A Phase 3 interventional study of Sotagliflozin and Insulin glargine (HOE901) in Type 2 Diabetes Mellitus, sponsored by Lexicon Pharmaceuticals. Completed at 106 sites in 8 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-05-11.
Sponsored by Lexicon Pharmaceuticals · Phase 3, Interventional, and Treatment
Primary Objective:
To demonstrate the superiority of sotagliflozin 400 milligrams (mg) versus placebo with respect to hemoglobin A1C (HbA1c) reduction in participants with type 2 diabetes mellitus (T2D) who have inadequate glycemic control on basal insulin alone or with oral antidiabetes drugs (OADs).
Secondary Objectives:
Up to 60 weeks (Screening phase of up to 2 weeks, a 4-week Lantus titration/single-blind placebo Run-in phase), a 52-week double blind Treatment Period, and a 2-week post-treatment Follow-up Period.
Exclusion criteria:
The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Following a 4-week run-in period, participants were randomized to matching placebo to sotagliflozin 200 milligrams (mg) administered as 2 tablets, once daily, before the first meal of the day in the double-blind treatment period for up to 52 weeks. Background therapy with insulin glargine (with or without OADs) continued throughout the study.
Drug: Insulin glargine (HOE901) · Drug: Placebo · Drug: Oral Antidiabetes Drugs (OADs)
Following a 4-week run-in period, participants were randomized to sotagliflozin 200 mg administered as 1 tablet and matching placebo as 1 tablet, once daily, before the first meal of the day in the double-blind treatment period for up to 52 weeks. Background therapy with insulin glargine (with or without OADs) continued throughout the study.
Drug: Sotagliflozin · Drug: Insulin glargine (HOE901) · Drug: Placebo · Drug: Oral Antidiabetes Drugs (OADs)
Following a 4-week run-in period, participants were randomized to sotagliflozin 400 mg administered as 2 tablets, once daily, before the first meal of the day in the double-blind treatment period for up to 52 weeks. Background therapy with insulin glargine (with or without OADs) continued throughout the study.
Drug: Sotagliflozin · Drug: Insulin glargine (HOE901) · Drug: Oral Antidiabetes Drugs (OADs)
Pharmaceutical form: Tablet Route of administration: Oral
Also known as: SAR439954
Pharmaceutical form: Solution Route of administration: Subcutaneous
Also known as: Lantus
Pharmaceutical form: Tablet Route of administration: Oral
OADs (including metformin) as prescribed by the investigator as per local labeling.
Change From Baseline in Hemoglobin A1c (HbA1c) at Week 18
An analysis of covariance (ANCOVA) model was used for the analysis.
Time frame: Baseline and Week 18
Change From Baseline in Fasting Plasma Glucose (FPG) at Week 18
FPG was performed in fasting state, that is, without any food intake (except for water) for at least 8 hours. An ANCOVA model was used for the analysis.
Time frame: Baseline and Week 18
Change From Baseline in Body Weight at Week 18
An ANCOVA model was used for the analysis.
Time frame: Baseline and Week 18
Change From Baseline in Systolic Blood Pressure (SBP) for Participants With Baseline SBP ≥130 mmHg at Week 12
An ANCOVA model was used for the analysis. Here, N is the number of participants with data available at a given time point.
Time frame: Baseline and Week 12
Change From Baseline in SBP at Week 12 for All Participants
An ANCOVA model was used for the analysis.
Time frame: Baseline to Week 12
Change From Baseline in HbA1c at Week 52
An ANCOVA model was used for the analysis.
Time frame: Baseline and Week 52
Change From Baseline in Body Weight at Week 52
An ANCOVA model was used for the analysis.
Time frame: Baseline and Week 52
Percentage of Participants With Adverse Events (AEs)
An AE is any untoward medical occurrence in a participants or clinical investigation participants administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.
