Exenatide Versus Glimepiride in Patients With Type 2 Diabetes
Long Term Treatment With Exenatide Versus Glimepiride in Patients With Type 2 Diabetes Pretreated With Metformin (EUREXA: European Exenatide Study)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Graz, Austria
- Research Site
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Innsbruck, Austria
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Salzburg, Austria
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Vienna, Austria
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Beroun, Czech Republic
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Ceske Budejovice, Czech Republic
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Hradec Kralove, Czech Republic
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Liberec, Czech Republic
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Pisek, Czech Republic
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Praha, Czech Republic
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Trebic, Czech Republic
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Helsinki, Finland
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Kuopio, Finland
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Pori, Finland
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Vaasa, Finland
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Alencon, France
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Bois-Guillaume, France
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Bourg des Comptes, France
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Broglie, France
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Bron, France
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Fleville Devant Nancy, France
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Le Creusot, France
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Le Mans, France
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Loudun, France
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Montigny les Metz, France
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Nevers, France
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Strasbourg, France
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Thouars, France
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Tours, France
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Valreas, France
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Vihiers, France
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Vénissieux, France
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Aschaffenburg, Germany
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Dresden, Germany
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Eisenach, Germany
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Essen, Germany
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Essen Schonnebeck, Germany
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Falkensee, Germany
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Fulda, Germany
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Hamburg, Germany
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Hamburg-Altona, Germany
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Hamburg-Ottmarschen, Germany
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Heidelberg, Germany
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Leipzig, Germany
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Munster, Germany
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Saarbrucken, Germany
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Schenklengsfeld, Germany
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Schkeuditz, Germany
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St. Ingbert, Germany
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Staffelstein, Germany
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Witten, Germany
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Budapest, Hungary
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Gyula, Hungary
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Kecskemet, Hungary
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Veszprem, Hungary
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Zalaegerszeg, Hungary
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County Galway, Ireland
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County Waterford, Ireland
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Dublin, Ireland
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Haifa, Israel
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Holon, Israel
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Jerusalem, Israel
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Tel Hashomer, Israel
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Ancona, Italy
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Arenzano, Italy
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Atri, Italy
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Bergamo, Italy
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Catanzaro, Italy
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Firenze, Italy
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Foggia, Italy
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Forli, Italy
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Genova, Italy
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Grosseto, Italy
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Milano, Italy
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Monserrato (Cagliari), Italy
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Napoli, Italy
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Palermo, Italy
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Perugia, Italy
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Pescara, Italy
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Pisa, Italy
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Ravenna, Italy
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Roma, Italy
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San Benedetto del Tronto, Italy
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Siena, Italy
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Treviso, Italy
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Verona, Italy
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Distrito Federal
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Mexico City, Distrito Federal, Mexico
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Guanajuato
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Celaya, Guanajuato, Mexico
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Hidalgo
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Pachuca, Hidalgo, Mexico
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Nuevo Leon
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Monterrey, Nuevo Leon, Mexico
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Bialystok, Poland
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Bydgoszcz, Poland
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Lublin, Poland
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Szczecin, Poland
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Warszawa, Poland
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Wroclaw, Poland
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Barcelona, Spain
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Madrid, Spain
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Fribourg, Switzerland
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Geneva, Switzerland
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Geneve, Switzerland
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Lausanne, Switzerland
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Luzern, Switzerland
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Bath, United Kingdom
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Belfast, United Kingdom
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Brandford on Avon, United Kingdom
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County Antrim, United Kingdom
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Downpatrick, United Kingdom
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Frome, United Kingdom
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Midsomer Norton, United Kingdom
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Omagh, United Kingdom
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Penzance, United Kingdom
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Plymouth, United Kingdom
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Southdown, United Kingdom
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Wiltshire, United Kingdom
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosed with type 2 diabetes mellitus.
- Treated with diet and exercise and a stable, maximally tolerated dose of metformin for at least 3 months prior to screening.
- HbA1c >=6.5% and <=9.0%.
- Body Mass Index (BMI) >=25 kg/m^2 and <40 kg/m^2.
Exclusion Criteria:
- Participated in an interventional medical, surgical, or pharmaceutical study within 30 days prior to screening.
- Characteristics contraindicating metformin or glimepiride use.
- Receiving drugs that directly affect gastrointestinal motility.
- Receiving chronic (lasting longer than 2 weeks) systemic glucocorticoid therapy.
- Have used any prescription drug to promote weight loss within 3 months prior to screening.
- Treated for longer than 2 weeks with any of the following medications within 3 months prior to screening: *insulin; *thiazolidinediones; *alpha-glucosidase inhibitors; *sulfonylurea; *meglitinides
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Exenatide
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subcutaneous injection (5mcg or 10mcg), twice a day
Other Names:
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Active Comparator: Glimepiride
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oral tablet (titrated to maximally tolerated dose), once daily
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of Patients With Treatment Failure
Time Frame: Baseline to end of Period II (up to 4.5 years)
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Treatment failure is defined as one of the following:1.
