A Phase 3 interventional study of Glimepiride and Canagliflozin (JNJ-28431754) in Diabetes Mellitus, Type 2, sponsored by Janssen Research & Development, LLC. Completed at 142 sites in 20 countries. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2017-01-30.
Sponsored by Janssen Research & Development, LLC · Phase 3, Interventional, and Treatment
The purpose of this study is to demonstrate the efficacy, safety, and tolerability of canagliflozin (JNJ-28431754) compared with glimepiride in patients with type 2 diabetes mellitus with inadequate control despite treatment with metformin.
Type 2 diabetes mellitus (T2DM) is well recognized as a major public health problem that presents patients with a significant risk of complications including heart disease, retinopathy, nephropathy, and neuropathy. Various classes of orally administered antihyperglycemic agents have been developed for the treatment of diabetes and although individual agents may be highly effective for some patients, it is still difficult to maintain optimal glycemic control in most patients, thereby resulting in high rates of morbidity and mortality in the diabetic population. This is a randomized, double-blind, active comparator-controlled, 3-arm, parallel-group, multicenter study to demonstrate the efficacy, safety, and tolerability of canagliflozin compared with a sulfonylurea (glimepiride) in patients with T2DM, 18 to 80 years of age, inclusive, who are not optimally controlled on metformin monotherapy. The primary study hypothesis is that the study drug will be non-inferior to glimepiride as assessed by the change in hemoglobin A1c (HbA1c) from baseline. The patients will receive capsules taken by mouth of canagliflozin (either 100 or 300 mg), or glimepiride with a starting dosage of 1 mg, which will be increased to a maximum dose of 6 or 8 mg once daily for a total duration of 104 weeks.
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Exclusion Criteria:
Each patient will receive glimepiride, at protocol-specified doses, once daily in combination with protocol-specified doses of metformin for 104 weeks.
Drug: Glimepiride · Drug: Metformin
Each patient will receive 100 mg of canagliflozin (JNJ-28431754) once daily with protocol-specified doses of metformin for 104 weeks.
Drug: Canagliflozin (JNJ-28431754) · Drug: Metformin
Each volunteer will receive 300 mg of canagliflozin (JNJ-28431754) once daily with protocol-specified doses of metformin for 104 weeks.
Drug: Canagliflozin (JNJ-28431754) · Drug: Metformin
Glimepiride will be given orally (by mouth), as over-encapsulated tablets, starting at a dose of 1mg once daily and increasing to a maximum of 6 mg or 8 mg once daily for 104 weeks.
Also known as: sulfonylurea
Canagliflozin (JNJ-28431754) will be given orally as over-encapsulated tablets, at a dose of 100 mg or 300 mg once daily for 104 weeks.
Metformin will be given orally at the protocol-specified dose for 104 weeks.
Change in HbA1c From Baseline to Week 52
The table below shows the least-squares (LS) mean change in HbA1c from Baseline to Week 52 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in the LS mean change.
Time frame: Day 1 (Baseline) and Week 52
Percentage of Patients Experiencing at Least 1 Hypoglycemic Event From Baseline to Week 52
The table below shows the percentage of patients who experienced at least 1 documented hypoglycemic event from Baseline to Week 52 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in percentages.
Time frame: Day 1 (Baseline) and Week 52
Percent Change in Body Weight From Baseline to Week 52
The table below shows the least-squares (LS) mean percent change in body weight from Baseline to Week 52 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in the LS mean percent change.
Time frame: Day 1 (Baseline) and Week 52
Change in HbA1c From Baseline to Week 104
The table below shows the least-squares (LS) mean change in HbA1c from Baseline to Week 104 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in the LS mean change.
