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Does Dapagliflozin Augment The Favorable Adaptation To Endurance Exercise Training?

19 mars 2019 mis à jour par: Christopher Bell
Exercise is frequently prescribed as a favorable lifestyle intervention to prevent/reverse type 2 diabetes. It is also prescribed in addition to concurrent pharmacological treatment, such as metformin. Recent data (animal and human) suggest that metformin may attenuate the favorable benefits of exercise training. In light of the physiological mechanism of Dapagliflozin (sodium-glucose co-transporter 2 (SGLT2) inhibition), one might speculate that rather than inhibit, it will augment the favorable adaptations to exercise training.

Aperçu de l'étude

Statut

Complété

Les conditions

Description détaillée

This is a randomized, placebo-controlled, double blind, repeated measures study. 30 sedentary adults will be recruited for participation and randomly assigned to one of two 12-week treatments: 1) supervised endurance exercise training 4 days per week plus daily oral administration of Dapagliflozin; 2) supervised endurance exercise training 4 days per week plus daily oral administration of placebo. Prior to and following completion of the treatment the following dependent variables will be quantified: a) maximal aerobic capacity; b) substrate utilization during standardized low-moderate intensity exercise; c) skeletal muscle aerobic enzyme activity; d) body composition; and, e) oral glucose tolerance, fasting glucose and insulin resistance.

The dose of Dapagliflozin will begin as 5 mg/day for the first 14-days. In the absence of complications, side effects, or unfavorable reactions, the dose will then increase to 10 mg/day for the remainder of the study.

Type d'étude

Interventionnel

Inscription (Réel)

37

Phase

  • Phase 2

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Colorado
      • Fort Collins, Colorado, États-Unis, 80523-1582
        • Colorado State University, Dept. of Health and Exercise Science

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 50 ans (Adulte)

Accepte les volontaires sains

Oui

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Provision of informed consent prior to any study specific procedures.
  2. No known Type 2 Diabetes.
  3. Body mass index 25-45 kg/m^2
  4. Sedentary (maximum of 2/week regularly scheduled activity sessions of < 20 minutes during the previous 2 years).
  5. Completion of a screening visit consisting of medical history, physical examination, and 12-lead electrocardiogram and blood pressure assessment at rest and during incremental exercise to volitional exhaustion (Note: Subjects with abnormal screening values may be eligible if the results are not clinically significant, as judged by the investigator or medical monitor).
  6. Agree to abide by the study schedule and to return for the required assessments.
  7. Be willing and able to repeatedly perform exercise.
  8. Women of childbearing potential must have negative pregnancy test and be using acceptable contraception.

Exclusion Criteria:

Subjects should not enter the study if any of the following exclusion criteria are fulfilled:

  1. Evidence of clinically significant cardiovascular, respiratory, renal, hepatic, pulmonary, gastrointestinal, hematological, neurological, psychiatric, or other disease that may interfere with the objectives of the study or the safety of the subject, as judged by the investigator in agreement with the sponsor or medical monitor, have been hospitalized in the past 2 years as a result of these conditions, or are receiving pharmacological treatment for these conditions.
  2. Use of prescription drugs (see exceptions listed below) or herbal preparations in the 4 weeks before study commencement.

    Permitted Prescription Drugs

    • Birth Control
    • Less than 7 days, short course antibiotics. Note: Rifampin is not permitted.
    • Other medicines, for gastroesophageal reflux disease (GERD), depression, seasonal allergies and over-the-counter analgesics, may be allowed, but will be approved on a case-by-case basis.
  3. Is currently enrolled in another clinical study for another investigational drug or has taken any other investigational drug within 30 days before the screening visit.
  4. Habitual and/or recent use (within 2 years) of tobacco.
  5. Being considered unsuitable for participation in this trial for any reason, as judged by the investigator or medical monitor.
  6. History of serious hypersensitivity reaction to Dapagliflozin.
  7. Severe renal impairment, end-stage renal disease, or dialysis.
  8. Pregnant or breastfeeding patients.
  9. Severe hepatic insufficiency and/or significant abnormal liver function defined as aspartate aminotransferase (AST) >3x upper limit of normal and/or alanine aminotransferase (ALT) >3x upper limit of normal.
  10. Total bilirubin >2.0 mg/dL (34.2 umol/L).
  11. Positive serologic evidence of current infectious liver disease including Hepatitis B viral antibody Immunoglobulin M, Hepatitis B surface antigen and Hepatitis C virus antibody.
  12. Estimated Glomerular Filtration Rate <60 mL/min/1.73 m^2 (calculated by Cockcroft-Gault formula).
  13. History of bladder cancer.
  14. Recent cardiovascular events in a patient, including any of the following: acute coronary syndrome within 2 months prior to enrollment; hospitalization for unstable angina or acute myocardial infarction within 2 months prior to enrolment; acute stroke or trans-ischemic attack within two months prior to enrollment; less than two months post coronary artery re-vascularization; congestive heart failure defined as New York Heart Association class IV, unstable or acute congestive heart failure. Note: eligible patients with congestive heart failure,especially those who are on diuretic therapy, should have careful monitoring of their volume status throughout the study.
  15. Blood pressure at enrollment: Systolic blood pressure ≥165 mmHg and/or diastolic blood pressure ≥100 mmHg.
  16. Blood pressure at randomization: Systolic blood pressure ≥165 mmHg and/or diastolic blood pressure ≥100 mmHg
  17. Patients who, in the judgment of the medical monitor, may be at risk for dehydration.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Science basique
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Tripler

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Dapagliflozin
The dose of Dapagliflozin will begin as one 5 mg tablet per day for the first 14-days. In the absence of complications, side effects, or unfavorable reactions, the dose will then increase to two 5 mg tablets per day for the remainder of the study.
Dapagliflozin tablets, 5 mg, one per day for the first 14 days, increase to two per day for 70 days.
Autres noms:
  • Farxiga
Comparateur placebo: Placebo
Matching placebo for Dapagliflozin 5 mg will begin as one tablet per day for the first 14-days. In the absence of complications, side effects, or unfavorable reactions, the dose will then increase to two tablets for the remainder of the study.
Matching placebo for Dapagliflozin 5 mg, one per day for the first 14 days, increase to two per day for 70 days.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change From Baseline of Maximal Oxygen Uptake at Week 12
Délai: Baseline,12 weeks
Indirect calorimetry
Baseline,12 weeks
Change From Baseline of Respiratory Exchange Ratio at Week 12
Délai: Baseline, 12 weeks
The respiratory exchange ratio (RER) is the ratio between the amount of carbon dioxide (CO2) produced in metabolism and oxygen (O2) used during standardized exercise.
Baseline, 12 weeks
Change From Baseline of Maximal Aerobic Enzyme Activities in Skeletal Muscle at Week 12
Délai: Baseline, 12 weeks
Maximal citrate synthase activity in skeletal muscle sample
Baseline, 12 weeks
Change From Baseline of Insulin Sensitivity at Week 12
Délai: Baseline, 12 weeks
Insulin Sensitivity was estimated by measuring circulating glucose and insulin concentrations after a 12-hour fast and after ingestion of 75 g of glucose. Glucose was measured 5, 10, 15, 20, 30, 45, 60, 75, 90, 105 and 120 minutes after glucose ingestion. Insulin was measured 15, 30, 45, 60, 90 and 120 minutes after glucose ingestion. Insulin sensitivity was estimated using the Matsuda Index, represented by the formula: Matsuda index = 10,000/SQRT [fasting glucose*fasting insulin* (mean glucose from time 5, 10, 15, 20, 30, 45, 60, 75, 90, 105 and 120 minutes) * (mean insulin from time 15, 30, 45, 60, 90 and 120 minutes)], with higher numbers indicating better insulin sensitivity.
Baseline, 12 weeks
Change From Baseline of Fat Free Mass at Week 12
Délai: Baseline, 12 weeks
Via dual energy X-ray absorptiometry
Baseline, 12 weeks

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Collaborateurs

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 juin 2015

Achèvement primaire (Réel)

1 janvier 2018

Achèvement de l'étude (Réel)

1 janvier 2018

Dates d'inscription aux études

Première soumission

13 février 2015

Première soumission répondant aux critères de contrôle qualité

19 février 2015

Première publication (Estimation)

25 février 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

10 avril 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

19 mars 2019

Dernière vérification

1 mars 2019

Plus d'information

Termes liés à cette étude

Plan pour les données individuelles des participants (IPD)

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Essais cliniques sur Dapagliflozin

3
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