Title

START-J: SiTAgliptin in eldeRly Trial in Japan
Efficacy and Safety Comparison of Sitagliptin and Glimepiride in Elderly Japanese Patients With Type 2 Diabetes
  • Phase

    N/A
  • Study Type

    Interventional
  • Study Participants

    305
The purpose of this study is to compare the efficacy and the safety of sitagliptin and glimepiride in drug naïve elderly patients with Type 2 diabetes as evaluated by HbA1c change from baseline at 52 W as efficacy and incidence of hypoglycemia from randomization to 52 W as safety. The clinical hypotheses are non-inferiority of sitagliptin to glimepiride in efficacy as judged by HbA1c change from baseline at 52 W and superiority of sitagliptin to glimepiride in safety as judged by incidence of hypoglycemia in drug naïve elderly patients with T2DM. In addition, comparison of efficacy is extended to 104 W.
Study Started
Aug 31
2010
Primary Completion
Jan 31
2015
Study Completion
Jan 31
2015
Results Posted
Apr 14
2017
Last Update
Apr 14
2017

Drug Sitagliptin

Starting dose for sitagliptin is 50mg per day, can be increased up to 100mg (25-50mg; estimate glomerular filtration rate (eGFR) 30=< <50).

Drug Glimepiride

Starting dose for glimepiride is 0.5mg per day, can be increased up to 6.0mg

Sitagliptin Experimental

Glimepiride Active Comparator

Criteria

Inclusion Criteria:

Patients with type 2 diabetes who are oral hypoglycemic agent naive or, α-glucosidase inhibitor or biguanide monotherapy (to be washed out 4 weeks prior to randomization)
Signed informed consent obtained before any trial-related activities
Treatment with diet and exercise for 12 weeks and longer at screening
Age =>60 y.o.
Male and Female
HbA1c 6.9%=< <8.9%

Exclusion Criteria:

Active proliferative retinopathy or maculopathy requiring treatment
Liver dysfunction (>x2 of upper normal limit), moderate or severe renal dysfunction(serum Cr>1.5mg/dL in male, Cr>1.3mg/dL in female, eGFR<30), severe cardiac disease (NYHA III or IV), malignancy or uncontrolled hypertension (treated or untreated) as judged by the Investigator
Mental incapacity (including moderate or severe dementia) precluding adequate understanding and/or cooperation as judged by the Investigator
Recurrent hypoglycaemia or hypoglycaemic unawareness as judged by the investigator
Previous history of severe allergy to pharmaceutical products
Systemic glucocorticoids users or potential users
Suspected type 1 diabetes (including slowly progressive insulin dependent diabetes mellitus) or positive anti-glutamic acid decarboxylase antibody
Any condition that the investigator considers a potential obstacle to trial participation and/or data analysis

Summary

Sitagliptin

Glimepiride

All Events

Event Type Organ System Event Term Sitagliptin Glimepiride

Change From Baseline in HbA1c at 52 W

Sitagliptin

-0.66
percent (Least Squares Mean)
95% Confidence Interval: -0.77 to -0.54

Glimepiride

-0.77
percent (Least Squares Mean)
95% Confidence Interval: -0.88 to -0.66

Number of Participants With Hypoglycaemia

Sitagliptin

Glimepiride

The Number of Participants Achieving HbA1c < 6.9 %

Sitagliptin

Glimepiride

Change From Baseline in HOMA-β at 52 W

β cell function is measured by the Homeostatic Model Assessment(HOMA-β). HOMA β = [20 x fasting insulin (μU/mL)] / [fasting plasma glucose (mmol/L) - 3.5]

Sitagliptin

10.2
percent (Mean)
Standard Deviation: 35.7

Glimepiride

23.7
percent (Mean)
Standard Deviation: 56.1

Change From Baseline in Insulin/Proinsulin Ratio at 52 W

Sitagliptin

-0.049
ratio (Mean)
Standard Deviation: 0.111

Glimepiride

-0.002
ratio (Mean)
Standard Deviation: 0.095

Change From Baseline in Body Weight at 52 W

Sitagliptin

-0.367
kg (Mean)
Standard Deviation: 2.441

Glimepiride

0.309
kg (Mean)
Standard Deviation: 2.915

Total

272
Participants

Age, Continuous

70.5
years (Mean)
Standard Deviation: 5.5

BMI

24.2
kg/m^2 (Mean)
Standard Deviation: 3.4

Body weight

60.9
kg (Mean)
Standard Deviation: 9.7

eGFR

68.4
mL/min/1.73m^2 (Mean)
Standard Deviation: 17.1

HbA1c

7.48
percent (Mean)
Standard Deviation: 0.67

HOMA-β

41.1
percent (Mean)
Standard Deviation: 33.9

Insulin/Proinsulin Ratio

0.211
ratio (Mean)
Standard Deviation: 0.125

Region of Enrollment

Sex: Female, Male

Overall Study

Sitagliptin

Glimepiride

Drop/Withdrawal Reasons

Sitagliptin

Glimepiride