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Trial · Interventional

CompletedPhase 4Results postedRegistry data

Efficacy and Safety of Toujeo® Versus Tresiba® in Insulin-Naive Patients With Type 2 Diabetes Mellitus Inadequately Controlled With Oral Antihyperglycemic Drug(s) ± GLP-1 Receptor Agonist

Short name BRIGHT

NCTNCT02738151 (opens ClinicalTrials.gov in a new tab)Other idLPS14584Other id2015-005101-36Other idU1111-1177-6327Other id2015

This trial does not test a peptide that PepBank tracks.

  • Measures Glucagon, does not give it. It appears in an outcome measure.

Overview

Status
Completed
Phase
Phase 4
Enrollment
929 participants (actual)
Sponsor
Sanofi · Industry
Design
Randomized · Open label (no masking)
Countries
16 countries

United States, Bulgaria, Croatia, Czechia, Denmark, France, Greece, Hungary, Israel, Italy, Romania, Serbia, Slovakia, Sweden, Switzerland, United Kingdom

Start
19 May 2016
Primary completion
15 Aug 2017
Completion
15 Aug 2017
First posted
14 Apr 2016 (estimated)
Last update posted
14 Sept 2018
Conditions
Diabetes Mellitus, Type 2

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
201620172018
  1. Ph 4

    BRIGHT

    NCT02738151

    19 May 2016 to 15 Aug 2017

Registry summary

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

Primary Objective: To demonstrate the noninferiority in the efficacy of Toujeo® to Tresiba® in glycated hemoglobin (HbA1c) change from Baseline to Week 24. Secondary Objectives: Change From Baseline in HbA1c to Week 12 To assess the effects of the insulin Toujeo® in comparison with insulin Tresiba® at week 12 and week 24 on: * Change in Fasting plasma glucose (FPG); * Change in Fasting self-monitored plasma glucose (SMPG) and 4-point SMPG and 8-point SMPG profile; * Percentage of participants reaching HbA1c targets \<7% or ≤6.5%; * Percentage of participants reaching HbA1c targets \<7% or ≤6.5% without severe and/or confirmed hypoglycemia * Frequency of occurrence and diurnal distribution of hypoglycemia by American Diabetes Association (ADA) category of hypoglycemia. To assess the safety in each treatment group. To assess the treatment effects in each treatment group on Patient Reported Outcomes (PRO). Percentage of participants requiring rescue therapy.

Interventions

  • Insulin glargine, 300U/mLDrug
  • Insulin degludec, 100 U/mLDrug
  • Non-insulin anti-diabetic treatmentDrug

Arms2

  • Experimental

    Toujeo

    Toujeo® (Insulin glargine, 300 U/mL) subcutaneous (SC) injection once daily up to Week 24 on top of non-insulin antidiabetic treatment.

  • Active comparator

    Tresiba

    Tresiba® (Insulin Degludec, 100 U/mL) SC injection once daily up to Week 24 on top of non-insulin antidiabetic treatment .

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Change From Baseline in HbA1c to Week 24

    Time frame · Baseline, Week 24

    Registry description

    Change in HbA1c was calculated by subtracting baseline value from Week 24 value. Adjusted Least Square (LS) means and standard errors were obtained from a mixed-effect model with repeated measures (MMRM) to account for missing data, using all post-baseline HbA1c data available during the 24-week on-treatment period.

Secondary outcomes(17)
  1. Change From Baseline in HbA1c to Week 12

    Time frame · Baseline, Week 12

    Registry description

    Change in HbA1c was calculated by subtracting baseline value from Week 12 value. Adjusted least square means and standard errors were obtained from a mixed-effect model with MMRM.

  2. Change From Baseline in Fasting Plasma Glucose (FPG) to Week 12 and Week 24

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    Change in FPG was calculated by subtracting baseline value from Week 12 and Week 24 value. Adjusted LS means were obtained from MMRM including post baseline values during the 24-week on-treatment period.

  3. Change From Baseline in Fasting Self-Monitoring Plasma Glucose (SMPG) to Week 12 and Week 24

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    Fasting SMPG was measured by the participant before breakfast and before the administration of the glucose-lowering agents once a day during the study. Adjusted LS means were obtained from MMRM including post baseline values during the 24 week on treatment period.

  4. Change From Baseline in 8 Point SMPG Profile to Week 12 and Week 24 Per Time Point

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    8-point SMPG profiles were measured at the following 8 points: 03:00 at night, pre-breakfast, 2 hours after breakfast, pre-lunch, 2 hours after lunch, pre-dinner, 2 hours after dinner, and bedtime.

  5. Change From Baseline in 4-point SMPG Profile to Week 12 and Week 24 Per Time Point

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    4-point SMPG profiles were measured at the following 4 points: prebreakfast, prelunch, predinner and bedtime.

