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出境医 / 临床实验 / Remission of Type 2 Diabetes With Dapagliflozin (READ Trial) (READ)

Remission of Type 2 Diabetes With Dapagliflozin (READ Trial) (READ)

Study Description
Brief Summary:
This is a multicenter, randomized, double-blind, placebo-controlled study to assess the effect of dapagliflozin add-on intensive lifestyle intervention for remission of type 2 diabetes in obese patients with Type 2 Diabetes Mellitus. The study consists of a 12-months treatment period (in which they will receive either Dapagliflozin plus intensive lifestyle intervention or placebo plus intensive lifestyle intervention in addition to the background therapy), and a 2-month follow-up period after treatment period.

Condition or disease Intervention/treatment Phase
Type 2 Diabetes Behavioral: Intensive lifestyle intervention Drug: Dapagliflozin 10 MG Oral Tablet Drug: Placebo Oral Tablet Phase 4

Detailed Description:
Diabetes remission is an important issue which has not been well studied. Some studies showed that bariatric surgery and intensive lifestyle intervention could lead to remission in diabetic patients. Our present study aims to assess the effect of dapagliflozin add-on intensive lifestyle intervention on remission of type 2 diabetes in obese patients with type 2 diabetes. This is a multicenter, randomized, double-blind, placebo-controlled study. The study consists of a 12-months treatment period (in which subjects will receive either dapagliflozin plus intensive lifestyle intervention or placebo plus intensive lifestyle intervention in addition to the background therapy), and a 2-month follow-up period after treatment period.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 328 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Effect of Dapagliflozin for Remission of Type 2 Diabetes Mellitus: A Multicenter, Randomized, Placebo-Controlled Trial
Actual Study Start Date : August 15, 2020
Estimated Primary Completion Date : November 30, 2022
Estimated Study Completion Date : June 30, 2023
Arms and Interventions
Arm Intervention/treatment
Experimental: Dapagliflozin plus intensive lifestyle intervention
The treatment of Dapagliflozin (Forxiga®) will be initiated and maintained at 10mg every morning until the completion of the study.
Behavioral: Intensive lifestyle intervention
Participants were will be asked to follow a weight management programme, in accordance with the American Diabetes Association guidelines. Weight loss will be induced with a diet replacement phase using an energy restriction diet (energy deficit by 500~750 kcal/day) for 3 months, with <35% as fat, >15% as protein. The minimum energy intake is 1200kcal/day for men and 1000kcal/day for women.. Additionally, participants were encouraged to increase physical exercise (≥150 minutes of brisk walking every week or ≥10000 steps per day).

Drug: Dapagliflozin 10 MG Oral Tablet
The treatment of Dapagliflozin (Forxiga®) will be initiated and maintained at 10mg every morning until the completion of the study.

Placebo Comparator: Placebo plus intensive lifestyle intervention
The treatment of placebo will be initiated and maintained at 10mg every morning until the completion of the study.
Behavioral: Intensive lifestyle intervention
Participants were will be asked to follow a weight management programme, in accordance with the American Diabetes Association guidelines. Weight loss will be induced with a diet replacement phase using an energy restriction diet (energy deficit by 500~750 kcal/day) for 3 months, with <35% as fat, >15% as protein. The minimum energy intake is 1200kcal/day for men and 1000kcal/day for women.. Additionally, participants were encouraged to increase physical exercise (≥150 minutes of brisk walking every week or ≥10000 steps per day).

Drug: Placebo Oral Tablet
The treatment of placebo will be initiated and maintained at 10mg every morning until the completion of the study.

