Type 2 Diabetes Mellitus Clinical Trial
— CONFIDENCEOfficial title:
A Parallel-group Treatment, Phase 2, Double-blind, Three-arm Study to Assess Efficacy and Safety of Finerenone Plus Empagliflozin Compared With Either Finerenone or Empagliflozin Alone in Participants With Chronic Kidney Disease and Type 2 Diabetes.
Finerenone works by blocking a group of proteins, called mineralocorticoid receptor. An increased stimulation of mineralocorticoid receptor is known to trigger injury and inflammation in the kidney and is therefore thought to play a role in CKD. Empagliflozin lowers blood sugar levels by increasing the excretion of glucose from the blood into the urine. In this study, the researchers want to learn how well the combination of finerenone and empagliflozin helps to slow down the worsening of the participants' kidney function compared to either treatment alone. For this, the level of protein in the urine will be measured. The investigators also want to know how safe the combination is compared to either treatment alone. Depending on the treatment group, the participants will either take the combination of finerenone and empagliflozin, or finerenone together with a placebo, or empagliflozin together with a placebo, once a day as tablets by mouth. A placebo looks like a treatment but does not have any medicine in it. Importantly, the participants will also continue to take their other current medicine for CKD and T2D. The participants will be in the study for up to 7.5 months and will take the study treatments for 6 months. During the study, participants will visit the study site 7 times. The study team will: - collect blood and urine samples - check the participants' vital signs - do a physical examination including height and weight - check the participants' heart health by using an electrocardiogram (ECG) - monitor the participants' blood pressure - ask the participants questions about how they are feeling and what adverse events they may be having An adverse event is any problem that happens during the trial. Doctors keep track of all events that happen in trials, even if they do not think the events might be related to the study treatments.
Status | Recruiting |
Enrollment | 807 |
Est. completion date | February 28, 2025 |
Est. primary completion date | January 31, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Participant with a clinical diagnosis of chronic kidney disease (CKD) and the following: - In Part A: eGFR 40-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnosis of CKD. - In Part B: eGFR 30-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using CKD-EPI formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnostic of CKD. - 100 =UACR <5000 mg/g at screening visit (mean value from 3 morning void samples) and documentation of albuminuria/proteinuria (quantitative or semi-quantitative measurement) in the participant's medical records at least 3 months prior to screening - Participant with type 2 diabetes (T2D) as defined by the American Diabetes Association (ADA 2021), with glycated hemoglobin (HbA1c) at screening <11%. - Participant treated with the clinically maximum tolerated dose, as per investigator judgment, of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), but not both, for more than 1 month at screening visit. Exclusion Criteria: - Participants with type 1 diabetes (T1D). - Participant with hepatic insufficiency classified as Child-Pugh C. - Participant with blood pressure at Day 1 visit (Visit 2) higher than 160 systolic blood pressure (SBP) or 100 diastolic blood pressure (DBP) or SBP lower than 90 mmHg. - Participant currently treated with a sodium/glucose cotransporter-2 inhibitor (SGLT2i) or SGLT-1/2i or who received a SGLT2i or SGLT-1/2i which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment. - Participant treated with another mineralocorticoid receptor antagonist (MRA) (e.g., eplerenone, esaxerenone, spironolactone, canrenone), a renin inhibitor, potassium supplements, a potassium sparing diuretic (e.g., amiloride, triamterene), a potassium binder agent, or angiotensin receptor-neprilysin inhibitor (ARNI) which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment. - Participants currently treated or who were treated with Finerenone (Kerendia©) within 8 weeks prior to the screening visit. - Participant with serum/plasma potassium (K+) above 4.8 mmol/L at screening visit (central laboratory value). |
Country | Name | City | State |
---|---|---|---|
Belgium | Onze-Lieve-Vrouwziekenhuis (OLVZ) - Campus Aalst | Aalst | |
Belgium | UZ Antwerpen | Edegem | |
Belgium | AZ St-Lucas Campus St-Lucas | Gent | |
Belgium | UZ Gent | Gent | |
Belgium | Regionaal ZH Jan Yperman Campus Mariaziekenhuis | Ieper | |
Belgium | AZ Groeninge Campus Kennedylaan | Kortrijk | |
Belgium | UZ Leuven Gasthuisberg | Leuven | |
Belgium | CHU de Charleroi Hôpital civil | Lodelinsart | Hainaut |
Belgium | AZ Delta | Roeselare | |
Canada | LMC Manna Research - Brampton | Brampton | Ontario |
Canada | LMC Manna Research - Calgary | Calgary | Alberta |
Canada | LMC Manna Research - Thornhill | Concord | Ontario |
Canada | LMC Manna Research - Etobicoke | Etobicoke | Ontario |
Canada | Hamilton Medical Research Group | Hamilton | Ontario |
Canada | Clinical Research Solutions, Inc. | Kitchener | Ontario |
Canada | Centricity Research Mirabel Multispecialty | Mirabel | Quebec |
Canada | William Osler Health centre, Sakuara Medical | Mississauga | Ontario |
Canada | Centre Hospitalier de l'Université de Montréal (CHUM) | Montreal | Quebec |
Canada | Recherche GCP Research | Montreal | Quebec |
Canada | LMC Manna Research - Ottawa | Nepean | Ontario |
Canada | Bluewater Clinical Research Group | Sarnia | Ontario |
Canada | LMC Manna Research - Barrie | TBC | Ontario |
Canada | LMC Manna Research - Bayview | Toronto | Ontario |
Canada | LMC Clinical Research Inc. Montreal | Ville Saint-Laurent | Quebec |
Canada | Sameh Fikry Professional Corporation | Waterloo | Ontario |
Denmark | Sydvestjysk Sygehus Esbjerg | Esbjerg | |
Denmark | Steno Diabetes Center Copenhagen | Herlev - Clinical and Translational Research Department | Herlev | |
Denmark | Region Midtjylland | Regionshospitalet Godstrup - Nephrology Department | Holstebro | |
Denmark | Bispebjerg Hospital | København NV | |
France | Hôpital François Mitterrand - Dijon | Dijon | |
France | Center Hospitalier Michallon - Grenoble | La Tronche | |
France | Hôpital Edouard Herriot - Lyon Cedex | Lyon Cedex | |
France | Many Locations | Multiple Locations | |
France | Hopital Carémeau - Nîmes | Nîmes | |
France | Hôpital Saint Joseph | Paris | |
Germany | Charité Campus Benjamin Franklin (CBF) | Berlin | |
Germany | Diabetologische Schwerpunkt Praxis Dortmund | Dortmund | Nordrhein-Westfalen |
Germany | ClinPhenomics GmbH&Co. KG | Frankfurt | Hessen |
Germany | Diabetes Zentrum Wandsbek | Hamburg | |
Germany | St. Josefskrankenhaus | Heidelberg | Baden-Württemberg |
Germany | Friedrich-Schiller-Uni. Jena | Jena | Thüringen |
Germany | Zentrum für Diabetologie und Ernährungsmedizin | Ludwigshafen | Rheinland-Pfalz |
Germany | Cardiologicum Pirna / Dresden-Seidnitz | Pirna | Sachsen |
India | Mavani Dialysis & Kidney Center | Ahmedabad | |
India | Manipal Hospital | Bangalore | Karnataka |
India | K.L.E.S. Dr. Prabhakar Kore Hospital & Medical Research Centre | Belgaum | Karnataka |
India | Bangalore Medical College & Research Institute | Bengaluru | |
India | Dr. Bantwal's Clinic | Bengaluru | |
India | All India Institute of Medical Sciences | Bhubaneswar | Delhi |
