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Trial · Interventional

CompletedPhase 3Results postedRegistry data

Exenatide Study of Cardiovascular Event Lowering Trial (EXSCEL): A Trial To Evaluate Cardiovascular Outcomes After Treatment With Exenatide Once Weekly In Patients With Type 2 Diabetes Mellitus

NCTNCT01144338 (opens ClinicalTrials.gov in a new tab)Other idD5551C00003Other idMB001-002Other idBCB109

Overview

Status
Completed
Phase
Phase 3
Enrollment
14,752 participants (actual)
Sponsor
AstraZeneca · Industry
Design
Randomized · Triple masking
Countries
30 countries

United States, Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, Chile, China, Colombia, Czechia, Germany, Hong Kong, Hungary, Israel, Italy, Latvia, Lithuania, Malaysia, Mexico, Netherlands, New Zealand, Philippines, Poland, Romania, Russia, Slovakia, South Africa, South Korea

Start
18 Jun 2010
Primary completion
21 Apr 2017
Completion
24 Apr 2017
First posted
15 Jun 2010 (estimated)
Last update posted
8 Aug 2018
Conditions
Type 2 Diabetes Mellitus

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20102012201420162018
  1. Ph 3

    Exenatide Study of Cardiovascular Event Lowering Trial (EXSCEL): A Trial To Evaluate Cardiovascular Outcomes After Treatment With Exenatide Once Weekly In Patients With Type 2 Diabetes Mellitus

    NCT01144338

    18 Jun 2010 to 24 Apr 2017

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

This study will compare the impact of including exenatide once weekly in addition to usual care vs. usual care without exenatide on major cardiovascular outcomes as measured by the primary composite endpoint of cardiovascular-related death, nonfatal myocardial infarction (MI), or nonfatal stroke.

Interventions

  • Exenatide Once WeeklyDrug
  • PlaceboDrug

Arms2

  • Experimental

    Exenatide Once Weekly

  • Placebo comparator

    Placebo

Primary outcomes2

Outcomes the sponsor listed as primary.

  1. Primary Efficacy Outcome MACE Events

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    The primary efficacy outcome variable is defined as the composite endpoint of cardiovascular death, nonfatal MI, or nonfatal stroke. The number of participants who had an event is reported in the results. The primary efficacy endpoint is the same as the primary safety endpoint, and the statistical analysis tests the superiority of exenatide against the placebo.

  2. Primary Safety Outcome MACE Events

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    The primary safety outcome variable is defined as the composite endpoint of cardiovascular death, nonfatal MI, or nonfatal stroke. The number of participants who had an event is reported in the results. The primary safety endpoint is the same as the primary efficacy endpoints, and the statistical analysis tests the non-inferiority of exenatide against placebo.

Secondary outcomes(6)
  1. Secondary Efficacy Outcome All-Cause Mortality

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    The secondary efficacy outcome variable is defined as the all-cause mortality (deaths). The number of participants who had an event is reported in the results.

  2. Secondary Efficacy Outcome CV Death

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    Component of the primary efficacy outcome: cardiovascular death. The number of participants who had an event is reported in the results.

  3. Secondary Efficacy Outcome MI

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    Component of primary efficacy outcome: fatal or non-fatal MI. The number of participants who had an event is reported in the results.

  4. Secondary Efficacy Outcome Stroke

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    Component of primary efficacy outcome: fatal or non-fatal stroke. The number of participants who had an event is reported in the results.

  5. Secondary Efficacy Outcome Hospitalization for ACS

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    The secondary efficacy outcome variable is defined as hospitalization for acute coronary syndrome. The number of participants who had an event is reported in the results.

  6. Secondary Efficacy Outcome Hospitalization for HF

    Time frame · Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

    Registry description

    The secondary efficacy outcome variable is defined as hospitalization for heart failure. The number of participants who had an event is reported in the results.

