Current partner codePEPTIDESDE
NCT02787551·Phase 3·INTERVENTIONAL

Efficacy and Safety of the Insulin Glargine/Lixisenatide Fixed Ratio Combination (FRC) Versus GLP-1 Receptor Agonist in Patients With Type 2 Diabetes, With a FRC Extension Period

Status

Completed

Phase

Phase 3

Enrollment

514

Locations

124

Results

Posted

Publications

5

Study summary

What the protocol is testing.

Primary Objective: To demonstrate the superiority of the insulin glargine/lixisenatide fixed ratio combination (FRC) versus GLP-1 receptor agonist (GLP-1 RA) in hemoglobin A1c (HbA1c) change. Secondary Objectives: To compare the overall efficacy and safety of the insulin glargine/lixisenatide FRC to GLP-1 RA on top of metformin (with or without pioglitazone, with or without sodium-glucose co-transporter 2 \[SGLT2\] inhibitor) in participants with type 2 diabetes. To evaluate safety, efficacy and other endpoints of FRC up to the end of the extension period.

Full detailed description

The maximum duration for GLP1-RA participants was approximately 29 weeks: up to 2 week screening period, a 26 week treatment period (either randomized or uncontrolled), and a 3 or 9 day post-treatment safety follow-up period. Maximum duration for FRC participants was approximately 55 weeks: up to 2-week screening period, a 26-week randomized treatment period, a 26-week extension period and a 3-day post-treatment safety follow-up period. All primary and secondary efficacy, safety and other outcome measures were assessed at the end of the extension period.

Interventions

Treatment arms and agents.

DRUG

Insulin glargine/lixisenatide fixed ratio combination

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUG

liraglutide

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUG

exenatide

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUG

exenatide extended-release

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUG

albiglutide

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUG

dulaglutide

Pharmaceutical form: solution for injection Route of administration: subcutaneous

DRUG

Background therapy: Oral Anti-diabetic Drug (Metformin, Pioglitazone, SGLT2 inhibitor)

Pharmaceutical form: tablet Route of administration: oral If previously taken, doses to remain stable through the study.

Timeline

From registration to results.

  1. First posted

    Jun 1, 2016

  2. Study start

    Jul 6, 2016

  3. Primary completion

    May 25, 2018

  4. Study completion

    Nov 17, 2018

  5. Results posted

    Jun 12, 2019

  6. Registry updated

    Mar 25, 2022

Outcomes

What the study measures.

Primary outcomes

Change From Baseline in Glycated Hemoglobin (HbA1c) to Week 26: Core Period

Time frame · Baseline, Week 26

Change in HbA1c was calculated by subtracting baseline value from Week 26 value. Adjusted least squares (LS) mean and standard error (SE) were obtained from Mixed-effect model with repeated measures (MMRM) to account for missing data using all available post baseline data during the 26 week treatment period.

Change From Baseline in Glycated Hemoglobin (HbA1c) to Week 52: Single Arm Extension Period

Time frame · Baseline, Week 52

Change in HbA1c was calculated by subtracting baseline value from Week 52 value.

Secondary outcomes

Percentage of Participants Reaching HbA1c <7% or <=6.5% at Week 26: Core Period

Time frame · Week 26

Participants without any available HbA1c assessment at Week 26 were considered as non-responders.

Percentage of Participants Reaching HbA1c <7 % or <=6.5% at Week 52: Single Arm Extension Period

Time frame · Week 52

Participants without any available HbA1c assessment at Week 52 were considered as non-responders.

Change From Baseline in Fasting Plasma Glucose (FPG) to Week 26: Core Period

Time frame · Baseline, Week 26

Change in FPG was calculated by subtracting baseline value from Week 26 value. Adjusted LS means and SE were obtained from MMRM to account for missing data using all available post baseline data during the 26 week treatment period.

Change From Baseline in Fasting Plasma Glucose (FPG) to Week 52: Single Arm Extension Period

Time frame · Baseline, Week 52

Change in FPG was calculated by subtracting baseline value from Week 52 value.

Change From Baseline in the Daily Average of the 7-point Self-monitored Plasma Glucose (SMPG) to Week 26: Core Period

Time frame · Baseline, Week 26

The 7-point SMPG profile was measured at the following 7 points: pre-prandial and 2 hours postprandial for breakfast, lunch, dinner and at bedtime. Two hours postprandial (breakfast, lunch and dinner) was defined as 2 hours after the start of the meal. Adjusted LS means and SE were obtained from MMRM to account for missing data using all available post baseline data during the 26 week treatment period.

Change From Baseline in the Daily Average of the 7-point Self-monitored Plasma Glucose (SMPG) to Week 52: Single Arm Extension Period

Time frame · Baseline, Week 52

The 7-point SMPG profile was measured at the following 7 points: pre-prandial and 2 hours postprandial for breakfast, lunch, dinner and at bedtime. Two hours postprandial (breakfast, lunch and dinner) was defined as 2 hours after the start of the meal.

