A Study of Tirzepatide (LY3298176) Versus Insulin Degludec in Participants With Type 2 Diabetes (SURPASS-3)

January 14, 2022 updated by: Eli Lilly and Company

A Randomized, Phase 3, Open-Label Trial Comparing the Effect of LY3298176 Versus Titrated Insulin Degludec on Glycemic Control in Patients With Type 2 Diabetes

The purpose of this study is to compare the effect of the study drug tirzepatide to insulin degludec on blood sugar levels in participants with type 2 diabetes. The study will last about 67 weeks and may include up to 22 visits.

Study Overview

Status

Completed

Study Type

Interventional

Enrollment (Actual)

1444

Phase

  • Phase 3

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, C1430CKE
        • AXISMED SRL - Bioclinica Research Network
      • Ciudad Autonoma de Buenos Aire, Argentina, C1120AAC
        • Centro Médico Viamonte
      • Ciudad Autonoma de Buenos Aire, Argentina, C1204AAD
        • Instituto Centenario
      • Ciudad Autonoma de Buenos Aire, Argentina, C1440AAD
        • CENUDIAB
    • Buenos Aires
      • Caba, Buenos Aires, Argentina, C1128AAF
        • Mautalen Salud e Investigación - Servicio de Endocrinología
      • Caba, Buenos Aires, Argentina, C1179AAB
        • Investigaciones Medicas IMOBA S.R.L.
      • Caba, Buenos Aires, Argentina, C1425DES
        • CEDIC-Centro de Investigaciones Clinicas
      • Ciudad Autonoma de, Buenos Aires, Argentina, C1119ACN
        • Centro de Investigacion y Prevencion Cardiovascular (CIPREC)
    • Mendoza
      • Godoy Cruz, Mendoza, Argentina, M5501ARP
        • CIPADI
      • Salzburg, Austria, 5020
        • Universitätsklinikum Salzburg
      • Wien, Austria, 1030
        • KA Rudolfstiftung
    • Niederösterreich
      • Stockerau, Niederösterreich, Austria, 2000
        • Landesklinikum Korneuburg-Stockerau, Standort Stockerau
    • Steiermark
      • Graz, Steiermark, Austria, 8036
        • Universitätsklinikum Graz
      • Athens, Greece, 11521
        • Athens Euroclinic
      • Larissa, Greece, 41110
        • University General Hospital of Larissa
      • Thessaloniki, Greece, 54645
        • Euromedica - General Clinic of Thessaloniki
      • Thessaloniki, Greece, 54636
        • AHEPA Hospital
      • Thessaloniki, Greece, 54639
        • Ippokrateio General Hospital of Thessaloniki
    • Athens
      • Palaio Faliro, Athens, Greece, 17562
        • Iatriko Palaiou Falirou, Medical Center
    • Attica
      • Ampelokipoi, Attica, Greece, 11527
        • Laiko General Hospital of Athens
    • Attiki
      • Athens, Attiki, Greece, 11527
        • Gen Hospital of Athens G Gennimatas
    • Thessaloniki
      • N. Efkarpia, Thessaloniki, Greece, 56403
        • General Hospital Of Thessaloniki Papageorgiou
      • Thermi, Thessaloniki, Greece, 57001
        • Thermi Clinic
      • Budapest, Hungary, 1089
        • ClinDiab Kft.
      • Budapest, Hungary, 1032
        • Szent Margit Rendelointézet
      • Budapest, Hungary, 1139
        • XIII.ker Onkormanyzat Egeszsegugyi Szolgalat
      • Budapest, Hungary, 1171
        • Strazsahegy Medicina Bt.
      • Budapest, Hungary, 1213
        • TRANTOR 99 Bt.
      • Nagykanizsa, Hungary, 8800
        • Kanizsai Dorottya Korhaz
      • Zalaegerszeg, Hungary, 8900
        • Zala Megyei Szent Rafael Kórház
    • Hajdu-Bihar
      • Debrecen, Hajdu-Bihar, Hungary, 4031
        • Kenézy Gyula Kórház És Rendelőintézet
      • Bari, Italy, 70124
        • Azienda Ospedaliera Policlinico Consorziale
      • Bergamo, Italy, 24128
        • Azienda Ospedaliera Papa Giovanni XXIII
      • Latina, Italy, 04100
        • Ospedale Santa Maria Goretti
    • Catanzaro
      • Germaneto, Catanzaro, Italy, 88100
        • Azienda ospedaliero-universitaria Mater Domini
    • Lazio
      • Roma, Lazio, Italy, 00168
        • Policlinico Univ. Agostino Gemelli
    • MI
      • Milano, MI, Italy, 20138
        • Centro Cardiologico Monzino, IRCCS
      • Ansan-si, Korea, Republic of, 15355
        • Korea University Ansan Hospital
      • Seoul, Korea, Republic of, 03080
        • Seoul National University Hospital
      • Seoul, Korea, Republic of, 02841
        • Korea University Anam Hospital
      • Seoul, Korea, Republic of, 03722
        • Severance Hospital Yonsei University Health System
      • Seoul, Korea, Republic of, 06351
        • Samsung Medical Center
      • Seoul, Korea, Republic of, 05278
        • Kyunghee University Hospital at Gangdong
    • Gyeonggi-do
      • Bucheon,, Gyeonggi-do, Korea, Republic of, 14647
        • Bucheon St. Mary's Hospital
      • Seongnam-si, Gyeonggi-do, Korea, Republic of, 13620
        • Seoul National University Bundang Hospital
    • Gyeonggido
      • Guri-si, Gyeonggido, Korea, Republic of, 11923
        • Hanyang University GURI Hospital
    • Korea
      • Seoul, Korea, Korea, Republic of, 06591
        • Seoul st. mary's hospital
      • Bialystok, Poland, 15-351
        • Nzoz Zdrowie Osteo-Medic
      • Bialystok, Poland, 15-404
        • Poradnia Diabetologiczna SN ZOZ Lege Artis
      • Krakow, Poland, 31-261
        • NZOZ Diab-Endo-Met
      • Lodz, Poland, 90-132
        • Gabinet Lekarski Malgorzata Saryusz-Wolska
      • Lodz, Poland, 90-242
        • Centrum Terapii Wspolczesnej J.M. Jasnorzewska S.K.A.
      • Lublin, Poland, 20-538
        • NZOZ Przychodnia Specjalistyczna Medica
      • Ruda Slaska, Poland, 41-709
        • NZOZ Przychodnia Specjalistyczna Henryk RudzkiAndrzej Wittek
    • Warminsko-Mazurki
      • Elblag, Warminsko-Mazurki, Poland, 82300
        • Ambulatorium Barbara Bazela
      • San Juan, Puerto Rico, 00917
        • GCM Medical Group PSC
      • San Juan, Puerto Rico, 00909
        • Latin Clinical Trial Center
      • Trujillo Alto, Puerto Rico, 00976
        • San Miguel Medical
      • Brasov, Romania, 500283
        • Centrul Medical de Diagnostic si Tratament Ambulatoriu Neomed SRL
      • Bucharest, Romania, 010507
        • Cabinetul Medical Nicodiab SRL
      • Bucuresti, Romania, 013671
        • SC Nutrilife SRL
      • Iasi, Romania, 700547
        • Consultmed SRL
    • Bihor
      • Oradea, Bihor, Romania, 410159
        • S. C. Grandmed S.R.L., Str.
    • Jud Satu-Mare
      • Satu-Mare, Jud Satu-Mare, Romania, 440055
        • Spitalul Judetean de Urgenta Satu Mare
    • Judetul Galati
      • Galati, Judetul Galati, Romania, 800291
        • SC Diamed Obesity SRL
    • Maramures
      • Baia Mare, Maramures, Romania, 430222
        • CMI DNBM Dr. Pop Lavinia
    • Mures
      • Targu Mures, Mures, Romania, 540098
        • Cosamext SRL
    • Sect.5
      • Bucuresti, Sect.5, Romania, 050538
        • Societatea Civila Medicala "Dr. Paveliu"
      • Alicante, Spain, 03004
        • Instituto de Ciencias Médicas
      • Granada, Spain, 18016
        • Hospital Clinico Universitario San Cecilio
      • Palma de Mallorca, Spain, 07014
        • Clínica Juaneda
      • Seville, Spain, 41003
        • Clínica Nuevas Tecnologías en Diabetes y Endocrinología
      • Teruel, Spain, 44002
        • Policlinica Galileo
    • Andalucía
      • Sevilla, Andalucía, Spain, 41010
        • Hospital Infanta Luisa
    • Cantabria
      • Santander, Cantabria, Spain, 39011
        • Hospital Universitario Marques de Valdecilla
    • Madrid
      • Pozuelo de Alarcon, Madrid, Spain, 28223
        • Hospital Universitario Quiron Madrid
      • Changhua, Taiwan, 500
        • Changhua Christian Hospital
      • Kaohsiung City, Taiwan, 833
        • Chang Gung Memorial Hospital - Kaohsiung
      • New Taipei, Taiwan, 23561
        • Taipei Medical University- Shuang Ho Hospital
      • Taichung, Taiwan, 40705, ROC
        • Taichung Veterans General Hospital
      • Taichung City, Taiwan, 40201
        • Chung Shan Medical University Hospital
      • Taichung County, Taiwan, 433
        • Kuang Tien General Hospital
      • Tainan, Taiwan, 70403
        • National Cheng Kung University Hospital
      • Tainan City, Taiwan, 71004
        • Chi-Mei Medical Center
      • Taipei, Taiwan, 11217
        • Taipei Veterans General Hospital
      • Dnipro, Ukraine, 49023
        • Dnipro City Clinical Hospital #9
      • Kyiv, Ukraine, 04114
        • V.P. Komisarenko Institute of Endocrinology and Metabolism of NAMS of Ukraine
      • Poltava, Ukraine, 36011
        • Communal Institution "Poltava Reg.Cl.H. n.a.M.V.Sklifosovskogo"
      • Vinnytsia, Ukraine, 21000
        • Vinnytsia Regional Clinical Highly Specialized Endocrinology Center
    • Arkansas
      • Little Rock, Arkansas, United States, 72205
        • Arkansas Clinical Research
    • California
      • Fresno, California, United States, 93720
        • Valley Research
      • Huntington Park, California, United States, 90255
        • National Research Institute
      • Los Angeles, California, United States, 90057
        • National Research Institute
      • Montclair, California, United States, 91763
        • Catalina Research Institute, LLC
      • Northridge, California, United States, 91325
        • Valley Clinical Trials, Inc.
      • Panorama City, California, United States, 91402
        • National Research Institute
      • Spring Valley, California, United States, 91978
        • Encompass Clinical Research
      • Tustin, California, United States, 92780
        • University Clinical Investigators, Inc.
    • Connecticut
      • Waterbury, Connecticut, United States, 06708
        • Chase Medical Research, LLC
    • Florida
      • Hialeah, Florida, United States, 33012
        • Indago Research & Health Center, Inc.
      • Jacksonville, Florida, United States, 32216
        • East Coast Institute for Research
      • Jacksonville, Florida, United States, 32204
        • East Coast Clinical Research
      • New Port Richey, Florida, United States, 34655
        • Bayside Clinical Research, LLC
    • Georgia
      • Macon, Georgia, United States, 31210
        • East Coast Institute for Research
      • Union City, Georgia, United States, 30291
        • Sky Clinical Research Network
    • Idaho
      • Blackfoot, Idaho, United States, 83221
        • Elite Clinical Trials LLLP
      • Boise, Idaho, United States, 83702
        • Humphreys Diabetes Center
      • Idaho Falls, Idaho, United States, 83404
        • Rocky Mountain Diabetes and Osteoporosis Center
    • Illinois
      • Springfield, Illinois, United States, 62711
        • Springfield Diabetes & Endocrine Center
    • Louisiana
      • Metairie, Louisiana, United States, 70006
        • Crescent City Clinical Research
    • Maryland
      • Rockville, Maryland, United States, 20852
        • Endocrine and Metabolic Consultants
    • Michigan
      • Troy, Michigan, United States, 48098
        • Troy Internal Medicine, PC
    • Minnesota
      • Minneapolis, Minnesota, United States, 55416
        • International Diabetes Center
    • Missouri
      • Chesterfield, Missouri, United States, 63005
        • Clinical Research Professionals
    • Nevada
      • Las Vegas, Nevada, United States, 89148
        • Palm Research Center
      • Las Vegas, Nevada, United States, 89128
        • Palm Research Center
    • Ohio
      • Columbus, Ohio, United States, 43213
        • Aventiv Research
    • Oregon
      • Corvallis, Oregon, United States, 97330
        • The Corvallis Clinic P.C.
    • Pennsylvania
      • Beaver, Pennsylvania, United States, 15009
        • Heritage Valley Medical Group, Inc.
      • Lansdale, Pennsylvania, United States, 19446
        • Detweiler Family Medicine
    • Texas
      • Corpus Christi, Texas, United States, 78414
        • Office of Dr. Osvaldo Brusco
      • Shavano Park, Texas, United States, 78231
        • Consano Clinical Research

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

16 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Participants must:

    • Have been diagnosed with type 2 diabetes mellitus (T2DM)
    • Have HbA1c between ≥7.0% and ≤10.5%
    • Be on stable treatment with unchanged dose of metformin or metformin plus an SGLT-2 inhibitor for at least 3 months before screening
    • Be of stable weight (± 5%) for at least 3 months before screening
    • Have a BMI ≥25 kilograms per meter squared (kg/m2) at screening

Exclusion Criteria:

  • Participants must not:

    • Have type 1 diabetes mellitus
    • Have had chronic or acute pancreatitis any time prior to study entry
    • Have proliferative diabetic retinopathy or diabetic maculopathy or nonproliferative diabetic retinopathy requiring acute treatment
    • Have disorders associated with slowed emptying of the stomach, or have had any stomach surgeries for the purpose of weight loss
    • Have acute or chronic hepatitis, signs and symptoms of any other liver disease, or blood alanine transaminase (ALT) enzyme level >3.0 times the upper limit of normal (ULN) for the reference range, as determined by the central laboratory. Participants with nonalcoholic fatty liver disease (NAFLD) are eligible for participation in this trial only if their ALT level is ≤3.0 the ULN for the reference range
    • Have an estimated glomerular filtration rate <45 mL/minute/1.73 m2 (or lower than the country specific threshold for using the protocol required dose of metformin per local label)
    • Have had a heart attack, stroke, or hospitalization for congestive heart failure in the past 2 months
    • Have a personal or family history of medullary thyroid carcinoma or personal history of multiple endocrine neoplasia syndrome type 2
    • Have been taking any other diabetes medicines other than metformin, or metformin plus an SGLT-2 inhibitor during the last 3 months
    • Have been taking weight loss drugs, including over-the-counter medications during the last 3 months

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: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 5 mg Tirzepatide
5 milligrams (mg) tirzepatide administered subcutaneously (SC) once a week.
Administered SC
Other Names:
  • LY3298176
Experimental: 10 mg Tirzepatide
10 mg tirzepatide administered SC once a week.
Administered SC
Other Names:
  • LY3298176
Experimental: 15 mg Tirzepatide
15 mg tirzepatide administered SC once a week.
Administered SC
Other Names:
  • LY3298176
Active Comparator: Insulin Degludec
Insulin degludec administered SC once a day.
Administered SC

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change From Baseline in Hemoglobin A1c (HbA1c) (10 mg and 15 mg)
Time Frame: Baseline, Week 52
HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with covariates Baseline + Pooled Country + Baseline Oral Antihyperglycemic Medication (OAM) Use (Metformin (Met), Met plus SGLT-2i) + Treatment + Time + Treatment*Time (Type III sum of squares).
Baseline, Week 52

