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出境医 / 临床实验 / A Study of Empagliflozin in Patients With Refractory Diabetes Mellitus With Insulin Resistance (EMPIRE-01)

A Study of Empagliflozin in Patients With Refractory Diabetes Mellitus With Insulin Resistance (EMPIRE-01)

Study Description
Brief Summary:
A multicenter, open-label, single-arm study with regard to the efficacy and safety of empagliflozin in patients with refractory diabetes mellitus with insulin resistance

Condition or disease Intervention/treatment Phase
Insulin Resistance - Type A Insulin Resistance - Type B Lipoatrophic Diabetes Mellitus Insulin Resistance Syndrome Drug: Empagliflozin Tablets Phase 3

Detailed Description:
To evaluate the clinical efficacy of a treatment with empagliflozin in refractory diabetes mellitus patients with insulin resistance (insulin resistance syndrome, lipoatrophic diabetes mellitus) by using the HbA1c change at Week 24 of treatment from baseline
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 8 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter, Open-label, Single-arm Study With Regard to the Efficacy and Safety of Empagliflozin in Patients With Refractory Diabetes Mellitus With Insulin Resistance
Actual Study Start Date : September 1, 2019
Estimated Primary Completion Date : July 31, 2021
Estimated Study Completion Date : October 30, 2021
Arms and Interventions
Arm Intervention/treatment
Experimental: Treatment of empagliflozin
Empagliflozin 10 mg is to be continuously administered once daily for 12 weeks. Measure an HbA1c level after 12 weeks and determine the dose (Week 13 to Week 24). In case of <7.0%, 10 mg will be continued: in case of >=7.0%, it will be increased to 25 mg.
Drug: Empagliflozin Tablets
The administration is oral administration with water before or after breakfast.
Other Name: BI10773

Outcome Measures
Primary Outcome Measures :
  1. HbA1c change at Week 24 of the treatment from baseline [ Time Frame: at Week 24 of the treatment from baseline ]
    With regard to the HbA1c change at Week 24 of the treatment from baseline, changes will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.


Secondary Outcome Measures :
  1. HbA1c change rate at Week 24 of the treatment from baseline [ Time Frame: at Week 24 of the treatment from baseline ]
    With regard to the HbA1c change rate at Week 24 of the treatment from baseline, change rates will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.

  2. HbA1c change at Week 12 of the treatment from baseline [ Time Frame: at Week 12 of the treatment from baseline ]
    With regard to the HbA1c change at Week 12 of the treatment from baseline, changes will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.

  3. HbA1c over time [ Time Frame: at Week 24 of the treatment from baseline ]
    The HbA1c level at measurement time point is tabulated by patient, as well as plotting the HbA1c level over time by line graph. In addition, the mean, standard deviation, interquartile range, minimum, median, and maximum of HbA1c at each time point will be calculated and tabulated, as well as displaying the mean at each measurement time point with error bar of standard deviation by line graph.

  4. Fasting plasma glucose (FPG) over time [ Time Frame: at Week 24 of the treatment from baseline ]
    The FPG level at measurement time point is tabulated by patient, as well as plotting the FPG level over time by line graph. In addition, the mean, standard deviation, interquartile range, minimum, median, and maximum of FPG at each time point will be calculated and tabulated, as well as displaying the mean at each measurement time point with error bar of standard deviation by line graph.

  5. FPG change at Week 24 of the treatment from baseline [ Time Frame: at Week 24 of the treatment from baseline ]
    With regard to the FPG change at Week 24 of the treatment from baseline, changes will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.

  6. Change of insulin dose [ Time Frame: at Week 24 of the treatment from baseline ]
    The insulin dose of each patient will be tabulated by time point.

  7. Postprandial glucose for 2 hours over time [ Time Frame: 2 Weeks from Day0 and Day140 ]
    The postprandial glucose for 2 hours at measurement time point is tabulated by patient, and the glucose level over time is plotted by line graph. In addition, the mean, standard deviation, interquartile range, minimum, median, and maximum of postprandial glucose for 2 hours at each time point will be tabulated, and the mean at each measurement time point with an error bar of standard deviation will be displayed by line graph.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   20 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • 1) A patient who has been diagnosed with insulin resistance syndrome (type A, type B, type non-A non-B) or lipoatrophic diabetes mellitus prior to obtaining consent
  • 2) A patient who has received consistent dosage and administration of drugs aiming a hypoglycemic effect and consistent instructions of diet therapy/exercise therapy for more than 12 weeks before enrollment
  • 3) A patient with >= 7.0 % of HbA1c at the time of screening
  • 4) A patient, if taking other SGLT2 inhibitor than empagliflozin, whose SGLT2 inhibitor can be washed out for more than 12 weeks prior to starting empagliflozin
  • 5) A patient at the age of >=20 years at the time of consent
  • 6) A patient who has received sufficient explanation with regard to information such as the objectives and details of this study, expected drug efficacy/pharmacological action, and risks, and has given written consent by her/himself.

Exclusion Criteria:

  • 1) A patient with a medical history of acute coronary syndrome (including non-ST-elevation myocardial infarction, ST-elevation myocardial infarction, and unstable angina pectoris), stroke or transient ischemic attack (TIA) within 3 months before obtaining consent
  • 2) A patient with suspected hepatic dysfunction, that either of serum ALT, AST or alkaline phosphatase in the screening period is exceeding 3-fold of upper limit of normal rang
  • 3) A patient who is receiving a systemic steroid at the time of consent (except for type B)
  • 4) A patient whose thyroid hormone product dose has been changed within 6 weeks before obtaining consent
  • 5) A patient with unstable endocrine diseases other than diabetes mellitus
  • 6) A patient with hemolysis or blood diseases that destabilize erythrocytic cells and other various disorders (e.g., malaria, babesiosis, hemolytic anemia).
  • 7) A premenopausal female patient (the latest menstruation was within 1 year before obtaining consent), a lactating or pregnant patient, or a patient who may be pregnant (without hysterectomy or ovariectomy) who has no intention to use efficacious contraception defined in this study during the treatment period and would not agree to receive regular pregnancy tests during the treatment period
  • 8) A patient who has experienced alcohol abuse or drug abuse within 3 months before obtaining consent, which may disturb the study participation
  • 9) A patient who is in the condition that makes it difficult to administer the study drug
  • 10) A patient with renal dysfunction of eGFR (MDRD calculating formula) < 45 mL/min/1.73 m2 in the screening period
  • 11) A patient who indicates a hypersensitivity response to empagliflozin or its excipients, or a patient with lactose-intolerance
  • 12) A patient with severe ketosis, diabetic coma or precoma, severe infection, perioperative status, or serious trauma
  • 13) A patient that the investigator and/or subinvestigator, etc., has judged to be ineligible to this study for other reasons
Contacts and Locations

Locations
Layout table for location information
Japan
Kobe University Hospital
Kobe, Hyogo, Japan, 650-0017
Tohoku University Hospital
Sendai, Miyagi, Japan, 980-8574
Jichi Medical University Hospital
Shimotsuke, Tochigi, Japan, 329-0498
NIhon University Hospital
Chiyoda-ku, Tokyo, Japan, 101-8309
Okayama University Hospital
Okayama, Japan, 700-8558
Sponsors and Collaborators
Kobe University
Boehringer Ingelheim
Investigators
Layout table for investigator information
Study Chair: Wataru Ogawa Kobe University Hospital
Tracking Information
First Submitted Date  ICMJE July 10, 2019
First Posted Date  ICMJE July 12, 2019
Last Update Posted Date March 3, 2021
Actual Study Start Date  ICMJE September 1, 2019
Estimated Primary Completion Date July 31, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 10, 2019)
HbA1c change at Week 24 of the treatment from baseline [ Time Frame: at Week 24 of the treatment from baseline ]
With regard to the HbA1c change at Week 24 of the treatment from baseline, changes will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: July 10, 2019)
  • HbA1c change rate at Week 24 of the treatment from baseline [ Time Frame: at Week 24 of the treatment from baseline ]
    With regard to the HbA1c change rate at Week 24 of the treatment from baseline, change rates will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.
  • HbA1c change at Week 12 of the treatment from baseline [ Time Frame: at Week 12 of the treatment from baseline ]
    With regard to the HbA1c change at Week 12 of the treatment from baseline, changes will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.
  • HbA1c over time [ Time Frame: at Week 24 of the treatment from baseline ]
    The HbA1c level at measurement time point is tabulated by patient, as well as plotting the HbA1c level over time by line graph. In addition, the mean, standard deviation, interquartile range, minimum, median, and maximum of HbA1c at each time point will be calculated and tabulated, as well as displaying the mean at each measurement time point with error bar of standard deviation by line graph.
  • Fasting plasma glucose (FPG) over time [ Time Frame: at Week 24 of the treatment from baseline ]
    The FPG level at measurement time point is tabulated by patient, as well as plotting the FPG level over time by line graph. In addition, the mean, standard deviation, interquartile range, minimum, median, and maximum of FPG at each time point will be calculated and tabulated, as well as displaying the mean at each measurement time point with error bar of standard deviation by line graph.
  • FPG change at Week 24 of the treatment from baseline [ Time Frame: at Week 24 of the treatment from baseline ]
    With regard to the FPG change at Week 24 of the treatment from baseline, changes will be shown by patient, as well as summarizing with the size of sample, mean, standard deviation, minimum, median, and maximum.
  • Change of insulin dose [ Time Frame: at Week 24 of the treatment from baseline ]
    The insulin dose of each patient will be tabulated by time point.
  • Postprandial glucose for 2 hours over time [ Time Frame: 2 Weeks from Day0 and Day140 ]
    The postprandial glucose for 2 hours at measurement time point is tabulated by patient, and the glucose level over time is plotted by line graph. In addition, the mean, standard deviation, interquartile range, minimum, median, and maximum of postprandial glucose for 2 hours at each time point will be tabulated, and the mean at each measurement time point with an error bar of standard deviation will be displayed by line graph.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE A Study of Empagliflozin in Patients With Refractory Diabetes Mellitus With Insulin Resistance
Official Title  ICMJE A Multicenter, Open-label, Single-arm Study With Regard to the Efficacy and Safety of Empagliflozin in Patients With Refractory Diabetes Mellitus With Insulin Resistance
Brief Summary A multicenter, open-label, single-arm study with regard to the efficacy and safety of empagliflozin in patients with refractory diabetes mellitus with insulin resistance
Detailed Description To evaluate the clinical efficacy of a treatment with empagliflozin in refractory diabetes mellitus patients with insulin resistance (insulin resistance syndrome, lipoatrophic diabetes mellitus) by using the HbA1c change at Week 24 of treatment from baseline
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Insulin Resistance - Type A
  • Insulin Resistance - Type B
  • Lipoatrophic Diabetes Mellitus
  • Insulin Resistance Syndrome
Intervention  ICMJE Drug: Empagliflozin Tablets
The administration is oral administration with water before or after breakfast.
Other Name: BI10773
Study Arms  ICMJE Experimental: Treatment of empagliflozin
Empagliflozin 10 mg is to be continuously administered once daily for 12 weeks. Measure an HbA1c level after 12 weeks and determine the dose (Week 13 to Week 24). In case of <7.0%, 10 mg will be continued: in case of >=7.0%, it will be increased to 25 mg.
Intervention: Drug: Empagliflozin Tablets
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Active, not recruiting
Actual Enrollment  ICMJE
 (submitted: July 10, 2019)
8
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE October 30, 2021
Estimated Primary Completion Date July 31, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • 1) A patient who has been diagnosed with insulin resistance syndrome (type A, type B, type non-A non-B) or lipoatrophic diabetes mellitus prior to obtaining consent
  • 2) A patient who has received consistent dosage and administration of drugs aiming a hypoglycemic effect and consistent instructions of diet therapy/exercise therapy for more than 12 weeks before enrollment
  • 3) A patient with >= 7.0 % of HbA1c at the time of screening
  • 4) A patient, if taking other SGLT2 inhibitor than empagliflozin, whose SGLT2 inhibitor can be washed out for more than 12 weeks prior to starting empagliflozin
  • 5) A patient at the age of >=20 years at the time of consent
  • 6) A patient who has received sufficient explanation with regard to information such as the objectives and details of this study, expected drug efficacy/pharmacological action, and risks, and has given written consent by her/himself.

Exclusion Criteria:

  • 1) A patient with a medical history of acute coronary syndrome (including non-ST-elevation myocardial infarction, ST-elevation myocardial infarction, and unstable angina pectoris), stroke or transient ischemic attack (TIA) within 3 months before obtaining consent
  • 2) A patient with suspected hepatic dysfunction, that either of serum ALT, AST or alkaline phosphatase in the screening period is exceeding 3-fold of upper limit of normal rang
  • 3) A patient who is receiving a systemic steroid at the time of consent (except for type B)
  • 4) A patient whose thyroid hormone product dose has been changed within 6 weeks before obtaining consent
  • 5) A patient with unstable endocrine diseases other than diabetes mellitus
  • 6) A patient with hemolysis or blood diseases that destabilize erythrocytic cells and other various disorders (e.g., malaria, babesiosis, hemolytic anemia).
  • 7) A premenopausal female patient (the latest menstruation was within 1 year before obtaining consent), a lactating or pregnant patient, or a patient who may be pregnant (without hysterectomy or ovariectomy) who has no intention to use efficacious contraception defined in this study during the treatment period and would not agree to receive regular pregnancy tests during the treatment period
  • 8) A patient who has experienced alcohol abuse or drug abuse within 3 months before obtaining consent, which may disturb the study participation
  • 9) A patient who is in the condition that makes it difficult to administer the study drug
  • 10) A patient with renal dysfunction of eGFR (MDRD calculating formula) < 45 mL/min/1.73 m2 in the screening period
  • 11) A patient who indicates a hypersensitivity response to empagliflozin or its excipients, or a patient with lactose-intolerance
  • 12) A patient with severe ketosis, diabetic coma or precoma, severe infection, perioperative status, or serious trauma
  • 13) A patient that the investigator and/or subinvestigator, etc., has judged to be ineligible to this study for other reasons
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 20 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE Japan
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04018365
Other Study ID Numbers  ICMJE 190012
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Wataru Ogawa, Kobe University
Study Sponsor  ICMJE Kobe University
Collaborators  ICMJE Boehringer Ingelheim
Investigators  ICMJE
Study Chair: Wataru Ogawa Kobe University Hospital
PRS Account Kobe University
Verification Date March 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP