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Trial · Interventional

CompletedPhase 3Results postedRegistry data

A Trial Comparing the Efficacy and Safety of Insulin Degludec/Liraglutide, Insulin Degludec and Liraglutide in Japanese Subjects With Type 2 Diabetes Mellitus.

Short name DUAL™ I Japan

NCTNCT02607306 (opens ClinicalTrials.gov in a new tab)Other idNN9068-4183Other idU1111-1170-1332Other idJapicCTI-153089

Overview

Status
Completed
Phase
Phase 3
Enrollment
819 participants (actual)
Sponsor
Novo Nordisk A/S · Industry
Design
Randomized · Open label (no masking)
Countries
1 country

Japan

Start
18 Nov 2015
Primary completion
15 Dec 2017
Completion
22 Dec 2017
First posted
18 Nov 2015 (estimated)
Last update posted
9 Apr 2021
Conditions
Diabetes · Diabetes Mellitus, Type 2

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
2015201620172018
  1. Ph 3

    DUAL™ I Japan

    NCT02607306

    18 Nov 2015 to 22 Dec 2017

Registry summary

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

This trial is conducted in Asia. The aim of this trial is to compare the efficacy and safety of insulin degludec/liraglutide, insulin degludec and liraglutide in Japanese subjects with type 2 diabetes mellitus.

Interventions

  • insulin degludec/liraglutideDrug
  • insulin degludecDrug
  • liraglutideDrug

Arms3

  • Experimental

    Insulin degludec/liraglutide OD

  • Active comparator

    Insulin degludec OD

  • Active comparator

    Liraglutide OD

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Change From Baseline in HbA1c (Glycosylated Haemoglobin) Tested for Non-inferiority of IDegLira vs IDeg and Superiority of IDegLira vs Lira

    Time frame · Week 0, Week 52

    Registry description

    Change from baseline (week 0) in HbA1c after 52 weeks of treatment was measured. Statistical analyses were performed to test the hypotheses: non-inferiority of IDegLira vs. IDeg and superiority of IDegLira vs. Liraglutide (Lira).

Secondary outcomes(20)
  1. Change From Baseline in Body Weight (kg)

    Time frame · Week 0, Week 52

    Registry description

    Change from baseline (week 0) in body weight after 52 weeks of treatment.

  2. Number of Treatment Emergent Severe or Blood Glucose (BG) Confirmed Hypoglycaemic Episodes

    Time frame · Weeks 0-52

    Registry description

    Treatment emergent hypoglycaemic episode is defined as an event that had onset date on or after the first day of trial product administration, and no later than 7 days after the last day on trial product. Severe or BG confirmed hypoglycaemic episodes were defined as episodes that were severe according to the American Diabetes Association (ADA) classification or BG confirmed by a plasma glucose value \< 3.1 mmol/L (56 mg/dL) with or without symptoms consistent with hypoglycaemia. Severe hypoglycaemia according to the ADA definition: an episode requiring assistance of another person to actively administer carbohydrate, glucagon, or take other corrective actions. Plasma glucose concentrations may not be available during an event, but neurological recovery following the return of plasma glucose to normal is considered sufficient evidence that the event was induced by a low plasma glucose concentration.

  3. Change From Baseline in HbA1c (Glycosylated Haemoglobin) Tested for Superiority of IDegLira vs IDeg

    Time frame · Week 0, Week 52

    Registry description

    Change from baseline (week 0) in HbA1c after 52 weeks of treatment was measured. Statistical analysis was performed to test the hypothesis: superiority of IDegLira vs. IDeg.

  4. Change From Baseline in Fasting Plasma Glucose (FPG)

    Time frame · Week 0, Week 52

    Registry description

    Change from baseline (week 0) in FPG after 52 weeks

  5. Insulin Dose

    Time frame · After 52 weeks of treatment

    Registry description

    Actual daily total insulin dose after 52 weeks of treatment.

  6. Responder (Yes/no): HbA1c Less Than 7.0%

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 7.0% after 52 weeks of treatment.

  7. Responder (Yes/no): HbA1c Less Than 7.0% and Change in Body Weight From Baseline Below or Equal to Zero

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 7.0% and without weight gain after 52 weeks of treatment.

