Type 2 Diabetes Clinical Trial
Official title:
A Phase 2b, Randomized, Double-Blind, Parallel-Group, Study of Safety and Efficacy of 16 Weeks of Treatment With DIO-902 or DIO-902 Placebo in Addition to Metformin and Atorvastatin or Atorvastatin Placebo in Subjects With Type 2 Diabetes Mellitus (Protocol No. DIO-502)
DiObex Inc. is developing an experimental drug (DIO-902) that is made up of part of the
ketoconazole molecule for the treatment of elevated blood glucose associated with type 2
diabetes mellitus. Ketoconazole (Nizoral®) is a drug available by prescription for the
treatment of fungal infections however DIO-902 is an investigational drug. DIO-902 may lower
blood glucose by lowering levels of a naturally occurring hormone called cortisol. Elevated
cortisol may contribute to the development of type 2 diabetes.
The purpose of this research study is to test the safety of DIO-902 when taken by mouth with
metformin and the cholesterol-lowering drug atorvastatin to determine the type and severity
of any side effects from this treatment.
Other purposes of the study are to see how the treatment affects your blood glucose levels,
cholesterol levels, blood pressure, and waist circumference.
Status | Terminated |
Enrollment | 200 |
Est. completion date | December 2008 |
Est. primary completion date | March 2008 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 75 Years |
Eligibility |
Inclusion Criteria: A subject may be included in this study if he/she meets all of the following criteria: 1. Male or female, age 18 to 75 2. Females of childbearing potential (intact uterus and within 1 year since the last menstrual period) should be non-lactating and have a negative serum pregnancy test. In addition, these subjects should agree to use the following acceptable birth control methods beginning at the Screening Visit and throughout the study: 1. abstinence 2. surgical sterilization (bilateral tubal ligation, hysterectomy, bilateral oophorectomy) 6 months minimum 3. IUD in place for at least 3 months 4. barrier methods (condom or diaphragm) with spermicide 5. surgical sterilization of the partner (vasectomy for 6 months) 6. hormonal contraceptives for at least 3 months prior to the first dose 3. Diagnosis of type 2 diabetes mellitus (DM) for at least 6 months. 4. Type 2 diabetes may be treated only with metformin (metformin hydrochloride tablets or metformin hydrochloride extended-release tablets) at a total daily dose of 500 mg to the maximum labeled dose. (See Appendix G for List of Drug Trade Names).The dose of metformin must be stable for >8 weeks prior to the Pre-Treatment Visit (Week -4) and throughout the course of the study. The subject must not be on any other pharmacologic or over-the-counter treatments for diabetes. 5. HbA1C level of 7.0 to 10.0% 6. Fasting C-peptide level of >0.33 nmol/l (1.0 ng/ml) 7. ACTH stimulation test results with any cortisol level of >18 µg/dl at baseline or 60 minutes 8. Normal complete blood count (CBC) with platelets and differential 9. 12-lead electrocardiogram (ECG) shows no acute ischemia or clinically significant abnormality. Subjects with QTc interval of >450 msec will be excluded from the study. 10. BMI of 27 to 42 kg/m2 (see Appendix B) 11. Subjects with a history of hypertension may be on a stable anti-hypertensive regimen for (except those drugs stated under Exclusion Criterion 8) for >6 weeks prior to the Pre-Treatment Visit (Week -4)) 12. Ability to comprehend and a willingness to provide informed consent Exclusion Criteria: - A subject may be excluded from this study if he/she meets any of the following criteria: 1. Previous participation in a clinical trial with DIO-902. 2. History of any atherosclerotic disorder (myocardial infarction, unstable angina, cerebrovascular accident, peripheral vascular disease or congestive heart failure secondary to ischemic myocardial injury) that would, in the estimation of the Investigator, make it unsafe to stop all lipid lowering drugs for up to 12 weeks during the course of the study. 3. Known hypersensitivity or idiosyncratic reaction related to ketoconazole or other imidazole compounds. 4. History of malignancy (except basal cell carcinoma) within the 3 years before the initial dose of the study medication. 5. Excessive alcohol intake (>20 g per day for females (1.5 standard alcohol drinks) or >30 g per day for males (2.0 standard alcohol drinks) (a standard drink contains 14 g of alcohol: 12 oz of beer, 5 oz of wine or 1.5 oz of spirits) or drug abuse. (1.0 fluid oz (US) = 29.57 ml) 6. Any other clinically significant medical condition, as determined by the Investigator. These clinically significant medical conditions include, but are not limited to, uncontrolled hypertension, NYHA class III or IV CHF, proliferative diabetic retinopathy and neuropathic symptoms that limit activities of daily living. 7. Participation in another clinical trial and/or treatment received with any investigational agent within one month before the initial dose of study medication. 8. Concomitant therapy with the following: (See Appendix G for List of Drug Trade Names) 1. weight loss medications 2. oral or injected hypoglycemics (metformin is allowed) or insulin 3. oral, parenteral or inhaled steroids; nasal, topical ocular, intravitreal, and low to moderate potency topical steroids are allowed 4. dihydropyridine calcium channel blockers (amlodipine, diltiazem and verapamil are allowed) 5. H2 antagonists and proton pump inhibitors (liquid and tablet antacids are allowed) 6. midazolam, triazolam, alprazolam, terfenadine, astemizole, digoxin, coumarin derivatives, phenytoin, rifampin, HIV protease inhibitors, spironolactone, aliskiren, erythromycin or clarithromycin, cyclosporine or tacrolimus 7. Subjects currently taking lipid lowering medications may be enrolled if the Investigator determines that the subject does not have any conditions that preclude cessation of lipid lowering treatment for up to 12 weeks. [All subjects will be required to discontinue all lipid lowering therapies during the 4 week Pre-Treatment Period and will then be randomized to receive either atorvastatin 10 mg or atorvastatin placebo during the first 8 weeks of the Treatment Period. All subjects will then receive atorvastatin 10 mg during weeks 8 to 16 of the Treatment Period.] Subjects may not be on any other lipid lowering agent through Visit 7 (Week 20) of the study. 9. History of HIV 10. Positive hepatitis B (HbsAg) or positive hepatitis C (Hepatitis C antibody) test during Screening 11. Liver function tests must not be above the following cut-offs: ALT and/or AST >3.0X ULN, AP >1.5X ULN and total bilirubin >ULN. (If all LFTs are WNL and total bilirubin is elevated, a retest of direct and indirect bilirubin may be performed. Subjects with indirect total bilirubin up to 3X ULN (presumed Gilbert's syndrome) may be enrolled if all other LFTs are WNL.) 12. CK must not be >2.5X ULN if not clearly related to recent exercise, injury or unusual activity 13. Creatinine must not be >1.4 mg/dl in females and >1.5 mg/dl in males. 14. Thyroid stimulating hormone level >1.5X ULN 15. History of lactic acidosis 16. Known hypersensitivity to cosyntropin (ACTH) or any component of the formulation (mannitol or sodium chloride) 17. Known intolerance to statin drugs 18. Any other condition which increases the risk of participation in the trial in the opinion of the investigator |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Australia | Flinders Medical Centre | Adelaide | South Australia |
Australia | ECRU | Box Hill, Melbourne | Victoria |
Australia | School of Medicine and Pharmacology | Fremantle | Western Australia |
Australia | Endocrinology Research Unit | Herston Road | |
Australia | Keough Institute | Nedands | Western Australia |
Australia | Lyell McEwin Hospital | North Western Adelaide | South Australia |
Australia | Endocrinology Department | St Leonards | |
Australia | Royal Melbourn Hospital | Victoria | |
New Zealand | Lipid and Diabetes Research | Christchurch | |
New Zealand | Waikaito Hospital | Hamilton | |
New Zealand | Middlemore Hospital | Otahuhu | Auckland |
New Zealand | Diabetes Centre | Wellington | |
United States | Covance CRU | Austin | Texas |
United States | Diabetes Research Goup University of Hawaii at Manoa | Honolulu | Hawaii |
United States | Research Solutions | Jonesboro | Arkansas |
United States | Advanced Medical Research | Lakewood | California |
United States | Arkansas Primary Care Clinic | Little Rock | Arkansas |
United States | Dr. Terence Hart | Muscle Shoals | Alabama |
United States | Creighton Diabetes Center | Omaha | Nebraska |
United States | Covance Clinical Research Unit - Dr. Andrew Ahmann | Portland | Oregon |
United States | Diabetes Glandular and Disease Research Associates | San Antonio | Texas |
United States | Mills-Peninsula Helath Services | San Mateo | California |
United States | Genova Research | Tucson | Arizona |
United States | AHS Oklahoma Physician Group | Tulsa | Oklahoma |
Lead Sponsor | Collaborator |
---|---|
DiObex |
United States, Australia, New Zealand,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | 1. The primary efficacy endpoint will be change from baseline to the end of treatment (Study Visit 6, Week 16) in HbA1c | 16 weeks | No | |
Secondary | 1. Change from baseline to Week 8 in total and LDL-cholesterol (LDL-C) 2. Change from baseline to the end of treatment (Week 16) in the following : Seated blood pressure (systolic, diastolic and mean arterial pressure) Fasting blood glucose | 16 weeks | No |
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