Efficacy of Pioglitazone and Fortamet Combination Therapy in Subjects With Type 2 Diabetes

Overview[ - collapse ][ - ]

Purpose The purpose of this study is to determine the efficacy of pioglitazone and metformin combination therapy, once daily (QD), on glycosylated hemoglobin in adults with type 2 diabetes.
ConditionDiabetes Mellitus
InterventionDrug: Pioglitazone and metformin
Drug: Metformin
PhasePhase 4
SponsorTakeda
Responsible PartyTakeda
ClinicalTrials.gov IdentifierNCT00754403
First ReceivedSeptember 17, 2008
Last UpdatedJuly 1, 2010
Last verifiedJuly 2010

Tracking Information[ + expand ][ + ]

First Received DateSeptember 17, 2008
Last Updated DateJuly 1, 2010
Start DateJuly 2005
Estimated Primary Completion DateOctober 2006
Current Primary Outcome MeasuresChange from randomization in Glycosylated Hemoglobin [Time Frame: Final Visit] [Designated as safety issue: No]
Current Secondary Outcome Measures
  • Change from randomization in Fasting Plasma Glucose [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Insulin [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Pro-Insulin [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Homeostasis Model Assessment [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Triglycerides [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Total Cholesterol [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Low-Density Lipoprotein Cholesterol [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in high-density Lipoprotein Cholesterol [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Lipid Fractionation [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in High Sensitivity C-Reactive Protein [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Creatine Phosphokinase [Time Frame: Final Visit] [Designated as safety issue: No]
  • Change from randomization in Creatine Phosphokinase [Time Frame: Final Visit] [Designated as safety issue: Yes]

Descriptive Information[ + expand ][ + ]

Brief TitleEfficacy of Pioglitazone and Fortamet Combination Therapy in Subjects With Type 2 Diabetes
Official TitleA Double-Blind, Randomized, Placebo-Controlled, Multicenter Study to Evaluate the Effects on Glycemic Control With Concomitantly Administered Pioglitazone HCl and Metformin HCl Extended Release (Fortamet®) in Subjects With Type 2 Diabetes
Brief Summary
The purpose of this study is to determine the efficacy of pioglitazone and metformin
combination therapy, once daily (QD), on glycosylated hemoglobin in adults with type 2
diabetes.
Detailed Description
Pioglitazone (ACTOS®) is a member of a class of oral antidiabetic agents known as
thiazolidinediones. The insulin-sensitizing actions of thiazolidinediones are at least
partially mediated through the peroxisome proliferator-activated receptor gamma. These
receptors are found primarily in adipocytes, vascular endothelial cells, monocytes,
hepatocytes, and to a lesser extent myocytes.

Metformin was developed as an extended-release formulation of metformin hydrochloride and
designed for once-a-day oral administration. Metformin is an antihyperglycemic agent, which
improves glucose tolerance in patients with, type 2 diabetes, lowering both basal and
postprandial plasma glucose.

On 15 July 1999, the FDA approved pioglitazone for use as an adjunct to diet and exercise to
improve glycemic control in patients with type 2 diabetes. Pioglitazone is indicated for
monotherapy and for use in combination with sulfonylureas, metformin, or insulin when diet
and exercise plus the single agent do not result in adequate glycemic control. On 26
November 2003, the FDA approved the combined use of pioglitazone with metformin.

This study is designed to evaluate the effect on glycemic control when pioglitazone and
metformin are taken together. Individuals participating in this study will provide written
informed consent and will be required to commit to a screening visit and approximately 5
additional visits at the study center. Study participation is anticipated to be about 31
weeks (or approximately 8 months). Multiple procedures will occur at each visit which may
include fasting, blood collection, urine collection, physical examinations and
electrocardiograms.
Study TypeInterventional
Study PhasePhase 4
Study DesignAllocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
ConditionDiabetes Mellitus
InterventionDrug: Pioglitazone and metformin
Pioglitazone 30 mg, tablets, orally, once daily and metformin 1000 mg, tablets, orally once daily for up to 16 weeks.
Other Names:
  • Actos
  • AD-4833XT
  • Fortamet
Drug: Metformin
Pioglitazone placebo-matching tablets, orally, once daily and metformin 1000 mg, tablets, orally once daily for up to 16 weeks.
Other Names:
Fortamet
Study Arm (s)
  • Experimental: Pioglitazone 30 mg QD + Metformin 1000 mg QD
  • Active Comparator: Metformin 1000 mg QD

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment312
Estimated Completion DateOctober 2006
Estimated Primary Completion DateOctober 2006
Eligibility Criteria
Inclusion Criteria

- 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

- Diagnosed with type 2 diabetes and must have received appropriate counseling on
lifestyle modification for type 2 diabetes including diet and exercise.

- If taking metformin monotherapy or metformin and sulfonylurea combination therapy,
has a glycosylated hemoglobin greater than or equal to 7.5% and less than or equal to
9.0% at screening and randomization.

- If naïve or taking sulfonylurea monotherapy has an glycosylated hemoglobin greater
than or equal to 8.5% and less than or equal to 10.0% at screening and greater than
or equal to 7.5% and less than or equal to 9.0% at randomization.

Exclusion Criteria

- Has type 1 diabetes mellitus

- Currently taking any thiazolidinedione or have taken any thiazolidinedione within 12
weeks prior to screening

- Has congestive heart failure; has a triglyceride level greater than 500 mg per dL

- Diastolic blood pressure greater than 100 mmHg or a systolic pressure greater than
160 mmHg

- Body mass index greater than or equal to 42 kg/m2 (weight /height2)

- Alanine transaminase level greater than or equal to 2.5 times the upper limit of
normal, active liver disease, or jaundice.

- Male subjects who have a serum creatinine level greater than or equal to 1.5 mg per
dL; female subjects who have a serum creatinine level greater than or equal to 1.4 mg
per dL at the screening visit and at randomization.

- Currently using insulin or has used insulin 3 months prior to Screening

- Acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without
coma.

- 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:

- Chronically used oral or parenteral glucocorticoids (eg, prednisone, cortisone,
hydrocortisone, dexamethasone)

- Niacin greater than 200 mg per day, including niacin-containing products such as
Advicor - 3 months prior to screening and during the study

- Chronically used steroid-joint injections - 3 months prior to screening and
during the study

- Thiazolidinediones - 3 months prior to screening and during the study

- Insulin - 3 months prior to screening

- Other oral antidiabetic medications (eg, nateglinide [Starlix], acarbose
[Precose]) with the exception of sulfonylurea - 3 months prior to screening and
during the study

- Metformin - Fortamet Stabilization and during the study
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesNot Provided

Administrative Information[ + expand ][ + ]

NCT Number NCT00754403
Other Study ID Numbers01-05-TL-OPIXT-010
Has Data Monitoring CommitteeNo
Information Provided ByTakeda
Study SponsorTakeda
CollaboratorsNot Provided
Investigators Study Director: VP Clinical Science Strategy Takeda
Verification DateJuly 2010