India | Government Kilpauk Medical College Hospital | Chennai | |
India | Sriram Chandra Bhanj Medical College & Hospital | Cuttack | |
India | Nizam's Institute of Medical Sciences (NIMS) | Hyderabad | |
India | Eternal Heart Care Centre (EHCC) and Research Institute | Jaipur | Rajasthan |
India | Sawami Man Singh (SMS) Medical College & Attached Hospitals | Jaipur | |
India | G.S.V.M. Medical College | Kanpur | Uttar Pradesh |
India | Institute of Post-Graduate Medical Education and Research | Kolkata | West Bengal |
India | Government Medical College | Kozhikode | |
India | Vinaya Hospital and Research Centre (A Unit of KIMS) | Mangalore | |
India | Seth Gordhandas Sunderdas Medical College (GSMC) - King Edward Memorial (KEM) Hospital | Mumbai | |
India | Asian Kidney Hospital and Medical Centre | Nagapur | |
India | Government Medical College and Hospital (GMCH) Nagpur | Nagpur | |
India | Indraprastha Apollo Hospital | New Delhi | Delhi |
India | Max Super Speciality Hospital (MSSH) - Saket | New Delhi | |
India | Grant Medical Foundation - Ruby Hall Clinic (RHC) | Pune | |
India | Lifepoint Multispecialty Hospital | Pune | |
India | Krishna Institute Of Medical Science | Secunderabad | |
India | Osmania General Hospital | Telangana | |
India | Vedanta Kidney Care | Vadodara | |
India | King George Hospital | Visakhapatnam | Andhra Pradesh |
Israel | Clalit Health Services through HaEmek Medical Center | Afula | |
Israel | Barzilai Medical Center | Ashkelon | |
Israel | Soroka University Medical Center | Beer Sheva | |
Israel | Edith Wolfson Medical Center | Holon | |
Israel | Hadassah University Medical Center (HUMC) | Jerusalem | |
Israel | Health Corporation of Galilee Medical Center | Nahariya | |
Israel | Clalit Health Services Rabin Medical Center-Beilinson Campus | Petach Tikva | |
Israel | DMC - Diabetes Medical Center | Tel Aviv | |
Israel | Health Corporation of the Ziv Medical Center (R.A.) | Zefat | |
Italy | ASST Papa Giovanni XXIII | Bergamo | Lombardia |
Italy | ASP di Catania | Catania | Sicilia |
Italy | Universita Degli Studi "Gabriele d'Annunzio" - Chieti - Centro Scienze dell'Invecchiamento (Centro Studi Sull'Invecchiamento | Chieti | |
Italy | IRCCS Casa Sollievo della Sofferenza | Foggia | Puglia |
Italy | ASL 4 Chiavarese | Genova | Liguria |
Italy | ASST Rhodense | Milano | Lombardia |
Italy | ASST Santi Paolo e Carlo | Milano | Lombardia |
Italy | Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico | Milano | Lombardia |
Italy | Ospedale San Raffaele s.r.l. | Milano | Lombardia |
Italy | Many Locations | Multiple Locations | |
Italy | A.O.U. di Parma | Parma | Emilia-Romagna |
Italy | A.O.U. Pisana | Pisa | Toscana |
Italy | ATS Sardegna - ASSL Olbia | Sassari | Sardegna |
Italy | A.O.U. San Luigi Gonzaga | Torino | Piemonte |
Italy | A.O.U.I. Verona | Verona | Veneto |
Japan | Fukuoka University Chikushi Hospital | Chikushino | Fukuoka |
Japan | Fukui-ken Saiseikai Hospital | Fukui | |
Japan | Social Medical Corporation the Chiyukai foundation Fukuoka Wajiro Hospital | Fukuoka | |
Japan | Public Central Hospital of Matto Ishikawa | Clinical Trial Management Office | Hakusan | |
Japan | Hirohata Naika Clinic | Kitakyushu | Fukuoka |
Japan | Kokura Memorial Hospital | Kitakyushu | Fukuoka |
Japan | Japanese Red Cross Kumamoto Hospital | Kumamoto | |
Japan | Saiseikai Matsuyama Hospital | Matsuyama | Ehime |
Japan | Many Locations | Multiple Locations | |
Japan | Naka Kinen Clinic | Naka | Ibaraki |
Japan | Jiyugaoka Yamada Internal Medicine Clinic | Obihiro | Hokkaido |
Japan | Kyosokai AMC NISHI-UMEDA Clinic | Osaka | |
Japan | Osaka General Medical Center | Osaka | |
Korea, Republic of | Korea University Ansan Hospital | Ansan Si, Kyung Ki Do | |
Korea, Republic of | Hallym University Sacred Heart Hospital | Anyang-si | Gyeonggido |
