Title

Efficacy and Safety of Alogliptin Used in Combination With α-glucosidase Inhibitor in Participants With Type 2 Diabetes in Japan
A Phase 2/3, Double-blind, Randomized, Placebo-controlled, Parallel-group, Multicenter Study to Determine the Efficacy and Safety of SYR-322 When Used in Combination With α-glucosidase Inhibitor in Subjects With Type 2 Diabetes in Japan
  • Phase

    Phase 2/Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    alogliptin voglibose ...
  • Study Participants

    230
The purpose of this study was to evaluate the efficacy and safety of alogliptin, once daily (QD) combined with an α-glucosidase inhibitor taken three times daily (TID) in type 2 diabetic patients with uncontrolled blood glucose.
Both insulin hyposecretion and insulin-resistance are considered to be involved in the development of type 2 diabetes mellitus.

Takeda is developing SYR-322 (alogliptin) for the improvement of glycemic control in patients with type 2 diabetes mellitus. Alogliptin is an inhibitor of the dipeptidyl peptidase IV (DPP-IV) enzyme. DPP-IV is thought to be primarily responsible for the degradation of 2 peptide hormones released in response to nutrient ingestion. It is expected that inhibition of DPP-IV will improve glycemic control in patients with type 2 diabetes.

In Japan, α-glucosidase inhibitors are widely used as a first-line treatment for type 2 diabetes mellitus. Because alogliptin has a different mechanism of action compared to α-glucosidase inhibitors, the study evaluated the efficacy and safety of alogliptin combined with an α-glucosidase inhibitor in type 2 diabetic patients with uncontrolled blood glucose while taking a α-glucosidase inhibitor and receiving diet and/or exercise therapies.

To evaluate the long-term safety and efficacy of the concomitant use of alogliptin and an α-glucosidase inhibitor, subjects who participated in the present study could enter a long-term extension study SYR-322/OCT-003 (NCT01263509) that was planned separately.
Study Started
Jan 31
2007
Primary Completion
Apr 30
2008
Study Completion
Apr 30
2008
Results Posted
Jul 11
2011
Estimate
Last Update
Feb 03
2012
Estimate

Drug Alogliptin and voglibose

Alogliptin 12.5 mg, tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 12 weeks.

  • Other names: SYR-322, BASEN®, Voglibose

Drug Alogliptin and voglibose

Alogliptin 25 mg, tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 12 weeks.

  • Other names: SYR-322, BASEN®, Voglibose

Drug Voglibose

Alogliptin placebo-matching tablets, orally, once daily and voglibose 0.2 mg, tablets, orally, three times daily for up to 12 weeks.

  • Other names: BASEN®

Voglibose 0.2 mg TID Active Comparator

Alogliptin 12.5 mg QD and Voglibose 0.2 mg TID Experimental

Alogliptin 25 mg QD and Voglibose 0.2 mg TID Experimental

Criteria

Inclusion Criteria:

Had been receiving a stable dose and regimen of an α-glucosidase inhibitor for the last 4 weeks or longer before the start of the screening phase (Week -8) and during the screening phase.
Had a glycosylated hemoglobin (HbA1c) value of 6.5% or more and below 10.0% 4 weeks after the start of the screening phase (Week -4).
Had HbA1c differences within 10.0% at the start of the screening phase (Week -8) and 4 weeks after the start of the screening phase (Week -4) from the HbA1c value at the start of the screening phase.
Was receiving a specific diet therapy and an exercise therapy (if any) for the last 4 weeks or longer before the start of the screening phase (Week -8).

Exclusion Criteria:

Had received any antidiabetic drug other than α-glucosidase inhibitors within the last 4 weeks before the start of the screening phase (Week -8) or during the screening phase.

Summary

Voglibose 0.2 mg TID

Alogliptin 12.5 mg QD

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

All Events

Event Type Organ System Event Term Voglibose 0.2 mg TID Alogliptin 12.5 mg QD Alogliptin 25 mg QD and Voglibose 0.2 mg TID

Change From Baseline in Glycosylated Hemoglobin (Week 12).