Time frame: Baseline, Week 104
This study evaluated the efficacy and safety of canagliflozin (JNJ-28431754) compared with glimepiride in participants with type 2 diabetes mellitus with inadequate glycemic control despite metformin treatment. The study was conducted between 28 August 2009 and 25 January 2013 and included 157 study centers in 19 countries worldwide.
| Milestone | Canagliflozin 100 mg: Baseline to Week 104 | Canagliflozin 300 mg: Baseline to Week 104 | Glimepiride: Baseline to Week 104 |
|---|---|---|---|
| Started | 483 | 485 | 482 |
| Completed | 343 | 323 | 314 |
| Not completed | 140 | 162 | 168 |
| Withdrew: Adverse event | 30 | 46 | 33 |
| Withdrew: Death | 2 | 2 | 1 |
| Withdrew: Lack of efficacy | 9 | 7 | 16 |
| Withdrew: Lost to follow-up | 17 | 12 | 11 |
| Withdrew: Physician decision | 8 | 5 | 9 |
| Withdrew: Protocol violation | 7 | 4 | 3 |
| Withdrew: Withdrawal by subject | 17 | 23 | 25 |
| Withdrew: Creatinine or egfr withdrawal criteria | 9 | 13 | 7 |
| Withdrew: Noncompliance with study drug | 4 | 1 | 6 |
| Withdrew: Unable to take rescue therapy | 12 | 12 | 17 |
| Withdrew: Other | 25 | 37 | 40 |
The table below shows the least-squares (LS) mean change in HbA1c from Baseline to Week 52 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in the LS mean change.
| Percent | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride |
|---|---|---|---|
| Change in HbA1c From Baseline to Week 52 | -0.82 ± 0.039 | -0.93 ± 0.039 | -0.81 ± 0.039 |
The table below shows the percentage of patients who experienced at least 1 documented hypoglycemic event from Baseline to Week 52 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in percentages.
| Percentage of patients | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride |
|---|---|---|---|
| Percentage of Patients Experiencing at Least 1 Hypoglycemic Event From Baseline to Week 52 | 5.6 | 4.9 | 34.2 |
The table below shows the least-squares (LS) mean percent change in body weight from Baseline to Week 52 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in the LS mean percent change.
| Percent change | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride |
|---|---|---|---|
| Percent Change in Body Weight From Baseline to Week 52 | -4.2 ± 0.2 | -4.7 ± 0.2 | 1.0 ± 0.2 |
The table below shows the least-squares (LS) mean change in HbA1c from Baseline to Week 104 for each treatment group. The statistical analyses show the treatment differences (ie, each canagliflozin group minus glimepiride) in the LS mean change.
| Percent | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride |
|---|---|---|---|
| Change in HbA1c From Baseline to Week 104 | -0.65 ± 0.042 | -0.74 ± 0.042 | -0.55 ± 0.043 |
Collected over Adverse event data were collected for the duration of the study (104 weeks).. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Canagliflozin 100 mg: Baseline to Week 52 | — | 24/483 (5%) | 138/483 (28.6%) |
| Canagliflozin 300 mg: Baseline to Week 52 | — | 26/485 (5.4%) | 150/485 (30.9%) |
| Glimepiride: Baseline to Week 52 | — | 39/482 (8.1%) | 175/482 (36.3%) |
| Canagliflozin 100 mg: Baseline to Week 104 | — | 47/483 (9.7%) | 198/483 (41%) |
| Canagliflozin 300 mg: Baseline to Week 104 | — | 47/485 (9.7%) | 204/485 (42.1%) |
| Glimepiride: Baseline to Week 104 | — | 69/482 (14.3%) | 242/482 (50.2%) |
| Event | Canagliflozin 100 mg: Baseline to Week 52 | Canagliflozin 300 mg: Baseline to Week 52 | Glimepiride: Baseline to Week 52 | Canagliflozin 100 mg: Baseline to Week 104 | Canagliflozin 300 mg: Baseline to Week 104 | Glimepiride: Baseline to Week 104 |
|---|---|---|---|---|---|---|
| CholelithiasisHepatobiliary disorders | 0/483 | 0/485 | 3/482 | 0/483 | 0/485 | 4/482 |
| Angina pectorisCardiac disorders | 1/483 | 2/485 | 2/482 | 3/483 | 2/485 | 3/482 |
| Non-cardiac chest painGeneral disorders | 0/483 | 1/485 | 2/482 | 0/483 | 2/485 | 3/482 |
| Uterine leiomyomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/483 | 2/485 | 0/482 | 0/483 | 3/485 | 0/482 |
| Angina unstableCardiac disorders | 0/483 | 1/485 | 1/482 | 1/483 | 1/485 | 2/482 |
| Atrial fibrillationCardiac disorders | 0/483 | 0/485 | 1/482 | 0/483 | 0/485 | 2/482 |
| Coronary artery diseaseCardiac disorders | 0/483 | 0/485 | 1/482 | 1/483 | 0/485 | 2/482 |
| CataractEye disorders | 1/483 | 0/485 | 0/482 | 1/483 | 0/485 | 2/482 |
| AppendicitisInfections and infestations | 0/483 | 0/485 | 2/482 | 0/483 | 0/485 | 2/482 |
| PneumoniaInfections and infestations | 1/483 | 1/485 | 2/482 | 1/483 | 2/485 | 2/482 |
| Event | Canagliflozin 100 mg: Baseline to Week 52 | Canagliflozin 300 mg: Baseline to Week 52 | Glimepiride: Baseline to Week 52 | Canagliflozin 100 mg: Baseline to Week 104 | Canagliflozin 300 mg: Baseline to Week 104 | Glimepiride: Baseline to Week 104 |
|---|---|---|---|---|---|---|
| HypoglycaemiaMetabolism and nutrition disorders | 15/483 | 9/485 | 61/482 | 17/483 | 16/485 | 86/482 |
| Upper respiratory tract infectionInfections and infestations | 17/483 | 27/485 | 41/482 | 36/483 | 38/485 | 56/482 |
| NasopharyngitisInfections and infestations | 33/483 | 37/485 | 37/482 | 47/483 | 55/485 | 51/482 |
| Urinary tract infectionInfections and infestations | 26/483 | 23/485 | 18/482 | 44/483 | 33/485 | 27/482 |
| DiarrhoeaGastrointestinal disorders | 24/483 | 33/485 | 29/482 | 25/482 | 39/485 | 34/482 |
| Back painMusculoskeletal and connective tissue disorders | 29/483 | 18/485 | 20/482 | 34/483 | 28/485 | 26/482 |
| HeadacheNervous system disorders | 14/483 | 25/485 | 24/482 | 21/483 | 29/485 | 33/482 |
| HypertensionVascular disorders | 8/483 | 10/485 | 13/482 | 15/483 | 11/485 | 30/482 |
| NauseaGastrointestinal disorders | 16/483 | 25/485 | 13/482 | 20/483 | 27/485 | 19/482 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 18/483 | 13/485 | 18/482 | 26/483 | 16/485 | 24/482 |
| Age, Categorical(Participants) | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride | Total |
|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 397 | 411 | 399 | 1207 |
| >=65 years | 86 | 74 | 83 | 243 |
| Age, Continuous(years) | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride | Total |
|---|---|---|---|---|
| Mean | 56.4 ± 9.49 | 55.8 ± 9.17 | 56.3 ± 9.01 | 56.2 ± 9.22 |
| Gender(Participants) | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride | Total |
|---|---|---|---|---|
| Female | 231 | 244 | 219 | 694 |
| Male | 252 | 241 | 263 | 756 |
| Region Enroll(participants) | Canagliflozin 100 mg | Canagliflozin 300 mg | Glimepiride | Total |
|---|---|---|---|---|
| ARGENTINA | 18 | 18 | 18 | 54 |
| BULGARIA | 7 | 7 | 7 | 21 |
| CANADA | 19 | 20 | 19 | 58 |
| COSTA RICA | 10 | 9 | 9 | 28 |
| DENMARK | 24 | 25 | 25 | 74 |
| FINLAND | 18 | 17 | 19 | 54 |
| GERMANY | 6 | 7 | 6 | 19 |
| INDIA | 55 | 55 | 56 | 166 |
| ISRAEL | 14 | 15 | 14 | 43 |
| MEXICO | 24 | 25 | 24 | 73 |
| NORWAY | 9 | 9 | 9 | 27 |
| PHILIPPINES | 14 | 13 | 13 | 40 |
| POLAND | 14 | 15 | 15 | 44 |
| ROMANIA | 43 | 43 | 44 | 130 |
| RUSSIAN FEDERATION | 23 | 22 | 22 | 67 |
| SLOVAKIA | 15 | 14 | 13 | 42 |
| SOUTH KOREA | 31 | 32 | 31 | 94 |
| UKRAINE | 22 | 22 | 22 | 66 |
| UNITED STATES | 117 | 117 | 116 | 350 |
Showing the first 100 of 142 sites across 20 countries.
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