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Trial · Interventional

CompletedPhase 1Results postedRegistry data

Roflumilast Plus Alogliptin Proof-of-Mechanism Study in Type2 Diabetes

NCTNCT01664624 (opens ClinicalTrials.gov in a new tab)Other idROF-T2D_107Other idU1111-1128-6945

Overview

Status
Completed
Phase
Phase 1
Enrollment
40 participants (actual)
Sponsor
AstraZeneca · Industry
Design
Randomized · Quadruple masking
Countries
1 country

United States

Start
Jul 2012
Primary completion
Nov 2012
Completion
Nov 2012
First posted
14 Aug 2012 (estimated)
Last update posted
1 Feb 2017 (estimated)
Conditions
Type 2 Diabetes

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20122013
  1. Ph 1

    Roflumilast Plus Alogliptin Proof-of-Mechanism Study in Type2 Diabetes

    NCT01664624

    Jul 2012 to Nov 2012

Registry summary

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

The purpose of this study is to assess the effect of roflumilast plus alogliptin on glucagon-like peptide-1 (GLP-1) and glucose levels in patients with type 2 diabetes.

Interventions

  • RoflumilastDrug
  • AlogliptinDrug
  • ExenatideDrug
  • Placebo to roflumilastDrug
  • Placebo to alogliptinDrug

Arms4

  • Experimental

    Roflumilast + alogliptin

    Roflumilast 500 μg, tablets, orally and alogliptin 25 mg, tablets, orally, once a day for 11 days.

  • Experimental

    Alogliptin alone

    Placebo to roflumilast, tablets, orally and alogliptin, 25 mg, tablets, orally, once a day for 11 days.

  • Experimental

    Roflumilast alone

    Roflumilast 500 μg, tablets, orally and placebo to alogliptin, tablets, orally, once a day, for 11 days.

  • Active comparator

    Exenatide

    Exenatide 5 μg subcutaneous injection twice a day for 11 days.

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Change From Baseline in Postprandial Area Under the Curve From Time 0 to 8 Hours (AUC[0-8]) for Active Glucagon-like Peptide-1

    Time frame · Baseline and Day 11; samples were taken at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

    Registry description

    The concentration of glucagon-like peptide-1 (GLP-1) in blood before and up to 8 hours after eating (postprandial) was plotted and the area under the curve calculated using the linear trapezoidal rule at Baseline and on Day 11. Least squares means of the change from Baseline to Day 11 were obtained using an analysis of covariance (ANCOVA) model with treatment as fixed effect, and Baseline postprandial AUC (0-8) of active GLP-1 as a continuous covariate.

Secondary outcomes(5)
  1. Change From Baseline in AUC(0-8) of Postprandial Plasma Glucose

    Time frame · Baseline and Day 11 at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

    Registry description

    The concentration of glucose in blood before and up to 8 hours after eating (postprandial) was plotted and the area under the curve calculated using the linear trapezoidal rule at Baseline and on Day 11. Least squares means of the change from Baseline to Day 11 were obtained using an ANCOVA model with treatment as fixed effect, and baseline postprandial AUC (0-8) of plasma glucose as a continuous covariate.

  2. Change From Baseline in Postprandial AUC(0-8) of C-peptide

    Time frame · Baseline and Day 11; samples were taken at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

    Registry description

    The concentration of C-peptide in blood before and up to 8 hours after eating (postprandial) was plotted and the area under the curve calculated using the linear trapezoidal rule at Baseline and on Day 11. Least squares means of the change from Baseline to Day 11 were obtained using an ANCOVA model with treatment as fixed effect, and Baseline postprandial AUC (0-8) of C-peptide as a continuous covariate.

  3. Change From Baseline in Postprandial AUC(0-8) of Insulin

    Time frame · Baseline and Day 11; samples were taken at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

    Registry description

    The concentration of insulin in blood before and up to 8 hours after eating was plotted and the area under the curve calculated using the linear trapezoidal rule at Baseline and on Day 11. Least squares means of the change from Baseline to Day 11 were obtained using an ANCOVA model with treatment as fixed effect, and Baseline postprandial AUC (0-8) of insulin as a continuous covariate.

  4. Change From Baseline to Day 11 in AUC(0-8) of Appetite Sensation

    Time frame · At Baseline and Day 11, every 30 minutes, starting 1 hour before eating until 8 hour after the meal.