Korea, Republic of | Soon Chun Hyang University Cheonan Hospital | Cheonan | Chungcheongnamdo |
Korea, Republic of | Chung Nam National University Hospital | Daejeon | |
Korea, Republic of | Hanyang University Guri Hospital | Gyeonggi-do | |
Korea, Republic of | The Catholic University of Korea, Incheon St.Mary's Hospital | Incheon | Incheon Gwang''yeogsi |
Korea, Republic of | Seoul National University Bundang Hospital | Seongnam-si | Gyeonggido |
Korea, Republic of | Asan Medical Center | Seoul | |
Korea, Republic of | Hallym University Kangnam Sacred Heart Hospital | Seoul | |
Korea, Republic of | Kyung Hee University Hospital at Gangdong | Seoul | |
Korea, Republic of | Seoul National University Hospital | Seoul | Seoul Teugbyeolsi |
Korea, Republic of | Severance Hospital, Yonsei University Health System | Seoul | |
Korea, Republic of | Yonsei University Wonju Christian Hospital | Wonju | Gang''weondo |
Netherlands | Meander Medisch Centrum | Amersfoort | |
Netherlands | Academisch Medisch Centrum (AMC) | Amsterdam | |
Netherlands | Onze Lieve Vrouwe Gasthuis | Amsterdam | |
Netherlands | Gelre Ziekenhuizen | Apeldoorn | |
Netherlands | Albert Schweitzer Ziekenhuis | Dordwijk - Cardiology Department | Dordrecht | |
Spain | Gerencia de Gestion Integrada A Coruna | Department of Endocrinology and Nutrition | A Coruna | A Coruña |
Spain | Hospital Principe de Asturias | Alcalá de Henares | Madrid |
Spain | Ciutat Sanitaria i Universitaria de la Vall d'Hebron | Barcelona | |
Spain | Hospital Quironsalud Barcelona | Internal Medicine Department | Barcelona | |
Spain | Hospital Vithas Sevilla | Endocrinology Department | Castilleja de la Cuesta | |
Spain | Complejo Hospitalario Universitario de Ferrol | Hospital Naval - Unidad de Hipertensión Arterial | Ferrol | A Coruña |
Spain | Hospital Universitario Virgen de las Nieves | Granada | |
Spain | Hospital SAS de Jerez de la Frontera | Jerez de la Frontera | Cádiz |
Spain | Hospital Clinico San Carlos | Madrid | |
Spain | Hospital Universitario 12 de Octubre | Madrid | |
Spain | Universidad Autonoma de Madrid (UAM) - Facultad de Medicina - Hospital Universitario Fundacion Jimenez Diaz (UAM-FJD) | Madrid | |
Spain | Hospital Universitario Puerta de Hierro Majadahonda | Clinical Pharmacology Department | Majadahonda | |
Spain | Hospital Universitario Virgen de la Victoria | Unidad de Investigacion Clinica - Endocrinology Department | Malaga | |
Spain | H. Costa del Sol (Marbella) | Marbella | |
Spain | Many Locations | Multiple Locations | |
Spain | Hospital Clínico Universitario de Santiago de Compostela | Santiago de Compostela | A Coruña |
Spain | Hospital Clínico Universitario de Valencia | Valencia | |
Spain | Hospital Universitario Dr. Peset | Valencia | |
Taiwan | Changhua Christian Hospital | Changhua | |
Taiwan | Chang Gung Memorial Hospital Kaohsiung | Kaohsiung | |
Taiwan | Many Locations | Multiple Locations | |
Taiwan | Far Eastern Memorial Hospital | Nephrology Department | New Taipei City | |
Taiwan | Taipei Medical University - Shuang Ho Hospital | New Taipei City | |
Taiwan | China Medical University Hospital | Taichung | |
Taiwan | Taichung Veterans General Hospital | Taichung | |
Taiwan | National Taiwan University Hospital | Taipei | |
Taiwan | Taipei Veterans General Hospital | Taipei | |
United States | Dr Nowreen Haq Endocrinology Clinic | Annapolis | Maryland |
United States | Randolph Medical Associates | Asheboro | North Carolina |
United States | Emory University School of Medicine | Atlanta | Georgia |
United States | University of North Carolina Kidney Center | Chapel Hill | North Carolina |
United States | Cook County Health and Hospital System | Chicago | Illinois |
United States | Velocity Clinical Research, Cincinnati | Cincinnati | Ohio |
