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

1 september 2015 uppdaterad av: 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.

Studieöversikt

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Faktisk)

139

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 75 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Aktiv komparator: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Percentage of subjects reaching fasting plasma glucose (FPG) target
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Biverkningar
Tidsram: 12 veckor
12 veckor
Number of days to first reach fasting plasma glucose target
Tidsram: 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
Tidsram: 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
Tidsram: 12 weeks
Fasting plasma glucose values over the entire study period will be summarized by mean and standard deviation
12 weeks
Hemoglobin A1c (HbA1c)
Tidsram: 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
Tidsram: 12 weeks
12 weeks
Rate of documented hypoglycemia in subjects that do not reach target
Tidsram: 12 weeks
12 weeks
Proportion of all patients with hypoglycemia
Tidsram: 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
Tidsram: 12 weeks
The number of times subjects contacted their physician/HCP during the study
12 weeks
Diabetes Treatment Satisfaction Questionnaire (DTSQ)
Tidsram: 12 weeks
A questionnaire to assess subject's overall satisfaction with their diabetes treatment
12 weeks
Hypoglycemia Fear Survey (HFS)
Tidsram: 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
Tidsram: 12 weeks
A questionnaire to measure emotional well-being to screening for likely depression in subjects with diabetes
12 weeks
Diabetes Distress Scale
Tidsram: 12 weeks
A questionnaire to assess diabetes-related emotional distress
12 weeks
LTHome Patient Satisfaction Survey
Tidsram: 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
Tidsram: 12 weeks
12 weeks
Number of dose recommendations prior to reaching target - LTHome only
Tidsram: 12 weeks
12 weeks
Number of dose recommendations after target is reached - LTHome only
Tidsram: 12 weeks
12 weeks
Number of days insulin glargine was taken - LTHome only
Tidsram: 12 weeks
12 weeks
Reasons for disregarding LTHome advice - LTHome only
Tidsram: 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
Tidsram: 12 weeks
12 weeks

Andra resultatmått

Resultatmått
Tidsram
Body weight (kg)
Tidsram: 12 weeks
12 weeks
List of concomitant medications initiated after randomization
Tidsram: 12 weeks
12 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Samarbetspartners

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 december 2013

Primärt slutförande (Faktisk)

1 mars 2015

Avslutad studie (Faktisk)

1 mars 2015

Studieregistreringsdatum

Först inskickad

21 augusti 2015

Först inskickad som uppfyllde QC-kriterierna

1 september 2015

Första postat (Uppskatta)

4 september 2015

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

4 september 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

1 september 2015

Senast verifierad

1 september 2015

Mer information

Termer relaterade till denna studie

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