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Primary Efficacy Outcome MACE Events

GroupValue (Participants)
Placebo905
Exenatide Once Weekly839
Primary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Primary Safety Outcome MACE Events

GroupValue (Participants)
Placebo905
Exenatide Once Weekly839
Secondary and other outcome results(6)
Secondary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Secondary Efficacy Outcome All-Cause Mortality

GroupValue (Participants)
Placebo584
Exenatide Once Weekly507
Secondary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Secondary Efficacy Outcome CV Death

GroupValue (Participants)
Placebo383
Exenatide Once Weekly340
Secondary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Secondary Efficacy Outcome MI

GroupValue (Participants)
Placebo493
Exenatide Once Weekly483
Secondary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Secondary Efficacy Outcome Stroke

GroupValue (Participants)
Placebo218
Exenatide Once Weekly187
Secondary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Secondary Efficacy Outcome Hospitalization for ACS

GroupValue (Participants)
Placebo570
Exenatide Once Weekly602
Secondary outcomeCount of participants· Time to first event. Information collected during study period (anticipated to be up to 7.5 years).

Secondary Efficacy Outcome Hospitalization for HF

GroupValue (Participants)
Placebo231
Exenatide Once Weekly219

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
PlaceboMatching placebo subcutaneous injections584 / 73721222 / 73720 / 0
Exenatide Once WeeklyExenatide 2mg once weekly subcutaneous injections507 / 73441234 / 73440 / 0

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies13

Studies that cite this trial.

Studies with results

8 studies on this page

Indexing hint: Meta-analysis (pooled) · 2025

15 results

Glucagon-like peptide 1 (GLP-1) receptor agonists for people with chronic kidney disease and diabetes.

Natale et al. 2025The Cochrane database of systematic reviewscited by 8

PMID 39963952PMC11834151DOI 10.1002/14651858.cd015849.pub2PUB-39963952

Rights unknown15 results

Indexing hint: Randomized controlled trial · 2022

7 results

Effect of race on cardiometabolic responses to once-weekly exenatide: insights from the Exenatide Study of Cardiovascular Event Lowering (EXSCEL).

Davis et al. 2022Cardiovascular diabetologycited by 5

PMID 35761271PMC9238154DOI 10.1186/s12933-022-01555-zPUB-35761271

CC BY7 results

Indexing hint: Randomized controlled trial · 2020

9 results

Within-Trial Evaluation of Medical Resources, Costs, and Quality of Life Among Patients With Type 2 Diabetes Participating in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL).

Reed et al. 2020Diabetes carecited by 7

PMID 31806653PMC7210004DOI 10.2337/dc19-0950PUB-31806653

Rights unknown9 results

Indexing hint: Randomized controlled trial · 2019

3 results

Changes in Serum Calcitonin Concentrations, Incidence of Medullary Thyroid Carcinoma, and Impact of Routine Calcitonin Concentration Monitoring in the EXenatide Study of Cardiovascular Event Lowering (EXSCEL).

Bethel et al. 2019Diabetes carecited by 31

PMID 31010875PMC6973544DOI 10.2337/dc18-2028PUB-31010875

Rights unknown3 results

PubMed tag: none · 2019

7 results

Effect of Once-Weekly Exenatide in Patients With Type 2 Diabetes Mellitus With and Without Heart Failure and Heart Failure-Related Outcomes: Insights From the EXSCEL Trial.

Fudim et al. 2019Circulationcited by 81

PMID 31542942PMC6924268DOI 10.1161/circulationaha.119.041659PUB-31542942

Rights unknown7 results

PubMed tag: none · 2019

6 results

Effects of exenatide and open-label SGLT2 inhibitor treatment, given in parallel or sequentially, on mortality and cardiovascular and renal outcomes in type 2 diabetes: insights from the EXSCEL trial.

Clegg et al. 2019Cardiovascular diabetologycited by 70

PMID 31640705PMC6805385DOI 10.1186/s12933-019-0942-xPUB-31640705

CC BY6 results

Indexing hint: Clinical trial · 2018

2 results

Effect of Once-Weekly Exenatide on Clinical Outcomes According to Baseline Risk in Patients With Type 2 Diabetes Mellitus: Insights From the EXSCEL Trial.

