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The objective of the current study is to investigate the efficacy, safety and tolerability of several doses of BI 1356 BS (0.5, 2.5 and 5 mg daily) compared to placebo over 12 weeks of treatment in patients with Type 2 diabetes and insufficient glycemic control. In addition, there will be an open-label treatment arm with metformin for sensitivity measurement with this patient population. Population pharmacokinetics of BI 1356 BS will also be assessed in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | Placebo tablets matching BI 1356 |
|
| BI 1356 0.5 mg | Experimental | BI 1356 dose 1 once daily |
|
| BI 1356 2.5 mg | Experimental | BI 1356 dose 2 once daily |
|
| BI 1356 5.0 mg | Experimental | BI 1356 dose 3 once daily |
|
| Metformin | Active Comparator | Metformin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Drug | Placebo matching BI 1356 |
| |
| BI 1356 dose 3 once daily |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in HbA1c (Glycosylated Haemoglobin) at Week 12 | The change from baseline reflects the Week 12 HbA1c minus the Week 0 HbA1c. Means are adjusted for baseline HbA1c. | Baseline, week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12 | Change from baseline reflects the Week 12 FPG minus the Week 0 FPG. Means are adjusted for baseline FPG. | Baseline, week 12 |
| Percentage of Patients With Absolute Efficacy Response (HbA1c <= 7.0%) at 12 Weeks |
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Inclusion criteria:
Male and female patients with a diagnosis of Type 2 diabetes treated only with diet and exercise (drug naïve) or with one or two oral hypoglycemic agents (as single treatment or in combination) other than rosiglitazone or pioglitazone -treatment. Antidiabetic therapy has to be stable for at least 10 weeks prior to screening.
Diagnosis of Type 2 diabetes with duration of at least 3 months
Glycosylated haemoglobin A1 (HbA1c) of:
7.5-10.0% at screening for drug naïve patients (no wash-out needed) 7.0-9.0% at screening for patients treated with only one oral antidiabetic agent (wash-out required) 6.5-8.0% at screening for patients treated with two oral antidiabetic agents (wash-out required)
HbA1c of 7.5%-10.0% at Visit 3 (beginning of the 2-week placebo run-in period).
Age >=21 and <=75 years.
BMI (Body Mass Index) >=25.0 and <=40 kg/m2.
Signed and dated written informed consent prior to admission to the study in accordance with Good Clinical Practice (GCP) and local legislation
Exclusion criteria:
Clinically relevant cardiovascular disease (e.g., myocardial infarction, stroke or transient ischemic attack within six months before enrollment)
Impaired hepatic function defined by serum levels of either alanine aminotransferase, aspartate aminotransferase or alkaline phosphatase above 3-fold upper limit of normal
Renal insufficiency or impaired renal function defined by serum creatinine above upper limit of normal at screening
Diseases of the central nervous system (such as epilepsy) or psychiatric disorders or clinically relevant neurologic disorders (including cerebrovascular but with the exception of polyneuropathy) that would interfere with participation in the trial
Chronic or clinically relevant acute infections (e.g., Human immunodeficiency virus, Hepatitis)
History of relevant allergy/hypersensitivity that would interfere with trial participation (including allergy to investigational product or its excipients)
Treatment with rosiglitazone or pioglitazone within 6 months prior to screening
Treatment with insulin within 3 months prior to screening
Alcohol or drug abuse within the last 3 months that would interfere with trial participation)
Participation in another trial with an investigational drug within two months prior to administration or during the trial
Fasting plasma glucose >240 mg/dl (= 13.3 mmol/L) at Visit 2, 3 or 4 any visit and confirmed by a second measurement (not on the same day)
Pre-menopausal women (last menstruation <=1 year prior to signing informed consent) who:
Intolerance of metformin
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| Name | Affiliation | Role |
|---|---|---|
| Boehringer Ingelheim | Boehringer Ingelheim | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 1218.5.10020 Boehringer Ingelheim Investigational Site | Chula Vista | California | United States | |||
| 1218.5.10001 Boehringer Ingelheim Investigational Site |
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | Patients randomized to receive treatment with matching placebo |
| FG001 | Linagliptin (BI 1356) 0.5 mg | Patients randomized to receive treatment with linagliptin 0.5 mg |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Drug |
BI 1356 dose 3 once daily |
|
| BI 1356 dose 2 once daily | Drug | BI 1356 dose 2 once daily |
|
| BI 1356 dose 1 once daily | Drug | BI 1356 dose 1 once daily |
|
| Metformin | Drug | Metformin |
|
An absolute efficacy response is defined as HbA1c <= 7.0% at 12 weeks. A non-response is defined as HbA1c > 7.0% at 12 weeks. |
| Baseline, week 12 |
| La Jolla |
| California |
| United States |
| 1218.5.10007 Boehringer Ingelheim Investigational Site | Walnut Creek | California | United States |
| 1218.5.10041 Boehringer Ingelheim Investigational Site | Denver | Colorado | United States |
| 1218.5.10018 Boehringer Ingelheim Investigational Site | Hollywood | Florida | United States |
| 1218.5.10016 Boehringer Ingelheim Investigational Site | Jacksonville | Florida | United States |
| 1218.5.10003 Boehringer Ingelheim Investigational Site | Miami | Florida | United States |
| 1218.5.10011 Boehringer Ingelheim Investigational Site | Miami | Florida | United States |
| 1218.5.10012 Boehringer Ingelheim Investigational Site | Orlando | Florida | United States |
| 1218.5.10017 Boehringer Ingelheim Investigational Site | Indianapolis | Indiana | United States |
| 1218.5.10008 Boehringer Ingelheim Investigational Site | Topeka | Kansas | United States |
| 1218.5.10024 Boehringer Ingelheim Investigational Site | Wichita | Kansas | United States |
| 1218.5.10039 Boehringer Ingelheim Investigational Site | Baltimore | Maryland | United States |
| 1218.5.10032 Boehringer Ingelheim Investigational Site | Springfield | Massachusetts | United States |
| 1218.5.10025 Boehringer Ingelheim Investigational Site | Chesterfield | Missouri | United States |
| 1218.5.10034 Boehringer Ingelheim Investigational Site | Butte | Montana | United States |
| 1218.5.10009 Boehringer Ingelheim Investigational Site | Omaha | Nebraska | United States |
| 1218.5.10042 Boehringer Ingelheim Investigational Site | Albany | New York | United States |
| 1218.5.10029 Boehringer Ingelheim Investigational Site | Endwell | New York | United States |
| 1218.5.10004 Boehringer Ingelheim Investigational Site | New Hyde Park | New York | United States |
| 1218.5.10026 Boehringer Ingelheim Investigational Site | Columbus | Ohio | United States |
| 1218.5.10035 Boehringer Ingelheim Investigational Site | Mentor | Ohio | United States |
| 1218.5.10023 Boehringer Ingelheim Investigational Site | Medford | Oregon | United States |
| 1218.5.10030 Boehringer Ingelheim Investigational Site | Philadelphia | Pennsylvania | United States |
| 1218.5.10044 Boehringer Ingelheim Investigational Site | Columbia | South Carolina | United States |
| 1218.5.10033 Boehringer Ingelheim Investigational Site | Greer | South Carolina | United States |
| 1218.5.10038 Boehringer Ingelheim Investigational Site | Simpsonville | South Carolina | United States |
| 1218.5.10006 Boehringer Ingelheim Investigational Site | Dallas | Texas | United States |
| 1218.5.10040 Boehringer Ingelheim Investigational Site | Houston | Texas | United States |
| 1218.5.10036 Boehringer Ingelheim Investigational Site | San Antonio | Texas | United States |
| 1218.5.10021 Boehringer Ingelheim Investigational Site | Tyler | Texas | United States |
| 1218.5.10027 Boehringer Ingelheim Investigational Site | Salem | Virginia | United States |
| 1218.5.10022 Boehringer Ingelheim Investigational Site | Federal Way | Washington | United States |
| 1218.5.10014 Boehringer Ingelheim Investigational Site | Renton | Washington | United States |
| 1218.5.61001 Boehringer Ingelheim Investigational Site | Miranda | New South Wales | Australia |
| 1218.5.61005 Boehringer Ingelheim Investigational Site | Box Hill | Victoria | Australia |
| 1218.5.61006 Boehringer Ingelheim Investigational Site | Dandenong | Victoria | Australia |
| 1218.5.61007 Boehringer Ingelheim Investigational Site | East Ringwood | Victoria | Australia |
| 1218.5.61004 Boehringer Ingelheim Investigational Site | Fremantle | Western Australia | Australia |
| 1218.5.61002 Boehringer Ingelheim Investigational Site | Nedlands | Western Australia | Australia |
| 1218.5.11011 Boehringer Ingelheim Investigational Site | Calgary | Alberta | Canada |
| 1218.5.11016 Boehringer Ingelheim Investigational Site | Calgary | Alberta | Canada |
| 1218.5.11003 Boehringer Ingelheim Investigational Site | Red Deer | Alberta | Canada |
| 1218.5.11004 Boehringer Ingelheim Investigational Site | Vancouver | British Columbia | Canada |
| 1218.5.11013 Boehringer Ingelheim Investigational Site | Vancouver | British Columbia | Canada |
| 1218.5.11015 Boehringer Ingelheim Investigational Site | Winnipeg | Manitoba | Canada |
| 1218.5.11005 Boehringer Ingelheim Investigational Site | Hamilton | Ontario | Canada |
| 1218.5.11014 Boehringer Ingelheim Investigational Site | Oakville | Ontario | Canada |
| 1218.5.11010 Boehringer Ingelheim Investigational Site | Ottawa | Ontario | Canada |
| 1218.5.11009 Boehringer Ingelheim Investigational Site | Sarnia | Ontario | Canada |
| 1218.5.11012 Boehringer Ingelheim Investigational Site | Thornhill | Ontario | Canada |
| 1218.5.11002 Boehringer Ingelheim Investigational Site | Toronto | Ontario | Canada |
| 1218.5.11006 Boehringer Ingelheim Investigational Site | Montague | Prince Edward Island | Canada |
| 1218.5.11017 Boehringer Ingelheim Investigational Site | Sainte-Foy | Quebec | Canada |
| 1218.5.11018 Boehringer Ingelheim Investigational Site | Saskatoon | Saskatchewan | Canada |
| 1218.5.42002 Boehringer Ingelheim Investigational Site | Olomouc | Czechia |
| 1218.5.42003 Boehringer Ingelheim Investigational Site | Prague | Czechia |
| 1218.5.42004 Boehringer Ingelheim Investigational Site | Prague | Czechia |
| 1218.5.42005 Boehringer Ingelheim Investigational Site | Prague | Czechia |
| 1218.5.42001 Boehringer Ingelheim Investigational Site | Sternberk | Czechia |
| 1218.5.70001 Boehringer Ingelheim Investigational Site | Moscow | Russia |
| 1218.5.70002 Boehringer Ingelheim Investigational Site | Moscow | Russia |
| 1218.5.70003 Boehringer Ingelheim Investigational Site | Moscow | Russia |
| 1218.5.70004 Boehringer Ingelheim Investigational Site | Saint Petersburg | Russia |
| 1218.5.70005 Boehringer Ingelheim Investigational Site | Saint Petersburg | Russia |
| 1218.5.38005 Boehringer Ingelheim Investigational Site | Kharkiv | Ukraine |
| 1218.5.38001 Boehringer Ingelheim Investigational Site | Kiev | Ukraine |
| 1218.5.38002 Boehringer Ingelheim Investigational Site | Kiev | Ukraine |
| 1218.5.38003 Boehringer Ingelheim Investigational Site | Kiev | Ukraine |
| 1218.5.38004 Boehringer Ingelheim Investigational Site | Lviv | Ukraine |
| 1218.5.38006 Boehringer Ingelheim Investigational Site | Vinnitsa | Ukraine |
| FG002 | Linagliptin (BI 1356) 2.5 mg | Patients randomized to receive treatment with linagliptin 2.5 mg |
| FG003 | Linagliptin (BI 1356) 5.0 mg | Patients randomized to receive treatment with linagliptin 5.0 mg |
| FG004 | Metformin | Patients randomized to receive treatment with metformin |
| COMPLETED |
|
| NOT COMPLETED |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | Patients randomized to receive treatment with matching placebo |
| BG001 | Linagliptin (BI 1356) 0.5 mg | Patients randomized to receive treatment with linagliptin 0.5 mg |
| BG002 | Linagliptin (BI 1356) 2.5 mg | Patients randomized to receive treatment with linagliptin 2.5 mg |
| BG003 | Linagliptin (BI 1356) 5.0 mg | Patients randomized to receive treatment with linagliptin 5.0 mg |
| BG004 | Metformin | Patients randomized to receive treatment with metformin |
| BG005 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Number | participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Number | participants |
| ||||||||||||||||
| Body Mass Index (BMI) | Mean | Standard Deviation | kilogram/square meter |
| |||||||||||||||
| Baseline glycosylated hemoglobin (HbA1c) | Mean | Standard Deviation | percentage |
| |||||||||||||||
| Fasting blood plasma glucose (FPG) | Mean | Standard Deviation | milligram/deciliter (mg/dL) |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in HbA1c (Glycosylated Haemoglobin) at Week 12 | The change from baseline reflects the Week 12 HbA1c minus the Week 0 HbA1c. Means are adjusted for baseline HbA1c. | Full Analysis Set includes all randomized patients with baseline and on-treatment value of HbA1c. Last observation carried forward (LOCF) was used as the imputation rule. | Posted | Least Squares Mean | Standard Error | percent | Baseline, week 12 |
|
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12 | Change from baseline reflects the Week 12 FPG minus the Week 0 FPG. Means are adjusted for baseline FPG. | Full Analysis Set includes all randomized patients with baseline and on-treatment value of HbA1c. Last observation carried forward (LOCF) was used as the imputation rule. | Posted | Least Squares Mean | Standard Error | mg/dL | Baseline, week 12 |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Percentage of Patients With Absolute Efficacy Response (HbA1c <= 7.0%) at 12 Weeks | An absolute efficacy response is defined as HbA1c <= 7.0% at 12 weeks. A non-response is defined as HbA1c > 7.0% at 12 weeks. | FAS patients with baseline HbA1c > 7.0%. Non-completers were considered as failure imputation (NCF). | Posted | Number | participants | Baseline, week 12 |
|
First dose of study medication up to a period of 30 days after the last dose of study medication, an average of 106 days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Placebo | Patients randomized to receive treatment with matching placebo | 1 | 67 | 18 | 67 | ||
| EG001 | Linagliptin (BI 1356) 0.5 mg | Patients randomized to receive treatment with linagliptin 0.5 mg | 1 | 58 | 15 | 58 | ||
| EG002 | Linagliptin (BI 1356) 2.5 mg | Patients randomized to receive treatment with linagliptin 2.5 mg | 2 | 57 | 9 | 57 | ||
| EG003 | Linagliptin (BI 1356) 5.0 mg | Patients randomized to receive treatment with linagliptin 5.0 mg | 0 | 55 | 8 | 55 | ||
| EG004 | Metformin | Patients randomized to receive treatment with metformin | 1 | 65 | 13 | 65 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Myocardial ischaemia | Cardiac disorders | MedDRA version 10.0 | Systematic Assessment |
| |
| Pancreatitis acute | Gastrointestinal disorders | MedDRA version 10.0 | Systematic Assessment |
| |
| Injection site abscess | Infections and infestations | MedDRA version 10.0 | Systematic Assessment |
| |
| Obstructive chronic bronchitis with acute exacerbation | Infections and infestations | MedDRA version 10.0 | Systematic Assessment |
| |
| Schizoaffective disorder | Psychiatric disorders | MedDRA version 10.0 | Systematic Assessment |
| |
| Renal colic | Renal and urinary disorders | MedDRA version 10.0 | Systematic Assessment |
| |
| Bronchitis chronic | Respiratory, thoracic and mediastinal disorders | MedDRA version 10.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | MedDRA version 10.0 | Systematic Assessment |
| |
| Influenza | Infections and infestations | MedDRA version 10.0 | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA version 10.0 | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | MedDRA version 10.0 | Systematic Assessment |
| |
| Blood glucose increased | Investigations | MedDRA version 10.0 | Systematic Assessment |
| |
| Hyperglycaemia | Metabolism and nutrition disorders | MedDRA version 10.0 | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA version 10.0 | Systematic Assessment |
|
Any publication of the result of this trial must be consistent with the Boehringer Ingelheim publication policy. The rights of the investigator and of the sponsor with regard to publication of the results of this trial are described in the investigator contract.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Boehringer Ingelheim Call Center | Boehringer Ingelheim Pharmaceuticals | 1-800-243-0127 | clintriage.rdg@boehringer-ingelheim.com |
| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D008687 | Metformin |
| ID | Term |
|---|---|
| D001645 | Biguanides |
| D006146 | Guanidines |
| D000578 | Amidines |
| D009930 | Organic Chemicals |
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| Male |
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| Hispanic |
|
| Black |
|
| Asian |
|
| Missing |
|
Linagliptin 2.5 mg versus placebo
| ANCOVA |
ANCOVA model includes treatment as a fixed classification effect and baseline HbA1c as a linear covariate. |
| 0.0032 |
| Mean Difference (Final Values) |
| -0.42 |
| 95 |
| -0.69 |
| -0.14 |
| No |
| Superiority or Other |
| Linagliptin 5.0 mg versus placebo | ANCOVA | ANCOVA model includes treatment as a fixed classification effect and baseline HbA1c as a linear covariate. | 0.0012 | Mean Difference (Final Values) | -0.46 | 95 | -0.74 | -0.18 | No | Superiority or Other |
| Metformin versus placebo | ANCOVA | ANCOVA model includes treatment as a fixed classification effect and baseline HbA1c as a linear covariate. | <0.0001 | Mean Difference (Final Values) | -0.85 | 95 | -1.1 | -0.59 | No | Superiority or Other |
| Metformin |
Patients randomized to receive treatment with metformin |
|
|
|
Patients randomized to receive treatment with metformin |
|
|
|