The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 12 or final visit and glycosylated hemoglobin collected at baseline.

Voglibose 0.2 mg TID

0.04
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.457

Alogliptin 12.5 mg QD

-0.96
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.553

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-0.91
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.485

Change From Baseline in Glycosylated Hemoglobin (Week 2).

The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 2 and glycosylated hemoglobin collected at baseline.

Voglibose 0.2 mg TID

-0.01
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.180

Alogliptin 12.5 mg QD

-0.19
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.149

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-0.21
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.175

Change From Baseline in Glycosylated Hemoglobin (Week 4).

The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 4 and glycosylated hemoglobin collected at baseline.

Alogliptin 12.5 mg QD

-0.44
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.234

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-0.43
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.263

Voglibose 0.2 mg TID

-0.02
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.301

Change From Baseline in Glycosylated Hemoglobin (Week 8).

The change in the value of glycosylated hemoglobin (the concentration of glucose bound to hemoglobin as a percent of the absolute maximum that can be bound) collected at week 8 and glycosylated hemoglobin collected at baseline.

Voglibose 0.2 mg TID

-0.01
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.398

Alogliptin 12.5 mg QD

-0.74
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.427

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-0.75
percentage of Glycosylated Hemoglobin (Mean)
Standard Deviation: 0.392

Change From Baseline in Fasting Plasma Glucose (Week 2).

The change between the value of fasting plasma glucose collected at week 2 and fasting plasma glucose collected at baseline.

Voglibose 0.2 mg TID

-3.5
mg/dL (Mean)
Standard Deviation: 21.28

Alogliptin 12.5 mg QD

-15.5
mg/dL (Mean)
Standard Deviation: 18.77

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-18.8
mg/dL (Mean)
Standard Deviation: 19.89

Change From Baseline in Fasting Plasma Glucose (Week 8).

The change between the value of fasting plasma glucose collected at week 8 and fasting plasma glucose collected at baseline.

Voglibose 0.2 mg TID

-2.5
mg/dL (Mean)
Standard Deviation: 25.94

Alogliptin 12.5 mg QD

-20.8
mg/dL (Mean)
Standard Deviation: 22.10

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-21.9
mg/dL (Mean)
Standard Deviation: 23.96

Change From Baseline in Fasting Plasma Glucose (Week 4).

The change between the value of fasting plasma glucose collected at week 4 and fasting plasma glucose collected at baseline.

Voglibose 0.2 mg TID

-0.6
mg/dL (Mean)
Standard Deviation: 23.71

Alogliptin 12.5 mg QD

-16.2
mg/dL (Mean)
Standard Deviation: 21.84

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-22.6
mg/dL (Mean)
Standard Deviation: 23.96

Change From Baseline in Fasting Plasma Glucose (Week 12).

The change between the value of fasting plasma glucose collected at week 12 or final visit and fasting plasma glucose collected at baseline.

Voglibose 0.2 mg TID

-5.6
mg/dL (Mean)
Standard Deviation: 27.87

Alogliptin 12.5 mg QD

-19.1
mg/dL (Mean)
Standard Deviation: 20.70

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-18.5
mg/dL (Mean)
Standard Deviation: 25.53

Change From Baseline in Fasting C-peptide (Week 2).

The change between the value of fasting C-peptide collected at week 2 and fasting C-peptide collected at baseline.

Voglibose 0.2 mg TID

0.03
ng/mL (Mean)
Standard Deviation: 0.668

Alogliptin 12.5 mg QD

-0.07
ng/mL (Mean)
Standard Deviation: 0.593

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-0.01
ng/mL (Mean)
Standard Deviation: 0.599

Change From Baseline in Fasting C-peptide (Week 4).

The change between the value of fasting C-peptide collected at week 4 and fasting C-peptide collected at baseline.

Voglibose 0.2 mg TID

0.05
ng/mL (Mean)
Standard Deviation: 0.753

Alogliptin 12.5 mg QD

0.06
ng/mL (Mean)
Standard Deviation: 0.955

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

0.01
ng/mL (Mean)
Standard Deviation: 0.682

Change From Baseline in Fasting C-peptide (Week 8).

The change between the value of fasting C-peptide collected at week 8 and fasting C-peptide collected at baseline.

Voglibose 0.2 mg TID

0.07
ng/mL (Mean)
Standard Deviation: 0.691

Alogliptin 12.5 mg QD

0.03
ng/mL (Mean)
Standard Deviation: 0.725

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-0.01
ng/mL (Mean)
Standard Deviation: 0.468

Change From Baseline in Fasting C-peptide (Week 12).

The change between the value of fasting C-peptide collected at week 12 or final visit and fasting C-peptide collected at baseline.

Voglibose 0.2 mg TID

0.02
ng/mL (Mean)
Standard Deviation: 0.664

Alogliptin 12.5 mg QD

0.06
ng/mL (Mean)
Standard Deviation: 0.680

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

0.1
ng/mL (Mean)
Standard Deviation: 0.620

Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (2-hr Postprandial Value).

The change between the value of blood glucose collected at week 12 or final visit and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and at 2 hours after the start of the meal.

Voglibose 0.2 mg TID

72.4
mg/dL (Mean)
Standard Deviation: 34.89

Alogliptin 12.5 mg QD

40.9
mg/dL (Mean)
Standard Deviation: 23.23

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

38.7
mg/dL (Mean)
Standard Deviation: 32.33

Change From Baseline in Blood Glucose Measured by Meal Tolerance Testing (AUC (0-2)).

The change between the value of blood glucose collected at week 12 or final visit and blood glucose collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and at 2 hours after the start of the meal.

Voglibose 0.2 mg TID

-4.3
mg·hr/dL (Mean)
Standard Deviation: 60.23

Alogliptin 12.5 mg QD

-74.7
mg·hr/dL (Mean)
Standard Deviation: 61.76

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-76.8
mg·hr/dL (Mean)
Standard Deviation: 63.19

Change From Baseline in Insulin Measured by Meal Tolerance Testing (AUC(0-2).

The change between the value of insulin collected at week 12 or final visit and insulin collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and at 2 hours after the start of the meal.

Alogliptin 12.5 mg QD

4.62
μU·hr/mL (Mean)
Standard Deviation: 16.599

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

1.5
μU·hr/mL (Mean)
Standard Deviation: 14.845

Voglibose 0.2 mg TID

-2.47
μU·hr/mL (Mean)
Standard Deviation: 10.817

Change From Baseline in C-peptide Measured by Meal Tolerance Testing (AUC(0-2).

The change between the value of C-peptide collected at week 12 or final visit and C-peptide collected at baseline as measured by the meal tolerance test. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and at 2 hours after the start of the meal.

Voglibose 0.2 mg TID

0.14
ng·hr/mL (Mean)
Standard Deviation: 1.670

Alogliptin 12.5 mg QD

0.69
ng·hr/mL (Mean)
Standard Deviation: 1.901

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

0.57
ng·hr/mL (Mean)
Standard Deviation: 2.247

Change From Baseline in Glucagon Measured by Meal Tolerance Testing (AUC (0-2)).

The change between the value of glucagons collected at week 12 or final visit and glucagons collected at baseline. Meal tolerance test measures blood glucose, insulin, C-peptide and glucagon through blood samples drawn before a meal and at 2 hours after the start of the meal.

Voglibose 0.2 mg TID

-0.4
pg·hr/mL (Mean)
Standard Deviation: 64.18

Alogliptin 12.5 mg QD

-19.2
pg·hr/mL (Mean)
Standard Deviation: 42.72

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

-20.5
pg·hr/mL (Mean)
Standard Deviation: 41.97

Total

230
Participants

Age, Customized

Sex: Female, Male

Overall Study

Voglibose 0.2 mg TID

Alogliptin 12.5 mg QD

Alogliptin 25 mg QD and Voglibose 0.2 mg TID

Drop/Withdrawal Reasons

Voglibose 0.2 mg TID

Alogliptin 12.5 mg QD

Alogliptin 25 mg QD and Voglibose 0.2 mg TID