Long-term Safety Study of Alogliptin Used in Combination With α-glucosidase Inhibitor in Participants With Type 2 Diabetes in Japan

A Long-term, Open-label Extension Study to Investigate the Long-term Safety of SYR-322 When Used in Combination With α-glucosidase Inhibitor in Subjects With Type 2 Diabetes in Japan

The purpose of this study was to evaluate the long-term safety and efficacy of alogliptin and an α-glucosidase inhibitor administered once daily (QD) or three times daily (TID) for 40 consecutive weeks in participants who completed a phase 2/3 α-glucosidase inhibitor add on study.

Study Overview

• Status: Completed
• Conditions: Type 2 Diabetes Mellitus
• Intervention / Treatment: Drug: Alogliptin and voglibose; Drug: Alogliptin and voglibose

Detailed Description

Both insulin hyposecretion and insulin-resistance are considered to be involved in the development of type 2 diabetes mellitus.

Takeda is developing SYR-322 (alogliptin) for the improvement of glycemic control in patients with type 2 diabetes mellitus. Alogliptin is an inhibitor of the dipeptidyl peptidase IV (DPP-IV) enzyme. DPP-IV is thought to be primarily responsible for the degradation of 2 peptide hormones released in response to nutrient ingestion. It is expected that inhibition of DPP-IV will improve glycemic control in patients with type 2 diabetes.

"To evaluate the long-term safety and efficacy of alogliptin and an α-glucosidase inhibitor, this extension study was administered for 40 consecutive weeks (52 weeks from the start of treatment in the phase 2 dose-ranging study) to participants who completed a phase 2/3 α-glucosidase inhibitor add on study 322/CCT-003 (NCT01263483).

• Study Type: Interventional
• Enrollment (Actual): 179
• Phase: Phase 2; Phase 3

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 33 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Had completed the phase 2 dose-ranging study (i.e., the subject had completed the study visit at Week 12).

Exclusion Criteria:

• Had clinical manifestations of hepatic impairment (e.g., an aspartate aminotransferase or alanine aminotransferase value 2.5 times or more of the upper reference limit at Week 8 of treatment in the phase 2 dose-ranging study).
• Had clinical manifestations of renal impairment (e.g., a creatinine value of 2 mg/dL or more at Week 8 of treatment in the phase 2 dose-ranging study).