Outcome Measures
Primary Outcome Measures :
  1. Incidence of patients with diabetes remission [ Time Frame: During the 12-month intervention ]
    Diabetes remission is defined as a HbA1c<6.5% and a fasting glucose level of <7.0 mmol/l in the absence of all antidiabetic medication for at least 2 months


Secondary Outcome Measures :
  1. Proportion of patients with diabetes remission [ Time Frame: During the 12-month intervention ]
  2. Net change in body weight [ Time Frame: At both 12 and 14 months ]
  3. Net change in waist circumference [ Time Frame: At both 12 and 14 months ]
  4. Net change in HOMA-IR [ Time Frame: At both 12 and 14 months ]
  5. Net change in serum lipids [ Time Frame: At both 12 and 14 months ]
  6. Net change in HbA1c [ Time Frame: At both 12 and 14 months ]
  7. Net change in body fat [ Time Frame: At both 12 and 14 months ]
  8. Net change in SBP [ Time Frame: At both 12 and 14 months ]
  9. Net change in Serum Creatine [ Time Frame: At both 12 and 14 months ]
  10. Net change in Albuminuria [ Time Frame: At both 12 and 14 months ]

Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   20 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men or women aged 20-70 years old who had a BMI ≥25 kg/m2.
  • Subjects had been diagnosed with type 2 diabetes within 6 years
  • HbA1C ≥6.5% and ≤10.0% at screening if on treatment with metformin alone or without antidiabetic agents, or HbA1C <6.5% at screening if on metformin treatment alone
  • Able and willing to provide written informed consent and to comply with the study

Exclusion Criteria:

  1. Patients have a history of myocardial infarction, unstable angina, cardiac surgery or revascularization (coronary artery bypass graft/percutaneous transluminal coronary angioplasty), or congestive heart failure New York Heart Association Class III or IV.
  2. Current insulin use.
  3. Weight loss of more than 5kg within the past 6 months.
  4. Women who are pregnant or plan to become pregnant.
  5. Diagnosis or history of acute metabolic diabetic complications such as ketoacidosis or hyperglycemic hyperosmolar state, or diabetes insipidus within 30 days.
  6. Alcohol or drug abuse within the 3 months prior to informed consent that would interfere with trial participation or any ongoing condition leading to a decreased compliance to study procedures or study drug intake.
  7. Intake of an investigational drug in another trial within 30 days prior to intake of study medication in this trial or participating in another trial (involving an investigational drug and /or follow-up).
  8. Patients with clinically apparent hepatobiliary disease, including but not limited to chronic active hepatitis and/or severe hepatic insufficiency. ALT or AST > 3x upper limit of normal (ULN), or serum total bilirubin (TB) >34.2 μmol/L (>2 mg/dL).
  9. Patients with severe renal impairment or end-stage renal disease (eGFR< 45 mL/min/1.73 m2).
  10. Bariatric surgery within the past two years and other gastrointestinal surgeries that induce chronic malabsorption.
  11. Malignancy within 5 years of the enrollment visit.
  12. Known immunocompromised status, including but not limited to, individuals who had undergone organ transplantation or acquired immunodeficiency syndrome (AIDS).
  13. History of bone fracture secondary to diagnosed severe osteoporosis.
  14. Current treatment with systemic steroids at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent or any other uncontrolled endocrine disorder except T2DM.
  15. Administration of sibutramine, phentermine, orlistat, rimonabant, benzphetamine, diethylpropion, methamphetamine, or phendimetrazine within 30 days of enrollment visit.
  16. Blood dyscrasias or any disorders causing haemolysis or unstable Red Blood Cell (e.g. malaria, babesiosis, haemolytic anaemia).
  17. Administration of any other investigational drug within 30 days of planned enrollment to this study, or within 5 half-life periods of other investigational drugs.
  18. Subject is, in the judgment of the Investigator, unlikely to comply with the protocol or has any severe concurrent medical or psychological condition that may affect the interpretation of efficacy or safety data
Contacts and Locations

Locations
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China
Shanghai Medical college of
Shanghai, China, 200032
Sponsors and Collaborators
Shanghai Zhongshan Hospital
Investigators
Layout table for investigator information
Principal Investigator: Xiaoying Li, MD Fudan University
Tracking Information
First Submitted Date  ICMJE June 28, 2019
First Posted Date  ICMJE July 2, 2019
Last Update Posted Date January 29, 2021
Actual Study Start Date  ICMJE August 15, 2020
Estimated Primary Completion Date November 30, 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 5, 2019)
Incidence of patients with diabetes remission [ Time Frame: During the 12-month intervention ]
Diabetes remission is defined as a HbA1c<6.5% and a fasting glucose level of <7.0 mmol/l in the absence of all antidiabetic medication for at least 2 months
Original Primary Outcome Measures  ICMJE
 (submitted: June 28, 2019)
The incidence of remission of diabetes [ Time Frame: During the 12-month intervention ]
Diabetes remission is defined as a HbA1c<6.5% and a fasting glucose level of <7.0 mmol/l in the absence of all antidiabetic medication for at least 2 months
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: July 5, 2019)
  • Proportion of patients with diabetes remission [ Time Frame: During the 12-month intervention ]
  • Net change in body weight [ Time Frame: At both 12 and 14 months ]
  • Net change in waist circumference [ Time Frame: At both 12 and 14 months ]
  • Net change in HOMA-IR [ Time Frame: At both 12 and 14 months ]
  • Net change in serum lipids [ Time Frame: At both 12 and 14 months ]
  • Net change in HbA1c [ Time Frame: At both 12 and 14 months ]
  • Net change in body fat [ Time Frame: At both 12 and 14 months ]
  • Net change in SBP [ Time Frame: At both 12 and 14 months ]
  • Net change in Serum Creatine [ Time Frame: At both 12 and 14 months ]
  • Net change in Albuminuria [ Time Frame: At both 12 and 14 months ]
Original Secondary Outcome Measures  ICMJE
 (submitted: June 28, 2019)
  • Proportion of remission of diabetes [ Time Frame: During the 12-month intervention ]
  • Net change in body weight [ Time Frame: At both 12 and 14 months ]
  • Net change in waist circumference [ Time Frame: At both 12 and 14 months ]
  • Net change in HOMA-IR [ Time Frame: At both 12 and 14 months ]
  • Net change in serum lipids [ Time Frame: At both 12 and 14 months ]
  • Net change in HbA1c [ Time Frame: At both 12 and 14 months ]
  • Net change in body fat [ Time Frame: At both 12 and 14 months ]
  • Net change in SBP [ Time Frame: At both 12 and 14 months ]
  • Net change in Serum Creatine [ Time Frame: At both 12 and 14 months ]
  • Net change in Albuminuria [ Time Frame: At both 12 and 14 months ]
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Remission of Type 2 Diabetes With Dapagliflozin (READ Trial)
Official Title  ICMJE Effect of Dapagliflozin for Remission of Type 2 Diabetes Mellitus: A Multicenter, Randomized, Placebo-Controlled Trial
Brief Summary This is a multicenter, randomized, double-blind, placebo-controlled study to assess the effect of dapagliflozin add-on intensive lifestyle intervention for remission of type 2 diabetes in obese patients with Type 2 Diabetes Mellitus. The study consists of a 12-months treatment period (in which they will receive either Dapagliflozin plus intensive lifestyle intervention or placebo plus intensive lifestyle intervention in addition to the background therapy), and a 2-month follow-up period after treatment period.
Detailed Description Diabetes remission is an important issue which has not been well studied. Some studies showed that bariatric surgery and intensive lifestyle intervention could lead to remission in diabetic patients. Our present study aims to assess the effect of dapagliflozin add-on intensive lifestyle intervention on remission of type 2 diabetes in obese patients with type 2 diabetes. This is a multicenter, randomized, double-blind, placebo-controlled study. The study consists of a 12-months treatment period (in which subjects will receive either dapagliflozin plus intensive lifestyle intervention or placebo plus intensive lifestyle intervention in addition to the background therapy), and a 2-month follow-up period after treatment period.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 4
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Condition  ICMJE Type 2 Diabetes
Intervention  ICMJE
  • Behavioral: Intensive lifestyle intervention
    Participants were will be asked to follow a weight management programme, in accordance with the American Diabetes Association guidelines. Weight loss will be induced with a diet replacement phase using an energy restriction diet (energy deficit by 500~750 kcal/day) for 3 months, with <35% as fat, >15% as protein. The minimum energy intake is 1200kcal/day for men and 1000kcal/day for women.. Additionally, participants were encouraged to increase physical exercise (≥150 minutes of brisk walking every week or ≥10000 steps per day).
  • Drug: Dapagliflozin 10 MG Oral Tablet
    The treatment of Dapagliflozin (Forxiga®) will be initiated and maintained at 10mg every morning until the completion of the study.
  • Drug: Placebo Oral Tablet
    The treatment of placebo will be initiated and maintained at 10mg every morning until the completion of the study.
Study Arms  ICMJE
  • Experimental: Dapagliflozin plus intensive lifestyle intervention
    The treatment of Dapagliflozin (Forxiga®) will be initiated and maintained at 10mg every morning until the completion of the study.
    Interventions:
    • Behavioral: Intensive lifestyle intervention
    • Drug: Dapagliflozin 10 MG Oral Tablet
  • Placebo Comparator: Placebo plus intensive lifestyle intervention
    The treatment of placebo will be initiated and maintained at 10mg every morning until the completion of the study.
    Interventions:
    • Behavioral: Intensive lifestyle intervention
    • Drug: Placebo Oral Tablet
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 Enrolling by invitation
Estimated Enrollment  ICMJE
 (submitted: June 28, 2019)
328
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE June 30, 2023
Estimated Primary Completion Date November 30, 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Men or women aged 20-70 years old who had a BMI ≥25 kg/m2.
  • Subjects had been diagnosed with type 2 diabetes within 6 years
  • HbA1C ≥6.5% and ≤10.0% at screening if on treatment with metformin alone or without antidiabetic agents, or HbA1C <6.5% at screening if on metformin treatment alone
  • Able and willing to provide written informed consent and to comply with the study

