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Long Acting Insulin Glargine Titration Web Tool (LTHome) vs Enhanced Usual Therapy of Glargine Titration (INNOVATE)

1 septembre 2015 mis à jour par: Ronnie Aronson, LMC Diabetes & Endocrinology Ltd.

A 12 Week, Parallel, Open-label, Randomized, Multi-center Study Evaluating Use, Safety and Effectiveness of a Web Based Tool vs. Enhanced Usual Therapy of Glargine Titration in T2DM Patients With a 4 Week Safety Extension

Evaluating patients with type 2 diabetes either starting once daily basal insulin or requiring increased basal titrations in order to compare the LTHome web based tool with the usual standard of practice for insulin glargine dosing adjustment.

Aperçu de l'étude

Description détaillée

INNOVATE is a 12 week, parallel, open-label, randomized, multi-center study evaluating use, safety and effectiveness of a web based tool (LTHome) vs. enhanced usual therapy (EUT) of glargine titration in T2DM patients.

The primary objective of this study is to compare the effectiveness LTHome versus EUT of glargine titration in people with T2DM patients on basal insulin not meeting local targets or patients requiring basal initiation. Success will be measured by the percentage of subjects reaching Canadian Diabetes Association (CDA) guideline targets.

The efficacy objective is to demonstrate that the percentage (%) of subjects to reach FPG target by titration of insulin glargine using the LTHome tool with dose adjustment advice is not inferior to the % of subjects to reach FPG target using Enhanced Usual Therapy glargine titration during study participation (LTHome vs. EUT treatments).

The secondary objectives of this study are to assess safety, effectiveness, satisfaction and adherence of LTHome use versus Enhanced Usual Therapy glargine titration.

Type d'étude

Interventionnel

Inscription (Réel)

139

Phase

  • N'est pas applicable

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

    • Ontario
      • Toronto, Ontario, Canada, M4G 3E8
        • LMC Diabetes & Endocrinology

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 75 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Patient with type 2 diabetes mellitus (T2DM) between 18 and 75 years old (inclusively) with BMI ≤ 45 kg/m2.
  • Signed written informed consent
  • Patients scheduled to: initiate basal insulin treatment or increase their dose of current basal insulin therapy, independently of study participation, because of :

    • inadequate blood glucose control

  • If on basal therapy at screening, must be using a stable dose of insulin glargine x 1 week prior to randomization
  • Patients with poor blood glucose control defined by:

    • HbA1c level between > 7% at screening AND
    • mean FPG > 7 mmol/l as determined by most recent self-measured blood glucose in 3 of 7 days prior to randomization
  • Patients proficient in computer literacy
  • Patient is able and willing to monitor glucose with a home glucose monitor, and consistently record his/her blood glucose and insulin doses in a patient diary/web tool.

Exclusion Criteria:

  • Any technical/administrative reason that makes it impossible to include the patient in the study, including closing enrollment due to full enrollment
  • Patient who has previously participated in any clinical trial investigating the LTHome algorithm
  • Patient who withdraws consent during screening (starting from signed informed consent form)
  • Use of systemic steroids in the last 90 days
  • Conditions/situations:

    • Patients with short life expectancy (less than 1 year)
    • Type 1 diabetes mellitus
    • Patients with conditions/concomitant diseases making them non-evaluable for the primary efficacy endpoint
    • Clinically significant cardiac disease, retinopathy, hepatic, renal dysfunction or relevant other major diseases as determined by Principal Investigator or designee.
    • Unstable oral antihyperglycemic drugs and/or Glucagon-Like Peptide Receptor (GLP-1R) Agonists therapy during the 4 week period prior to screening
    • Impossibility to meet specific protocol requirements (e.g. ability to perform blood glucose measurements, manage their own insulin glargine administration or deemed unlikely to safely manage insulin dosage on guidance by their HCP)
    • Patient is a primary relative of the Investigator or any Sub-Investigator, research assistant, pharmacist, study coordinator, or other staff or is directly involved in the conduct of the protocol
    • Patients with hypoglycemia unawareness, severe hypoglycemic episode in the last 90 days or hospitalization (for any reason) in the last 30 days
    • Cognitive disorder, dementia or any neurologic disorder, that would affect patient's ability to participate in the study, or patients who have no legal capacity or are under guardianship
  • Pregnant or breastfeeding women, or women of child-bearing potential not protected by highly effective method(s) of birth control (as defined in the informed consent form and/or in a local protocol addendum) and who are unwilling or unable to be tested for pregnancy.
  • Patients who are using, or need to start using, mealtime (Bolus) insulin during the timeframe of the study.
  • Night shift workers

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: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: LTHome web tool
The long-acting insulin glargine titration web tool (LTHome) will provide insulin glargine titration suggestions based on user inputted blood glucose readings.
The LTHome study arm will receive insulin glargine titration instructions from the LTHome web-based tool
Individual diabetes education, detailed instructions on the use of the blood glucose monitor and unlimited availability of blood glucose monitoring supplies.
Comparateur actif: Enhanced Usual Therapy (EUT)
The Enhanced Usual Therapy arm will receive insulin glargine titration instructions that are the usual therapy provided by the physician/HCP, in addition to diabetes education.
Individual diabetes education, detailed instructions on the use of the blood glucose monitor and unlimited availability of blood glucose monitoring supplies.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Percentage of subjects reaching fasting plasma glucose (FPG) target
Délai: 12 weeks

The primary outcome is defined as all of the following

  • At least 4 out of 7 FPG readings done within a 10 day period are within the target range of 5-7.2 mmol/L
  • Mean glucose for three consecutive prior FPG values is between 5-7.2 mmol/L
  • There is no severe hypoglycemia during the 7-10 day period (Severe hypoglycemia is defined as third party intervention in management of the hypoglycemia).
12 weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Événements indésirables
Délai: 12 semaines
12 semaines
Number of days to first reach fasting plasma glucose target
Délai: 12 weeks
The number of days in the study until the first day the target is reached.
12 weeks
Number of days in target range after reaching fasting plasma glucose target
Délai: 12 weeks
The number of days after reaching target where the FPG was between 5.0 and 7.2 mmol/L (inclusive)
12 weeks
Fasting plasma glucose
Délai: 12 weeks
Fasting plasma glucose values over the entire study period will be summarized by mean and standard deviation
12 weeks
Hemoglobin A1c (HbA1c)
Délai: 12 weeks
The change in HbA1c will be evaluated as an expression of overall glycemic control in the two treatment arms and compared.
12 weeks
Rate of documented hypoglycemia in subjects that reach target
Délai: 12 weeks
12 weeks
Rate of documented hypoglycemia in subjects that do not reach target
Délai: 12 weeks
12 weeks
Proportion of all patients with hypoglycemia
Délai: 12 weeks
A summary of any hypoglycemia, severe hypoglycemia, nocturnal hypoglycemia, day-time hypoglycemia, symptomatic hypoglycemia, probable symptomatic hypoglycemia, and asymptomatic hypoglycemia will be summarized
12 weeks
Frequency of contact with physician/HCP
Délai: 12 weeks
The number of times subjects contacted their physician/HCP during the study
12 weeks
Diabetes Treatment Satisfaction Questionnaire (DTSQ)
Délai: 12 weeks
A questionnaire to assess subject's overall satisfaction with their diabetes treatment
12 weeks
Hypoglycemia Fear Survey (HFS)
Délai: 12 weeks
A questionnaire to assess the subject's behaviours to avoid hypoglycemia and to measure the subjects' worries about hypoglycemia and its consequences
12 weeks
WHO-5 Well-Being Index
Délai: 12 weeks
A questionnaire to measure emotional well-being to screening for likely depression in subjects with diabetes
12 weeks
Diabetes Distress Scale
Délai: 12 weeks
A questionnaire to assess diabetes-related emotional distress
12 weeks
LTHome Patient Satisfaction Survey
Délai: 12 weeks
LTHome arm only; a questionnaire to measure satisfaction of the use of the LTHome
12 weeks
Number of days subjects self-monitored their fasting plasma glucose
Délai: 12 weeks
12 weeks
Number of dose recommendations prior to reaching target - LTHome only
Délai: 12 weeks
12 weeks
Number of dose recommendations after target is reached - LTHome only
Délai: 12 weeks
12 weeks
Number of days insulin glargine was taken - LTHome only
Délai: 12 weeks
12 weeks
Reasons for disregarding LTHome advice - LTHome only
Délai: 12 weeks
A summary of the reasons that subjects gave for not taking the insulin glargine dose recommendation given by the LTHome web tool when the recommendation was not followed
12 weeks
Serious adverse events
Délai: 12 weeks
12 weeks

Autres mesures de résultats

Mesure des résultats
Délai
Body weight (kg)
Délai: 12 weeks
12 weeks
List of concomitant medications initiated after randomization
Délai: 12 weeks
12 weeks

Collaborateurs et enquêteurs

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

Collaborateurs

Les enquêteurs

  • Chercheur principal: Ronnie Aronson, MD, LMC Diabetes & Endocrinology Ltd.

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.

Publications générales

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

1 décembre 2013

Achèvement primaire (Réel)

1 mars 2015

Achèvement de l'étude (Réel)

1 mars 2015

Dates d'inscription aux études

Première soumission

21 août 2015

Première soumission répondant aux critères de contrôle qualité

1 septembre 2015

Première publication (Estimation)

4 septembre 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

4 septembre 2015

Dernière mise à jour soumise répondant aux critères de contrôle qualité

1 septembre 2015

Dernière vérification

1 septembre 2015

Plus d'information

Termes liés à cette étude

Mots clés

Autres numéros d'identification d'étude

  • INNOVATE (Autre identifiant: Inovio INO-4800 Vaccine Trial for Efficacy)

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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