A Phase 4 interventional study of Pioglitazone and Glyburide in Diabetes Mellitus and Liver, sponsored by Takeda. Completed. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2012-02-28.
Sponsored by Takeda · Phase 4, Interventional, and Treatment
The purpose of this study is to determine the liver safety of pioglitazone, once daily (QD), versus glyburide taken with metformin and insulin.
Type 2 diabetes generally arises from an initial state of insulin resistance that coincides with a gradual decline in insulin secretion due to beta-cell dysfunction. Together, these factors contribute to impaired glucose tolerance and eventually hyperglycemia.
Thiazolidinediones are selective agonists for the nuclear receptor peroxisomal proliferator-activated receptor gamma. These receptors are found in tissues with insulin action including adipose tissue, skeletal muscle and the liver. Thiazolidinediones reduce insulin resistance by enhancing insulin sensitivity in adipose tissue, muscle cells and hepatic cells without directly affecting insulin secretion. These effects improve glycemic control and result in reduced levels of circulating insulin.
Pioglitazone is a thiazolidinedione developed by Takeda Chemical Industries, Ltd., and depends on the presence of insulin for its mechanism of action. Glyburide is an oral antidiabetic agent of the sulfonylurea class, and impacts glycemic control by stimulating the pancreas to release insulin, an effect that is dependent upon beta-cells in the pancreatic islets.
Elevated levels of hepatic enzymes, hepatocellular inflammation, and viral susceptibility are known to occur with increased frequency in individuals with type 2 diabetes mellitus regardless of the type of antidiabetic therapy used. Subject to the approval of pioglitazone, the Food and Drug Administration requested a 3-year outcome study evaluating the occurrence of serious liver disease in subjects treated with pioglitazone. The present study was designed to fulfill this phase 4, postmarketing commitment to the Food and Drug Administration, pursuant to demonstrating the long-term hepatic safety of pioglitazone. This study was designed to determine whether pioglitazone is associated with a difference in the incidence of elevated levels of alanine aminotransferase, a marker of hepatocellular inflammation or injury, when compared with glyburide. Glyburide is used for treatment of patients with type 2 diabetes mellitus; its use in this study as a comparator should provide a basis for evaluating whether pioglitazone is associated with an increased risk of hepatocellular inflammation or injury.
10,925 studies on the registry are indexed under Diabetes Mellitus; 1,319 are open to participants now.
This study's enrollment of 2,120 is above the median of 80 across 8,367 interventional studies indexed under Diabetes Mellitus.
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Of its 173 completed or terminated interventional studies of FDA-regulated products, 149 (86%) have results posted.
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Exclusion Criteria:
Is required to take or continues taking any disallowed medication, prescription medication, herbal treatment or over-the counter medication that may interfere with evaluation of the study medication, including:
Drug: Pioglitazone
Drug: Glyburide
Pioglitazone 15 mg or 30 mg titrated to 45 mg, tablets, orally, once daily and glyburide placebo-matching capsules, orally, once daily for up to 156 weeks.
Also known as: Actos, AD-4833
Pioglitazone placebo-matching tablets, orally, once daily and glyburide 5 mg or 10 mg titrated to 15 mg, capsules, orally, once daily for up to 156 weeks.
Incidence of liver inflammation or injury greater than 3 times the upper limit of normal, as monitored by serum alanine aminotransaminase elevation.
Time frame: At All Visits
Incidence of alanine aminotransferase greater than 8 times the upper limit of normal.
Time frame: At All Visits
Incidence of alanine aminotransferase greater than 3 times the upper limit of normal but less than or equal to 8 times the upper limit of normal on 4 consecutive measurements within a 3-month period.
Time frame: At All Visits
Incidence of alanine aminotransferase greater than 3 times the upper limit of normal and total bilirubin greater than 2 times the upper limit of normal.
Time frame: At All Visits
Change from Baseline or greater than 1.5 times the upper limit of normal (whichever is greater) in the level of alanine aminotransferase, aspartate aminotransferase, total or direct bilirubin, alkaline phosphatase or gamma-glutamyl transpeptidase.
Time frame: At All Visits
No study locations are listed for this record.
This study is completed, as verified in Feb 2012. You cannot join it, but the record below documents what was studied.
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