Mentz et al. 2018Journal of the American Heart Associationcited by 26

PMID 30371301PMC6404902DOI 10.1161/jaha.118.009304PUB-30371301

Free to read · publisher termsCC BY-NC2 results

Indexing hint: Randomized controlled trial · 2017

Baseline characteristics of patients enrolled in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL).

Mentz et al. 2017American heart journalcited by 45

PMID 28454792PMC9849915DOI 10.1016/j.ahj.2017.02.005PUB-28454792

Rights unknown
Source link

Indexing hint: Randomized controlled trial · 2017

11 results

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Holman et al. 2017The New England journal of medicinecited by 1,607

PMID 28910237PMC9792409DOI 10.1056/nejmoa1612917PUB-28910237

Rights unknown11 results

Indexing hint: Randomized controlled trial · 2016

Rationale and design of the EXenatide Study of Cardiovascular Event Lowering (EXSCEL) trial.

Holman et al. 2016American heart journalcited by 80

PMID 26995376DOI 10.1016/j.ahj.2015.12.009PUB-26995376

Full text at the publisher
Publisher page

More studies

3 studies on this page

PubMed tag: none · 2022

Lifetime cost-effectiveness simulation of once-weekly exenatide in type 2 diabetes: A cost-utility analysis based on the EXSCEL trial.

Becker et al. 2022Diabetes research and clinical practicecited by 7

PMID 34813910PMC8844554DOI 10.1016/j.diabres.2021.109152PUB-34813910

CC BY
Download PDF

PubMed tag: none · 2018

Generalizability of glucagon-like peptide-1 receptor agonist cardiovascular outcome trials enrollment criteria to the US type 2 diabetes population.

Wittbrodt et al. 2018The American journal of managed carecited by 21

PMID 29693361PUB-29693361

Full text at the publisher

Indexing hint: Observational study · 2012

Health and economic outcomes for exenatide once weekly, insulin, and pioglitazone therapies in the treatment of type 2 diabetes: a simulation analysis.

Gaebler et al. 2012Vascular health and risk managementcited by 18

PMID 22566747PMC3346268DOI 10.2147/vhrm.s28744PUB-22566747

Free to read · publisher termsCC BY-NC
Read at source

Other registry references

References listed at the registry that are not in PepBank. They link to PubMed.

  • DerivedUmapathysivam MM, Araldi E, Hastoy B, Dawed AY, Vatandaslar H, Mayrhofer JE, Lindquist P, Silva PN, Goga A, Trullinger GO, Godbersen S, Sengupta S, Kaufmann A, Thomsen SK, Hartmann B, Chen YC, Jonsson AE, Kabakci H, Thaman S, Grarup N, Have CT, Pallo LP, Faerch K, Gjesing AP, Nawaz S, Cheeseman J, Neville MJ, Pedersen O, Walker M, Sun H, Jennison C, Hattersley AT, Rehfeld JF, Holman RR, Verchere BC, Hansen T, Karpe F, Holst JJ, Rosenkilde MM, Jones AG, Ristow M, McCarthy MI, Pearson ER, Stoffel M, Gloyn AL. Type 2 diabetes risk alleles in peptidyl-glycine alpha-amidating monooxygenase influence GLP-1 levels and response to GLP-1 receptor agonists. Genome Med. 2026 Mar 29;18(1):40. doi: 10.1186/s13073-026-01630-0. PMID 41906117
  • DerivedKoychev I, Reid G, Nguyen M, Mentz RJ, Joyce D, Shah SH, Holman RR. Inflammatory proteins associated with Alzheimer's disease reduced by a GLP1 receptor agonist: a post hoc analysis of the EXSCEL randomized placebo controlled trial. Alzheimers Res Ther. 2024 Oct 2;16(1):212. doi: 10.1186/s13195-024-01573-x. PMID 39358806
  • DerivedOulhaj A, Aziz F, Suliman A, Eller K, Bentoumi R, Buse JB, Al Mahmeed W, von Lewinski D, Coleman RL, Holman RR, Sourij H. Estimated glomerular filtration rate slope and risk of primary and secondary major adverse cardiovascular events and heart failure hospitalization in people with type 2 diabetes: An analysis of the EXSCEL trial. Diabetes Obes Metab. 2024 Oct;26(10):4602-4612. doi: 10.1111/dom.15817. Epub 2024 Jul 31. PMID 39086032
  • DerivedGao N, Dakin HA, Holman RR, Lim LL, Leal J, Clarke P. Estimating Risk Factor Time Paths Among People with Type 2 Diabetes and QALY Gains from Risk Factor Management. Pharmacoeconomics. 2024 Sep;42(9):1017-1028. doi: 10.1007/s40273-024-01398-4. Epub 2024 Jun 26. PMID 38922488
  • DerivedBethel MA, Stevens SR, Buse JB, Choi J, Gustavson SM, Iqbal N, Lokhnygina Y, Mentz RJ, Patel RA, Ohman P, Schernthaner G, Lecube A, Hernandez AF, Holman RR. Exploring the Possible Impact of Unbalanced Open-Label Drop-In of Glucose-Lowering Medications on EXSCEL Outcomes. Circulation. 2020 Apr 28;141(17):1360-1370. doi: 10.1161/CIRCULATIONAHA.119.043353. Epub 2020 Feb 26. PMID 32098501
  • DerivedStandl E, Stevens SR, Lokhnygina Y, Bethel MA, Buse JB, Gustavson SM, Maggioni AP, Mentz RJ, Hernandez AF, Holman RR; EXSCEL Study Group. Confirming the Bidirectional Nature of the Association Between Severe Hypoglycemic and Cardiovascular Events in Type 2 Diabetes: Insights From EXSCEL. Diabetes Care. 2020 Mar;43(3):643-652. doi: 10.2337/dc19-1079. Epub 2019 Dec 27. PMID 31882409
  • DerivedBadjatiya A, Merrill P, Buse JB, Goodman SG, Katona B, Iqbal N, Pagidipati NJ, Sattar N, Holman RR, Hernandez AF, Mentz RJ, Patel MR, Jones WS. Clinical Outcomes in Patients With Type 2 Diabetes Mellitus and Peripheral Artery Disease: Results From the EXSCEL Trial. Circ Cardiovasc Interv. 2019 Dec;12(12):e008018. doi: 10.1161/CIRCINTERVENTIONS.119.008018. Epub 2019 Nov 22. PMID 31752517

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years up to 130 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * Patient has type 2 diabetes mellitus * Patient has an HbA1c of ≥ 6.5 % and ≤ 10.0% and is currently using one of the following treatment regimens: A) Treatment with 0-3 oral antihyperglycemic agents B) Insulin therapy, either alone or in combination with up to two oral agents * Female patients must not be breast feeding and agree to use an effective method of contraception or must not otherwise be at risk of becoming pregnant. Exclusion Criteria: * Patient has a diagnosis of type 1 diabetes mellitus, or a history of ketoacidosis. * Patient has ever been treated with an approved or investigational GLP-1 receptor agonist. * Patient is enrolled in another experimental protocol which involves the use of an investigational drug or device, or an intervention that would interfere with the conduct of the trial. * Patient has a planned or anticipated revascularization procedure. * Pregnancy or planned pregnancy during the trial period. * Patient has end-stage renal disease or an estimated glomerular filtration rate (eGFR) of \<30 mL/min/1.73m2. * Patient has a history of gastroparesis or pancreatitis. * Personal or family history of medullary thyroid cancer or MEN2 (Multiple EndocrineNeoplasia Type 2) or calcitonin level of \>40 ng/L at baseline.

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