Change From Baseline in 2-Hour Postprandial Plasma Glucose (PPG) During Standardized Meal Test to Week 26: Core Period

Time frame · Baseline, Week 26

The 2-hour PPG test measured blood glucose 2 hours after eating a liquid standardized breakfast meal. Change in PPG was calculated by subtracting baseline value from Week 26 value. Missing data was imputed using last observation carried forward (LOCF).

Change From Baseline in 2-Hour Postprandial Plasma Glucose (PPG) During Standardized Meal Test to Week 52: Single Arm Extension Period

Time frame · Baseline, Week 52

The 2-hour PPG test measured blood glucose 2 hours after eating a liquid standardized breakfast meal. Change in PPG was calculated by subtracting baseline value from Week 52 value. Missing data was imputed using LOCF.

Change From Baseline in 2-Hour Blood Glucose Excursion During Standardized Meal Test to Week 26: Core Period

Time frame · Baseline, Week 26

2-hour plasma glucose excursion = 2-hour PPG value minus plasma glucose value obtained 30 minutes prior to the start of meal and before investigational medicinal product (IMP) administration if IMP was injected before breakfast. Change in plasma glucose excursions were calculated by subtracting baseline value from Week 26 value. Missing data was imputed using LOCF.

Change From Baseline in 2-Hour Blood Glucose Excursion During Standardized Meal Test to Week 52: Single Arm Extension Period

Time frame · Baseline, Week 52

2-hour plasma glucose excursion = 2-hour PPG value minus plasma glucose value obtained 30 minutes prior to the start of meal and before IMP administration if IMP was injected before breakfast. Change in plasma glucose excursions were calculated by subtracting baseline value from Week 52 value. Missing data was imputed using LOCF.

Eligibility

Who can take part.

Minimum age
18 Years
Maximum age
Not reported
Sex
ALL
Healthy volunteers
No

Inclusion criteria : * Participants with type 2 diabetes mellitus diagnosed at least 1 year prior to screening visit. * Participants who were treated with one of the following GLP-1 receptor agonists for at least 4 months prior to screening visit 1 (V1), and with stable dose for at least 3 months prior to screening visit (V1): * Liraglutide (Victoza®) 1.8 milligram (mg) QD or 1.2 mg QD, if the 1.8 mg QD dose was not well tolerated according to the Investigator's judgment or * Exenatide (Byetta®) 10 microgram (µg) BID or of 5 µg BID, if 10 µg BID dose was not well tolerated according to the Investigator's judgment in combination with metformin (daily dose greater than equal to \[\>=\] 1500 mg/day or maximum tolerated dose \[MTD\]), with or without pioglitazone, with or without SGLT2 inhibitor, all at stable dose for at least 3 months prior to screening. or Participants who were treated with stable dose of one of the following GLP-1 receptor agonists for at least 6 months prior to screening visit (V1): * Exenatide extended-release (Bydureon®) 2 mg once weekly (QW), if well tolerated according to Investigator's judgment, * Albiglutide (Tanzeum®) 50 mg QW or 30 mg QW, if 50 mg QW was not well tolerated according to Investigator's judgment, * Dulaglutide (Trulicity®) 1.5 mg QW or 0.75 mg QW, if 1.5 mg QW was not well tolerated according to Investigator's judgment in combination with metformin (daily dose ≥1500 mg/day or MTD), with or without pioglitazone, with or without SGLT2 inhibitor, all at stable dose for at least 3 months prior to screening; -Signed written informed consent. Exclusion criteria: * At screening visit, age \<18. * Screening HbA1c \<7% and \>9%. * Pregnancy or lactation, women of childbearing potential with no effective contraceptive method. * Any use of antidiabetic drugs within 3 months prior to the screening visit other than those described in the inclusion criteria. * Previous treatment with insulin in the year prior to screening visit (note: short-term treatment with insulin \[\<=10 days\] due to intercurrent illness including gestational diabetes was allowed at the discretion of the study physician). * Laboratory findings at the time of screening, including: * Fasting plasma glucose (FPG) \>250 mg/dL (13.9 millimoles per litre \[mmol/L\]), * Amylase and/or lipase \>3 times the upper limit of the normal laboratory range (ULN), * Alanine transaminase or aspartate transaminase \>3 ULN, * Calcitonin \>=20 pg/mL (5.9 pmol/L), * Positive pregnancy test. * Participant who had renal function impairment with estimated glomerular filtration rate \<30mL/min/1.73m\^2 (using the Modification of Diet in Renal Disease formula) or end-stage renal disease. * Contraindication to use of insulin glargine, or lixisenatide or GLP-1 receptor agonist (Victoza®, Byetta®, Bydureon®, Tanzeum® or Trulicity®) according to local labeling. * Any contraindication to metformin or pioglitazone or SGLT2 inhibitor use, according to local labeling. * History of hypersensitivity to insulin glargine, or to any of the excipients. * History of allergic reaction to any GLP-1 receptor agonist or to meta-cresol. * Personal or immediate family history of medullary thyroid cancer (MTC) or genetic condition that predisposes to MTC (eg, multiple endocrine neoplasia type 2 syndromes). * History of pancreatitis (unless pancreatitis was related to gallstones and cholecystectomy was already performed), chronic pancreatitis, pancreatitis during a previous treatment with incretin therapies, pancreatectomy. * Body mass index \<=20 or \>40 kg/m\^2. Exclusion criteria for the extension period: * Participants in the FRC arm with a rescue therapy and HbA1c \>8% at week 22. * Participants in the FRC arm who discontinued prematurely from FRC treatment before week 26. * Participants in the GLP-1 RA treatment arm after randomization. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Study locations