    Registry description

    Appetite sensations were measured using a visual analog scale (VAS) questionnaire. Participants were asked to indicate their level of fullness, hunger, satiety, and prospective consumption (how much do you think you can eat?) on a 100 mm line ranging from "Not at all" (0 mm) to "extremely" (100 mm). Appetite sensation scores before and up to 8 hours after eating were plotted and the area under the curve calculated using the linear trapezoidal rule at Baseline and on Day 11. Least squares means of the change from Baseline to Day 11 were obtained using an ANCOVA model with treatment as fixed effect, and Baseline postprandial AUC (0-8) of appetite sensation VAS score as a continuous covariate.

  5. Change From Baseline to Day 11 in 24-hour Average Plasma Glucose

    Time frame · Baseline (Day -1) and Day 11, from 12 AM through 24 hours.

    Registry description

    Plasma glucose was measured by Continuous Glucose Monitoring System (CGMS). CGMS measures glucose every 5 minutes, starting in the fasting state 8 hour prior to the standardized breakfast (12 AM) until 16 hours after the breakfast. The average 24-hour plasma glucose concentration was calculated. Least squares means were obtained using an ANCOVA model with treatment as fixed effect, and Baseline 24-hour Glucose Measured by CGMS as a continuous covariate.

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 outcomeLeast squares mean· Baseline and Day 11; samples were taken at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

Change From Baseline in Postprandial Area Under the Curve From Time 0 to 8 Hours (AUC[0-8]) for Active Glucagon-like Peptide-1

GroupValue (pmol/L*hr)Spread
Roflumilast + Alogliptin26.54.04
Alogliptin Alone31.64.01
Roflumilast Alone3.83.94
Exenatide-2.34.14
Secondary and other outcome results(5)
Secondary outcomeLeast squares mean· Baseline and Day 11 at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

Change From Baseline in AUC(0-8) of Postprandial Plasma Glucose

GroupValue (mmol/L*hr)Spread
Roflumilast + Alogliptin-13.42.70
Alogliptin Alone-9.82.71
Roflumilast Alone-9.02.71
Exenatide-18.52.85
Secondary outcomeLeast squares mean· Baseline and Day 11; samples were taken at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

Change From Baseline in Postprandial AUC(0-8) of C-peptide

GroupValue (ng/mL*hr)Spread
Roflumilast + Alogliptin1.01.15
Alogliptin Alone1.41.16
Roflumilast Alone-0.71.17
Exenatide0.01.22
Secondary outcomeLeast squares mean· Baseline and Day 11; samples were taken at -15 min and -5 min (pre-meal), and 15 min, 30 min, and 1, 2, 3, 4, 6, and 8 hours (post-meal).

Change From Baseline in Postprandial AUC(0-8) of Insulin

GroupValue (pmol/L*hr)Spread
Roflumilast + Alogliptin-49.5181.09
Alogliptin Alone107.8180.75
Roflumilast Alone26.9180.38
Exenatide-136.4190.12
Secondary outcomeLeast squares mean· At Baseline and Day 11, every 30 minutes, starting 1 hour before eating until 8 hour after the meal.

Change From Baseline to Day 11 in AUC(0-8) of Appetite Sensation

GroupValue (mm*hr)Spread
Roflumilast + Alogliptin70.559.73
Alogliptin Alone62.056.52
Roflumilast Alone136.057.81
Exenatide116.859.51
Secondary outcomeLeast squares mean· Baseline (Day -1) and Day 11, from 12 AM through 24 hours.

Change From Baseline to Day 11 in 24-hour Average Plasma Glucose

GroupValue (mg/dL)Spread
Roflumilast + Alogliptin-25.46.67
Alogliptin Alone-17.56.67
Roflumilast Alone-14.56.66
Exenatide-34.97.02

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Roflumilast + AlogliptinRoflumilast 500 μg, tablets, orally and alogliptin 25 mg, tablets, orally, once a day for 11 days.–1 / 106 / 10
Alogliptin AlonePlacebo to roflumilast, tablets, orally and alogliptin, 25 mg, tablets, orally, once a day for 11 days.–0 / 115 / 11
Roflumilast AloneRoflumilast 500 μg, tablets, orally and placebo to alogliptin, tablets, orally, once a day, for 11 days.–0 / 108 / 10
ExenatideExenatide 5 μg subcutaneous injection twice a day for 11 days.–0 / 97 / 9

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

Studies0

Studies that cite this trial.

No study cites this trial.

