VERIFY:A Study to Compare Combination Regimen With Vildagliptin & Metformin Versus Metformin in Treatment-naïve Patients With Type 2 Diabetes Mellitus

September 1, 2020 updated by: Novartis Pharmaceuticals

A 5-year Study to Compare the Durability of Glycemic Control of a Combination Regimen With Vildagliptin & Metformin Versus Standard-of-care Monotherapy With Metformin, Initiated in Treatment-naïve Patients With Type 2 Diabetes Mellitus

The purpose of this study was to determine whether the initiation of a vildagliptin plus metformin combination regimen would result in more durable glycemic control than metformin monotherapy in treatment-naïve patients with type-2 diabetes mellitus (T2DM).

Study Overview

Detailed Description

This was a multi-center, double-blind, placebo-controlled, 2-arm, parallel group study with a run-in period and up to 5 years treatment period. Following a screening visit (Visit 1) and a screening period of up to 2 weeks, treatment-naïve patients, meeting all eligibility criteria entered the run-in period at Visit 2.

  • Run-in period: At Visit 2, in all eligible patients, metformin treatment was initiated and/or up-titrated. At the end of the 3-week run-in period, patients who were able to tolerate a total dose of at least 1000 mg and up to 2000 mg daily proceeded to randomization and started in Period 1.
  • Period 1 (vildagliptin/metformin combination versus metformin): At Visit 3, patients were randomized 1:1 to one of the following study regimens:

    • Metformin up to 1000 mg bid plus vildagliptin 50mg bid or
    • Metformin up to 1000 mg bid plus matching placebo bid

The duration of Period 1 could differ between patients depending on the time when the second of two HbA1c measurements taken at two consecutive visits after randomisation confirmed HbA1c ≥ 7.0%.

• Period 2 (vildagliptin/metformin combination versus vildagliptin add-on to metformin): In the case of two consecutive HbA1c measurements ≥7.0% from two consecutive study visits during Period 1, patients who were randomised to the placebo arm in Period 1 received vildagliptin 50 mg bid. Patients who were randomised to the active vildagliptin 50 mg bid arm in Period 1 continued to receive vildagliptin 50 mg bid. All patients continued to take their metformin dose unchanged. Period 2 remained masked to the patient and both patients and investigators remained masked to the treatment allocation in Period 1.

If, during Period 2, therapy intensification was required in accordance with the local guidelines, the patient entered Period 3. The duration of Period 2 could differ between patients. End of Period 2 was considered when insulin treatment was initiated, or alternatively when the patient was discontinued because insulin treatment was not initiated in Period 3.

• Period 3 (insulin initiation): In Period 3, patients were to be initiated on open-label insulin. The study drug regimen continued unchanged and remained masked to the patient in Period 3 and both patients and investigators remained masked to the treatment allocation in Period 1.

Study Type

Interventional

Enrollment (Actual)

2004

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Buenos Aires, Argentina, C1120AAC
        • Novartis Investigative Site
      • Cordoba, Argentina, X5000AAW
        • Novartis Investigative Site
      • Corrientes, Argentina, 3400
        • Novartis Investigative Site
    • Buenos Aires
      • Caba, Buenos Aires, Argentina, C1056ABJ
        • Novartis Investigative Site
      • Caba, Buenos Aires, Argentina, C1425AGC
        • Novartis Investigative Site
      • San Isidro, Buenos Aires, Argentina, 1642
        • Novartis Investigative Site
    • Capital Federal
      • Caba, Capital Federal, Argentina, C1179AAB
        • Novartis Investigative Site
    • New South Wales
      • Brookvale, New South Wales, Australia, 2100
        • Novartis Investigative Site
      • Woy Woy, New South Wales, Australia, 2256
        • Novartis Investigative Site
    • Queensland
      • Morayfield, Queensland, Australia, 4506
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      • Wien, Austria, A-1130
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    • CE
      • Fortaleza, CE, Brazil, 60170-320
        • Novartis Investigative Site
      • Fortaleza, CE, Brazil, 60430-350
        • Novartis Investigative Site
    • DF
      • Brasilia, DF, Brazil, 71625-009
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    • GO
      • Goiania, GO, Brazil, 74935-530
        • Novartis Investigative Site
    • PA
      • Belem, PA, Brazil, 66073-000
        • Novartis Investigative Site
    • PR
      • Curitiba, PR, Brazil, 80810-040
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    • RS
      • Porto Alegre, RS, Brazil, 90430 001
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    • SP
      • Mogi das Cruzes, SP, Brazil, 08780-090
        • Novartis Investigative Site
      • Sao Paulo, SP, Brazil, 05403 000
        • Novartis Investigative Site
      • Sao Paulo, SP, Brazil, 04023-900
        • Novartis Investigative Site
      • São Paulo, SP, Brazil, 01224-000
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      • São Paulo, SP, Brazil, 01244-030
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      • Gabrovo, Bulgaria, 5300
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      • Kazanlak, Bulgaria, 6100
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      • Plovdiv, Bulgaria, 4002
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      • Razgrad, Bulgaria
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      • Ruse, Bulgaria, 7200
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      • Smolian, Bulgaria, 4700
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      • Sofia, Bulgaria, 1431
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      • Sofia, Bulgaria, 1606
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      • Sofia, Bulgaria
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      • Baranquilla, Colombia
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      • Bogotá, Colombia
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    • Bolivar
      • Cartagena, Bolivar, Colombia
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    • Cundinamarca
      • Bogota, Cundinamarca, Colombia, 110221
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      • Brandys Nad Labem, Czechia, 250 01
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      • Praha, Czechia, 149 01
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    • Czech Republic
      • Pisek, Czech Republic, Czechia, 397 01
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      • Prague 5, Czech Republic, Czechia, 150 30
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      • Santo Domingo, Dominican Republic
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    • Republica Dominicana
      • Santo Domingo, Republica Dominicana, Dominican Republic
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      • Saku, Estonia, 75501
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      • Tallinn, Estonia, 10117
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      • Tallinn, Estonia, 11315
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      • Tallinn, Estonia, 11911
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      • Tallinn, Estonia, 13415
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      • Kerava, Finland, 04200
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      • Kouvola, Finland, 45100
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      • Tampere, Finland, 33100
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    • Suomi
      • Lahti, Suomi, Finland, 15110
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      • Aschaffenburg, Germany, 63739
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      • Dresden, Germany, 01307
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      • Duesseldorf, Germany, 40225
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      • Essen, Germany, 45276
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      • Essen, Germany, 45329
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      • Esslingen am Neckar, Germany, 73728
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      • Saint Ingbert - Oberwuerzbach, Germany, 66386
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      • Wangen, Germany, 88239
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    • Hainburg
      • Hainstadt, Hainburg, Germany, 63512
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      • Guatemala City, Guatemala, 01010
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      • Guatemala City, Guatemala, 010014
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      • Hong Kong, Hong Kong
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      • HongKong, Hong Kong
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      • Budapest, Hungary, 1042
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      • Budapest, Hungary, 1212
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      • Csongrad, Hungary, 6640
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      • Eger, Hungary, H-3300
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      • Kalocsa, Hungary, 6300
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      • Szeged, Hungary, H 6725
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      • Veszprem, Hungary, H 8200
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    • Zala
      • Zalaegerszeg, Zala, Hungary, 8900
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      • Chandigarh, India, 160 012
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    • Delhi
      • New Delhi, Delhi, India, 110076
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    • Karnataka
      • Bangalore, Karnataka, India, 560003
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      • Bangalore, Karnataka, India, 560034
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      • Bangalore, Karnataka, India, 560043
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    • Kerala
      • Kochi, Kerala, India, 682 041
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    • Madhya Pradesh
      • Indore, Madhya Pradesh, India, 452010
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    • Maharashtra
      • Pune, Maharashtra, India, 411004
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      • Pune, Maharashtra, India, 411011
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    • Rajasthan
      • Jaipur, Rajasthan, India, 302015
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    • Tamil Nadu
      • Chennai, Tamil Nadu, India, 600 086
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    • Tamilnadu
      • Chennai, Tamilnadu, India, 600008
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      • Heifa, Israel
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      • Jerusalem, Israel, 91192
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      • Kfar Saba, Israel, 4428164
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      • Rehovot, Israel, 7610001
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      • Tel Aviv, Israel, 6209804
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      • Tel Giborim, Holon, Israel, 58100
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    • BS
      • Montichiari, BS, Italy, 25018
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    • CB
      • Campobasso, CB, Italy, 86100
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    • GE
      • Arenzano, GE, Italy, 16011
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    • MI
      • Milano, MI, Italy, 20132
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      • Milano, MI, Italy, 20100
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    • PV
      • Casorate Primo, PV, Italy, 27022
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    • RM
      • Roma, RM, Italy, 00161
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      • Roma, RM, Italy, 00133
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      • Daejeon, Korea, Republic of, 301-804
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      • Incheon, Korea, Republic of, 403-720
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      • Seoul, Korea, Republic of, 150-713
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    • Gyeonggi-do
      • Incheon, Gyeonggi-do, Korea, Republic of, 21431
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      • Suwon, Gyeonggi-do, Korea, Republic of, 442-723
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      • Uijeongbu-Si, Gyeonggi-do, Korea, Republic of, 480-717
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    • Korea
      • Seoul, Korea, Korea, Republic of, 03312
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    • Seocho Gu
      • Seoul, Seocho Gu, Korea, Republic of, 06591
        • Novartis Investigative Site
      • Daugavpils, Latvia, LV-5417
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      • Riga, Latvia, LV 1002
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      • Riga, Latvia, 1057
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    • LV
      • Jelgava, LV, Latvia, 3001
        • Novartis Investigative Site
      • Liepaja, LV, Latvia, 3401
        • Novartis Investigative Site
      • Ogre, LV, Latvia, 5001
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      • Riga, LV, Latvia, 1011
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      • Riga, LV, Latvia, 1002
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      • Talsi, LV, Latvia, 3201
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      • Jonava, Lithuania, 55268
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      • Kaunas, Lithuania, 48259
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      • Kaunas, Lithuania, 51270
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      • Vilnius, Lithuania, LT-08661
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    • LT
      • Vilnius, LT, Lithuania
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    • LTU
      • Kaunas, LTU, Lithuania, LT 50161
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      • Kuala Lumpur, Malaysia, 59100
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      • Kuala Lumpur, Malaysia, 56000
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    • Kelantan
      • Kota Bahru, Kelantan, Malaysia, 16150
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      • Aguascalientes, Mexico, 20230
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      • Distrito Federal, Mexico, 14000
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      • Durango, Mexico, 34000
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      • Querétaro, Mexico, 76000
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    • Distrito Federal
      • Ciudad De Mexico, Distrito Federal, Mexico, 11850
        • Novartis Investigative Site
      • Mexico D.F, Distrito Federal, Mexico, 03100
        • Novartis Investigative Site
      • México, Distrito Federal, Mexico, 03800
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    • Morelos
      • Cuautla, Morelos, Mexico, 62746
        • Novartis Investigative Site
      • Cuernavaca, Morelos, Mexico, 62250
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      • Enebakk, Norway, 1912
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      • Fetsund, Norway, 1900
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      • Honefoss, Norway, 3515
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      • Oslo, Norway, 0424
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      • Spikkestad, Norway, 3430
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      • Panama City, Panama
        • Novartis Investigative Site
      • Panama City, Panama, 0834-01862
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      • Arequipa, Peru
        • Novartis Investigative Site
    • La Libertad
      • Trujillo, La Libertad, Peru
        • Novartis Investigative Site
    • Lima
      • Cercado De Lima, Lima, Peru, 01
        • Novartis Investigative Site
      • Chorrillos, Lima, Peru, 09
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      • Magdalena, Lima, Peru, 17
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      • San Isidro, Lima, Peru, 27
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      • San Martin de Porres, Lima, Peru, 31
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      • Marikina City, Philippines, 1800
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      • Pasay City, Philippines, 1300
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      • Pasig City, Philippines, 1600
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      • San Juan City, Philippines, 1500
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    • Metro Manila
      • Marikina, Metro Manila, Philippines, 1810
        • Novartis Investigative Site
      • Quezon City, Metro Manila, Philippines, 1109
        • Novartis Investigative Site
      • Poznan, Poland, 60-821
        • Novartis Investigative Site
      • Poznan, Poland, 61-251
        • Novartis Investigative Site
      • Poznan, Poland, 61-655
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      • Wroclaw, Poland, 50-349
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      • Zabrze, Poland, 41-800
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      • Bucharest, Romania, 020045
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      • Bucharest, Romania, 020475
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      • Bucuresti, Romania
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      • Timisoara, Romania
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    • Bihor
      • Oradea, Bihor, Romania, 410001
        • Novartis Investigative Site
    • Jud. Bihor
      • Oradea, Jud. Bihor, Romania, 410619
        • Novartis Investigative Site
    • Jud. Prahova
      • Ploiesti, Jud. Prahova, Romania, 100097
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      • Moscow, Russian Federation, 101990
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      • N.Novgorod, Russian Federation, 603126
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      • Penza, Russian Federation, 440026
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      • Petrozavodsk, Russian Federation, 185019
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      • Ryazan, Russian Federation, 390026
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      • Saint Petersburg, Russian Federation, 198260
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      • Saint Petersburg, Russian Federation, 194044
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      • Saratov, Russian Federation, 410012
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      • Smolensk, Russian Federation, 214019
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      • St-Petersburg, Russian Federation, 194358
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      • St.- Petersburg, Russian Federation, 199034
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      • Banska Bystrica, Slovakia, 974 01
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      • Kosice, Slovakia, 040 01
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      • Kosice, Slovakia, 040 22
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      • Levice, Slovakia, 934 01
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      • Nové Zámky, Slovakia, 940 01
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      • Presov, Slovakia, 080 01
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      • Sabinov, Slovakia, 08301
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      • Sered, Slovakia, 92601
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      • Sturovo, Slovakia, 94301
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      • Zilina, Slovakia, 012 07
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    • Slovak Republic
      • Bratislava, Slovak Republic, Slovakia, 85101
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      • Kosice, Slovak Republic, Slovakia, 04001
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      • Lucenec, Slovak Republic, Slovakia, 98401
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      • Namestovo, Slovak Republic, Slovakia, 02901
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      • Roznava, Slovak Republic, Slovakia, 04801
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      • Trebisov, Slovak Republic, Slovakia, 075 01
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      • Alberton, South Africa, 1449
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      • Cape Town, South Africa, 7925
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      • Gauteng, South Africa
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      • Johannesburg, South Africa, 1820
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      • Pretoria, South Africa, 0184
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      • Barcelona, Spain, 08020
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    • Barcelona
      • Sant Adria Del Besos, Barcelona, Spain, 08930
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    • Cataluña
      • Barcelona, Cataluña, Spain, 08025
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      • Hsintien, Taiwan, 231
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      • Taichung, Taiwan, 40705
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      • Taipei, Taiwan, 114
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      • Taoyuan, Taiwan, 33305
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      • Adana, Turkey, 01330
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      • Antalya, Turkey, 07070
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      • Denizli, Turkey, 20070
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      • Diskapi / Ankara, Turkey, 06770
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      • Istanbul, Turkey, 34093
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      • Izmir, Turkey, 35040
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      • Izmir, Turkey, 35340
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      • Kahramanmaras, Turkey, 46100
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Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Key Inclusion Criteria:

  • Type 2 Diabetes Mellitus (T2DM) diagnosed ≤ 24 months ago
  • glycosylated hemoglobin (HbA1c) ≥6.5% and ≤7.5% at Visit 1
  • Treatment-naïve.
  • Body mass index (BMI) ≥22 and ≤40 kg/m2 at Visit 1

Key Exclusion Criteria:

  • Pregnant or nursing (lactating) women
  • Fasting plasma glucose (FPG) ≥ 270 mg/dL (≥ 15.0 mmol/L)
  • Previous or current participation in any vildagliptin clinical study.
  • History of hypersensitivity to dipeptidyl peptidase-4 (DPP-4) inhibitors.
  • Concurrent medical condition that may interfere with the interpretation of efficacy and safety data during the study.
  • Donation of blood or significant blood loss equaling to at least one unit of blood within the past 2 weeks of start of study or a blood transfusion within the past 12 weeks or planned regular transfusions during the study period.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Vilda 50mg bid + metformin
Metformin + vildagliptin
One tablet (50 mg oral) of vildagliptin in the morning and one tablet in the evening with or without food.
Other Names:
  • LAF237
Twice daily (bid) regimen during or after meals at the same time as vildagliptin.
Experimental: Placebo + metformin
Metformin + Placebo of vildagliptin
Twice daily (bid) regimen during or after meals at the same time as vildagliptin.
Other Names:
  • Placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to Initial Treatment Failure
Time Frame: Visit 4 (Week 13) up to End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)

Treatment failure was defined as two consecutive scheduled visits with HbA1c >= 7.0% (starting from 13 weeks after randomization) and the time to treatment failure was the number of days from randomization to the second of the consecutive scheduled visits.

Participants who discontinued the study for any reason during Period 1 were censored at the date of discontinuation. Participants who remained under the threshold (or whose measurement above the threshold was not confirmed at next scheduled visit) were censored at the date of last study visit.

Visit 4 (Week 13) up to End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of Loss in Glycemic Control During Period 1
Time Frame: Visit 5 (Week 26) to End of Period 1

The rate of loss in glycemic control was estimated using the slope of HbA1c over time (years).

HbA1c data collected from Week 26 up to and including the end of Period 1 visit was included in the analysis. Baseline HbA1c was the sample obtained on day 1, or the sample obtained at an earlier visit (scheduled or unscheduled) which was closest to Day 1, if the Day 1 measurement was missing. End of Period 1 was defined as the final post-baseline assessment obtained at any visit within Period 1 (scheduled or unscheduled), up to the last scheduled visit.

