Type 2 Diabetes Mellitus Clinical Trial
Official title:
A Randomized, Double-Blind, Placebo-Controlled Trial to Assess Safety and Tolerability During Treatment of Type 2 Diabetes (T2DM) With Usual Diabetes Therapy (UDT) and Either Cycloset or Placebo
Cycloset, a new quick-release oral formulation of bromocriptine mesylate, effectively
reduces blood sugar by the proposed mechanism of reversing many of the metabolic alterations
associated with insulin resistance and obesity by resetting central (hypothalamic) circadian
organization of monoamine neuronal activities.
The primary analysis of this study will test the hypothesis that the rate of all-cause
severe adverse events for those receiving usual drug therapy for diabetes management plus
Cycloset is not greater than that for usual drug therapy plus placebo by more than an
acceptable margin. While the primary purpose of this study is to establish the safety
profile of Cycloset in type 2 diabetes, any potential positive cardiovascular benefits will
be evaluated as well.
Bromocriptine mesylate, an ergot derivative, is a sympatholytic dopamine D2 receptor agonist
that can exert inhibitory effects on serotonin turnover in the central nervous system. It
has been proposed that bromocriptine can reverse many of the metabolic alterations
associated with insulin resistance and obesity by resetting central (hypothalamic) circadian
organization of monoamine neuronal activities.
While Cycloset has demonstrated efficacy by reducing HbA1c, fasting and post-prandial
glucose and fasting and post-prandial triglycerides, the relatively small numbers of
individuals treated for type 2 diabetes during the controlled Phase III clinical trials of
Cycloset did not allow for a full evaluation of the safety profile. Since persons with
diabetes are already at higher risk for cardiovascular disease, it is important to examine
more fully the spectrum of potential adverse or positive effects from Cycloset in a large
sample of persons with diabetes. Accordingly, the present study is designed to investigate
the clinical safety of treatment with Cycloset in a broad population of persons with type 2
diabetes.
To determine in subjects with type 2 diabetes mellitus receiving Usual Diabetes Therapy
(UDT) consisting of either diet, oral hypoglycemic agents (OHA) (no more than 2), or insulin
(with or without no more than 1 OHA) plus either Placebo or Cycloset:
1. Whether add-on therapy with Cycloset results in all-cause rate of serious adverse
events, which are not higher than add-on therapy with Placebo.
2. Whether add-on therapy with Cycloset results in disease-specific rate of serious
cardiovascular adverse events, which are not higher than add-on therapy with Placebo.
While the primary purpose of this study is to establish the safety profile of Cycloset
in type 2 diabetes, any potential positive cardiovascular benefits will be evaluated as
well.
Other clinical measures:
3. The impact (either positive or negative) of Cycloset on HbA1c, fasting plasma glucose,
weight, triglycerides lipids, blood pressure and patient tolerability after 12 months
of therapy.
Furthermore, Hba1c changes from baseline to 24 weeks between Cycloset and Placebo among
subjects with a baseline Hba1c of >= 7.5% among the following subgroups:
A. Treated at baseline with any Oral hypoglycemic agent (OHA) including injectable insulin
secretagogues B. Metformin plus or minus one OHA or injectable insulin secretagogue C.
Sulphonylurea plus or minus one OHA or injectable insulin secretagogue D. Treated at
baseline with Metformin and one sulphonylurea
;
Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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