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years up to 80 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: 1. Male or female, aged 18 to 80 years, inclusive, at the time of dosing on Day 1. 2. Has an historical diagnosis of type 2 diabetes mellitus (T2DM) disease. 3. Has a documented history of a diet and exercise plan and is receiving metformin as monotherapy at a stable dose for at least 8 weeks prior to Screening; has no chronic use (\>7 days) of any other antidiabetic therapy within the 8 weeks prior to Screening. 4. Has inadequate glycemic control at Screening, as evidenced by HbA1c (glycosylated hemoglobin) level between 7.0% and 10.0%, inclusive. 5. Has a body mass index (BMI) of ≥23.0 kg/m\^2 and ≤45.0 kg/m\^2, at Screening. 6. A female of childbearing potential who is sexually active with a nonsterilized male partner agrees to use routinely adequate contraception from signing of informed consent throughout the duration of the study and for 30 days after the last dose of study drug. 7. A male who is nonsterilized and sexually active with a female partner of childbearing potential agrees to use adequate contraception from signing of informed consent throughout the duration of the study and for 30 days after last dose of study drug 8. In the opinion of the investigator, the participant is capable of understanding and complying with protocol requirements. 9. The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures. Exclusion Criteria: 1. Has a history of type 1 diabetes. 2. Has a history of acute metabolic diabetic complications. 3. Has has abnormal Screening or Check-in (Day -2) laboratory values that suggest a clinically significant underlying disease (eg, active liver disease or jaundice) or participant with the following laboratory abnormalities: alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) \>3 × upper limit of normal (ULN). 4. Has a history of diabetic gastroparesis or history of gastric bypass surgery. 5. Has a history of coronary angioplasty, coronary stent placement, coronary bypass surgery, or myocardial infarction within 6 months prior to Screening. 6. Has New York Heart Association heart failure of Class (III-IV) regardless of therapy. 7. Has a supine blood pressure \>150 mm Hg for systolic or \>90 mm Hg for diastolic, confirmed on repeat testing within a maximum of 5 minutes, at Screening and Check-in (Day -2). 8. Has presence or history of neuropsychiatric disorder (eg, psychosis, psychotic disorders, depression associated with suicidal thinking, suicidal ideation or behavior). 9. Has a history of drug abuse (defined as illicit drug use) or a history of alcohol abuse (defined as regular or daily consumption of more than 4 alcoholic drinks per day) within the past 2 years or is unwilling to agree to abstain from alcohol and drugs throughout the study. 10. Has a hemoglobin ≤120 g/L for men and ≤100 g/L for women. 11. Has a history of clinically significant allergies or idiosyncrasies to roflumilast, alogliptin and exenatide or any inactive ingredient(s) of these products, eg, rare hereditary problems of galactose intolerance, the Lapp lactase deficiency, glucose-galactose malabsorption or phenylketonuria. 12. Has received alogliptin or roflumilast in a previous clinical study or as a therapeutic agent within 2 months prior to Screening, or is taking prescription roflumilast for chronic obstructive pulmonary disease (COPD), or has received any other investigational compound within 30 days prior to the first dose of study medication, or is participating or plans to participate in any other clinical trial during this study. 13. If female, is pregnant or lactating or intending to become pregnant before, during, or within 30 days after last dose; or intending to donate ova during such time period. 14. If male, intends to donate sperm during the course of the study or for 30 days after last dose of study medication. 15. Is an immediate family member, study site employee, or in a dependent relationship with a study site employee who is involved in the conduct of this study (eg, spouse, parent, child, sibling) or may consent under duress. 16. Has a history of cancer, except basal cell or squamous cell carcinoma which has been in remission for at least 5 years prior to Day 1. 17. Serum creatinine ≥1.5 mg/dL for males and ≥1.4 mg/dL for females or creatinine clearance \<60 mL/minutes, based on calculation by central lab using the Cockcroft-Gault approximation at Screening Visit. 18. Has a history of any hemoglobinopathy that may affect determination of HbA1c. 19. Has positive test result for Hepatitis B surface antigen (HBsAg), Hepatitis C antibody (HCV), any known history of infection with human immunodeficiency virus (HIV), any acute infection, or severe immunological diseases (eg, multiple sclerosis, systemic lupus erythematosus, and progressive multifocal leukoencephalopathy). 20. Has a risk of suicide according to the Investigator's clinical judgment per Columbia-Suicide Severity Rating Scale (C-SSRS) at Screening or has made a suicide attempt in the past 6 months. 21. Has any clinically relevant abnormal laboratory values suggesting an unknown disease and requiring further clinical evaluation (as assessed by the investigator). 22. Does not have an adequate standard of literacy to allow him or her to complete the study diary during non-clinic days. 23. Has poor peripheral venous access. 24. Has Screening or Check-in (Day -2) abnormal clinically significant electrocardiogram (ECG). Entry of any participant with abnormal not clinically significant ECG must be approved and documented by signature of Principal Investigator and Medical Monitor.

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