Clinical trial • Phase IV • Endocrinology
Dapagliflozin propanediol for Type 2 diabetes mellitus
Phase IV trial of Dapagliflozin propanediol for Type 2 diabetes mellitus.
Overview
- Trial Therapeutic Area
- Endocrinology
- Trial Disease
- Type 2 diabetes mellitus
- Trial Stage
- Phase IV
- Drug Modality
- Small molecule
Key dates
- Initial CTIS Submission Date
- 20-08-2024
- First CTIS Authorization Date
- 30-08-2024
Trial design
Randomised, dapagliflozin (test): active substance dapagliflozin propanediol, oral, max daily dose 10 mg (product entry maxdailydoseamount 10 mg). metformin (comparator): metformin, oral, max daily dose 3000 mg (product entry maxdailydoseamount 3000 mg). detailed dosing schedules not specified in the ctis data.-controlled Phase IV trial in Sweden.
- Randomised
- Yes
- Comparator
- DAPAGLIFLOZIN (test): active substance dapagliflozin propanediol, oral, max daily dose 10 mg (product entry maxDailyDoseAmount 10 mg). METFORMIN (comparator): metformin, oral, max daily dose 3000 mg (product entry maxDailyDoseAmount 3000 mg). Detailed dosing schedules not specified in the CTIS data.
- Target Sample Size
- 2200
- Trial Duration For Participant
- 730
Stratification factors
- Prior glucose-lowering drug (GLD) treatment status: Stratum A - drug naïve or ≤4 weeks total GLD treatment; Stratum B - ongoing or previous monotherapy with oral GLD medication >4 weeks
Eligibility
Recruits 2200 Vulnerable population flag selected. Participants must be adults (age > 18 years) and provide signed informed consent. No assent procedures are indicated. Participation requires acceptance of individual data collection from the Swedish National Diabetes Register (NDR) and from SoS/SCB..
- Pregnancy Exclusion
- Pregnancy or breastfeeding, women of childbearing potential (WOCBP; including perimenopausal women who have had a menstrual period within 1 year) without adequate anticonception during any part of the study period
- Vulnerable Population
- Vulnerable population flag selected. Participants must be adults (age > 18 years) and provide signed informed consent. No assent procedures are indicated. Participation requires acceptance of individual data collection from the Swedish National Diabetes Register (NDR) and from SoS/SCB.
Inclusion criteria
- {"criterion_text":"- Diagnosis of T2D (according to WHO criteria) with less than 4 years duration.\n- Men and women, age > 18 years\n- BMI 18.5 - 45 kg/m2\n- Medication for type 2 diabetes: a) drug naïve, or newly started or short temporary medication (Stratum A: no GLD treatment, except for any ongoing or previous treatment for maximally 4 weeks in total) b) ongoing or previous monotherapy with oral GLD medication for more than 4 weeks in total (Stratum B).\n- Participation in the Swedish National Diabetes Register (NDR) and accepting individual data collection from this register and those of SoS/SCB.\n- Signed informed consent"}
Exclusion criteria
- {"criterion_text":"- Known or suspected other form of diabetes than type 2\n- Ongoing or >4 weeks in total of any previous treatment for type 2 diabetes with: insulin, GLP-1 receptor agonists, SGLT2 inhibitors or combination of any diabetes medications\n- Medical need for any specific GLD treatment, eg. insulin due to marked hyperglycemia\n- HbA1c >70 mmol/mol for patients on monotherapy. >80 in drug naïve, but a higher HbA1c can be accepted if the current glucose levels imply a rapid trajectory towards acceptable glucose control\n- Contraindication to either metformin or dapagliflozin, or any unacceptable risk with either treatment as assessed by the investigator\n- History of established cardiovascular disease: diagnosis of myocardial infarction, angina pectoris, stroke, lower extremity arterial disease, heart failure or ongoing diabetic foot ulcers.\n- Any serious illness or other condition with short life expectancy (<4 yr)\n- Renal impairment (eGFR <60 ml/min/1,73m2)\n- Any condition, as judged by the investigator, that suggests that the patient will be non-compliant or otherwise unsuitable to study medication or study participation. For example, serious psychiatric or alcohol or substance abuse disorders.\n- Pregnancy or breastfeeding, women of childbearing potential (WOCBP; including perimenopausal women who have had a menstrual period within 1 year) without adequate anticonception during any part of the study period\n- Involvement in the planning and/or conduct of the study\n- Ongoing participation in another clinical trial"}
Endpoints
Primary endpoints
- {"endpoint_text":"- Time to first of: 1. All-cause death 2. Major adverse cardiovascular events (MACE; myocardial infarction, stroke, heart failure) 3. Microvascular events (occurrence or progression of retinopathy, nephropathy, or diabetic foot lesions)","definition_or_measurement_approach":"Time-to-event (time from randomization to first occurrence of any of the listed components: all-cause death, MACE [myocardial infarction, stroke, heart failure], or microvascular events [occurrence/progression of retinopathy, nephropathy, diabetic foot lesions])."}
Secondary endpoints
- {"endpoint_text":"- Modified composite endpoint with weighted components 1-3 of primary endpoint based on their individual degrees of severity (falling in that order). Ordinal analysis at 2 years of follow-up.","definition_or_measurement_approach":"Ordinal analysis of a weighted composite of the three primary components at 2 years follow-up; components weighted by severity."}
- {"endpoint_text":"- Time to first event among: individual components of the primary endpoint or initiation of insulin treatment.","definition_or_measurement_approach":"Time-to-event (time from randomization to first occurrence of any individual primary component or initiation of insulin)."}
- {"endpoint_text":"- Time to first of: non-fatal myocardial infarction, stroke, heart failure, unstable angina or cardiovascular death","definition_or_measurement_approach":"Time-to-event for composite cardiovascular outcome (first occurrence of listed events)."}
- {"endpoint_text":"- Time to first of: heart failure or cardiovascular death Time to event of death","definition_or_measurement_approach":"Time-to-event for heart failure or cardiovascular death; also time-to-death endpoints."}
- {"endpoint_text":"- Time to first microvascular event; occurrence or progression of retinopathy, nephropathy, diabetic foot lesions","definition_or_measurement_approach":"Time-to-event for microvascular complications (occurrence or progression of retinopathy, nephropathy, diabetic foot lesions)."}
- {"endpoint_text":"- Time to initiation of insulin treatment","definition_or_measurement_approach":"Time-to-event to initiation of insulin therapy."}
- {"endpoint_text":"- Time to any treatment failure, defined as add-on or switch to another GLD","definition_or_measurement_approach":"Time-to-event to treatment failure defined as need for add-on therapy or switching to another glucose-lowering drug (GLD)."}
- {"endpoint_text":"- Change in: 1) HbA1c 2) total cholesterol 3) LDL- cholesterol 4) HDL-cholesterol 5) Triglycerides 6) Urinary albumin/creatinine ratio 7) BMI 8) Systolic blood pressure 9) Diastolic blood pressure","definition_or_measurement_approach":"Change from baseline in listed laboratory and clinical measures (e.g., HbA1c, lipids, UACR, BMI, blood pressure) measured at scheduled visits/registry data; assessed as continuous change."}
- {"endpoint_text":"- Diagnosis-based (IDG) costs for all health care during study period plus medication cost","definition_or_measurement_approach":"Health economic endpoint: diagnosis-based costs (IDG) for healthcare and medication during study period, derived from registry/administrative data."}
- {"endpoint_text":"- Results from RAND-36 and DTSQ questionnaires, 0-2 years after randomization.","definition_or_measurement_approach":"Patient-reported outcomes measured by RAND-36 and Diabetes Treatment Satisfaction Questionnaire (DTSQ) at intervals up to 2 years post-randomization."}
- {"endpoint_text":"- Occurrence of SAEs (all non-elective hospitalisations or other SAEs).","definition_or_measurement_approach":"Safety endpoint: occurrence of serious adverse events, including all non-elective hospitalisations or other events meeting SAE criteria, captured during study period."}
- {"endpoint_text":"- Occurrence of diabetes- and treatment-specific SAEs (hospitalisations for diabetes, severe hypoglycaemia, ketoacidosis, lactate acidosis, diabetic coma, amputations, fractures).","definition_or_measurement_approach":"Occurrence of diabetes- and treatment-specific serious adverse events as listed, captured via clinical/registry data."}
Recruitment
- Registry Or Advocacy Recruitment
- True, Swedish National Diabetes Register (NDR); SoS/SCB
- Planned Sample Size
- 2200
- Recruitment Window Months
- 73
- Consent Approach
- Signed informed consent is required from participants (inclusion criterion). Subject information and informed consent form (L1_SIS ICF_Adults) is provided for adults. Participants must accept registry data collection (NDR, SoS/SCB). No assent procedures are indicated (participants are adults >18). Languages of consent documents not specified in CTIS data.