  6. Change From Baseline in 24-hour Average 8-point SMPG Profile to Week 12 and Week 24

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    The 8-point SMPG profile was measured at the following 8 points: 03:00 at night, pre-breakfast, 2 hours after breakfast, pre-lunch, 2 hours after lunch, pre-dinner, 2 hours after dinner, and bedtime. Adjusted LS means were obtained from MMRM.

  7. Change From Baseline in Variability of Fasting SMPG to Week 12 and Week 24

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    Adjusted LS means were obtained from MMRM. Variability was assessed by the mean of coefficient of variation calculated over at least 3 SMPG measured during the 7 days preceding the given visit.

  8. Change From Baseline in Variability of 24-Hour 8-Point SMPG Profiles at Week 12 and Week 24

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    Adjusted LS means were obtained from MMRM.

  9. Percentage of Participants Reaching Target HbA1c of < 7% and =<6.5% at Week 12 and Week 24

    Time frame · Week 12, and Week 24

    Registry description

    Only the post-baseline HbA1c measurements before rescue and during the 12 week and 24-week on-treatment period were considered in the analysis.

  10. Percentage of Participants Reaching Target HbA1c <7% and =<6.5% at Week 12 and Week 24 Without Severe and/or Confirmed Hypoglycemia (70 mg/dL) Event

    Time frame · Week 12, and Week 24

    Registry description

    Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. Severe and/or confirmed hypoglycemia event was a severe event or an event confirmed by plasma glucose =\<3.9 mmol/L (=\<70 mg/dL).

  11. Percentage of Participants With Sulphonylurea or Meglitinide Dose Reduction/ Discontinuation Due to Hypoglycemia During 24 Weeks Treatment Period

    Time frame · Baseline to Week 24

    Registry description

    Percentage of participants With Sulphonylurea or Meglitinide dose reduction/ discontinuation due to Hypoglycemia during 24 Week treatment period were reported. Only participants with Sulphonylurea or meglitinides at Screening as per actual strata were taken into account in this analysis.

  12. Percentage of Participants Requiring a Rescue Therapy During 24 Weeks Treatment Period

    Time frame · Baseline to Week 24

    Registry description

    Routine fasting SMPG and central laboratory FPG (and HbA1c after Week 12) values were used to determine the requirement of rescue medication. Threshold values at Week 12: FPG \>200 mg/dL (11 mmol/L), or HbA1c \>8.5%.

  13. Change From Baseline in Basal Insulin Dose (U/kg Body Weight) to Week 12 and Week 24

    Time frame · Baseline, Week 12 and Week 24

    Registry description

    Only the insulin dose measurements performed before initiation of rescue therapy and during the on-treatment period were considered in the analysis.

  14. Percentage of Participants With At Least One Hypoglycemic Events (Any, Severe and/or Confirmed Hypoglycemia: Any Time of the Day) by Study Period

    Time frame · Day 1-Week 12, Week 13-Week 24, and 24 Week Period

    Registry description

    Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. Severe and/or confirmed hypoglycemia event was a severe event or an event confirmed with plasma glucose =\<70 mg/dL (=\<3.9 mmol/L), or \< 54 mg/dL (\<3.0 mmol/L). Assessment was done by treatment period (for =\<12 weeks, for \>12 weeks to =\<24 weeks (24W)). Percentage of participants with at least one hypoglycemia (hypo) event at any time of the day were reported.

  15. Percentage of Participants With At Least One Hypoglycemic Events (Any, Severe and/or Confirmed Hypoglycemia: Nocturnal) by Study Period

    Time frame · Day 1-Week 12, Week 13-Week 24, and 24 Week Period

    Registry description

    Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. Severe and/or confirmed hypoglycaemia event was a severe event or an event confirmed with plasma glucose =\<70 mg/dL (=\<3.9 mmol/L), or \< 54 mg/dL (\<3.0 mmol/L). Nocturnal hypoglycemia was hypoglycemia that occurred between 00:00 and 05:59 hours (clock time). Assessment was done by treatment period (for =\<12 weeks, for \>12 weeks to =\<24 weeks).

  16. Hypoglycemia (Any, Severe and/or Confirmed Hypoglycemia: Any Time of the Day) Event Rate Per Participant Year During Study Period

    Time frame · Day 1-Week 12, Week 13-Week 24, and 24 Week Period

    Registry description

    Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. Severe and/or confirmed hypoglycemia event was a severe event or an event confirmed with plasma glucose =\<70 mg/dL (=\<3.9 mmol/L), or \< 54 mg/dL (\<3.0 mmol/L).

  17. Hypoglycemia (Any, Severe and/or Confirmed Hypoglycemia: Nocturnal ) Event Rate Per Participant Year During Study Period

    Time frame · Day 1-Week 12, Week 13-Week 24, and 24 Week Period

    Registry description

    Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. Severe and/or confirmed hypoglycemia event was a severe event or an event confirmed with plasma glucose =\<70 mg/dL (=\<3.9 mmol/L), or \< 54 mg/dL (\<3.0 mmol/L). Nocturnal hypoglycemia was hypoglycemia that occurred between 00:00 and 05:59 hours (clock time).

