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Trial · Interventional

CompletedPhase 3Results postedRegistry data

A Double-blinded Trial Comparing the Efficacy and Safety of Insulin Degludec/Liraglutide and Insulin Degludec Both in Combination With Metformin in Japanese Subjects With Type 2 Diabetes Mellitus Inadequately Controlled With Basal or Pre-mix/Combination Insulin Therapy and Oral Anti-diabetic Drugs

Short name DUAL™ II Japan

NCTNCT02911948 (opens ClinicalTrials.gov in a new tab)Other idNN9068-4184Other idU1111-1178-3453Other idJapicCTI-163385

Overview

Status
Completed
Phase
Phase 3
Enrollment
210 participants (actual)
Sponsor
Novo Nordisk A/S · Industry
Design
Randomized · Double masking
Countries
1 country

Japan

Start
21 Sept 2016
Primary completion
17 Nov 2017
Completion
22 Nov 2017
First posted
23 Sept 2016 (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
201620172018
  1. Ph 3

    DUAL™ II Japan

    NCT02911948

    21 Sept 2016 to 22 Nov 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 and insulin degludec both in combination with metformin in Japanese subjects with type 2 diabetes mellitus inadequately controlled with basal or pre-mix/combination insulin therapy and oral anti-diabetic drugs.

Interventions

  • Insulin degludec/liraglutideDrug
  • Insulin degludecDrug

Arms2

  • Experimental

    Insulin degludec/liraglutide

  • Active comparator

    Insulin degludec

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Change in Glycosylated Haemoglobin (HbA1c)

    Time frame · week 0, week 26

    Registry description

    Change from baseline (week 0) in HbA1c after 26 weeks of treatment.

Secondary outcomes(20)
  1. Change in Body Weight

    Time frame · week 0, week 26

    Registry description

    Change from baseline (week 0) in body weight after 26 weeks of treatment.

  2. Change in Fasting Plasma Glucose (FPG)

    Time frame · week 0, week 26

    Registry description

    Change from baseline (week 0) in FPG after 26 weeks of treatment.

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

    Time frame · During 26 weeks of treatment

    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.

  4. Daily Insulin Dose

    Time frame · After 26 weeks

    Registry description

    Actual daily total insulin dose after 26 weeks.

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

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than 7.0% after 26 weeks.

  6. Responder (Yes/no): HbA1c Less Than 7.0% and Without Weight Gain

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than 7.0% and without weight gain after 26 weeks.

  7. 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 26 weeks

    Registry description

    Number of subjects with HbA1c less than 7.0% after 26 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.

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

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than 7.0% and no weight gain after 26 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 or Equal to 6.5%

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than or equal to 6.5% after 26 weeks.

  10. Responder (Yes/no): HbA1c Less Than or Equal to 6.5% and Without Weight Gain

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than or equal to 6.5% and without weight gain

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

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than or equal to 6.5% after 26 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.

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

    Time frame · After 26 weeks

    Registry description

    Number of subjects with HbA1c less than or equal to 6.5% and no weight gain after 26 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. Change in Waist Circumference

    Time frame · week 0, week 26

    Registry description

    Change from baseline (week 0) in waist circumference after 26 weeks of treatment.

  14. Change in Blood Pressure (Systolic and Diastolic)

    Time frame · week 0, week 26

    Registry description

    Change from baseline in blood pressure (systolic and diastolic) after 26 weeks of treatment.

  15. Self-measured Blood Glucose (SMBG) 9-point Profile (Individual Points in the Profile)

    Time frame · After 26 weeks

    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.

  16. Change in SMBG 9-point Profile: Mean of the 9-point Profile

    Time frame · Week 0, week 26

    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.

  17. Change in SMBG 9-point Profile: Mean of Postprandial Plasma Glucose Increments (From Before Meal to 90 Minutes After Breakfast, Lunch and Dinner)

    Time frame · Week 0, week 26

    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.

  18. Fasting Lipid Profile

    Time frame · Week 0, week 26

    Registry description

    Lipid profile includes total cholesterol, low density lipoprotein cholesterol (LDL cholesterol), high density lipoprotein cholesterol (HDL cholesterol), very low density lipoprotein cholesterol (VLDL cholesterol), triglycerides and free fatty acids. Lipid profile parameters are represented as ratio to baseline values.

  19. Number of Treatment Emergent Adverse Events (TEAE)

    Time frame · During 26 weeks of treatment

    Registry description

    Treatment emergent adverse event 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. If the event had onset date before the first day of exposure on randomised treatment and increased in severity during the treatment period and until 7 days after the last drug date, then this event was considered as a TEAE.

  20. Number of Treatment Emergent Severe or BG Confirmed Symptomatic Hypoglycaemic Episodes

    Time frame · During 26 weeks of treatment

    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 symptomatic 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 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.

