Rosiglitazone-Metformin Combination Versus Metformin-Sulfonylurea Combination On Beta-Cell Function In Type 2 Diabetes - Full Text View

Sponsor:	GlaxoSmithKline
Information provided by:	GlaxoSmithKline
ClinicalTrials.gov Identifier:	NCT00367055

Purpose

It has been shown in previous study that progressive glycemic deterioration was associated with progressive loss of b-cell function, measured by the decrease in plasma insulin levels, irrespective of the therapy used (diet, sulfonylureas or metformin).There is growing evidence that thiazolidinediones could have a positive action on the b-cell function. But it has not yet been demonstrated that they could protect from a deterioration in insulin secretion in the long term. So, it appears interesting to study the long term evolution of the b-cell function and the possible protection with rosiglitazone in patients with type 2 diabetes showing evidence of loss of b-cell function with metformin alone.

Condition	Intervention	Phase
Type 2 Diabetes Mellitus	Drug: rosiglitazone-metformin Drug: Metformin Drug: metformin+ gliclazide	Phase IV

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Comparison of the Action of the Rosiglitazone-metformin Fixed-dose Combination and of a Metformin-sulfonylurea Free Combination on the B-cell Function in Type 2 Diabetic Patients Not Controlled With Metformin Alone.

Resource links provided by NLM:

Genetics Home Reference related topics: 6q24-related transient neonatal diabetes mellitus

MedlinePlus related topics: Diabetes Diabetes Medicines Diabetes Type 2

Drug Information available for: Gliclazide Rosiglitazone Rosiglitazone Maleate Avandamet Metformin Metformin hydrochloride

U.S. FDA Resources

Further study details as provided by GlaxoSmithKline:

Primary Outcome Measures:

Median Change From Baseline in the Insulin Secretory Capacity After a 36-month Treatment [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Change from baseline in the insulin secretory capacity was measured by the assesment of blood insulin concentrations (conc.) using the hyperglycaemic clamp (HC) technique, per intravenous glucose perfusion by a catheter. Change from baseline for insulin conc peaks (highest conc level) was calculated as the Month 36 value minus the baseline value. Insulin secretion was assessed by calculating AUC during the first 10 minutes of HC (incremental and total AUC0-10 min) and the AUC after the first 10 minutes of the HC (10-180min).

Secondary Outcome Measures:

Median Change From Baseline in the Ratio M/I After a 36-month Treatment [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Median Change From Baseline in the Insulin Secretion Capacity After an 18-month Treatment [ Time Frame: Baseline and Month 18 ] [ Designated as safety issue: No ]
Change from baseline was calculated as the Month 18 value minus the baseline value. Insulin secretion capacity is measured in blood (blood level of insulin) and is a response of the pancreatic beta-cells to hyperglycemia induced by a glucose IV bolus, then infusion. Hyperglycemic clamp (HC) is a reference technique to evaluate the initial and the secondary phases of insulin secretion.
Mean Change From Baseline in HbA1c at Month 36 [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Change from baseline was calculated as the Month 36 value minus the baseline value. HbA1c levels were measured by blood draw.
Mean Change From Baseline in FBG at Month 36 [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Change from baseline was calculated as the Month 36 value minus the baseline value. FBG levels were measured by blood draw.
Median Change From Baseline in Insulin Resistance Index (HOMA-IR) After a 36-month Treatment [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Median Change From Baseline in Beta Cell Function Index (HOMA-beta) After a 36-month Treatment [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Mean Change From Baseline in CPP Total and Incremental AUC T0-T30 After a 36-month Treatment [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Mean Change From Baseline in CPP Concentration Peak and Incremental Concentration Peak T0-T30 After a 36-month Treatment [ Time Frame: Baseline and Month 36 ] [ Designated as safety issue: No ]
Mean Change From Baseline in Insulin Sensitivity Index at Months 18 and 36 [ Time Frame: Baseline and Months 18 and 36 ] [ Designated as safety issue: No ]
Change from baseline was calculated as the Month 18 and 36 values minus the baseline value. Insulin sensitivity is measured as the quantity of glucose metabolized per unit of plasma insulin concentration.

Enrollment:	84
Study Start Date:	October 2004
Study Completion Date:	October 2008
Primary Completion Date:	October 2008 (Final data collection date for primary outcome measure)

Intervention Details:

Other Names:

rosiglitazone-metformin
Metformin
metformin+ gliclazide

Eligibility

Ages Eligible for Study:	40 Years to 75 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

INCLUSION CRITERIA:

Males and females 40 to 75 years of age (inclusive at the time of screening)
Type 2 diabetes mellitus as defined by the WHO criteria, diagnosed for at least 1 year
Subjects receiving 1.5 to 3g of metformin alone at a constant dose for at least 8 weeks prior to visit 1
Patients with 6.5% < HbA1c > 8% at visit 1 and visit 2
25 < BMI < 35

EXCLUSION CRITERIA:

Patient with type 1 diabetes
Treatment with other hypoglycaemic agents than metformin in the last 3 months
FPG >200 mg/dL at visit 2
Hypersensitivity to the studied treatments (rosiglitazone, metformin chlorhydrate, gliclazide)
Congestive heart failure (NYHA class I to IV), unstable or severe angina, recent myocardial infarction
Respiratory insufficiency
Subjects who have required the use of insulin for glycaemic control in the past 6 months prior to visit 1 (except during pregnancy or acute episodes such as hospitalization, trauma or infection) or subjects with a history of metabolic acidosis including diabetic ketoacidosis
Anemia defined by haemoglobin concentration <11.0 g/dL for males and <10.0 g/dL for females
Renal disease or renal dysfunction, e.g. as suggested by serum creatinine levels ≥135.0 µmol/L in males and ≥110.0 µmol/L in females and/or creatinine clearance <40 mL/min
Presence of clinically significant hepatic disease, with ALT, AST, total bilirubin, alkaline phosphatase >2.5 times the upper limit of the normal reference range
Subjects with chronic diseases requiring periodic ot intermittent treatment with oral or IV corticosteroids
Subjects receiving danazol, miconazole or phenylbutazone
Active alcohol, drug or medication abuse within the last 6 months or any condition that would indicate the likelihood of poor subject compliance
Women who are lactating, pregnant or planning to become pregnant
Any clinically significant abnormality identified at screening which, in the investigator's judgement, makes the subject unsuitable for inclusion in the study
Use of any other investigational agent within 30 days or 5 half-lives (whichever is longer) prior to visit 1
Subjects who receive or anticipate receiving radiocontrast dye during the study

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00367055

Sponsors and Collaborators

GlaxoSmithKline

Investigators

Study Director:

GSK Clinical Trials, MD

GlaxoSmithKline

More Information

No publications provided

Responsible Party:	Study Director, GSK
ClinicalTrials.gov Identifier:	NCT00367055 History of Changes
Other Study ID Numbers:	101765, AVAF4001
Study First Received:	August 21, 2006
Results First Received:	October 2, 2009
Last Updated:	July 20, 2010
Health Authority:	France: National Consultative Ethics Committee for Health and Life Sciences

Keywords provided by GlaxoSmithKline:

Beta cell function
Type 2 diabetes
Combination treatment

Additional relevant MeSH terms:

Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Rosiglitazone

Gliclazide
Metformin
Hypoglycemic Agents
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on February 12, 2012