HbA1c exceeding 9% at any visit after the initial 3 months of treatment (i.e., earliest at Month 6), on the maximally tolerated dose of antidiabetic agents.
2. HbA1c exceeding 7% at 2 consecutive visits 3 months apart, after the initial 6 months of treatment (i.e., earliest at Month 9), on the maximally tolerated dose of antidiabetic agents.
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Baseline to end of Period II (up to 4.5 years)
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Time to Treatment Failure
Time Frame: Baseline to end of Period II (up to 4.5 years)
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Treatment failure is defined as one of the following:1.
HbA1c exceeding 9% at any visit after the initial 3 months of treatment (i.e., earliest at Month 6), on the maximally tolerated dose of antidiabetic agents.
2. HbA1c exceeding 7% at 2 consecutive visits 3 months apart, after the initial 6 months of treatment (i.e., earliest at Month 9), on the maximally tolerated dose of antidiabetic agents.
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Baseline to end of Period II (up to 4.5 years)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Homeostasis Model Assessment of Beta-cell Function (HOMA-B) at Year 3
Time Frame: Year 3 in Period II
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HOMA-B at Year 3. HOMA-B is an index of beta-cell function and was calculated as: HOMA-B = (20 x fasting insulin (measured in pmol/L))/((fasting glucose (measured in mmol/L) - 3.5) x 7.175).
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Year 3 in Period II
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Change in HOMA-B From Baseline to Endpoint
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change in HOMA-B from baseline to endpoint.
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Baseline, end of Period II (up to 4.5 years)
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Fasting Proinsulin/Insulin Ratio at Year 3
Time Frame: Year 3 in Period II
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Fasting proinsulin (measured in pmol/L)/insulin (measured in pmol/L) ratio at Year 3.
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Year 3 in Period II
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Change in Fasting Proinsulin/Insulin Ratio From Baseline to Endpoint.
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change in fasting proinsulin (measured in pmol/L)/insulin (measured in pmol/L) ratio from baseline to endpoint.
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Baseline, end of Period II (up to 4.5 years)
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Ratio of the 30 Minute Increment in Plasma Insulin Concentration and the 30 Minute Increment in Plasma Glucose During the Oral Glucose Tolerance Test (DI30/DG30 Ratio) at Year 3
Time Frame: Year 3 in Period II
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DI30/DG30 at Year 3. DI30/DG30 ratio was calculated as (30 minute post prandial insulin - fasting insulin) (measured in pmol/L)/(30 minute post prandial glucose - fasting glucose) (measured in mmol/L).
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Year 3 in Period II
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Change in DI30/DG30 Ratio From Baseline to Endpoint
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change in DI30/DG30 ratio from baseline to endpoint.
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Baseline, end of Period II (up to 4.5 years)
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Disposition Index at Year 3
Time Frame: Year 3 in Period II
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Disposition Index at Year 3. Disposition index was calculated as (DI30/DG30 ratio)/(HOMA index for insulin resistance (HOMA-IR)); where HOMA-IR=(fasting insulin (measured in pmol/L) x fasting glucose (measured in mmol/L))/(22.5
x 7.175).
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Year 3 in Period II
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Change in Disposition Index From Baseline to Endpoint
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change in disposition index from baseline to endpoint.
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Baseline, end of Period II (up to 4.5 years)
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Change in HbA1c From Baseline to Year 3
Time Frame: Baseline, Year 3 in Period II
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Change in HbA1c from baseline to Year 3.
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Baseline, Year 3 in Period II
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Change in HbA1c From Baseline to Endpoint
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change in HbA1c from baseline to endpoint.
Endpoint for HbA1c was defined as the HbA1c measured at the treatment failure for patients reaching primary endpoint and was the last observation in study period II for other patients (either followed until the end of the study period II or discontinuing the study).
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Baseline, end of Period II (up to 4.5 years)
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Fasting Plasma Glucose at Year 3
Time Frame: Year 3 in Period II
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Fasting plasma glucose at Year 3.
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Year 3 in Period II
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Change in Fasting Plasma Glucose From Baseline to Endpoint
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change in fasting plasma glucose from baseline to endpoint.
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Baseline, end of Period II (up to 4.5 years)
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Postprandial (2 Hours) Plasma Glucose at Year 3
Time Frame: Year 3 in Period II
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Postprandial (2 hours) plasma glucose at Year 3.
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Year 3 in Period II
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Change in Postprandial (2 Hours) Plasma Glucose From Baseline to Endpoint
Time Frame: Baseline, end of Period II (up to 4.5 years)
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Change from baseline in postprandial (2 hours) plasma glucose to endpoint.
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Baseline, end of Period II (up to 4.5 years)
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Change in Body Weight From Baseline to Year 3
Time Frame: Baseline, Year 3 in Period II
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Change in Body weight from baseline to Year 3.