Time frame: First dose of study drug to last dose of study drug (up to 55.7 weeks) + 2 weeks
Percentage of Participants With Hypoglycemic Events
Percentage of participants with hypoglycemic events are reported for the following 3 categories: Any hypoglycemia (as reported in the Electronic Case Report Form); Documented symptomatic hypoglycemia \[typical symptoms of hypoglycemia (increased sweating, nervousness, asthenia/weakness, tremor, dizziness, increased appetite, palpitations, headache, sleep disorder, confusion, seizures, unconsciousness, and/or coma) and plasma glucose ≤ 70 mg/dL (3.9 mmol/L)\]; Severe \[an event requiring assistance of another person to actively administer carbohydrate, glucagon, intravenous glucose or other resuscitative actions\] or documented symptomatic hypoglycemia \[typical symptoms of hypoglycemia and plasma glucose ≤ 70 mg/dL\].
Time frame: Up to 55.7 weeks
Participants took part in the study at 101 investigative sites in the United States, Bulgaria, Canada, Czech Republic, France, Hungary, Slovakia, the United Kingdom from 15 September 2017 to 27 September 2019.
| Milestone | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Started | 144 | 141 | 286 |
| Treated | 144 | 141 | 285 |
| Completed | 129 | 130 | 249 |
| Not completed | 15 | 11 | 37 |
| Withdrew: At the participant's own request | 10 | 5 | 21 |
| Withdrew: Adverse event | 2 | 2 | 6 |
| Withdrew: Poor compliance to protocol | 0 | 0 | 1 |
| Withdrew: Lost to follow-up | 0 | 0 | 1 |
| Withdrew: Reason not specified | 3 | 4 | 8 |
An analysis of covariance (ANCOVA) model was used for the analysis.
| percentage of HbA1c | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in Hemoglobin A1c (HbA1c) at Week 18 | -0.27 ± 0.073 | -0.72 ± 0.073 | -0.81 ± 0.056 |
FPG was performed in fasting state, that is, without any food intake (except for water) for at least 8 hours. An ANCOVA model was used for the analysis.
| milligram per deciliter (mg/dL) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in Fasting Plasma Glucose (FPG) at Week 18 | 12.882 ± 3.6045 | -2.975 ± 3.6083 | -8.949 ± 2.7550 |
An ANCOVA model was used for the analysis.
| kilogram (kg) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in Body Weight at Week 18 | 0.36 ± 0.249 | -0.73 ± 0.250 | -1.37 ± 0.190 |
An ANCOVA model was used for the analysis. Here, N is the number of participants with data available at a given time point.
| mmHg | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in Systolic Blood Pressure (SBP) for Participants With Baseline SBP ≥130 mmHg at Week 12 | -4.67 ± 1.470 | -8.58 ± 1.447 | -8.50 ± 1.103 |
An ANCOVA model was used for the analysis.
| mmHg | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in SBP at Week 12 for All Participants | -0.21 ± 1.120 | -5.15 ± 1.117 | -4.10 ± 0.867 |
An ANCOVA model was used for the analysis.
| percentage of HbA1c | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in HbA1c at Week 52 | 0.00 ± 0.279 | -0.52 ± 0.152 | -0.57 ± 0.114 |
An ANCOVA model was used for the analysis.
| kg | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Change From Baseline in Body Weight at Week 52 | -0.18 ± 0.579 | -1.19 ± 0.620 | -0.83 ± 0.374 |
An AE is any untoward medical occurrence in a participants or clinical investigation participants administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.
| percentage of participants | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Percentage of Participants With Adverse Events (AEs) | 64.6 | 54.6 | 59.3 |
Percentage of participants with hypoglycemic events are reported for the following 3 categories: Any hypoglycemia (as reported in the Electronic Case Report Form); Documented symptomatic hypoglycemia \[typical symptoms of hypoglycemia (increased sweating, nervousness, asthenia/weakness, tremor, dizziness, increased appetite, palpitations, headache, sleep disorder, confusion, seizures, unconsciousness, and/or coma) and plasma glucose ≤ 70 mg/dL (3.9 mmol/L)\]; Severe \[an event requiring assistance of another person to actively administer carbohydrate, glucagon, intravenous glucose or other resuscitative actions\] or documented symptomatic hypoglycemia \[typical symptoms of hypoglycemia and plasma glucose ≤ 70 mg/dL\].