Visit 5 (Week 26) to End of Period 1
Rate of Loss in Glycemic Control in HbA1c Over Time During Period 2
Time Frame: From 26 weeks after start of Period 2 to end of Period 2

The rate of loss in glycemic control was estimated using the slope of HbA1c over time (years).

HbA1c data collected from 26 weeks after the start of Period 2 to the end of Period 2 were included in the analysis, for participants who started insulin therapy in Period 3 or discontinued during Period 2 due to being unable or unwilling to initiate insulin therapy in period 3. Participants who completed the study in Period 1 or Period 2 were not be included in the analysis.

From 26 weeks after start of Period 2 to end of Period 2
Rate of Loss in Glycemic Control in Fasting Plasma Glucose (FPG) During Period 1
Time Frame: Visit 5 (Week 26) to End of Period 1

Rate of loss in glycemic control was estimated using the slope of FPG over time (years).

FPG (fasting plasma glucose) data from Week 26 to the end of Period 1 was included in the analysis. Baseline FPG was the sample obtained on day 1, or the sample obtained at an earlier visit (scheduled or unscheduled) which was closest to Day 1, if the Day 1 measurement is missing. Participants who completed the study in Period 1 or Period 2 were not be included in the analysis.

Visit 5 (Week 26) to End of Period 1
Rate of Loss in Glycemic Control in Fasting Plasma Glucose (FPG) Over Time During Period 2
Time Frame: From 26 weeks after start of Period 2 to end of Period 2

Rate of loss in glycemic control was estimated using the slope of FPG over time (years).

FPG (fasting plasma glucose) data from 26 weeks after the start of Period 2 to then end of Period 2 was included in the analysis. Only participants who started insulin therapy in Period 3 or discontinued during Period 2 due to being unable or unwilling to initiate insulin therapy in period 3 were included. Participants who completed the study in Period 1 or Period 2 were not be included in the analysis.

From 26 weeks after start of Period 2 to end of Period 2
Rate of Loss of Beta Cell Function From Baseline to End of Study
Time Frame: Visit 4 (Week 13), End of Period 1, End of Period 2, End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)
The rate of change of beta cell function was assessed using the slope of AUC of ISR/G over time (years) where AUC of ISR/G is defined as (Area under curve of Insulin secretion rate (derived using c-peptide))/(Area under curve of Glucose), using meal-test data from 0 to 120 minutes. Baseline AUC of ISR/G was derived based on samples obtained on day 1, or samples obtained at an earlier visit (scheduled or unscheduled) which was closest to Day 1, if the Day 1 measurements were missing. Three analyses were included, using data from Week 13 to the end of Period 1, end of Period 2 and end of study, respectively.
Visit 4 (Week 13), End of Period 1, End of Period 2, End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)
Rate of Change in Insulin Sensitivity From Baseline to End of Study
Time Frame: Visit 4 (Week 13), End of Period 1, End of Period 2, End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)
The rate of change of insulin sensitivity is assessed using the slope of OGIS over time (years) where Oral glucose insulin sensitivity (OGIS) was calculated as a function of glucose and insulin, using meal-test data from 0 to 120 minutes. Baseline OGIS is derived based on samples obtained on day 1, or samples obtained at an earlier visit (scheduled or unscheduled) which was closest to Day 1, if the Day 1 measurements are missing. Three analyses were included, using data from Week 13 to the end of Period 1, end of Period 2 and end of study, respectively.
Visit 4 (Week 13), End of Period 1, End of Period 2, End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)
Percentage of Participants With Adverse Events, Serious Adverse Events and Death
Time Frame: From first dose of study treatment until End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)
Analysis of absolute and relative frequencies for treatment emergent Adverse Event (AE), Serious Adverse Event (SAE) and Deaths by primary System Organ Class (SOC) in each treatment arm to demonstrate that LAF237 is safe for the treatment of naïve patients with type 2 diabetes mellitus through the monitoring of relevant clinical and laboratory safety parameters.
From first dose of study treatment until End of Study (Study Drug Discontinuation or Premature Subject Discontinuation)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 30, 2012

Primary Completion (Actual)

April 4, 2019

Study Completion (Actual)

April 4, 2019

Study Registration Dates

First Submitted

February 3, 2012

First Submitted That Met QC Criteria

February 3, 2012

First Posted (Estimate)

February 7, 2012

Study Record Updates

Last Update Posted (Actual)

September 24, 2020

Last Update Submitted That Met QC Criteria

September 1, 2020

Last Verified

September 1, 2020

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Plan Description

Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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