  8. Responder (Yes/no): HbA1c Less Than 7.0% Without Treatment Emergent Severe or Blood Glucose (BG) Confirmed Symptomatic Hypoglycaemic Episodes During the Last 12 Weeks of Treatment.

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 7.0% after 52 weeks, who did not experience treatment emergent severe or BG confirmed symptomatic hypoglycaemic episodes during the last 12 weeks of treatment. Treatment emergent hypoglycaemic episode is defined as an event that had onset date on or after the first day of trial product administration, and no later than 7 days after the last day on trial product. Severe or BG confirmed symptomatic hypoglycaemic episodes were defined as episodes that were severe according to the ADA classification or BG confirmed by a plasma glucose value \< 3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia.

  9. Responder (Yes/no): HbA1c Less Than 7.0% and Change in Body Weight From Baseline Below or Equal to Zero and Without Treatment Emergent Severe or BG Confirmed Symptomatic Hypoglycaemic Episodes During the Last 12 Weeks of Treatment

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 7.0% and without weight gain, who did not experience treatment emergent severe or BG confirmed symptomatic hypoglycaemic episodes during the last 12 weeks of treatment. Treatment emergent hypoglycaemic episode is defined as an event that had onset date on or after the first day of trial product administration, and no later than 7 days after the last day on trial product. Severe or BG confirmed symptomatic hypoglycaemic episodes were defined as episodes that were severe according to the ADA classification or BG confirmed by a plasma glucose value \< 3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia.

  10. Responder (Yes/no): HbA1c Less Than 6.5%

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 6.5% after 52 weeks of treatment.

  11. Responder (Yes/no): HbA1c Less Than 6.5% and Change in Body Weight From Baseline Below or Equal to Zero

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 6.5% and without weight gain after 52 weeks of treatment.

  12. Responder (Yes/no): HbA1c Less Than 6.5% Without Treatment Emergent Severe or Blood Glucose (BG) Confirmed Symptomatic Hypoglycaemic Episodes During the Last 12 Weeks of Treatment.

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 6.5% after 52 weeks, who did not experience treatment emergent severe or BG confirmed symptomatic hypoglycaemic episodes during the last 12 weeks of treatment. Treatment emergent hypoglycaemic episode is defined as an event that had onset date on or after the first day of trial product administration, and no later than 7 days after the last day on trial product. Severe or BG confirmed symptomatic hypoglycaemic episodes were defined as episodes that were severe according to the ADA classification or BG confirmed by a plasma glucose value \< 3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia.

  13. Responder (Yes/no): HbA1c Less Than 6.5% and Change in Body Weight From Baseline Below or Equal to Zero and Without Treatment Emergent Severe or BG Confirmed Symptomatic Hypoglycaemic Episodes During the Last 12 Weeks of Treatment

    Time frame · After 52 weeks of treatment

    Registry description

    Number of subjects with HbA1c less than 6.5% with no weight gain, who did not experience treatment emergent severe or BG confirmed symptomatic hypoglycaemic episodes during the last 12 weeks of treatment. Treatment emergent hypoglycaemic episode is defined as an event that had onset date on or after the first day of trial product administration, and no later than 7 days after the last day on trial product. Severe or BG confirmed symptomatic hypoglycaemic episodes were defined as episodes that were severe according to the ADA classification or BG confirmed by a plasma glucose value \< 3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia.

  14. Change in Waist Circumference

    Time frame · Week 0, Week 52

    Registry description

    Change from baseline (week 0) in waist circumference after 52 weeks of treatment.

  15. Change in Blood Pressure (Systolic and Diastolic)

    Time frame · Week 0, Week 52

    Registry description

    Change from baseline in blood pressure (systolic and diastolic) after 52 weeks of treatment.

  16. Self-Measured Blood Glucose (SMBG) 9-point Profile: 9-point Profile (Individual Points in the Profile)

    Time frame · After 52 weeks of the treatment

    Registry description

    Subjects were instructed to measure their plasma glucose at following timepoints: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after start of dinner, at bedtime, at 4:00 a.m. and before breakfast the following day.

  17. Change in SMBG 9-point Profile - Mean of the 9-point Profile

    Time frame · Week 0, week 52

    Registry description

    Subjects were instructed to measure their plasma glucose at following timepoints: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after start of dinner, at bedtime, at 4:00 a.m. and before breakfast the following day. Mean of the 9-point profile was defined as the area under the profile (calculated using the trapezoidal method) divided by the measurement time.

  18. Change in SMBG 9-point Profile - Mean of Postprandial Increments (From Before Meal to 90 Min After for Breakfast, Lunch and Dinner)

    Time frame · Week 0, week 52

    Registry description

    Subjects were instructed to measure their plasma glucose at following timepoints: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after start of dinner, at bedtime, at 4:00 a.m. and before breakfast the following day. The mean increment over all meals was derived as the mean of all available meal increments.

  19. Total Cholesterol as a Ratio to Baseline at 52 Weeks

    Time frame · After 52 weeks of treatment

    Registry description

    Total cholesterol after 52 weeks of treatment was represented as ratio to baseline (week 0) values.

  20. Low Density Lipoprotein (LDL) Cholesterol as a Ratio to Baseline at 52 Weeks

    Time frame · After 52 weeks of treatment

    Registry description

    Low density lipoprotein (LDL) cholesterol after 52 weeks of treatment was represented as ratio to baseline (week 0) values.

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 outcomeMean· Week 0, Week 52

Change From Baseline in HbA1c (Glycosylated Haemoglobin) Tested for Non-inferiority of IDegLira vs IDeg and Superiority of IDegLira vs Lira

GroupValue (Percentage of HbA1c)Spread
Insulin Degludec/Liraglutide-2.421.04
Insulin Degludec-1.801.02
Liraglutide-1.800.92
Secondary and other outcome results(7)
Secondary outcomeMean· Week 0, Week 52

Change From Baseline in Body Weight (kg)

GroupValue (Kg)Spread
Insulin Degludec/Liraglutide2.93.2
Insulin Degludec4.14.3
Liraglutide-1.03.4
Secondary outcomeNumber· Weeks 0-52

Number of Treatment Emergent Severe or Blood Glucose (BG) Confirmed Hypoglycaemic Episodes

GroupValue (Episodes)
Insulin Degludec/Liraglutide467
Insulin Degludec869
Liraglutide13
Secondary outcomeMean· Week 0, Week 52

Change From Baseline in HbA1c (Glycosylated Haemoglobin) Tested for Superiority of IDegLira vs IDeg

GroupValue (Percentage of HbA1c)Spread
Insulin Degludec/Liraglutide-2.421.04
Insulin Degludec-1.801.02
Liraglutide-1.800.92
Secondary outcomeMean· Week 0, Week 52

Change From Baseline in Fasting Plasma Glucose (FPG)

GroupValue (mmol/L)Spread
Insulin Degludec/Liraglutide-4.082.47
Insulin Degludec-3.972.56
Liraglutide-2.621.95
Secondary outcomeMean· After 52 weeks of treatment

Insulin Dose

GroupValue (Insulin Units/Day)Spread
Insulin Degludec/Liraglutide27.714.8
Insulin Degludec34.826.0
Secondary outcomeCount of participants· After 52 weeks of treatment

Responder (Yes/no): HbA1c Less Than 7.0%

GroupValue (Participants)
Insulin Degludec/Liraglutide245
Insulin Degludec189
Liraglutide208
Secondary outcomeCount of participants· After 52 weeks of treatment

Responder (Yes/no): HbA1c Less Than 7.0% and Change in Body Weight From Baseline Below or Equal to Zero

GroupValue (Participants)
Insulin Degludec/Liraglutide44
Insulin Degludec22
Liraglutide142