| percentage of participants | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Any hypoglycemia | 62.5 | 56.0 | 62.8 |
| Documented symptomatic hypoglycemia | 44.4 | 41.8 | 46 |
| Severe or documented symptomatic hypoglycemia | 44.4 | 41.8 | 46 |
Collected over Deaths: Up to approximately 60 weeks; Adverse Events: First dose of study drug to last dose of study drug (up to 55.7 weeks) + 2 weeks. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo | 2/144 (1.4%) | 16/144 (11.1%) | 30/144 (20.8%) |
| Sotagliflozin 200 mg | 1/141 (0.7%) | 19/141 (13.5%) | 18/141 (12.8%) |
| Sotagliflozin 400 mg | 6/285 (2.1%) | 28/285 (9.8%) | 45/285 (15.8%) |
| Event | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| Atrial fibrillationCardiac disorders | 3/144 | 0/141 | 0/285 |
| Back painMusculoskeletal and connective tissue disorders | 0/144 | 2/141 | 0/285 |
| Acute myocardial infarctionCardiac disorders | 2/144 | 0/141 | 2/285 |
| Peripheral arterial occlusive diseaseVascular disorders | 0/144 | 1/141 | 0/285 |
| Adenocarcinoma pancreasNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/144 | 1/141 | 0/285 |
| Basal cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/144 | 1/141 | 0/285 |
| Squamous cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/144 | 1/141 | 0/285 |
| Postoperative thrombosisInjury, poisoning and procedural complications | 0/144 | 1/141 | 0/285 |
| Angina unstableCardiac disorders | 1/144 | 1/141 | 0/285 |
| Atrial flutterCardiac disorders | 0/144 | 1/141 | 0/285 |
| Event | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg |
|---|---|---|---|
| NasopharyngitisInfections and infestations | 7/144 | 9/141 | 14/285 |
| Vitamin D deficiencyMetabolism and nutrition disorders | 9/144 | 4/141 | 10/285 |
| Upper respiratory tract infectionInfections and infestations | 8/144 | 1/141 | 14/285 |
| Urinary tract infectionInfections and infestations | 8/144 | 6/141 | 11/285 |
Intent-to-treat (ITT) population included all randomized participants irrespective of compliance with the study protocol and procedures.
| Age, Continuous(years) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| Mean | 62.2 ± 8.9 | 62.1 ± 10.2 | 62.7 ± 9.1 | 62.4 ± 9.4 |
| Sex: Female, Male(Participants) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| Female | 58 | 65 | 132 | 255 |
| Male | 86 | 76 | 154 | 316 |
| Ethnicity (NIH/OMB)(Participants) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| Hispanic or Latino | 12 | 25 | 42 | 79 |
| Not Hispanic or Latino | 129 | 113 | 239 | 481 |
| Unknown or Not Reported | 3 | 3 | 5 | 11 |
| Race (NIH/OMB)(Participants) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 2 | 1 | 2 | 5 |
| Asian | 9 | 1 | 6 | 16 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 3 | 3 |
| Black or African American | 10 | 10 | 27 | 47 |
| White | 117 | 124 | 234 | 475 |
| More than one race | 1 | 0 | 1 | 2 |
| Unknown or Not Reported | 5 | 5 | 13 | 23 |
| Region of Enrollment(participants) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| Bulgaria | 9 | 13 | 35 | 57 |
| Canada | 7 | 6 | 16 | 29 |
| Czechia | 14 | 11 | 24 | 49 |
| France | 8 | 8 | 14 | 30 |
| Hungary | 12 | 13 | 21 | 46 |
| Slovakia | 24 | 21 | 32 | 77 |
| United Kingdom | 0 | 0 | 4 | 4 |
| United States | 70 | 69 | 140 | 279 |
| Hemoglobin A1c (HbA1c)(percentage of HbA1c) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| Mean | 8.76 ± 0.79 | 8.76 ± 0.83 | 8.69 ± 0.80 | 8.72 ± 0.80 |
| Systolic Blood Pressure (SBP)(millimeter of Mercury (mmHg)) | Placebo | Sotagliflozin 200 mg | Sotagliflozin 400 mg | Total |
|---|---|---|---|---|
| Mean | 137.59 ± 14.12 | 136.40 ± 15.54 | 135.84 ± 14.95 | 136.42 ± 14.89 |
Showing the first 100 of 106 sites across 8 countries.
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Lexicon Pharmaceuticals