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Safety and Tolerability Study of Cotadutide in Japanese Obese Subjects With Type 2 Diabetes Melitus

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.
 
ClinicalTrials.gov Identifier: NCT04208620
Recruitment Status : Active, not recruiting
First Posted : December 23, 2019
Last Update Posted : April 24, 2020
Sponsor:
Collaborator:
MedImmune LLC
Information provided by (Responsible Party):
AstraZeneca

Brief Summary:
This is a Phase 1 study designed to assess the safety and tolerability of MEDI0382 (Cotadutide) in Japanese T2DM patients.

Condition or disease Intervention/treatment Phase
Type 2 Diabetes Drug: Placebo Drug: Cotadutide Phase 1

Detailed Description:
This is a randomized, blinded, placebo-controlled study designed to evaluate the safety, tolerability, PK and efficacy of ascending doses of Cotadutide in Japanese obese subjects with T2DM. Approximately 20 subjects will be screened in total and 16 subjects will be randomized to Cotadutide or placebo in a 3:1 ratio. Those subjects who receive Cotadutide will be titrated up to HCTD. The study has a 2-week screening period, a run-in period of 9 days and an up to 7-week up-titration treatment period followed by a 3-week treatment extension period (if applicable), followed by a 28-day follow-up period.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 16 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 1 Randomized, Blinded, Placebo-controlled Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Efficacy of Cotadutide in Japanese Obese Subjects With Type 2 Diabetes Mellitus
Actual Study Start Date : January 21, 2020
Estimated Primary Completion Date : July 27, 2020
Estimated Study Completion Date : July 27, 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Placebo Comparator: Placebo
Placebo administered subcutaneously
Drug: Placebo
Placebo administered subcutaneously

Experimental: Cotadutide
Cotadutide administered subcutaneously
Drug: Cotadutide
Cotadutide administered subcutaneously




Primary Outcome Measures :
  1. Incidence of treatment-emergent adverse events (TEAEs) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  2. Incidence of treatment-emergent serious adverse events (TESAEs) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  3. Clinically important changes in 12-lead electrocardiogram (ECG) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  4. Vital signs as measured by pulse rate (bpm) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  5. Vital signs as measured by blood pressure (mmHg) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  6. ABPM (Ambulatory blood pressure monitoring) to measure pulse rate (bpm) and blood pressure (mmHg) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  7. Physical examination (abnormality to be reported as part of adverse events) [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide

  8. Clinical laboratory evaluations [ Time Frame: Baseline until the follow-up period, 28 days post-last dose ]
    To assess the safety and tolerability of Cotadutide


Secondary Outcome Measures :
  1. Area under the concentration-time curve (AUC) during the dosing interval (AUCtau) [ Time Frame: Day1 of Up-titration treatment period to Day 21 of Treatment extension period, total of up to 10 weeks ]
    To characterize the PK profile of Cotadutide

  2. Maximum observed concentration (Cmax) [ Time Frame: Day1 of Up-titration treatment period to Day 21 of Treatment extension period, total of up to 10 weeks ]
    To characterize the PK profile of Cotadutide

  3. Time to Cmax (tmax) [ Time Frame: Day1 of Up-titration treatment period to Day 21 of Treatment extension period, total of up to 10 weeks ]
    To characterize the PK profile of Cotadutide

  4. Trough plasma concentration (Ctrough) [ Time Frame: Day1 of Up-titration treatment period to Day 21 of Treatment extension period, total of up to 10 weeks ]
    To characterize the PK profile of Cotadutide

  5. Anti-drug antibodies (ADAs) to Cotadutide [ Time Frame: At baseline through end of study, 98 days in total ]
    To characterize the immunogenicity of Cotadutide

  6. Change in average glucose levels (mg/dL) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by continuous glucose monitoring (CGM)

  7. Change in coefficient of variation [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by continuous glucose monitoring (CGM)

  8. Change in percentage time spent in hyperglycemia (> 140 mg/dL) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by continuous glucose monitoring (CGM)

  9. Change in percentage time spent in normoglycemia (70 -140 mg/dL) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by continuous glucose monitoring (CGM)

  10. Change in percentage time spent in clinically significant hypoglycemia (< 54 mg/dL) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by continuous glucose monitoring (CGM)

  11. Change in estimated hemoglobin A1c (HbA1c) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by continuous glucose monitoring (CGM)