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, Week 24

Change From Baseline in HbA1c to Week 24

GroupValue (percentage of HbA1c)Spread
Toujeo-1.640.037
Tresiba-1.590.037
Secondary and other outcome results(7)
Secondary outcomeLeast squares mean· Baseline, Week 12

Change From Baseline in HbA1c to Week 12

GroupValue (percentage of HbA1c)Spread
Toujeo-1.370.036
Tresiba-1.390.036
Secondary outcomeLeast squares mean· Baseline, Week 12 and Week 24

Change From Baseline in Fasting Plasma Glucose (FPG) to Week 12 and Week 24

GroupValue (mmol/L)Spread
Toujeo-3.640.099
Tresiba-3.890.100
Secondary outcomeLeast squares mean· Baseline, Week 12 and Week 24

Change From Baseline in Fasting Self-Monitoring Plasma Glucose (SMPG) to Week 12 and Week 24

GroupValue (mmol/L)Spread
Toujeo-3.260.067
Tresiba-3.250.067
Secondary outcomeMean· Baseline, Week 12 and Week 24

Change From Baseline in 8 Point SMPG Profile to Week 12 and Week 24 Per Time Point

GroupValue (mmol/L)Spread
Toujeo-2.773.16
Tresiba-2.283.49
Secondary outcomeMean· Baseline, Week 12 and Week 24

Change From Baseline in 4-point SMPG Profile to Week 12 and Week 24 Per Time Point

GroupValue (mmol/L)Spread
Toujeo-3.412.75
Tresiba-2.972.62
Secondary outcomeLeast squares mean· Baseline, Week 12 and Week 24

Change From Baseline in 24-hour Average 8-point SMPG Profile to Week 12 and Week 24

GroupValue (mmol/L)Spread
Toujeo-2.570.092
Tresiba-2.500.093
Secondary outcomeLeast squares mean· Baseline, Week 12 and Week 24

Change From Baseline in Variability of Fasting SMPG to Week 12 and Week 24

GroupValue (percentage of mean variability)Spread
Toujeo2.380.418
Tresiba2.620.416

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
ToujeoToujeo® (Insulin glargine, 300 U/mL) SC injection once daily up to Week 24 on top of non-insulin antidiabetic treatment.1 / 46221 / 46256 / 462
TresibaTresiba® (Insulin Degludec, 100 U/mL) SC injection once daily up to Week 24 on top of non-insulin antidiabetic treatment.0 / 46220 / 46258 / 462

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.

Other registry references

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

  • DerivedRosenstock J, Cheng A, Ritzel R, Bosnyak Z, Devisme C, Cali AMG, Sieber J, Stella P, Wang X, Frias JP, Roussel R, Bolli GB. More Similarities Than Differences Testing Insulin Glargine 300 Units/mL Versus Insulin Degludec 100 Units/mL in Insulin-Naive Type 2 Diabetes: The Randomized Head-to-Head BRIGHT Trial. Diabetes Care. 2018 Oct;41(10):2147-2154. doi: 10.2337/dc18-0559. Epub 2018 Aug 13. PMID 30104294

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion criteria : * Adult participants with type 2 diabetes mellitus (T2DM) inadequately controlled with OADs therapy with/without GLP-1 receptor agonist at stable dose for at least 3 months. * Signed written informed consent. Exclusion criteria: * Age \<18 years. * HbA1c \<7.5% or \>10.5% (at screening visit). Body mass index (BMI) \<25 kg/m\^2 or \>40 kg/m\^2. * History of T2DM for less than 1 year before screening. * Less than 6 months before screening on OADs treatment and GLP-1 receptor agonist (if taken). * Current or previous insulin use except for a maximum of 8 consecutive days or totally 15 days (eg, acute illness, surgery) during the last year prior to screening. * Initiation of new glucose-lowering medications and/or weight loss drug in the last 3 months before screening visit. * Participant receiving only noninsulin antihyperglycemic drugs not approved for combination with insulin according to local labelling/local treatment guideline. * History of hypoglycemia unawareness or repeated episodes of severe hypoglycemia or metabolic acidosis, including hospitalization for diabetic ketoacidosis during the last 12 months prior to screening. * Unstable proliferative diabetic retinopathy or any other rapidly progressive diabetic retinopathy or macular edema likely to require treatment (eg, laser, surgical treatment, or injectable drugs) during the study period. * End stage renal disease. * Any acute or chronic condition that in the opinion of Investigator would affect the safety of participant, compliance, or study results. * Any contraindication to use of Toujeo® or Tresiba® as defined in the national product label, hypersensitivity to Toujeo® or Tresiba® active ingredients or one of the excipients. * Pregnant or breast-feeding women. The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

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