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Efficacy, Safety and Tolerability of Pioglitazone-Azilsartan in Subjects With Type 2 Diabetes Mellitus

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00376181
Recruitment Status : Terminated (Combination formulation concerns)
First Posted : September 14, 2006
Last Update Posted : June 22, 2010
Information provided by:

Brief Summary:
The purpose of this study is to evaluate the efficacy and safety of pioglitazone-azilsartan, once daily (QD), in subjects with type 2 diabetes mellitus with poor glycemic control.

Condition or disease Intervention/treatment Phase
Type 2 Diabetes Drug: Pioglitazone and Azilsartan Drug: Pioglitazone Phase 3

Detailed Description:

Type 2 diabetes is a chronic disease. In the United States, an estimated 21 million people have diabetes, with type 2 diabetes occurring in 90% to 95% of cases. Hypertension (high blood pressure) affects approximately 50 million individuals in the United States. The association of diabetes and hypertension is increased in this population; hypertension is more common in persons with diabetes while individuals with hypertension are 2.5 times more likely to develop diabetes than those who have normal blood pressure. As a result, more than 70% of adults with diabetes have hypertension (defined as having blood pressure greater than or equal to 130/80 mm Hg or using prescription medication for hypertension).

Patients with type 2 diabetes and hypertension are at high risk of other illnesses and death. Diabetes and hypertension are associated with insulin resistance (normal amounts of insulin are no adequate to produce a normal insulin response from fat, muscle and liver cells). and hyperinsulinemia (excess levels of insulin in the blood), which are independent risk factors for cardiovascular (heart vessel) disease. Individuals with type 2 diabetes carry a 2 to 4- time greater risk of cardiovascular disease and stroke compared with the general population. Uncontrolled hypertension also is associated with an increased risk of cardiovascular disease and stroke.

Takeda Global Research and Development Center, Inc. is developing a fixed-dose combination product, AD-4833-536. AD-4833-536 is a combination of AD-4833 (pioglitazone) and TAK-536 (azilsartan). Pioglitazone is an oral antidiabetic agent that acts by reducing insulin resistance and approved for treatment of adult patients with type 2 diabetes mellitus. Azilsartan is a angiotensin II receptor blocker that modulates the renin-angiotensin-aldosterone system that regulates blood pressure.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 96 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 3 Double-Blind, Randomized, Placebo-Controlled Study to Determine the Efficacy, Safety, and Tolerability of AD-4833-536 in the Treatment of Subjects With Type 2 Diabetes
Study Start Date : June 2006
Actual Primary Completion Date : May 2007
Actual Study Completion Date : May 2007

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Pioglitazone 45 mg/Azilsartan 20 mg QD Drug: Pioglitazone and Azilsartan
Pioglitazone 45 mg and Azilsartan 20 mg combination tablets, orally, once daily for up to 24 weeks.
Other Names:
  • Actos
  • AD-4833
  • TAK-536

Experimental: Pioglitazone 45 mg/Azilsartan 40 mg QD Drug: Pioglitazone and Azilsartan
Pioglitazone 45 mg and Azilsartan 40 mg combination tablets, orally, once daily for up to 24 weeks.
Other Names:
  • Actos
  • AD-4833
  • TAK-536

Active Comparator: Pioglitazone 45 mg QD Drug: Pioglitazone
Pioglitazone 45 mg, tablets, orally, once daily for up to 24 weeks.
Other Names:
  • Actos
  • AD-4833

Primary Outcome Measures :
  1. Change from Baseline in Glycosylated Hemoglobin. [ Time Frame: Baseline and Week 24 ]
    The change between the value of Glycosylated Hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 24 or including final visit, and Glycosylated Hemoglobin collected at baseline.

Secondary Outcome Measures :
  1. Change from Baseline in Diastolic Blood Pressure [ Time Frame: Baseline and Weeks 4, 8, 12, 16, 20, and 24. ]
    The change between Diastolic Blood Pressure measured at each week indicated including final visit and Diastolic Blood Pressure measured at baseline.

  2. Change from Baseline in Systolic Blood Pressure [ Time Frame: Baseline and Weeks 4, 8, 12, 16, 20, and 24 ]
    The change between Systolic Blood Pressure measured at each week indicated including final visit and Systolic Blood Pressure measured at baseline.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

  • Type 2 diabetes with glycosylated hemoglobin of greater than or equal to 9.0 to less than or equal to 11.0% at Screening.
  • Documented hypertension.
  • On a stable diet and exercise program in addition to metformin alone or combination of metformin and a sulfonylurea for a minimum of 8 weeks prior to screening.
  • If receiving antihypertensive therapy, must be on no more than 3 agents and be on a stable regimen.
  • Clinical laboratory evaluations (including clinical chemistry, hematology, and urinalysis) within the reference range unless the results are deemed not clinically significant for inclusion into this study by the investigator.
  • Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.

Exclusion Criteria

  • Type 1 diabetes mellitus.
  • Diastolic blood pressure greater than 104 mm Hg at randomization visit.
  • Currently taking an angiotensin II-receptor blocker.
  • Unstable angina or heart failure of any etiology with New York Heart Association functional class III or IV.
  • History of myocardial infarction, cerebrovascular accident (stroke), percutaneous coronary intervention, coronary artery bypass graft or transient ischemic attack within the previous six months.
  • Clinically significant cardiac conduction defects.
  • Secondary hypertension of any etiology.
  • Body mass index greater than 45 kg/m2
  • Has significant renal dysfunction.
  • History of drug abuse or a history of alcohol abuse within the past 2 years.
  • Previous history of cancer, other than basal cell carcinoma or stage 1 squamous cell carcinoma of the skin that has not been in remission for at least 5 years prior to the first dose of study drug.
  • Alanine transaminase or aspartate transaminase level of greater than 2.5 times the upper limit of normal, active liver disease, or jaundice.
  • Serum potassium greater than the upper limit of normal.
  • Currently participating in another investigational study or has participated in an investigational study within 30 days prior to Randomization.
  • Any other serious disease or condition that would compromise subject safety, might affect life expectancy, or make it difficult to successfully manage and follow the subject according to the protocol.
  • Is hypersensitive to angiotensin II receptor blockers.
  • Is hypersensitive to thiazolidinediones.
  • Is required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:

    • any anti-diabetic agent (including thiazolidinediones and/or insulin) except for metformin or a combination of metformin and a sulfonylurea
    • niacin more than 200mg per day
    • tricyclic antidepressants or phenothiazines
    • Angiotensin II receptor blockers
    • Thiazolidinediones
    • Insulin

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00376181

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Sponsors and Collaborators
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Study Director: VP Clinical Science Strategy Takeda
Additional Information:
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Responsible Party: Sr. VP, Clinical Science, Takeda Global Research & Development Center, Inc. Identifier: NCT00376181    
Other Study ID Numbers: 01-06-TL-OPI536-003
U1111-1114-1098 ( Registry Identifier: WHO )
First Posted: September 14, 2006    Key Record Dates
Last Update Posted: June 22, 2010
Last Verified: June 2010
Keywords provided by Takeda:
type 2 diabetes
blood pressure
diastolic blood pressure
Additional relevant MeSH terms:
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Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Azilsartan medoxomil
Hypoglycemic Agents
Physiological Effects of Drugs
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists
Molecular Mechanisms of Pharmacological Action