  12. Change in fasting plasma glucose (mg/dL) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by additional measrues of glucose control

  13. Change in HbA1c [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on glucose control as measured by additional measrues of glucose control

  14. Percentage change in body weight [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on body weight

  15. Absolute change in body weight (kg) [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on body weight

  16. Proportion of subjects achieving > 5% body weight loss [ Time Frame: At baseline through end of study, 98 days in total ]
    To assess the effect of Cotadutide on body weight



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   20 Years to 74 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  1. Provision of signed and dated written informed consent prior to any mandatory study specific procedures, sampling, and analyses.
  2. Subject must be 20 to 74 years of age at screening.
  3. HbA1c range of 6.5% to 8.5% at screening and run-in visit.
  4. Willing and able to self-inject investigational product for the duration of the study.
  5. Individuals who are diagnosed with T2DM and have inadequate glycaemic control with diet and exercise.
  6. Individuals whose current condition at enrolment are drug naïve defined as

    • Never received medical treatment for diabetes (insulin and/or other anti-diabetic agents [oral or injection]) OR
    • Received medical treatment for diabetes for less than 30 days since diagnosis.Subjects also should not have a history of insulin therapy within 2 weeks of screening (with the exception of insulin therapy during a hospitalization for other causes or use in gestational diabetes) OR
    • Previously received medical treatment for diabetes but have not been treated within 6 weeks of randomization.
  7. BMI within the range 25 to 35 kg/m2 at screening.
  8. Negative pregnancy test for female subjects.
  9. Female subjects of childbearing potential who are sexually active with a male partner must be willing to use at least one highly effective method of contraception from screening and up to 4 weeks after the last dose of investigational product.

Exclusion Criteria

  1. Subjects with any of the following results at screening and run-in visit
  2. History of, or any existing condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product, put the subject at risk, influence the subject's ability to participate or affect the interpretation of the results of the study and/or any subject unable or unwilling to follow study procedures.
  3. Acute pancreatitis at screening or history of chronic pancreatitis or serum triglyceride levels > 11 mmol/L (1000 mg/dL) at screening.
  4. Significant inflammatory bowel disease, gastroparesis or other severe disease or surgery affecting the upper GI tract (including weight-reducing surgery and procedures), which may affect gastric emptying or could affect the interpretation of safety and tolerability data.
  5. Significant hepatic disease (except for NASH or non-alcoholic fatty liver disease without portal hypertension or cirrhosis) and/or subjects with any of the following results at screening or run-in visit.

    • Aspartate transaminase (AST) ≥ 3 × upper limit of normal (ULN)
    • Alanine transaminase (ALT) ≥ 3 × ULN
    • Total bilirubin (TBL) ≥ 2 × ULN
  6. Impaired renal function defined as estimated glomerular filtration rate (GFR) < 60 mL/minute/1.73m2 at screening or run-in visit (GFR estimated according to Modification of Diet in Renal Disease [MDRD] using MDRD Study Equation IDMS-traceable [International System of Units (SI)]).
  7. Poorly controlled hypertension defined as, For age ≤ 55 years; Systolic BP > 140 mmHg Diastolic BP ≥ 90 mmHg For age > 55 years; Systolic BP > 150 mmHg Diastolic BP ≥ 90 mmHg After 10 minutes of supine rest and confirmed by repeated measurement at screening or run-in visit. Subjects who fail BP screening criteria may be considered for 24-hour or day time ABPM at the discretion of the investigator. Subjects who maintain a mean 24-hour BP < 130/80 mmHg with a preserved nocturnal dip of > 15% or day time BP < 135/85 mmHg will be considered eligible
  8. Resting heart rate is ≥ 80 bpm at screening or run-in visit.
  9. Any clinically important abnormalities in rhythm, conduction, or morphology of the 12-lead ECG or any abnormalities that may interfere with the interpretation of serial ECG changes, including QTc interval changes at screening, as judged by the investigator.
  10. Prolonged QT intervals corrected for heart rate using Fridericia's formula (QTcF) > 450 msec, or family history of long QT-segment at screening or run-in visit.
  11. PR (PQ) interval prolongation (> 220 msec), intermittent second (Wenckebach block while asleep is not exclusive), or third-degree atrioventricular (AV) block, or AV dissociation at screening or run-in visit.
  12. Persistent or intermittent complete bundle branch block. A QRS duration < 120 msec is acceptable if there is no evidence of ventricular hypertrophy or preexcitation at screening or run-in visit.
  13. Abnormal findings during the exercise stress test, such as chest pain, dyspnoea, presyncope, arrhytmias, signs of cardiac ischemia on ECG as judged by the investigator.
  14. History of, unstable angina pectoris, myocardial infarction, transient ischemic attack, or stroke, or subjects who have undergone percutaneous coronary intervention or a coronary artery bypass graft or who are due to undergo these procedures at the time of screening.
  15. Severe congestive heart failure (New York Heart Association Class III or IV).
  16. Basal calcitonin level > 50 ng/L at screening, or history/family history of medullary thyroid carcinoma or multiple endocrine neoplasia.
  17. Hemoglobinopathy, hemolytic anemia or chronic anemia (hemoglobin, < 11.5 g/dL [115 g/L]) for males, < 10.5 g/dL (105 g/L) for females) at screening or run-in visit, or any other condition known to interfere with the interpretation of HbA1c measurement.
  18. History of neoplastic disease within 5 years prior to screening, except for adequately treated basal cell, squamous cell skin cancer, or in situ cervical cancer.
  19. Any positive results for serum hepatitis B surface antigen, hepatitis C antibody, and human HIV antibody.
  20. History of substance dependence, alcohol abuse, or excessive alcohol intake (defined as an average weekly intake of > 21 alcoholic drinks for men or > 10 alcoholic drinks for women) within 3 years prior to screening and/or a positive screen for drugs of abuse or alcohol at screening or run-in visit. Subjects who use benzodiazepines for chronic anxiety or sleep disorders may be permitted to enter the study.
  21. Symptoms of depression or any other psychiatric disorder requiring treatment with medication (eg, anti-depressants, anti-psychotics) at screening. However, subjects who use benzodiazepines for chronic anxiety or sleep disorders may be permitted to enter the study.
  22. History of severe allergy/hypersensitivity, including to any component of the investigational product formulation including excipients or other biological agent, any of the proposed study treatments, or ongoing clinically important allergy/hypersensitivity.
  23. Any subject who has received another investigational product as part of a clinical study or a GLP-1 analogue containing preparation within the last 30 days or 5 half-lives of the drug (whichever is longer) at the time of screening.
  24. Any subject who has received any of the following medications within the specified timeframe prior to the start of the study.

    • Herbal preparations within one week prior to the start of screening or drugs licensed for control of body weight or appetite within 30 days (or 5 half-lives of the drug) prior to the start of screening
    • Opiates, domperidone, metoclopramide, or other drugs known to alter gastric emptying and within 2 weeks prior to the start of dosing
    • Antimicrobials within the quinolone, macrolide or azole class within 2 weeks prior to the start of dosing
    • Any change in antihypertensive medication within 3 months prior to screening
    • Any change in thyroid replacement therapy within 2 months prior to screening
    • Aspirin at a total daily dose of greater than 150 mg
    • Paracetamol or paracetamol-containing preparations at a total daily dose of greater than 3000 mg
    • Ascorbic acid (vitamin C) supplements at a total daily dose of greater than 1000 mg
  25. Concurrent participation in another study of any kind and repeat randomization in this study.
  26. Received Cotadutide in another clinical study prior to enrolment in this study.

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 ClinicalTrials.gov identifier (NCT number): NCT04208620


Locations
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Japan
Research Site
Shinjuku-ku, Japan, 160-0008
Research Site
Shinjuku-ku, Japan, 162-0053
Research Site
Suita-shi, Japan, 565-0853
Sponsors and Collaborators
AstraZeneca
MedImmune LLC
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Responsible Party: AstraZeneca
ClinicalTrials.gov Identifier: NCT04208620    
Other Study ID Numbers: D5671C00003
First Posted: December 23, 2019    Key Record Dates
Last Update Posted: April 24, 2020
Last Verified: April 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Time Frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
Access Criteria: When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
URL: https://astrazenecagroup-dt.pharmacm.com/DT/Home

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by AstraZeneca:
Diabetes
Cotadutide
MEDI0382
D5671C00003
Type 2 Diabetes
Additional relevant MeSH terms:
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Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases