Clinical trial NCT00376181: Efficacy, Safety and Tolerability of Pioglitazone-Azilsartan in Subjects With Type 2 Diabetes Mellitus
Official title: A Phase 3 Double-Blind, Randomized, Placebo-Controlled Study to Determine the Efficacy, Safety, and Tolerability of AD-4833-536 in the Treatment of Subjects With Type 2 Diabetes
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE3
Conditions: Type 2 Diabetes
Keywords: type 2 diabetes
hypertension
blood pressure
diastolic blood pressure
Lead sponsor: Takeda
Sponsor class: INDUSTRY
First posted: 2006-09-14
Enrollment: 96
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate the efficacy and safety of pioglitazone-azilsartan, once daily (QD), in subjects with type 2 diabetes mellitus with poor glycemic control.

Detailed description: Type 2 diabetes is a chronic disease. In the United States, an estimated 21 million people have diabetes, with type 2 diabetes occurring in 90% to 95% of cases. Hypertension (high blood pressure) affects approximately 50 million individuals in the United States. The association of diabetes and hypertension is increased in this population; hypertension is more common in persons with diabetes while individuals with hypertension are 2.5 times more likely to develop diabetes than those who have normal blood pressure. As a result, more than 70% of adults with diabetes have hypertension (defined as having blood pressure greater than or equal to 130/80 mm Hg or using prescription medication for hypertension).

Patients with type 2 diabetes and hypertension are at high risk of other illnesses and death. Diabetes and hypertension are associated with insulin resistance (normal amounts of insulin are no adequate to produce a normal insulin response from fat, muscle and liver cells). and hyperinsulinemia (excess levels of insulin in the blood), which are independent risk factors for cardiovascular (heart vessel) disease. Individuals with type 2 diabetes carry a 2 to 4- time greater risk of cardiovascular disease and stroke compared with the general population. Uncontrolled hypertension also is associated with an increased risk of cardiovascular disease and stroke.

Takeda Global Research and Development Center, Inc. is developing a fixed-dose combination product, AD-4833-536. AD-4833-536 is a combination of AD-4833 (pioglitazone) and TAK-536 (azilsartan). Pioglitazone is an oral antidiabetic agent that acts by reducing insulin resistance and approved for treatment of adult patients with type 2 diabetes mellitus. Azilsartan is a angiotensin II receptor blocker that modulates the renin-angiotensin-aldosterone system that regulates blood pressure.

Eligibility criteria: Inclusion Criteria

* Type 2 diabetes with glycosylated hemoglobin of greater than or equal to 9.0 to less than or equal to 11.0% at Screening.
* Documented hypertension.
* On a stable diet and exercise program in addition to metformin alone or combination of metformin and a sulfonylurea for a minimum of 8 weeks prior to screening.
* If receiving antihypertensive therapy, must be on no more than 3 agents and be on a stable regimen.
* Clinical laboratory evaluations (including clinical chemistry, hematology, and urinalysis) within the reference range unless the results are deemed not clinically significant for inclusion into this study by the investigator.
* Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.

Exclusion Criteria

* Type 1 diabetes mellitus.
* Diastolic blood pressure greater than 104 mm Hg at randomization visit.
* Currently taking an angiotensin II-receptor blocker.
* Unstable angina or heart failure of any etiology with New York Heart Association functional class III or IV.
* History of myocardial infarction, cerebrovascular accident (stroke), percutaneous coronary intervention, coronary artery bypass graft or transient ischemic attack within the previous six months.
* Clinically significant cardiac conduction defects.
* Secondary hypertension of any etiology.
* Body mass index greater than 45 kg/m2
* Has significant renal dysfunction.
* History of drug abuse or a history of alcohol abuse within the past 2 years.
* Previous history of cancer, other than basal cell carcinoma or stage 1 squamous cell carcinoma of the skin that has not been in remission for at least 5 years prior to the first dose of study drug.
* Alanine transaminase or aspartate transaminase level of greater than 2.5 times the upper limit of normal, active liver disease, or jaundice.
* Serum potassium greater than the upper limit of normal.
* Currently participating in another investigational study or has participated in an investigational study within 30 days prior to Randomization.
* Any other serious disease or condition that would compromise subject safety, might affect life expectancy, or make it difficult to successfully manage and follow the subject according to the protocol.
* Is hypersensitive to angiotensin II receptor blockers.
* Is hypersensitive to thiazolidinediones.
* Is required to take or intends to continue taking any disallowed medication, any prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:

  * any anti-diabetic agent (including thiazolidinediones and/or insulin) except for metformin or a combination of metformin and a sulfonylurea
  * niacin more than 200mg per day
  * tricyclic antidepressants or phenothiazines
  * Angiotensin II receptor blockers
  * Thiazolidinediones
  * Insulin

Primary outcomes:
measure: Change from Baseline in Glycosylated Hemoglobin.
timeFrame: Baseline and Week 24
Secondary outcomes:
measure: Change from Baseline in Diastolic Blood Pressure
timeFrame: Baseline and Weeks 4, 8, 12, 16, 20, and 24.
measure: Change from Baseline in Systolic Blood Pressure
timeFrame: Baseline and Weeks 4, 8, 12, 16, 20, and 24
Other outcomes:
Locations:
city: Huntsville
country: United States
state: Alabama
city: Tallassee
country: United States
state: Alabama
city: Little Rock
country: United States
state: Arkansas
city: Auburn
country: United States
state: California
city: Bakersfield
country: United States
state: California
city: Buena Park
country: United States
state: California
city: Chula Vista
country: United States
state: California
city: Huntington Park
country: United States
state: California
city: Los Gatos
country: United States
state: California
city: Norwalk
country: United States
state: California
city: Orangevale
country: United States
state: California
city: Sacramento
country: United States
state: California
city: Stockton
country: United States
state: California
city: Deerfield Beach
country: United States
state: Florida
city: Hialeah
country: United States
state: Florida
city: Hollywood
country: United States
state: Florida
city: Jacksonville
country: United States
state: Florida
city: Kissimmee
country: United States
state: Florida
city: Marianna
country: United States
state: Florida
city: Melbourne
country: United States
state: Florida
city: Miami
country: United States
state: Florida
city: Pembroke Pines
country: United States
state: Florida
city: Winter Haven
country: United States
state: Florida
city: Augusta
country: United States
state: Georgia
city: Dunwoody
country: United States
state: Georgia
city: Chicago
country: United States
state: Illinois
city: Bloomington
country: United States
state: Indiana
city: Evansville
country: United States
state: Indiana
city: Shawnee Mission
country: United States
state: Kansas
city: Prince Frederick
country: United States
state: Maryland
city: Livonia
country: United States
state: Michigan
city: St. Clair Shores
country: United States
state: Michigan
city: Las Vegas
country: United States
state: Nevada
city: Trenton
country: United States
state: New Jersey
city: Albany
country: United States
state: New York
city: Johnson City
country: United States
state: New York
city: Staten Island
country: United States
state: New York
city: Charlotte
country: United States
state: North Carolina
city: Salisbury
country: United States
state: North Carolina
city: Winston-Salem
country: United States
state: North Carolina
city: Marion
country: United States
state: Ohio
city: Oklahoma City
country: United States
state: Oklahoma
city: Buckingham
country: United States
state: Pennsylvania
city: Jeannette
country: United States
state: Pennsylvania
city: Mt. Pleasant
country: United States
state: South Carolina
city: Simpsonville
country: United States
state: South Carolina
city: Bristol
country: United States
state: Tennessee
city: New Tazewell
country: United States
state: Tennessee
city: Dallas
country: United States
state: Texas
city: El Paso
country: United States
state: Texas
city: Euless
country: United States
state: Texas
city: Fort Worth
country: United States
state: Texas
city: Houston
country: United States
state: Texas
city: McKinney
country: United States
state: Texas
city: Midland
country: United States
state: Texas
city: North Richland Hills
country: United States
state: Texas
city: San Antonio
country: United States
state: Texas
city: Falls Church
country: United States
state: Virginia
city: Virginia Beach
country: United States
state: Virginia
city: Buenos Aires
country: Argentina
city: Cordoba
country: Argentina
city: Santa Fe
country: Argentina
city: Santiago
country: Chile
city: Temuco
country: Chile
city: Leon
country: Mexico
state: Guanajuato
city: Zapopan
country: Mexico
state: Jalisco
city: Monterrey
country: Mexico
state: NL
city: Guadalajara
country: Mexico
city: Mexico, DF
country: Mexico
city: Arequipa
country: Peru
city: Lambayeque
country: Peru
city: Lima
country: Peru
city: Trujillo
country: Peru
Study officials:
affiliation: Takeda
name: VP Clinical Science Strategy
role: STUDY_DIRECTOR
References: