A Study in Adults With Type 1 Diabetes (ELEMENT 1)
2014年10月3日 更新者:Eli Lilly and Company
A Prospective, Randomized, Open-label Comparison of a Long-Acting Basal Insulin Analog LY2963016 to Lantus in Combination With Mealtime Insulin Lispro in Adult Patients With Type 1 Diabetes Mellitus
The purpose of this study is to compare the effectiveness and safety of LY2963016 versus Lantus when taken once daily in combination with insulin lispro before meals three times a day.
調査の概要
研究の種類
介入
入学 (実際)
536
段階
- フェーズ 3
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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Alabama
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Birmingham、Alabama、アメリカ、35294
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
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Florida
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Hollywood、Florida、アメリカ、33021
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New Port Richey、Florida、アメリカ、34652
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West Palm Beach、Florida、アメリカ、33401
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Georgia
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Atlanta、Georgia、アメリカ、30303
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Roswell、Georgia、アメリカ、30076
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Illinois
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Springfield、Illinois、アメリカ、62704
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Iowa
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Des Moines、Iowa、アメリカ、50314
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Kansas
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Topeka、Kansas、アメリカ、66606
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Kentucky
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Lexington、Kentucky、アメリカ、40503
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Louisiana
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Metairie、Louisiana、アメリカ、70006
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Michigan
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Kalamazoo、Michigan、アメリカ、49048
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Nebraska
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Omaha、Nebraska、アメリカ、68131
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New Hampshire
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Nashua、New Hampshire、アメリカ、03063
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New York
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Mineola、New York、アメリカ、11501
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New Hyde Park、New York、アメリカ、11040
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Syracuse、New York、アメリカ、13210
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North Carolina
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Asheville、North Carolina、アメリカ、28803
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Texas
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Austin、Texas、アメリカ、78731
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Dallas、Texas、アメリカ、75390
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San Antonio、Texas、アメリカ、78229
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Athens、ギリシャ、11527
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Haidari/Athens、ギリシャ、12462
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Thessaloniki、ギリシャ、56429
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Fulda、ドイツ、36037
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Hamburg、ドイツ、22607
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Heidelberg、ドイツ、69115
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St. Ingbert-Oberwürzbach、ドイツ、66386
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Budapest、ハンガリー、1134
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Debrecen、ハンガリー、4032
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Salgotarjan、ハンガリー、3100
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Brussels、ベルギー、1090
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Leuven、ベルギー、3000
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Liège、ベルギー、4000
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Krakow、ポーランド、31-530
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
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Lodz、ポーランド、90-153
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Szczecin、ポーランド、70-376
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Guadalajara、メキシコ、44600
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Monterrey、メキシコ、64461
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Puebla、メキシコ、72190
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Tampico、メキシコ、89249
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Bucharest、ルーマニア、020359
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Galati、ルーマニア、800587
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Iasi、ルーマニア、700547
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Oradea、ルーマニア、410025
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Timisoara、ルーマニア、300182
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Fukuoka、日本、815-8555
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Kanagawa、日本、235-0045
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Kumamoto、日本、862-0976
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Miyazaki、日本、880-0034
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Nagasaki、日本、857-1195
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Tokyo、日本、105-8471
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
18年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- Have type 1 diabetes mellitus based on the disease diagnostic criteria [World Health Organization (WHO) Classification]
- Have duration of diabetes greater than or equal to one year
- Have Hemoglobin A1c (HbA1c) less than or equal to 11.0%
- On basal-bolus insulin therapy for at least 1 year [basal insulin must be once daily (QD) injection of human insulin isophane suspension (NPH), Lantus, or detemir and combined with mealtime injections of human regular insulin, or insulin analog lispro, aspart or glulisine]
- Have a body mass index (BMI) of less than or equal to 35 kilograms/square meter (kg/m²)
Exclusion Criteria:
- Have had more than one episode of severe low blood sugar (defined as needing someone else to help because you had very low blood sugar) within the 6 months before entering the study
- Have had more than one episode of diabetic ketoacidosis or emergency room visits for uncontrolled diabetes leading to hospitalization within the 6 months before entering the study
- Have known hypersensitivity or allergy to any of the study insulins (insulin glargine or insulin lispro) or to excipients of the study insulins
- Have significant renal, cardiac, gastrointestinal or liver disease
- Have active cancer or cancer within the past 5 years
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:LY2963016 + Insulin Lispro
LY2963016 titrated based on blood glucose readings, administered subcutaneously, once daily at the same timing (daytime or evening/bedtime) as participant's prestudy basal insulin injection schedule in combination with premeal insulin lispro.
Insulin lispro titrated based on blood glucose readings, administered subcutaneously, three times a day for 52 weeks.
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皮下投与
Administered subcutaneously
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アクティブコンパレータ:Lantus + Insulin Lispro
Lantus titrated based on blood glucose readings, administered subcutaneously, once daily at the same timing (daytime or evening/bedtime) as participant's prestudy basal insulin injection schedule in combination with premeal insulin lispro.
Insulin lispro titrated based on blood glucose readings, administered subcutaneously, three times a day for 52 weeks.
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皮下投与
Administered subcutaneously
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change From Baseline up to 24 Weeks in Hemoglobin A1c (HbA1c)
時間枠:Baseline, Endpoint (up to 24 weeks)
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HbA1c is the glycosylated fraction of hemoglobin A which provides an estimate of a participant's blood sugar control over a 6- to 12-week period.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline HbA1c, treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline, Endpoint (up to 24 weeks)
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change From Baseline in Insulin Antibody Levels
時間枠:Baseline, 6 weeks and 12 weeks and Endpoints (up to 24 weeks and up to 52 weeks)
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Blood samples are collected from participants and percentage of insulin antibody binding was measured to determine the insulin antibody levels.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline, 6 weeks and 12 weeks and Endpoints (up to 24 weeks and up to 52 weeks)
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Change From Baseline in Hemoglobin A1c (HbA1c)
時間枠:Baseline, 6 weeks and 12 weeks and 24 weeks and 36 weeks and 52 weeks and Endpoint (up to 52 weeks)
|
HbA1c is the glycosylated fraction of hemoglobin A which provides an estimate of a participant's blood sugar control over a 6- to 12-week period.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline HbA1c, treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline, 6 weeks and 12 weeks and 24 weeks and 36 weeks and 52 weeks and Endpoint (up to 52 weeks)
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7-Point Self-Monitored Blood Glucose (SMBG) Profiles
時間枠:Baseline and Endpoints [up to 24 weeks (wk) and up to 52 weeks]
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7-point SMBG measurements are completed at the following timepoints: Morning (AM) Pre-Meal, AM Post-Prandial (PP), Midday (MD) Pre-Meal, MD PP, Evening (EV) Pre-Meal, Bed Time and 0300 hours.
PP glucose is measured 2 hours (hrs) after the start of the meal.
Values for the 7-point SMBG profiles were averaged over the three 7-point SMBG profiles during 2-week period prior to each visit.
If only 1 of the 3 days of data was collected, then the value of the 1 day was used.
If only 2 of the 3 days of data were collected, then the average of the 2 days was used.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline and Endpoints [up to 24 weeks (wk) and up to 52 weeks]
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Glycemic Variability of Fasting Blood Glucose
時間枠:Baseline and Endpoints (up to 24 weeks and up 52 weeks)
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Glycemic variability is the intra-participant standard deviation (SD) value of fasting blood glucose as measured by the actual morning premeal blood glucose value from the 7-point self-monitoring blood glucose (SMBG) profiles.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline and Endpoints (up to 24 weeks and up 52 weeks)
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Change From Baseline in Body Weight
時間枠:Baseline, 6 weeks and 12 weeks and 18 weeks and Endpoints (up to 24 weeks and up to 52 weeks)
|
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline, 6 weeks and 12 weeks and 18 weeks and Endpoints (up to 24 weeks and up to 52 weeks)
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Adult Low Blood Sugar Survey (ALBSS)
時間枠:Baseline and 24 weeks and Endpoint (up to 52 weeks)
|
ALBSS contains 33 items, with each item scored on a 5-point response scale: 0 (never) to 4 (almost always).
Items are categorized in 2 domains: Behavior (or avoidance) Items 1 to 15 and Worry (or affect) Items 16 to 33.
Behavior Total Score (TS) range is 0 to 60 and Worry TS range is 0 to 72.
Higher scores on "Behavior" items (related to avoidance of hypoglycemia) reflect greater awareness and/or effort of the participant to prevent low blood sugar.
Higher scores on "Worry" items (related to worries about low blood sugar and its consequences) reflect greater participant concern about having low blood sugar.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline and 24 weeks and Endpoint (up to 52 weeks)
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Insulin Treatment Satisfaction Questionnaire (ITSQ)
時間枠:Baseline and 24 weeks and Endpoint (up to 52 weeks)
|
ITSQ is a validated instrument containing 22 items that assess treatment satisfaction for participants with diabetes and on insulin.
Items measured on a 7-point scale: 1 (no bother at all) to 7 (a tremendous bother), with lower scores reflecting better outcomes.
Items divided into 5 domains: Inconvenience of Regimen [(IR) 5 items: scores range 5-35], Lifestyle Flexibility [(LF) 3 items: scores range 3-21], Glycemic Control [(GC) 3 items: scores range 3-21], Hypoglycemic Control [(HC) 5 items: scores range 5-35], Insulin Delivery Device [(IDD) 6 items: scores range 6-42].
ITSQ Total Overall Scores range from 22-154.
Data presented are the transformed score on a scale of 0-100, where transformed score=100×[(7-raw score)/6].
Higher scores indicate better treatment satisfaction.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Baseline and 24 weeks and Endpoint (up to 52 weeks)
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Insulin Dose Per Body Weight (U/kg) (Total and by Component [Basal and Bolus (Lispro)])
時間枠:Endpoints [up to 24 weeks (wk) and up to 52 weeks]
|
Total daily insulin dose was adjusted for body weight [units of insulin/kilogram/day (U/kg/day)].
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
|
Endpoints [up to 24 weeks (wk) and up to 52 weeks]
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Insulin Dose - Units [Total and by Component [Basal and Bolus (Lispro)])
時間枠:Endpoints [up to 24 weeks (wk) and up to 52 weeks]
|
Units of insulin taken daily were presented.
Least Squares (LS) means were calculated by analysis of covariance (ANCOVA) and adjusted for baseline hemoglobin A1c (HbA1c), treatment and time of basal insulin injection (daytime, evening/bedtime) and country.
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Endpoints [up to 24 weeks (wk) and up to 52 weeks]
|
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Percentage of Participants With Hemoglobin A1c (HbA1c) <7.0% and HbA1c ≤6.5%
時間枠:Baseline and 6 weeks and 12 weeks and 24 weeks and 36 weeks and 52 weeks and Endpoints (up to 24 weeks and up to 52 weeks)
|
HbA1c is the glycosylated fraction of hemoglobin A which provides an estimate of a participant's blood sugar control over a 6- to 12-week period.
The percentage of participants with Hemoglobin A1c (HbA1c) <7.0% or HbA1c ≤6.5% is calculated as the number of participants with an HbA1c level of the cut-off value (<7.0% or ≤6.5%) divided by the number of participants treated, then multiplied by 100.
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Baseline and 6 weeks and 12 weeks and 24 weeks and 36 weeks and 52 weeks and Endpoints (up to 24 weeks and up to 52 weeks)
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Incidence of Hypoglycemic Events
時間枠:Baseline through 24 weeks (wk) and 52 weeks
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Incidence of hypoglycemic events is defined as the number of hypoglycemic events.
A hypoglycemic event is defined as any time a participant feels that he/she is experiencing a sign or symptom that is associated with hypoglycemia, or has a blood glucose (BG) concentration of ≤ 70 milligrams/deciliter [mg/dL (3.9 millimoles/liter (mmol/L)], even if it was not associated with signs, symptoms, or treatment consistent with current guidelines [American Diabetes Association (ADA) 2005].
Severe hypoglycemia is defined as a hypoglycemic event requiring 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; also, BG measurements may not be available during such an event).
Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking.
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Baseline through 24 weeks (wk) and 52 weeks
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Rate Per 30 Days of Hypoglycemic Events
時間枠:Baseline through 24 weeks (wk) and 52 weeks
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The rate of hypoglycemic events per 30 days is defined as the total number of events between visits divided by the actual number of days between visits, and then multiplied by 30 days.
A hypoglycemic event is defined as any time a participant feels that he/she is experiencing a sign or symptom that is associated with hypoglycemia, or has blood glucose (BG) concentration of ≤ 70 milligrams/deciliter [mg/dL (3.9 millimoles/liter (mmol/L)], even if it was not associated with signs, symptoms, or treatment consistent with current guidelines (ADA 2005).
Severe hypoglycemia is defined as a hypoglycemic event requiring 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; also, BG measurements may not be available during such an event).
Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking.
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Baseline through 24 weeks (wk) and 52 weeks
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研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2011年8月1日
一次修了 (実際)
2012年8月1日
研究の完了 (実際)
2013年4月1日
試験登録日
最初に提出
2011年8月19日
QC基準を満たした最初の提出物
2011年8月19日
最初の投稿 (見積もり)
2011年8月22日
学習記録の更新
投稿された最後の更新 (見積もり)
2014年10月9日
QC基準を満たした最後の更新が送信されました
2014年10月3日
最終確認日
2014年10月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。