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Baseline, Year 3 in Period II
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Systolic Blood Pressure at Year 3
Time Frame: Year 3 in Period II
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Systolic Blood pressure at Year 3.
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Year 3 in Period II
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Diastolic Blood Pressure at Year 3
Time Frame: Year 3 in Period II
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Diastolic Blood pressure at Year 3.
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Year 3 in Period II
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Heart Rate at Year 3
Time Frame: Year 3 in Period II
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Heart rate at Year 3.
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Year 3 in Period II
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Triglycerides at Year 3
Time Frame: Year 3 in Period II
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Triglycerides at Year 3.
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Year 3 in Period II
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Total Cholesterol at Year 3
Time Frame: Year 3 in Period II
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Total Cholesterol at Year 3.
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Year 3 in Period II
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High-density Lipoprotein (HDL) Cholesterol at Year 3
Time Frame: Year 3 in Period II
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HDL Cholesterol at Year 3.
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Year 3 in Period II
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Hypoglycemia Rate Per Year
Time Frame: Baseline to end of Period II (up to 4.5 years)
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All hypoglycemia episodes were taken into account.
Severe hypoglycemia: event requiring assistance of another person to administer carbohydrate, glucagons, or other resuscitative actions; Documented symptomatic hypoglycemia: event with typical symptoms accompanied by a measured plasma glucose concentration <=70 mg/dL; Asymptomatic hypoglycemia: event not accompanied by typical symptoms but with a measured plasma glucose concentration <=70 mg/dL; Probable symptomatic hypoglycemia: event with symptoms not accompanied by a plasma glucose determination.
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Baseline to end of Period II (up to 4.5 years)
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Change in HbA1c From Baseline to Year 2 for Patients Randomized at Entry in Period III
Time Frame: Baseline in Period III, Year 2 in Period III
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Change in HbA1c from baseline to Year 2.
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Baseline in Period III, Year 2 in Period III
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Change in HbA1c From Baseline to Year 2 for Patients Not Randomized at Entry in Period III
Time Frame: Baseline in Period III, Year 2 in Period III
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Change in HbA1c from baseline to Year 2.
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Baseline in Period III, Year 2 in Period III
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Hypoglycemia Rate Per Year in Period III
Time Frame: Start of Period III to end of study
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All hypoglycemia episodes were taken into account.
Severe hypoglycemia: event requiring assistance of another person to administer carbohydrate, glucagons, or other resuscitative actions; Documented symptomatic hypoglycemia: event with typical symptoms accompanied by a measured plasma glucose concentration <=70 mg/dL; Asymptomatic hypoglycemia: event not accompanied by typical symptoms but with a measured plasma glucose concentration <=70 mg/dL; Probable symptomatic hypoglycemia: event with symptoms not accompanied by a plasma glucose determination.
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Start of Period III to end of study
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: James Malone, MD, Eli Lilly and Company
Publications and helpful links
General Publications
- Simo R, Guerci B, Schernthaner G, Gallwitz B, Rosas-Guzman J, Dotta F, Festa A, Zhou M, Kiljanski J. Long-term changes in cardiovascular risk markers during administration of exenatide twice daily or glimepiride: results from the European exenatide study. Cardiovasc Diabetol. 2015 Sep 4;14:116. doi: 10.1186/s12933-015-0279-z.
- Schernthaner G, Rosas-Guzman J, Dotta F, Guerci B, Simo R, Festa A, Kiljanski J, Zhou M, Gallwitz B. Treatment escalation options for patients with type 2 diabetes after failure of exenatide twice daily or glimepiride added to metformin: results from the prospective European Exenatide (EUREXA) study. Diabetes Obes Metab. 2015 Jul;17(7):689-98. doi: 10.1111/dom.12471. Epub 2015 May 8.
- Gallwitz B, Guzman J, Dotta F, Guerci B, Simo R, Basson BR, Festa A, Kiljanski J, Sapin H, Trautmann M, Schernthaner G. Exenatide twice daily versus glimepiride for prevention of glycaemic deterioration in patients with type 2 diabetes with metformin failure (EUREXA): an open-label, randomised controlled trial. Lancet. 2012 Jun 16;379(9833):2270-8. doi: 10.1016/S0140-6736(12)60479-6. Epub 2012 Jun 9.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Glucose Metabolism Disorders
- Metabolic Diseases
- Endocrine System Diseases
- Diabetes Mellitus
- Diabetes Mellitus, Type 2
- Hypoglycemic Agents
- Physiological Effects of Drugs
- Anti-Arrhythmia Agents
- Immunosuppressive Agents
- Immunologic Factors
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Anti-Obesity Agents
- Incretins
- Glimepiride
- Exenatide
Other Study ID Numbers
Other Study ID Numbers
- H8O-EW-GWBE
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