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

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Alogliptin 12.5 mg QD and Voglibose 0.2 mg TID	Drug: Alogliptin and voglibose; Alogliptin 12.5 mg, tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 40 weeks.; Other Names: SYR-322; Voglibose; BASEN®; Drug: Alogliptin and voglibose; Alogliptin 25 mg, tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 40 weeks.; Other Names: SYR-322; Voglibose; BASEN®
Experimental: Alogliptin 25 mg QD and Voglibose 0.2 mg TID	Drug: Alogliptin and voglibose; Alogliptin 12.5 mg, tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 40 weeks.; Other Names: SYR-322; Voglibose; BASEN®; Drug: Alogliptin and voglibose; Alogliptin 25 mg, tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 40 weeks.; Other Names: SYR-322; Voglibose; BASEN®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With Adverse Events.	A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug and within 30 days after receiving the last dose of study drug. A TEAE may also be a pre-treatment adverse event or a concurrent medical condition diagnosed prior to the date of first dose of study drug, which increases in intensity after the start of dosing. Adverse events data with onset occurring more than 30 days after last dose of study drug (AE start date - last dose date >30) will be listed, but not included in the summary tables below.	52 Weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Glycosylated Hemoglobin (Week 8).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 8 and glycosylated hemoglobin collected at baseline.	Baseline and Week 8.
Change From Baseline in Glycosylated Hemoglobin (Week 12).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 12 and glycosylated hemoglobin collected at baseline.	Baseline and Week 12.
Change From Baseline in Glycosylated Hemoglobin (Week 16).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 16 and glycosylated hemoglobin collected at baseline.	Baseline and Week 16.
Change From Baseline in Glycosylated Hemoglobin (Week 20).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 20 and glycosylated hemoglobin collected at baseline.	Baseline and Week 20.
Change From Baseline in Glycosylated Hemoglobin (Week 24).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 24 and glycosylated hemoglobin collected at baseline.	Baseline and Week 24.
Change From Baseline in Glycosylated Hemoglobin (Week 28).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 28 and glycosylated hemoglobin collected at baseline.	Baseline and Week 28.
Change From Baseline in Glycosylated Hemoglobin (Week 32).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 32 and glycosylated hemoglobin collected at baseline.	Baseline and Week 32.
Change From Baseline in Glycosylated Hemoglobin (Week 36).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 36 and glycosylated hemoglobin collected at baseline.	Baseline and Week 36.
Change From Baseline in Glycosylated Hemoglobin (Week 40).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 40 and glycosylated hemoglobin collected at baseline.	Baseline and Week 40.
Change From Baseline in Glycosylated Hemoglobin (Week 44).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 44 and glycosylated hemoglobin collected at baseline.	Baseline and Week 44.
Change From Baseline in Glycosylated Hemoglobin (Week 48).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 48 and glycosylated hemoglobin collected at baseline.	Baseline and Week 48.
Change From Baseline in Glycosylated Hemoglobin (Week 52).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 52 and glycosylated hemoglobin collected at baseline.	Baseline and Week 52.
Change From Baseline in Glycosylated Hemoglobin (Final Visit).	The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 52 or final visit and glycosylated hemoglobin collected at baseline.	Baseline and Final Visit (up to Week 52).
Change From Baseline in Fasting Plasma Glucose (Week 8).	The change between the value of fasting plasma glucose collected at week 8 and fasting plasma glucose collected at baseline.	Baseline and Week 8.
Change From Baseline in Fasting Plasma Glucose (Week 12).	The change between the value of fasting plasma glucose collected at week 12 and fasting plasma glucose collected at baseline.	Baseline and Week 12.
Change From Baseline in Fasting Plasma Glucose (Week 16).	The change between the value of fasting plasma glucose collected at week 16 and fasting plasma glucose collected at baseline.	Baseline and Week 16.
Change From Baseline in Fasting Plasma Glucose (Week 20).	The change between the value of fasting plasma glucose collected at week 20 and fasting plasma glucose collected at baseline.	Baseline and Week 20.
Change From Baseline in Fasting Plasma Glucose (Week 24).	The change between the value of fasting plasma glucose collected at week 24 and fasting plasma glucose collected at baseline.	Baseline and Week 24.
Change From Baseline in Fasting Plasma Glucose (Week 28).	The change between the value of fasting plasma glucose collected at week 28 and fasting plasma glucose collected at baseline.	Baseline and Week 28.
Change From Baseline in Fasting Plasma Glucose (Week 32).	The change between the value of fasting plasma glucose collected at week 32 and fasting plasma glucose collected at baseline.	Baseline and Week 32.
Change From Baseline in Fasting Plasma Glucose (Week 36).	The change between the value of fasting plasma glucose collected at week 36 and fasting plasma glucose collected at baseline.	Baseline and Week 36.
Change From Baseline in Fasting Plasma Glucose (Week 40).	The change between the value of fasting plasma glucose collected at week 40 and fasting plasma glucose collected at baseline.	Baseline and Week 40.
Change From Baseline in Fasting Plasma Glucose (Week 44).	The change between the value of fasting plasma glucose collected at week 44 and fasting plasma glucose collected at baseline.	Baseline and Week 44.
Change From Baseline in Fasting Plasma Glucose (Week 48).	The change between the value of fasting plasma glucose collected at week 48 and fasting plasma glucose collected at baseline.	Baseline and Week 48.
Change From Baseline in Fasting Plasma Glucose (Week 52).	The change between the value of fasting plasma glucose collected at week 52 and fasting plasma glucose collected at baseline.	Baseline and Week 52.
Change From Baseline in Fasting Plasma Glucose (Final Visit).	The change between the value of fasting plasma glucose collected at week 52 or final visit and fasting plasma glucose collected at baseline.	Baseline and Final Visit (up to Week 52).
Change From Baseline in Fasting C-peptide (Week 8).	The change between the value of fasting C-peptide collected at week 8 and fasting C-peptide collected at baseline.	Baseline and Week 8.
Change From Baseline in Fasting C-peptide (Week 12).	The change between the value of fasting C-peptide collected at week 12 and fasting C-peptide collected at baseline.	Baseline and Week 12.
Change From Baseline in Fasting C-peptide (Week 16).	The change between the value of fasting C-peptide collected at week 16 and fasting C-peptide collected at baseline.	Baseline and Week 16.
Change From Baseline in Fasting C-peptide (Week 20).	The change between the value of fasting C-peptide collected at week 20 and fasting C-peptide collected at baseline.	Baseline and Week 20.
Change From Baseline in Fasting C-peptide (Week 24).	The change between the value of fasting C-peptide collected at week 24 and fasting C-peptide collected at baseline.	Baseline and Week 24.
Change From Baseline in Fasting C-peptide (Week 28).	The change between the value of fasting C-peptide collected at week 28 and fasting C-peptide collected at baseline.	Baseline and Week 28.
Change From Baseline in Fasting C-peptide (Week 32).	The change between the value of fasting C-peptide collected at week 32 and fasting C-peptide collected at baseline.	Baseline and Week 32.
Change From Baseline in Fasting C-peptide (Week 36).	The change between the value of fasting C-peptide collected at week 36 and fasting C-peptide collected at baseline.	Baseline and Week 36.
Change From Baseline in Fasting C-peptide (Week 40).	The change between the value of fasting C-peptide collected at week 40 and fasting C-peptide collected at baseline.	Baseline and Week 40.
Change From Baseline in Fasting C-peptide (Week 44).	The change between the value of fasting C-peptide collected at week 44 and fasting C-peptide collected at baseline.	Baseline and Week 44.
Change From Baseline in Fasting C-peptide (Week 48).	The change between the value of fasting C-peptide collected at week 48 and fasting C-peptide collected at baseline.	Baseline and Week 48.
Change From Baseline in Fasting C-peptide (Week 52).	The change between the value of fasting C-peptide collected at week 52 and fasting C-peptide collected at baseline.	Baseline and Week 52.
Change From Baseline in Fasting C-peptide (Final Visit).	The change between the value of fasting C-peptide collected at week 52 or final visit and fasting C-peptide collected at baseline.	Baseline and Final Visit (up to Week 52).
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (2-hr Postprandial Value) (Week 12).	The change between the value of blood glucose collected at week 12 and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 12.
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (2-hr Postprandial Value) (Week 24).	The change between the value of blood glucose collected at week 24 and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 24.
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (2-hr Postprandial Value) (Week 52).	The change between the value of blood glucose collected at week 52 and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 52.
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (2-hr Postprandial Value) (Final Visit).	The change between the value of blood glucose collected at week 52 or final visit and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Final Visit (up to Week 52).
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (AUC (0-2)) (Week 12).	The change between the value of blood glucose collected at week 12 and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 12.
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (AUC (0-2)) (Week 24).	The change between the value of blood glucose collected at week 24 and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 24.
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (AUC (0-2)) (Week 52).	The change between the value of blood glucose collected at week 52 and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 52.
Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (AUC (0-2)) (Final Visit).	The change between the value of blood glucose collected at week 52 or final visit and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Final Visit (up to Week 52).
Change From Baseline in Insulin Measured by Meal Tolerance Testing (AUC(0-2)) (Week 12).	The change between the value of insulin collected at week 12 and insulin collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 12.
Change From Baseline in Insulin Measured by Meal Tolerance Testing (AUC(0-2)) (Week 24).	The change between the value of insulin collected at week 24 and insulin collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 24.
Change From Baseline in Insulin Measured by Meal Tolerance Testing (AUC(0-2)) (Week 52).	The change between the value of insulin collected at week 52 and insulin collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 52.
Change From Baseline in Insulin Measured by Meal Tolerance Testing (AUC(0-2)) (Final Visit).	The change between the value of insulin collected at week 52 or final visit and insulin collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Final Visit (up to Week 52).
Change From Baseline in C-peptide Measured by Meal Tolerance Testing (AUC(0-2)) (Week 12).	The change between the value of C-peptide collected at week 12 and C-peptide collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 12.
Change From Baseline in C-peptide Measured by Meal Tolerance Testing (AUC(0-2)) (Week 24).	The change between the value of C-peptide collected at week 24 and C-peptide collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 24.
Change From Baseline in C-peptide Measured by Meal Tolerance Testing (AUC(0-2)) (Week 52).	The change between the value of C-peptide collected at week 52 and C-peptide collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 52.
Change From Baseline in C-peptide Measured by Meal Tolerance Testing (AUC(0-2)) (Final Visit).	The change between the value of C-peptide collected at week 52 or final visit and C-peptide collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Final Visit (up to Week 52).
Change From Baseline in Glucagon Measured by Meal Tolerance Testing (AUC (0-2)) (Week 12).	The change between the value of glucagons collected at week 12 and glucagons collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 12.
Change From Baseline in Glucagon Measured by Meal Tolerance Testing (AUC (0-2)) (Week 24).	The change between the value of glucagons collected at week 24 and glucagons collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 24.
Change From Baseline in Glucagon Measured by Meal Tolerance Testing (AUC (0-2)) (Week 52).	The change between the value of glucagons collected at week 52 and glucagons collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Week 52.
Change From Baseline in Glucagon Measured by Meal Tolerance Testing (AUC (0-2)) (Final Visit).	The change between the value of glucagons collected at week 52 or final visit and glucagons collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and 2 hours after the start of the meal.	Baseline and Final Visit (up to Week 52).

Collaborators and Investigators

• Sponsor: Takeda
• Investigators: Study Director: Professor, Department of Medicine, Kawasaki Medical School

Publications and helpful links

General Publications

• Seino Y, Fujita T, Hiroi S, Hirayama M, Kaku K. Alogliptin plus voglibose in Japanese patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial with an open-label, long-term extension. Curr Med Res Opin. 2011 Nov;27 Suppl 3:21-9. doi: 10.1185/03007995.2011.614936.

Study record dates

Study Major Dates

• Study Start: June 1, 2007
• Primary Completion (Actual): October 1, 2008
• Study Completion (Actual): October 1, 2008

Study Registration Dates

• First Submitted: December 17, 2010
• First Submitted That Met QC Criteria: December 17, 2010
• First Posted (Estimate): December 20, 2010

Study Record Updates

• Last Update Posted (Estimate): February 3, 2012
• Last Update Submitted That Met QC Criteria: February 1, 2012
• Last Verified: February 1, 2012

More Information

Terms related to this study

• Keywords: Drug Therapy; Diabetes Mellitus; Diabetes Mellitus - Type 2
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 2; Hypoglycemic Agents; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Protease Inhibitors; Micronutrients; Vitamins; Incretins; Vitamin B Complex; Dipeptidyl-Peptidase IV Inhibitors; Glycoside Hydrolase Inhibitors; Inositol; Alogliptin; Voglibose
• Other Study ID Numbers: SYR-322/OCT-003; U1111-1118-3992 (Registry Identifier: WHO)