Methods
- Register-based recruitment: participation requires inclusion in and acceptance of individual data collection from the Swedish National Diabetes Register (NDR) and linkage to SoS/SCB registries (explicit in inclusion criteria).
- Site-based recruitment at participating clinical sites (primary care centres and hospitals) across Sweden (trialSites list of participating regions/centres).
Geography
- Total Number Of Sites
- 35
- Total Number Of Participants
- 2200
Sweden
- Earliest CTIS Part Ii Submission Date
- 07-08-2024
- Latest Decision Or Authorization Date
- 30-08-2024
- Processing Time Days
- 23
- Number Of Sites
- 35
- Number Of Participants
- 2200
Sites
- Site Name
- Region Norrbotten
- Department Name
- Arvidsjaurs hälsocentral, 933 83 Arvidsjaur
- Principal Investigator Name
- Tove Bokrantz
- Principal Investigator Email
- forskning@norrbotten.se
- Contact Person Name
- Tove Bokrantz
- Contact Person Email
- forskning@norrbotten.se
- Site Name
- Region Dalarna
- Department Name
- Dalecarlia Clinical Research Center, Torggatan 18, 795 30 Rättvik
- Principal Investigator Name
- Hans Larnefeldt
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Hans Larnefeldt
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Region Kronoberg
- Department Name
- Vårdcentralen Dalbo, Brittsommarvägen 2 B, 352 37 Växjö
- Principal Investigator Name
- Yasir Mahdi
- Principal Investigator Email
- fou@kronoberg.se
- Contact Person Name
- Yasir Mahdi
- Contact Person Email
- fou@kronoberg.se
- Site Name
- Region Oestergoetland
- Department Name
- VC Ekholmen, Ekholmsvägen 7, 589 29 Linköping
- Principal Investigator Name
- Carl Johan Östgren
- Principal Investigator Email
- kanslikliniskastudier@regionostergotland.se
- Contact Person Name
- Carl Johan Östgren
- Contact Person Email
- kanslikliniskastudier@regionostergotland.se
- Site Name
- Region Dalarna
- Department Name
- Malungs vårdcentral, Box 64, 782 22 Malung
- Principal Investigator Name
- Peter Rytter
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Peter Rytter
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Region Soermland
- Department Name
- VC Centrum Flen, Drottninggatan 1, 64237 Flen
- Principal Investigator Name
- Kaj Possler
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Kaj Possler
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Region Dalarna
- Department Name
- Norslunds vårdcentral, Kopparvägen 29, 791 42 Falun
- Principal Investigator Name
- Anna Karls
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Anna Karls
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Uppsala University Hospital
- Department Name
- VO Specialmedicin, Endokrinsektionen
- Principal Investigator Name
- Jan Eriksson
- Principal Investigator Email
- diabetesforskning@akademiska.se
- Contact Person Name
- Jan Eriksson
- Contact Person Email
- diabetesforskning@akademiska.se
- Site Name
- Vaestra Goetalandsregionen
- Department Name
- Närhälsan Dalaberg Vårdcentral, Lövskogsg 8, 451 70 Uddevalla
- Principal Investigator Name
- Intisar Weheliye
- Principal Investigator Email
- gothia.forum@vgregion.se
- Contact Person Name
- Intisar Weheliye
- Contact Person Email
- gothia.forum@vgregion.se
- Site Name
- Region Uppsala
- Department Name
- APC forskning, Nära vård och hälsa. Region Uppsala Ledningskontoret, Kungsgärdet, 751 85 Uppsala
- Principal Investigator Name
- Mats Martinell
- Principal Investigator Email
- kliniskaprovningar@akademiska.se
- Contact Person Name
- Mats Martinell
- Contact Person Email
- kliniskaprovningar@akademiska.se
- Site Name
- Sahlgrenska University Hospital-Vaestra Goetalandsregionen
- Department Name
- Lundberglab för diabetes-forskning
- Principal Investigator Name
- Björn Eliasson
- Principal Investigator Email
- gothia.forum@vgregion.se
- Contact Person Name
- Björn Eliasson
- Contact Person Email
- gothia.forum@vgregion.se
- Site Name
- Region Oerebro Laen
- Department Name
- Enheten för kliniska studier, Entre S2, Universitetssjukhuset, 701 85 Örebro
- Principal Investigator Name
- Stefan Jansson
- Principal Investigator Email
- etikansokan@regionorebrolan.se
- Contact Person Name
- Stefan Jansson
- Contact Person Email
- etikansokan@regionorebrolan.se
- Site Name
- Vaestra Goetalandsregionen
- Department Name
- Närhälsan Södra Ryd Vårdcentral, Timmerv 3A, 541 64 Skövde
- Principal Investigator Name
- Margareta Hellgren
- Principal Investigator Email
- gothia.forum@vgregion.se
- Contact Person Name
- Margareta Hellgren
- Contact Person Email
- gothia.forum@vgregion.se
- Site Name
- Region Stockholm – SLSO
- Department Name
- Citydiabetes Serafen, Hantverkargatan 2D, 112 21 Stockholm
- Principal Investigator Name
- Bengt-Olov Tengmark
- Principal Investigator Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Contact Person Name
- Bengt-Olov Tengmark
- Contact Person Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Site Name
- Region Stockholm – SLSO
- Department Name
- Handens vårdcentral, Dalarövägen 6, 136 46 Handen
- Principal Investigator Name
- Charlotta Jacobsson
- Principal Investigator Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Contact Person Name
- Charlotta Jacobsson
- Contact Person Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Site Name
- Region Oestergoetland
- Department Name
- Vårdcentralen Cityhälsan Centrum, Gamla Lasarettsgatan 18, 602 39 Norrköping
- Principal Investigator Name
- Fredrik H. Nyström
- Principal Investigator Email
- kanslikliniskastudier@regionostergotland.se
- Contact Person Name
- Fredrik H. Nyström
- Contact Person Email
- kanslikliniskastudier@regionostergotland.se
- Site Name
- Region Norrbotten
- Department Name
- Laponia hälsocentral, Källgatan 14, 982 82 Gällivare
- Principal Investigator Name
- Roxana Sculeanu
- Principal Investigator Email
- forskning@norrbotten.se
- Contact Person Name
- Roxana Sculeanu
- Contact Person Email
- forskning@norrbotten.se
- Site Name
- Region Dalarna
- Department Name
- Vårdcentralen i Vansbro, Moravägen 27, 786 33 Vansbro
- Principal Investigator Name
- Katarina Link
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Katarina Link
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Region Vaermland
- Department Name
- Vårdcentralen Kristinehamn, Solrosbacken 1, 681 80 Kristinehamn
- Principal Investigator Name
- Carin Krödel Boelke
- Principal Investigator Email
- region@regionvarmland.se
- Contact Person Name
- Carin Krödel Boelke
- Contact Person Email
- region@regionvarmland.se
- Site Name
- Region Gaevleborg
- Department Name
- Gävle Strand Hälsoscentral OCH Valbo Hälsocenter, Norra Skeppsbron 13, 803 10 Gävle
- Principal Investigator Name
- Nicklas Persson
- Principal Investigator Email
- kliniskaprovningar@regiongavleborg.se
- Contact Person Name
- Nicklas Persson
- Contact Person Email
- kliniskaprovningar@regiongavleborg.se
- Site Name
- Region Skane Skanes Universitetssjukhus
- Department Name
- Klinisk forskningsenhet, Inga Marie Nilssonsgata 22, Plan 5, 205 01 Malmö
- Principal Investigator Name
- Louise Bennet
- Principal Investigator Email
- studiesupport.sus@skane.se
- Contact Person Name
- Louise Bennet
- Contact Person Email
- studiesupport.sus@skane.se
- Site Name
- Region Soermland
- Department Name
- Vårdcentralen Mariefred, Solvändan 3, 647 31 Mariefred
- Principal Investigator Name
- Henrietta Norman
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Henrietta Norman
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Region Dalarna
- Department Name
- Domnarvets vårdcentral, Bergebyv 5 alt Box, 731, 781 27 Borlänge
- Principal Investigator Name
- Per-Olov Mattson
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Per-Olov Mattson
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Region Skane Skanes Universitetssjukhus
- Department Name
- Prövningsenheten Kliniska studier Sverige, Skånes universitetssjukhus, 221 85 Lund
- Principal Investigator Name
- Louise Hagman Bennet
- Principal Investigator Email
- studiesupport.sus@skane.se
- Contact Person Name
- Louise Hagman Bennet
- Contact Person Email
- studiesupport.sus@skane.se
- Site Name
- Region Vaesterbotten
- Department Name
- Storumans Hälsocentral, Backvägen 2, 923 32 Storuman
- Principal Investigator Name
- Mante Hedman
- Principal Investigator Email
- klinisktforskningscentrum@regionvasterbotten.se
- Contact Person Name
- Mante Hedman
- Contact Person Email
- klinisktforskningscentrum@regionvasterbotten.se
- Site Name
- Region Gotland
- Department Name
- Hemse vårdcentral, Hagagatan 30, 623 51 Hemse
- Principal Investigator Name
- Gustaf Jörnérus
- Principal Investigator Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Contact Person Name
- Gustaf Jörnérus
- Contact Person Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Site Name
- Region Soermland
- Department Name
- Tunafors vårdcentral, Lundbladsv 6, 631 88 Eskilstuna
- Principal Investigator Name
- Ban Paulus
- Principal Investigator Email
- forummellansverige-ucr@uu.se
- Contact Person Name
- Ban Paulus
- Contact Person Email
- forummellansverige-ucr@uu.se
- Site Name
- Stift Carlanderska Sjukhuset
- Department Name
- Carlanderska sjukhuset, Carlandersparken 1, 405 45 Göterborg
- Principal Investigator Name
- Felix Lundin
- Principal Investigator Email
- cmc-info@carlanderska.se
- Contact Person Name
- Felix Lundin
- Contact Person Email
- cmc-info@carlanderska.se
- Site Name
- Region Stockholm – SLSO
- Department Name
- Centrum för diabetes, Solnavägen 1e, 11365 Stockholm
- Principal Investigator Name
- Sergiu Catrina
- Principal Investigator Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Contact Person Name
- Sergiu Catrina
- Contact Person Email
- forumstockholmgotland.karolinska@regionstockholm.se
- Site Name
- Region Joenkoepings Laen
- Department Name
- Rosenhälsans vårdcentral, Huskvarna vårdcentrum Jönköpingsv. 19, 561 31 Huskvarna
- Principal Investigator Name
- Maria Samefors
- Principal Investigator Email
- futurum@rjl.se
- Contact Person Name
- Maria Samefors
- Contact Person Email
- futurum@rjl.se
- Site Name
- Region Oestergoetland
- Department Name
- VC Kärna, Kärnabrunnsgatan 10, 586 62 Malmslätt
- Principal Investigator Name
- Karin Rådholm
- Principal Investigator Email
- kanslikliniskastudier@regionostergotland.se
- Contact Person Name
- Karin Rådholm
- Contact Person Email
- kanslikliniskastudier@regionostergotland.se
- Site Name
- Region Vaesterbotten
- Department Name
- Backens hälsocentral, Box 1442, 901 24 Umeå
- Principal Investigator Name
- Torbjörn Lundberg
- Principal Investigator Email
- klinisktforskningscentrum@regionvasterbotten.se
- Contact Person Name
- Torbjörn Lundberg
- Contact Person Email
- klinisktforskningscentrum@regionvasterbotten.se
- Site Name
- Region Kronoberg
- Department Name
- Vårdcentralen Teleborg, Södra Vallviksvägen 1, 35235 Växjö
- Principal Investigator Name
- Yasir Mahdi
- Principal Investigator Email
- fou@kronoberg.se
- Contact Person Name
- Yasir Mahdi
- Contact Person Email
- fou@kronoberg.se
- Site Name
- Region Oestergoetland
- Department Name
- Vikbolandet VC, Bygdevägen 13, 610 24 Vikbolandet
- Principal Investigator Name
- Staffan Nilsson
- Principal Investigator Email
- kanslikliniskastudier@regionostergotland.se
- Contact Person Name
- Staffan Nilsson
- Contact Person Email
- kanslikliniskastudier@regionostergotland.se
- Site Name
- Capio vardcentral Orust
- Department Name
- Kaprifolvägen 2E, 473 32 Henån
- Principal Investigator Name
- Halfdan Hilmarsson
- Principal Investigator Email
- helpdesk@capio.se
- Contact Person Name
- Halfdan Hilmarsson
- Contact Person Email
- helpdesk@capio.se
Sponsor
Primary sponsor
- Full Name
- Uppsala University
- Organisation Type
- Educational Institution
- Country Of Registered Address
- Sweden
Investigational products
- Investigational Product Name
- DAPAGLIFLOZIN
- Active Substance
- Dapagliflozin propanediol
- Modality
- Small molecule
- Routes Of Administration
- ORAL USE
- Route
- Oral
- Authorisation Status
- Authorised
- Starting Dose
- 10 mg
- Frequency
- Once daily
- Maximum Dose
- 10 mg/day
- Investigational Product Name
- METFORMIN
- Active Substance
- Metformin
- Modality
- Small molecule
- Routes Of Administration
- ORAL USE
- Route
- Oral
- Authorisation Status
- Authorised
- Frequency
- Daily (schedule not specified)
- Maximum Dose
- 3000 mg/day
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