United States | Cleveland Clinic Foundation | Cleveland | Ohio |
United States | Baliga Family Practice | Columbus | Ohio |
United States | Office of Osvaldo A. Brusco, MD | Corpus Christi | Texas |
United States | Dunes Clinical Research LLC | Dakota Dunes | South Dakota |
United States | Thyroid, Endocrinology, and Diabetes (TED) PA | Dallas | Texas |
United States | Florida Kidney Physicians | Delray Beach | Florida |
United States | Southeast Kidney Associates | East Point | Georgia |
United States | DaVita Clinical Research - Texas | El Paso | Texas |
United States | Nephrology Associates Of Northern Illinois And Ind - Fort Wayne | Fort Wayne | Indiana |
United States | Eastern Nephrology Associates / Greenville NC | Greenville | North Carolina |
United States | Blue Sky, MD/ Lamond Family Medicine | Hendersonville | North Carolina |
United States | Nephrology Associates of Northern Illinois and Indiana (NANI) - Hinsdale | Hinsdale | Illinois |
United States | Global Kidney Center | Houston | Texas |
United States | Victorium Clinical Research | Houston | Texas |
United States | East Coast Institute for Research, Inc. - Jacksonville | Jacksonville | Florida |
United States | Clinical Research Consultants | Kansas City | Missouri |
United States | Kansas City VA Medical Center | Kansas City | Missouri |
United States | Eastern Nephrology Associates - Kinston | Kinston | North Carolina |
United States | Healor Primary Care / CCT Research | Las Vegas | Nevada |
United States | Santa Rosa Medical Centers of Nevada / CCT Research | Las Vegas | Nevada |
United States | North Texas Kidney Disease Associates, PLLC | Lewisville | Texas |
United States | Somnos Clinical Research | Lincoln | Nebraska |
United States | Academic Medical Research Institute | Los Angeles | California |
United States | Biopharma Informatic, LLC | McAllen | Texas |
United States | DarSalud Care / LifeDOC Research | Memphis | Tennessee |
United States | University of Tennessee Health Science Center | Memphis | Tennessee |
United States | Desert Clinical Research - CCT Research | Mesa | Arizona |
United States | Nola Care Clinical Research | Metairie | Louisiana |
United States | Omega Clinical Research Center | Metairie | Louisiana |
United States | Circuit Clinical/Crystal Run | Middletown | New York |
United States | Meridian Clinical Research- Norfolk | Norfolk | Nebraska |
United States | Northridge Hospital | Northridge | California |
United States | West Orange Endocrinology & Clinical Research | Ocoee | Florida |
United States | Advent Health | Orlando | Florida |
United States | South Shore Nephrology | Plymouth | Massachusetts |
United States | Innovative Research Institute | Port Charlotte | Florida |
United States | Lake Michigan Nephrology | Saint Joseph | Missouri |
United States | St. Louis Heart & Vascular, PC | Saint Louis | Missouri |
United States | Washington University School of Medicine | Saint Louis | Missouri |
United States | Salem VA Medical Center | Salem | Virginia |
United States | Olympus Family Medicine | Salt Lake City | Utah |
United States | Clinical Advancement Center, PLLC | San Antonio | Texas |
United States | University of Texas Health Science Center | San Antonio | Texas |
United States | University of Texas Health Science Center | San Antonio | Texas |
United States | Meridian Clinical Research- Savannah | Savannah | Georgia |
United States | MultiCare Rockwood Clinic Diabetes & Endocrinology Center | Spokane | Washington |
United States | Southwest Kidney Institute, PLC | Surprise | Arizona |
United States | Olive View - UCLA Medical Center | Sylmar | California |
United States | Oakland Medical Center | Troy | Michigan |
United States | Touro University California | Vallejo | California |