124 registered sites.

Canada · Estonia · Germany · Israel · Italy · Romania · Slovakia · Spain · United States. Showing up to 24 locations stored in the fast local snapshot.

Investigational Site Number 8400064

Birmingham, Alabama, United States

Investigational Site Number 8400073

Fountain Hills, Arizona, United States

Investigational Site Number 8400047

Phoenix, Arizona, United States

Investigational Site Number 8400103

Bakersfield, California, United States

Investigational Site Number 8400137

Fresno, California, United States

Investigational Site Number 8400043

Huntington Park, California, United States

Investigational Site Number 8400124

Lamont, California, United States

Investigational Site Number 8400027

Lancaster, California, United States

Investigational Site Number 8400098

Los Angeles, California, United States

Investigational Site Number 8400013

Los Angeles, California, United States

Investigational Site Number 8400042

Mission Hills, California, United States

Investigational Site Number 8400006

Northridge, California, United States

Investigational Site Number 8400021

Orange, California, United States

Investigational Site Number 8400126

Rialto, California, United States

Investigational Site Number 8400094

Santa Ana, California, United States

Investigational Site Number 8400009

Ventura, California, United States

Investigational Site Number 8400071

Denver, Colorado, United States

Investigational Site Number 8400036

Denver, Colorado, United States

Investigational Site Number 8400114

Jacksonville, Florida, United States

Investigational Site Number 8400133

Miami, Florida, United States

Investigational Site Number 8400058

Port Charlotte, Florida, United States

Investigational Site Number 8400084

Tampa, Florida, United States

Investigational Site Number 8400112

West Palm Beach, Florida, United States

Investigational Site Number 8400045

Lawrenceville, Georgia, United States

Publications

Results and literature.

PMID 35332216Kuruvilla DE, Mann JI, Tepper SJ, Starling AJ, Panza G, Johnson MAL. Phase 3 randomized, double-blind, sham-controlled Trial of e-TNS for the Acute treatment of Migraine (TEAM). Sci Rep. 2022 Mar 24;12(1):5110. doi: 10.1038/s41598-022-09071-6.PMID 35257461Ferrannini E, Niemoeller E, Dex T, Servera S, Mari A. Fixed-ratio combination of insulin glargine plus lixisenatide (iGlarLixi) improves ss-cell function in people with type 2 diabetes. Diabetes Obes Metab. 2022 Jun;24(6):1159-1165. doi: 10.1111/dom.14688. Epub 2022 Mar 28.PMID 34894329Guja C, Giorgino F, Blonde L, Ali A, Prazny M, Meier JJ, Souhami E, Lubwama R, Ji C, Rosenstock J. Concomitant iGlarLixi and Sodium-Glucose Co-transporter-2 Inhibitor Therapy in Adults with Type 2 Diabetes: LixiLan-G Trial and Real-World Evidence Results. Diabetes Ther. 2022 Jan;13(1):205-215. doi: 10.1007/s13300-021-01180-1. Epub 2021 Dec 11.PMID 33468520Blonde L, Rosenstock J, Frias J, Birkenfeld AL, Niemoeller E, Souhami E, Ji C, Del Prato S, Aroda VR. Durable Effects of iGlarLixi Up to 52 Weeks in Type 2 Diabetes: The LixiLan-G Extension Study. Diabetes Care. 2021 Mar;44(3):774-780. doi: 10.2337/dc20-2023. Epub 2021 Jan 19.PMID 31530665Blonde L, Rosenstock J, Del Prato S, Henry R, Shehadeh N, Frias J, Niemoeller E, Souhami E, Ji C, Aroda VR. Switching to iGlarLixi Versus Continuing Daily or Weekly GLP-1 RA in Type 2 Diabetes Inadequately Controlled by GLP-1 RA and Oral Antihyperglycemic Therapy: The LixiLan-G Randomized Clinical Trial. Diabetes Care. 2019 Nov;42(11):2108-2116. doi: 10.2337/dc19-1357. Epub 2019 Sep 17.

Primary links

Continue at the source.

Related trials

More studies on Lixisenatide.

Related PeptideStat pages

Put the record in context.

Research pages describe evidence. Vendor pages, where available, describe independently tracked research-product listings and are not clinical recommendations.