Exclusion Criteria:

  1. Patients have a history of myocardial infarction, unstable angina, cardiac surgery or revascularization (coronary artery bypass graft/percutaneous transluminal coronary angioplasty), or congestive heart failure New York Heart Association Class III or IV.
  2. Current insulin use.
  3. Weight loss of more than 5kg within the past 6 months.
  4. Women who are pregnant or plan to become pregnant.
  5. Diagnosis or history of acute metabolic diabetic complications such as ketoacidosis or hyperglycemic hyperosmolar state, or diabetes insipidus within 30 days.
  6. Alcohol or drug abuse within the 3 months prior to informed consent that would interfere with trial participation or any ongoing condition leading to a decreased compliance to study procedures or study drug intake.
  7. Intake of an investigational drug in another trial within 30 days prior to intake of study medication in this trial or participating in another trial (involving an investigational drug and /or follow-up).
  8. Patients with clinically apparent hepatobiliary disease, including but not limited to chronic active hepatitis and/or severe hepatic insufficiency. ALT or AST > 3x upper limit of normal (ULN), or serum total bilirubin (TB) >34.2 μmol/L (>2 mg/dL).
  9. Patients with severe renal impairment or end-stage renal disease (eGFR< 45 mL/min/1.73 m2).
  10. Bariatric surgery within the past two years and other gastrointestinal surgeries that induce chronic malabsorption.
  11. Malignancy within 5 years of the enrollment visit.
  12. Known immunocompromised status, including but not limited to, individuals who had undergone organ transplantation or acquired immunodeficiency syndrome (AIDS).
  13. History of bone fracture secondary to diagnosed severe osteoporosis.
  14. Current treatment with systemic steroids at time of informed consent or change in dosage of thyroid hormones within 6 weeks prior to informed consent or any other uncontrolled endocrine disorder except T2DM.
  15. Administration of sibutramine, phentermine, orlistat, rimonabant, benzphetamine, diethylpropion, methamphetamine, or phendimetrazine within 30 days of enrollment visit.
  16. Blood dyscrasias or any disorders causing haemolysis or unstable Red Blood Cell (e.g. malaria, babesiosis, haemolytic anaemia).
  17. Administration of any other investigational drug within 30 days of planned enrollment to this study, or within 5 half-life periods of other investigational drugs.
  18. Subject is, in the judgment of the Investigator, unlikely to comply with the protocol or has any severe concurrent medical or psychological condition that may affect the interpretation of efficacy or safety data
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 20 Years to 70 Years   (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 China
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04004793
Other Study ID Numbers  ICMJE ZSE-201901
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
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Xiaoying Li, Shanghai Zhongshan Hospital
Study Sponsor  ICMJE Shanghai Zhongshan Hospital
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Xiaoying Li, MD Fudan University
PRS Account Shanghai Zhongshan Hospital
Verification Date January 2021

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