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This study compared the effects of delayed-release metformin (Met DR, EFB0027) administered once daily in the morning (qAM), administered once daily in the evening (qPM), and administered twice daily (BID) on circulating glucose concentrations and metformin pharmacokinetics (PK) in subjects with type 2 diabetes mellitus (T2DM).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 500 mg Met DR BID | Active Comparator | Two doses of 500 mg metformin delayed-release |
|
| 1000 mg Met DR qAM | Experimental | One dose of 1000 mg metformin delayed-release in the morning |
|
| 1000 mg Met DR qPM | Experimental | One dose of 1000 mg metformin delayed-release in the evening |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Met DR | Drug | metformin delayed-release tablets |
|
| Measure | Description | Time Frame |
|---|---|---|
| AUC (0-24) of Plasma Metformin | AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Times points to create the AUC (0-24) were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner. |
| Cmax of Plasma Metformin | Cmax = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Times points to determine Cmax were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner. |
| AUC (0-24) of Plasma Glucose | AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Times points to create the AUC (0-24) were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.75, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 18.5, 19, 19.5, 20, 21, 22, 23, and 24 hours relative to the time of the standardized dinner. |
| Rmax (0-24) of Plasma Glucose | Rmax (0-24) = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Times points to determine Rmax were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.75, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 18.5, 19, 19.5, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner. |
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Inclusion Criteria:
18 to 70 (inclusive) years old at Visit 1 (Screening)
Was diagnosed with type 2 diabetes mellitus with
HbA1c between 6.0 to 9.5% (inclusive) for subjects managing their diabetes with:
i. Diet and exercise alone, or ii. A stable regimen (minimum of 2 months at Visit 1) of metformin alone, or iii. A stable regimen (minimum of 2 months at Visit 1) of DPP-4 inhibitor alone OR
HbA1c between 6.0 to 8.5% (inclusive) for subjects managing their diabetes with a stable (minimum of 2 months at Visit 1) combination regimen of metformin and DPP-4 inhibitors
Had normal renal function with an estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m^2 based on the Modification of Diet in Renal Disease (MDRD) equation
Body mass index (BMI) of 25.0 to 40.0 kg/m^2 (inclusive) at Screening
Male, or if female and met all of the following criteria:
Had a physical examination with no clinically significant abnormalities as judged by the investigator
Ability to understand and willingness to adhere to protocol requirements
If on chronic thyroid pharmacologic therapy, the dose must have been stable for at least 3 months prior to Visit 1 (Screening), and must have thyroid-stimulating hormone (TSH) test result in normal range at Visit 1 (Screening)
Exclusion Criteria:
Had a clinically significant medical condition that could potentially affect study participation and/or personal well-being, as judged by the investigator, including but not limited to the following conditions:
Had any chronic disease requiring medication that was adjusted in the past 90 days (subjects could take acute intermittent over-the-counter medications such as Tylenol, if needed)
Had any drug treatment that affects gastric pH (prescription or over-the-counter), including any antacids or medications such as Rolaids or Pepcid within 2 days of Visit 1 (Screening)
Had major surgery of any kind within 6 months of Visit 1 (Screening)
Had received a blood transfusion within 6 months of Visit 1 (Screening)
Had a history of >5 kg weight change within 3 months of Visit 1 (Screening)
Had clinical laboratory test (clinical chemistry, hematology, or urinalysis) abnormalities other than those expected in subjects with type 2 diabetes and judged by the investigator to be clinically significant at Visit 1 (Screening)
Had a physical, psychological, or historical finding that, in the investigator's opinion, would make the subject unsuitable for the study
Abused drugs or alcohol or had a history of abuse that in the investigator's opinion would cause the individual to be noncompliant with study procedures
Had donated blood within 3 months of the date of the first dose of randomized study medication, or was planning to donate blood during the study
Used insulin within 3 months of Visit 1 (Screening)
Had received GLP-1 receptor agonists and/or thiazolidinedione treatment within 6 months of Visit 1 (Screening)
Had known intolerance to metformin
Had received any investigational drug within 2 months (or five half-lives of the investigational drug, whichever was greater) of Visit 1 (Screening)
Had known allergies or hypersensitivity to any component of study treatment
Was employed by Elcelyx Therapeutics, Inc. (that is an employee, temporary contract worker, or designee of the company)
Smoked more than 10 cigarettes per day, 3 cigars per day, 3 pipes per day, used more than 1 can of smokeless tobacco per week, or used a combination of tobacco products that approximate nicotine doses equivalent to 10 cigarettes per day
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| Name | Affiliation | Role |
|---|---|---|
| Danielle Armas, MD | Celerion | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26285584 | Background | Buse JB, DeFronzo RA, Rosenstock J, Kim T, Burns C, Skare S, Baron A, Fineman M. The Primary Glucose-Lowering Effect of Metformin Resides in the Gut, Not the Circulation: Results From Short-term Pharmacokinetic and 12-Week Dose-Ranging Studies. Diabetes Care. 2016 Feb;39(2):198-205. doi: 10.2337/dc15-0488. Epub 2015 Aug 18. | |
| 27216492 |
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| ID | Title | Description |
|---|---|---|
| FG000 | Sequence 1: ABC | Treatment A = 1000 mg Met DR qAM Treatment B = 1000 mg Met DR qPM Treatment C = 500 mg Met DR BID |
| FG001 | Sequence 2: BCA | Treatment A = 1000 mg Met DR qAM Treatment B = 1000 mg Met DR qPM Treatment C = 500 mg Met DR BID |
| FG002 | Sequence 3: CAB | Treatment A = 1000 mg Met DR qAM Treatment B = 1000 mg Met DR qPM Treatment C = 500 mg Met DR BID |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Randomized (ITT) Population
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| ID | Title | Description |
|---|---|---|
| BG000 | Sequence 1: ABC | Treatment A = 1000 mg Met DR qAM Treatment B = 1000 mg Met DR qPM Treatment C = 500 mg Met DR BID |
| BG001 | Sequence 2: BCA | Treatment A = 1000 mg Met DR qAM Treatment B = 1000 mg Met DR qPM Treatment C = 500 mg Met DR BID |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | AUC (0-24) of Plasma Metformin | AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Evaluable Population | Posted | Least Squares Mean | Standard Error | ng*h/mL | Times points to create the AUC (0-24) were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner. |
|
Approximately 36 to 91 days depending on the number of days between the start of Visit 1 and Visit 2 and the number of washout days between the treatment periods.
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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 | 1000 mg Met DR qAM | One dose of 1000 mg metformin delayed-release in the morning Met DR: metformin delayed-release tablets |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Palpitations | Cardiac disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Senior Director, Development | Elcelyx Therapeutics, Inc | 858-876-1814 | info@elcelyx.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 |
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| DeFronzo RA, Buse JB, Kim T, Burns C, Skare S, Baron A, Fineman M. Once-daily delayed-release metformin lowers plasma glucose and enhances fasting and postprandial GLP-1 and PYY: results from two randomised trials. Diabetologia. 2016 Aug;59(8):1645-54. doi: 10.1007/s00125-016-3992-6. Epub 2016 May 23. |
| Non-Compliance |
|
| Personal Reason |
|
| BG002 | Sequence 3: CAB | Treatment A = 1000 mg Met DR qAM Treatment B = 1000 mg Met DR qPM Treatment C = 500 mg Met DR BID |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| BMI | Mean | Standard Deviation | kg/m^2 |
|
| Diabetes Management | Number | participants |
|
| Fasting Serum Glucose | Mean | Standard Deviation | mg/dL |
|
| HbA1c | Mean | Standard Deviation | % |
|
One dose of 1000 mg metformin delayed-release in the morning Met DR: metformin delayed-release tablets |
| OG002 | 1000 mg Met DR qPM | One dose of 1000 mg metformin delayed-release in the evening Met DR: metformin delayed-release tablets |
|
|
|
| Primary | Cmax of Plasma Metformin | Cmax = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Evaluable Population | Posted | Least Squares Mean | Standard Error | ng/mL | Times points to determine Cmax were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 19, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner. |
|
|
|
|
| Primary | AUC (0-24) of Plasma Glucose | AUC (0-24) = Area under the curve from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Evaluable Population | Posted | Least Squares Mean | Standard Error | mg*h/dL | Times points to create the AUC (0-24) were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.75, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 18.5, 19, 19.5, 20, 21, 22, 23, and 24 hours relative to the time of the standardized dinner. |
|
|
|
|
| Primary | Rmax (0-24) of Plasma Glucose | Rmax (0-24) = maximum response from the start time of the standardized dinner (0 h) to 24 hours after the standardized dinner. Study medication was administered at t = 0 hours for Treatments B and C and at t = 12 hours for Treatments A and C. | Evaluable Population | Posted | Least Squares Mean | Standard Error | mg/dL | Times points to determine Rmax were: t = -0.08, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7, 8, 9, 10, 11, 11.75, 11.92, 12.5, 13, 13.5, 14, 14.5, 15, 16, 17, 18, 18.5, 19, 19.5, 20, 21, 22, 23, and 24 hours relative to the start time of the standardized dinner. |
|
|
|
|
| 0 |
| 23 |
| 6 |
| 23 |
| EG001 | 1000 mg Met DR qPM | One dose of 1000 mg metformin delayed-release in the evening Met DR: metformin delayed-release tablets | 0 | 24 | 5 | 24 |
| EG002 | 500 mg Met DR BID | Two doses of 500 mg metformin delayed-release Met DR: metformin delayed-release tablets | 0 | 23 | 7 | 23 |
| Abdominal Pain | Gastrointestinal disorders |
|
| Breath Odour | Gastrointestinal disorders |
|
| Constipation | Gastrointestinal disorders |
|
| Diarrhoea | Gastrointestinal disorders |
|
| Dry Mouth | Gastrointestinal disorders |
|
| Dyspepsia | Gastrointestinal disorders |
|
| Nausea | Gastrointestinal disorders |
|
| Vomiting | Gastrointestinal disorders |
|
| Fatigue | General disorders |
|
| Thirst | General disorders |
|
| Vessel Puncture Site Bruise | General disorders |
|
| Vessel Puncture Site Pain | General disorders |
|
| Vessel Puncture Site Swelling | General disorders |
|
| Urinary Tract Infection | Infections and infestations |
|
| Glomerular Filtration Rate Decreased | Investigations |
|
| Haemoglobin Decreased | Investigations |
|
| Dizziness | Nervous system disorders |
|
| Dizziness Postural | Nervous system disorders |
|
| Headache | Nervous system disorders |
|
| Presyncope | Nervous system disorders |
|
| Tremor | Nervous system disorders |
|
| Anxiety | Psychiatric disorders |
|
| Urinary Incontinence | Renal and urinary disorders |
|
| Urine Odour Abnormal | Renal and urinary disorders |
|
| Pruritus Genital | Reproductive system and breast disorders |
|
| Hyperhidrosis | Skin and subcutaneous tissue disorders |
|
| Pallor | Vascular disorders |
|
The results of the Study may be published by INSTITUTE, however the publication shall not disclose any SPONSOR Confidential Information, the INSTITUTE shall send the SPONSOR a copy of any such proposed publication 90 days prior to submission for publication, the INSTITUTE, on request of the SPONSOR, shall delete any SPONSOR Confidential Information in the proposed publication, and the INSTITUTE shall, on the SPONSOR's request, delay submission while the SPONSOR files applications for patents.
| D004700 | Endocrine System Diseases |
500 mg Met DR BID is the denominator for the % ratio of LS means and the comparator for the p-values. |
| ANOVA |
Included treatment, sequence, and period and as fixed effects and subject nested within sequence as a random effect. |
| 0.3867 |
| % Ratio of LS Means |
| 111.3 |
| 2-Sided |
| 90 |
| 90.37 |
| 136.99 |
| No |
| Superiority or Other |
| 500 mg Met DR BID is the denominator for the % ratio of LS means and the comparator for the p-values. | ANOVA | Included treatment, sequence, and period and as fixed effects and subject nested within sequence as a random effect. | 0.0294 | % Ratio of LS Means | 132.7 | 2-Sided | 90 | 107.78 | 163.39 | No | Superiority or Other |
|
Pretreatment value is the denominator for the % ratio of LS means and the comparator for the p-values. |
| ANOVA |
Treatment, sequence, period, status (on-/pre-treatment) and treatment*status as fixed effects and subject nested within sequence as a random effect. |
| 0.0024 |
| % Ratio of LS Means |
| 90.9 |
| 2-Sided |
| 95 |
| 85.58 |
| 96.53 |
| No |
| Superiority or Other |
| Pretreatment value is the denominator for the % ratio of LS means and the comparator for the p-values. | ANOVA | Treatment, sequence, period, status (on-/pre-treatment) and treatment*status as fixed effects and subject nested within sequence as a random effect. | 0.0992 | % Ratio of LS Means | 95.1 | 2-Sided | 95 | 89.54 | 100.99 | No | Superiority or Other |
|
Pretreatment value is the denominator for the % ratio of LS means and the comparator for the p-values. |
| ANOVA |
Treatment, sequence, period, status (on-/pre-treatment) and treatment*status as fixed effects and subject nested within sequence as a random effect. |
| 0.0007 |
| % Ratio of LS Means |
| 90.5 |
| 2-Sided |
| 95 |
| 85.65 |
| 95.67 |
| No |
| Superiority or Other |
| Pretreatment value is the denominator for the % ratio of LS means and the comparator for the p-values. | ANOVA | Treatment, sequence, period, status (on-/pre-treatment) and treatment*status as fixed effects and subject nested within sequence as a random effect. | 0.0389 | % Ratio of LS Means | 94.3 | 2-Sided | 95 | 89.24 | 99.69 | No | Superiority or Other |