United States | Versailles Family Medicine | Versailles | Kentucky |
United States | Chase Medical Research, LLC | Waterbury | Connecticut |
United States | Metabolic Research Institute, Inc. | West Palm Beach | Florida |
Lead Sponsor | Collaborator |
---|---|
Bayer |
United States, Belgium, Canada, Denmark, France, Germany, India, Israel, Italy, Japan, Korea, Republic of, Netherlands, Spain, Taiwan,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Relative change from baseline in UACR at 180 days in combination therapy group versus empagliflozin alone | Urinary albumin to-creatinine ratio (UACR) | Up to 180 days | |
Primary | Relative change from baseline in UACR at 180 days in combination therapy group versus finerenone alone | Up to 180 days | ||
Primary | Mean ratio of change from baseline to Day 180 in UACR for the combination therapy group, to empagliflozin alone | Upto 180 days | ||
Primary | Mean ratio of change from baseline to Day 180 in UACR for the combination therapy group, to finerenone alone | Up to 180 days | ||
Secondary | Relative change in UACR between end of treatment visit (Day 180) and 30 days after end of treatment visit (Day 210) | Up to 210 days | ||
Secondary | Relative change in UACR between 30 days after end of treatment visit (Day 210) and baseline (Day 1) | Up to 210 days | ||
Secondary | Relative change in UACR category (>30%, >40%, >50%) at 180 days | Up to 180 days | ||
Secondary | Ratio of change from baseline in eGFR at 30 days | estimated glomerular filtration rate (eGRF) | Up to 30 days | |
Secondary | eGFR decline greater than 30% at 30 days from baseline | Up to 30 days | ||
Secondary | Ratio of change in eGFR at 180 days and 210 days from Day 30 | Up to 210 days | ||
Secondary | Proportion of participants with of acute kidney injury (AKI) events | AKI is defined as any of the following:
An increase in serum creatinine by greater than or equal to 0.3 mg/dL within 48 hours; or An increase in serum creatinine by greater than or equal to 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or A urine volume less than 0.5 ml/kg/h for 6 hours |
Up to 180 days | |
Secondary | Total number of AKI events | Up to 180 days | ||
Secondary | Proportion of participants with hyperkalemia events (moderate hyperkalemia [5.5 <K+ =6.0 mmol/L], severe hyperkalemia [K+ >6.0 mmol/L]) | serum/plasma potassium (k+) | Up to 180 days | |
Secondary | Total number of hyperkalemia events (moderate hyperkalemia [5.5 <K+ =6.0 mmol/L], severe hyperkalemia [K+ >6.0 mmol/L]) | Up to 180 days | ||
Secondary | Change from baseline in K+ | Up to 180 days | ||
Secondary | Proportion of participants with severe hypoglycemia events | Severe hypoglycemia is defined as glucose level of <3.0 mmol/L (<54 mg/dL). | Up to 180 days | |
Secondary | Total number of events of severe hypoglycemia events | Up to 180 days | ||
Secondary | Proportion of participants with symptomatic hypotension events | Up to 180 days | ||
Secondary | Total number of symptomatic hypotension events | Up to 180 days | ||
Secondary | Proportion of participants with genital mycotic events | Up to 180 days | ||
Secondary | Total number of genital mycotic events | Up to 180 days | ||
Secondary | Proportion of participants with ketoacidosis events | Up to 180 days | ||
Secondary | Total number of ketoacidosis events | Up to 180 days | ||
Secondary | Proportion of participants with necrotizing fasciitis of the perineum events | Up to 180 days | ||
Secondary | Total number of necrotizing fasciitis of the perineum events | Up to 180 days | ||
Secondary | Proportion of participants with urosepsis and pyelonephritis events | Up to 180 days | ||
Secondary | Total number of urosepsis and pyelonephritis events | Up to 180 days |
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