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change From Baseline in HbA1c (5 mg)
Time Frame: Baseline, Week 52
HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with covariates Baseline + Pooled Country + Baseline OAM Use (Met, Met plus SGLT-2i) + Treatment + Time + Treatment*Time (Type III sum of squares).
Baseline, Week 52
Change From Baseline in Body Weight
Time Frame: Baseline, Week 52
LS mean was determined by MMRM model with Baseline + Pooled Country + Baseline OAM Use (Met, Met plus SGLT-2i) + Baseline HbA1c Group (<=8.5%, >8.5%) + Treatment + Time + Treatment*Time (Type III sum of squares) as covariates.
Baseline, Week 52
Change From Baseline in Fasting Serum Glucose
Time Frame: Baseline, Week 52
LS mean was determined by MMRM model with variables Baseline + Pooled Country + Baseline OAM Use (Met, Met plus SGLT-2i) + Baseline HbA1c Group (<=8.5%, >8.5%) + Treatment + Time + Treatment*Time (Type III sum of squares).
Baseline, Week 52
Percentage of Participants Achieving an HbA1c Target Value of <7%
Time Frame: Week 52
Hemoglobin A1c (HbA1c) is the glycosylated fraction of hemoglobin A. HbA1c is measured to identify average plasma glucose concentration over prolonged periods of time. Imputed data includes observed value and imputed value if endpoint measure is missing. Missing endpoint measures are imputed by predictions from an MMRM analysis model using observed data in the efficacy analysis set and adjusted for Baseline Value, Pooled Country, Baseline OAM Use (Met, Met plus SGLT-2i), Treatment, Visit and Visit*Treatment.
Week 52
Mean Change From Baseline in Daily Average 7-Point Self-Monitored Blood Glucose (SMBG) Values
Time Frame: Baseline, Week 52
The self-monitored plasma glucose (SMBG) data were collected at the following 7 time points: Morning Premeal - Fasting, Morning 2-hour Postmeal, Midday Premeal, Midday 2-hour Postmeal, Evening Premeal, Evening 2-hour Postmeal and Bedtime. LS mean was determined by mixed-model repeated measures (MMRM) model with variables Baseline + Baseline HbA1c Group (<=8.5%, >8.5%) + Pooled Country + Baseline OAM Use (Met, Met plus SGLT-2i) + Treatment + Time + Treatment*Time (Type III sum of squares).
Baseline, Week 52
Percentage of Participants Who Achieved Weight Loss ≥5%
Time Frame: Week 52
Percentage of Participants who Achieved Weight Loss ≥5%
Week 52
Diabetes Treatment Satisfaction as Measured by the Diabetes Treatment Satisfaction Questionnaire, Change Version (DTSQc) Hyperglycemia, Hypoglycemia and Treatment Satisfaction Score
Time Frame: Week 52
DTSQc, an 8-item questionnaire, assesses relative change in treatment satisfaction perceived frequency of hyperglycemia, and perceived frequency of hypoglycemia from baseline to week 52 or early termination.The treatment satisfaction score ranges from -18 to 18 where the higher the score the greater the improvement in satisfaction with treatment. The lower the score the greater the deterioration in satisfaction with treatment. The hyperglycemia and hypoglycemia scores range from -3 to 3 where negative scores indicate fewer problems with blood glucose levels and positive scores indicate more problems than before. LS mean was determined by ANCOVA model for endpoint measures: Variable = Baseline DTSQs + Pooled Country + Baseline HbA1c Group (<=8.5%, >8.5%) + Baseline OAM Use (Met, Met plus SGLT-2i) + Treatment (Type III sum of squares).
Week 52
Rate of Hypoglycemia With Blood Glucose <54 Milligram/Deciliter (mg/dL) [<3.0 (Millimole/Liter (mmol/L))] or Severe Hypoglycemia
Time Frame: Baseline through Safety Follow-Up (Up to Week 56)
The hypoglycemia events were defined by participant reported events with blood glucose <54mg/dL (<3.0 mmol/L) or severe hypoglycemia. Severe hypoglycemia is defined as an episode with severe cognitive impairment requiring the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. These episodes may be associated with sufficient neuroglycopenia to induce seizure or coma. The rate of postbaseline hypoglycemia was estimated by negative binomial model: Number of episodes = Pooled Country + Baseline OAM Use (Met, Met plus SGLT-2i) + Baseline HbA1c Group (<=8.5%, >8.5%) + Treatment, with log (exposure in days/365.25) as an offset variable.
Baseline through Safety Follow-Up (Up to Week 56)

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)

April 1, 2019

Primary Completion (Actual)

December 11, 2020

Study Completion (Actual)

January 4, 2021

Study Registration Dates

First Submitted

March 19, 2019

First Submitted That Met QC Criteria

March 19, 2019

First Posted (Actual)

March 20, 2019

Study Record Updates

Last Update Posted (Actual)

January 19, 2022

Last Update Submitted That Met QC Criteria

January 14, 2022

Last Verified

January 1, 2022

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 16997
  • I8F-MC-GPGH (Other Identifier: Eli Lilly and Company)
  • 2018-003422-84 (EudraCT Number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Plan Description

Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.

IPD Sharing Time Frame

Data are available 6 months after the primary publication and approval of the indication studied in the US and EU, whichever is later. Data will be indefinitely available for requesting.

IPD Sharing Access Criteria

A research proposal must be approved by an independent review panel and researchers must sign a data sharing agreement.

IPD Sharing Supporting Information Type

  • Study Protocol
  • Statistical Analysis Plan (SAP)
  • Clinical Study Report (CSR)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

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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