication, or less than 220 mg/dL if on any single antidiabetic agent, and less than 200 mg/dL if on any combination of 2 oral antidiabetic agents at Screening.
- Has fasting C-peptide concentration greater than or equal to 0.8 ng/mL at Screening.
- Weighs at least 50 kg (110 lb) and has a body mass index between 18 and 40 kg/m2, inclusive at Screening.
- Has not received treatment with weight-loss drugs within the 3 months prior to Screening.
- Has a systolic blood pressure less than or equal to 160 mm Hg and a diastolic blood pressure of less than or equal to 100 mm Hg at Screening and at Check-in (Day -2).
- Female participant is not of child-bearing potential (ie, surgically sterile [hysterectomy, bilateral oophorectomy, or 2 years post-tubal ligation] or postmenopausal [2 years since last menses]).
- Is able and willing to monitor blood glucose concentrations with a home glucose monitor during the Washout Interval and record results in the daily diary.
- Has negative test results at Screening and Check-in for selected substances of abuse, including alcohol and cotinine.
- Has Screening and Check-in clinical laboratory evaluations [including fasting clinical chemistry, hematology, and complete urinalysis (excluding glucose results)] within the reference range for the testing laboratory, unless the investigator deems the out-of-range results to be not clinically significant.
- Has negative test results for hepatitis B surface antigen and antibody to hepatitis C virus, and no known history of human immunodeficiency virus.
- Is willing to refrain from strenuous exercise from 72 hours before Check-in and throughout the study.
- Is considered by the investigator to be in a good health (other than being diabetic) as determined during the medical history review, physical examination findings, electrocardiogram and vital sign results, and clinical laboratory evaluations.
- Has creatinine clearance greater than 60 mL/min at Screening and Check-in.
Exclusion Criteria:
- Has a history of abdominal surgery (except laparoscopic cholecystectomy or uncomplicated appendectomy), thoracic, or nonperipheral vascular surgery within 6 months prior to Check-in.
- Has a known hypersensitivity to TAK-875, or other related compounds.
- Has a history of cardiac arrhythmia, systolic dysfunction congestive heart failure, angina, myocardial ischemia or infarction, or stroke within 1 year prior to Screening, or the presence of an abnormal electrocardiogram that, in the investigator's opinion, is clinically significant.
- Has a history of drug abuse or a history of alcohol abuse within 2 years prior to Screening.
- Has used any tobacco (ie, nicotine) products within 90 days prior to Check-in, and is unwilling to abstain from these products for the duration of the study.
- Has a history of cancer that has not been in remission for at least 5 years prior to the first dose of study drug. This criterion does not apply to basal cell or stage I squamous cell carcinoma of the skin.
- Has an alanine aminotransferase, alkaline phosphatase or aspartate aminotransferase level greater than or equal to 2 times the upper limit normal for the testing laboratory, active liver disease, or jaundice at Screening or Check-in.
- Has a total bilirubin greater than 2 mg/dL at Screening or Check-in.
- Has donated blood or experienced acute blood loss (including plasmapheresis) of greater than 500 mL within 90 days prior to the first dose of study drug.
- Participant is on any insulin treatment.
- The subject has a history of proteinuria greater than 300 mg/day on a 12- or 24-hour urine collection or an albumin/creatinine ratio greater than 300 μg/mg at Screening. If elevated, the subject may be rescreened within 1 week, and may be included in study with agreement between Principal Investigator and the Takeda Global Research and Development Medical Monitor.
- Has a history of any clinically significant retinopathy, which is defined as more than moderate nonproliferative diabetic retinopathy or any stage of proliferative diabetic retinopathy or any history of laser-treated retinopathy.
- Has history of treated or clinically significant peripheral or autonomic neuropathy.
- The subject has a history of ulcerative colitis or Crohn's disease, or has undergone gastric resection.
- The subject has a history of a psychiatric disorder that will affect the subject's ability to participate in the study.
- Has a history of angioedema.
- Had an acute, clinically significant illness within 30 days prior to Check-in, or any other condition or prior therapy that, in the opinion of the investigator, would make the subject unsuitable for the study.
- Participant took or requires the use of any restricted medication or products within the timeframes listed.
- Is participating in another investigational study or has taken any investigational drug within 30 days prior to Check-in.
- Has poor venous access.
- Has been randomized in a previous TAK-875 study within 6 months prior to the first dose of study drug.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Sr. VP, Clinical Science, Takeda Global Research & Development Center, Inc. |
| ClinicalTrials.gov Identifier: | NCT00949091 History of Changes |
| Other Study ID Numbers: | TAK-875_102, U1111-1114-2888 |
| Study First Received: | July 28, 2009 |
| Last Updated: | June 9, 2010 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Takeda Global Research & Development Center, Inc.:
|
Diabetes Mellitus, Non Insulin Dependent Diabetes Mellitus, Type II Type 2 Diabetes Mellitus Drug Therapy |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on May 16, 2013