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 26

Change in Glycosylated Haemoglobin (HbA1c)

GroupValue (Percentage of HbA1c)Spread
Insulin Degludec/Liraglutide-1.951.01
Insulin Degludec-0.650.98
Secondary and other outcome results(7)
Secondary outcomeMean· week 0, week 26

Change in Body Weight

GroupValue (Kg)Spread
Insulin Degludec/Liraglutide-0.73.5
Insulin Degludec0.72.7
Secondary outcomeMean· week 0, week 26

Change in Fasting Plasma Glucose (FPG)

GroupValue (mmol/L)Spread
Insulin Degludec/Liraglutide-2.813.17
Insulin Degludec-2.292.68
Secondary outcomeNumber· During 26 weeks of treatment

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

GroupValue (Number of episodes)
Insulin Degludec/Liraglutide124
Insulin Degludec109
Secondary outcomeMean· After 26 weeks

Daily Insulin Dose

GroupValue (Units)Spread
Insulin Degludec/Liraglutide37.611.4
Insulin Degludec41.211.5
Secondary outcomeCount of participants· After 26 weeks

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

GroupValue (Participants)
Insulin Degludec/Liraglutide75
Insulin Degludec23
Secondary outcomeCount of participants· After 26 weeks

Responder (Yes/no): HbA1c Less Than 7.0% and Without Weight Gain

GroupValue (Participants)
Insulin Degludec/Liraglutide50
Insulin Degludec9
Secondary outcomeCount of participants· After 26 weeks

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

GroupValue (Participants)
Insulin Degludec/Liraglutide70
Insulin Degludec20

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) in combination with metformin (at stable pre-trial dose and frequency level) for 26 weeks. The starting dose of IDegLira was 10 dose steps (10 units IDeg/0.36 mg liraglutide), with the option of choosing up to 16 dose steps (16 units IDeg/0.6 mg liraglutide) at the investigator's discretion. 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). IDegLira was injected subcutaneously (s.c.), once daily (OD) in the thigh, upper arm (deltoid region) or abdomen. One follow-up contact was scheduled at least 7 to 10 days after end of treatment.0 / 1053 / 10554 / 105
Insulin DegludecEligible subjects were treated with insulin degludec (IDeg) in combination with metformin (at stable pre-trial dose and frequency level) for 26 weeks. The starting dose of IDeg was 10 units IDeg, with the option of choosing up to 16 units IDeg at the investigator's discretion. IDeg was titrated twice weekly according to a predefined titration algorithm to a maximum of 50 units IDeg, aiming to reach a fasting plasma glucose target between 72 mg/dL (4.0 mmol/L) and 90 mg/dL (5.0 mmol/L). IDeg was injected subcutaneously (s.c.), once daily (OD) in the thigh, upper arm (deltoid region) or abdomen. One follow-up contact was scheduled at least 7 to 10 days after end of treatment.0 / 1054 / 10548 / 105

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

Studies3

Studies that cite this trial.

Studies with results

1 study on this page

Indexing hint: Randomized controlled trial · 2019

5 results

Superior HbA1c control with the fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with a maximum dose of 50 units of insulin degludec in Japanese individuals with type 2 diabetes in a phase 3, double-blind, randomized trial.

Watada et al. 2019Diabetes, obesity & metabolismcited by 26

PMID 31423685PMC6900157DOI 10.1111/dom.13859PUB-31423685

Free to read · publisher termsCC BY-NC5 results

More studies

2 studies 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

PubMed tag: none · 2020

IDegLira Improves Glycemic Control in Japanese Patients with Uncontrolled Type 2 Diabetes on Premixed Insulin Therapy.

Watada et al. 2020Diabetes therapy : research, treatment and education of diabetes and related disorderscited by 11

PMID 31760599PMC6965526DOI 10.1007/s13300-019-00730-yPUB-31760599

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 * T2DM (type 2 diabetes mellitus) subjects (diagnosed clinically) for at least 6 months prior to screening * HbA1c (glycosylated haemoglobin) 7.5-11.0 per cent \[58 mmol/mol-97 mmol/mol\] (both inclusive) by central laboratory analysis * Subjects on stable daily insulin doses for at least 60 days prior to screening administered once or twice daily, either as basal insulin (e.g. IDeg, insulin glargine, insulin detemir, NPH insulin) or pre-mix/combination insulin (e.g. biphasic insulin aspart, insulin degludec/insulin aspart). Total daily insulin dose in the previous 60 days should be within 20-50 units, both inclusive, and on the day of screening, but fluctuations of plus/minus 20 per cent within the 60 days prior to screening are acceptable. The specified insulin treatment should be administered in combination with a stable daily dose of metformin within current approved Japanese label for at least 60 days prior to screening - additionally, the anti-diabetic treatment can be with or without a stable daily dose of one of the following other OADs (oral anti-diabetic drug): SU (sulfonylureas), glinides, alpha-glucosidase inhibitor, SGLT2i (sodium glucose co-transporter 2 inhibitor) or TZD (thiazolidinedione) within current approved Japanese label for at least 60 days prior to screening * Body Mass Index (BMI) equal or above 23 kg/m\^2 Exclusion Criteria: * Receipt of any investigational medicinal product (IMP) within 30 days before screening * Use of any anti-diabetic drug in a period of 60 days before screening (except premix/ combination or basal insulin, metformin, SU, glinides, α-GI, SGLT2i, or TZD) or anticipated change in concomitant medication, which in the investigators opinion could interfere with glucose metabolism (e.g. systemic corticosteroids or bolus insulin) * Treatment with glucagon-like peptide-1 (GLP-1) receptor agonist during the last 60 days prior to screening and furthermore, the discontinuation of GLP-1 receptor agonist at any point in time must not have been due to safety concerns, tolerability issues or lack of efficacy, as judged by the investigator * Treatment with dipetidyl peptidase-4 (DPP-4) inhibitors during the last 60 days prior to screening - Impaired liver function, defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) equal or above 2.5 times upper limit of normal * Renal impairment estimated Glomerular Filtration Rate (eGFR) below 60 mL/min/1.73m\^2 as per Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) * Screening calcitonin equal 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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