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
Insulin Degludec/LiraglutideEligible subjects were treated with insulin degludec/liraglutide (IDegLira) once daily (OD) in combination with pre-trial oral anti diabetic drugs (at stable dose level and dosing frequency; dose reduction was allowed in case of safety concern). The recommended starting dose of IDegLira was 10 dose steps (10 units IDeg/0.36 mg liraglutide). IDegLira was titrated twice weekly according to a predefined titration algorithm to a maximum of 50 dose steps (50 units IDeg/1.8 mg liraglutide), aiming to reach a fasting plasma glucose target between 72 mg/dL (4.0 mmol/L) and 90 mg/dL (5.0 mmol/L). One follow-up visit was scheduled 7 days after end of treatment. IDegLira was injected subcutaneously in the thigh, upper arm (deltoid region) or abdomen. The injection area chosen remained unchanged throughout the trial, although rotation within the area was recommended.1 / 27517 / 275153 / 275
Insulin DegludecEligible subjects were treated with insulin degludec (IDeg) once daily (OD) in combination with pre-trial oral anti diabetic drugs (at stable dose level and dosing frequency unless there were safety concerns, in which case dose reduction was allowed). The recommended starting dose of IDeg was 10 units. IDeg was titrated twice weekly according to a predefined titration algorithm, aiming to reach a fasting plasma glucose target between 72 mg/dL (4.0 mmol/L) and 90 mg/dL (5.0 mmol/L). There was no maximum dose decided for IDeg. One follow-up visit was scheduled 7 days after end of treatment. IDeg was injected subcutaneously in the thigh, upper arm (deltoid region) or abdomen. The injection area chosen remained unchanged throughout the trial, although rotation within the area was recommended.0 / 27113 / 271137 / 271
LiraglutideEligible subjects were treated with liraglutide once daily (OD) in combination with pre-trial oral anti diabetic drugs (at stable dose level and dosing frequency unless there were safety concerns, in which case dose reduction was allowed). For liraglutide the starting dose of liraglutide was 0.3 mg/day and subsequent weekly dose escalation by 0.3 mg weekly to a fixed maximum dose of 1.8 mg/day. One follow-up visit was scheduled 7 days after end of treatment. Liraglutide was injected subcutaneously in the thigh, upper arm (deltoid region) or abdomen. The injection area chosen remained unchanged throughout the trial, although rotation within the area was recommended.0 / 27314 / 273158 / 273

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

Studies2

Studies that cite this trial.

Studies with results

1 study on this page

Indexing hint: Randomized controlled trial · 2019

12 results

Superior efficacy with a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with insulin degludec and liraglutide in insulin-naïve Japanese patients with type 2 diabetes in a phase 3, open-label, randomized trial.

Kaku et al. 2019Diabetes, obesity & metabolismcited by 23

PMID 31407845PMC6899795DOI 10.1111/dom.13856PUB-31407845

Free to read · publisher termsCC BY-NC12 results

More studies

1 study on this page

PubMed tag: none · 2021

Efficacy and safety of the fixed-ratio combination of insulin degludec and liraglutide by baseline glycated hemoglobin, body mass index and age in Japanese individuals with type 2 diabetes: A subgroup analysis of two phase III trials.

Komatsu et al. 2021Journal of diabetes investigationcited by 10

PMID 33595901PMC8409843DOI 10.1111/jdi.13525PUB-33595901

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

Eligibility

Who could join, as posted.

Sex
All
Age
from 20 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: * Male or female Japanese subjects, age at least 20 years at the time of signing informed consent * Type 2 diabetes subjects (diagnosed clinically) at least 6 months prior to screening * HbA1c (glycosylated haemoglobin) 7.0-11.0 % (both inclusive) by central laboratory analysis, with the aim of a median of 8.3%. When approximately 50% of the randomised subjects have a HbA1c above 8.3%, the remaining subjects randomised must have a HbA1c below or equal to 8.3%; or when approximately 50% of the randomised subjects have a HbA1c below or equal to 8.3%, the remaining subjects randomised must have a HbA1c above 8.3% * Body-mass index (BMI) above or equal to 20 kg/m\^2 * Subjects on stable therapy with one OAD (defined as unchanged medication and unchanged dose) for at least 60 days (metformin, a-GI, TZD, SU, SGLT2i or glinide) prior to screening according to approved Japanese labelling Exclusion Criteria: * Previous treatment with insulin (except for short-term treatment in connection with intercurrent illness including gestational diabetes) * Treatment with any medication for the indication of diabetes or obesity other than stated in the inclusion criteria in a period of 60 days before screening * Anticipated initiation or change in concomitant medications in excess of 14 days known to affect weight or glucose metabolism * Impaired liver function, defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) equal to or above 2.5 times upper limit of normal * Renal impairment estimated Glomerular Filtration Rate (eGFR) below 60mL/min/1.73m\^2 as per Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) * Screening calcitonin equal to or above 50 ng/L * History of pancreatitis (acute or chronic) * Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia type 2 (MEN 2) * Subjects presently classified as being in New York Heart Association (NYHA) Class IV

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