The purpose of this study was to determine the long-term safety of TAK-559, once daily (QD), in subjects with Type 2 Diabetes.
Insulin is a primary regulator of blood glucose concentrations. A subnormal response to circulating insulin levels at target tissues leads to a decrease in insulin-mediated glucose uptake. Insulin resistance is associated with normal to high insulin levels and is often accompanied by dyslipidemia, a disruption in lipid metabolism resulting in increased triglycerides and low-density lipoprotein levels as well as decreased high-density lipoprotein levels in patients with type 2 diabetes mellitus. In the early stages of insulin resistance, a compensatory mechanism of increased insulin secretion by the pancreas maintains normal to near-normal glucose levels. Once the pancreas fails to maintain the increased insulin output, overt type 2 diabetes mellitus occurs. Insulin also plays an important role in the metabolism of fat and proteins and exerts its influence at the peroxisome proliferator-activated receptor level. Peroxisome proliferator-activated receptor -alpha receptors are expressed predominantly in skeletal muscle, adipose tissue, heart, liver, kidney, gut, macrophages, and vascular tissue, and play a key role in energy storage, glucose homeostasis, and vascular biology. Thus, as insulin activates peroxisome proliferator-activated receptor-alpha receptors, this results in the cellular uptake of glucose. Peroxisome proliferator-activated receptor receptors are ligand-activated transcription elements that regulate gene expression necessary for metabolism. For this reason, peroxisome proliferator-activated receptors play a pivotal role in glucose homeostasis, adipocyte differentiation, and lipid storage. The genes predominantly targeted by transcription activity of activated peroxisome proliferator-activated receptor-alpha receptors are those that mediate fatty acid uptake, fatty acid oxidation, and lipoprotein metabolism. As such, peroxisome proliferator-activated receptor-alpha agonists have their greatest effect on lipid metabolism and vascular biology. TAK-559 is a novel oxyiminoalkanoic acid under investigation for use as an oral agent in the treatment of patients with type 2 diabetes mellitus. TAK-559 has partial peroxisome proliferator-activated receptor-alpha agonist activity, potent peroxisome proliferator-activated receptor-alpha activity, and modest peroxisome proliferator-activated receptor-gamma activity at high concentrations in nonclinical models.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
316
TAK-559 32 mg, tablets, orally, once daily for up to 24 months.
Change from baseline in clinical laboratory hematology tests.
Time frame: Week 2 and Months 6, 12, 18, and Final Visit
Change from baseline in clinical laboratory chemistry tests.
Time frame: Week 2 and Months 6, 12, 18, and Final Visit
Blood pressure measurements.
Time frame: All visits.
Pulse measurements.
Time frame: All visits.
Body weight.
Time frame: All visits.
Physical examinations.
Time frame: Months 6, 12, 18, and Final Visit
12-lead electrocardiogram.
Time frame: Months 6, 12, and Final Visit
Adverse event occurrence.
Time frame: All visits or at occurrence
Change from baseline in glycosylated hemoglobin.
Time frame: Months 3, 6, 9, 12, 15, 18, 21, and Final Visit
Change from baseline in fasting plasma glucose.
Time frame: All visits.
Change from baseline in fasting insulin.
Time frame: Months 3, 6, 9, 12, 15, 18, 21, and Final Visit
Change from baseline in fasting C-peptide.
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Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in triglycerides.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in total cholesterol.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in high-density lipoprotein.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in low-density lipoprotein.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in very-low-density lipoprotein.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in low-density lipoprotein fractionation.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in intermediate-density lipoprotein size.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in large low-density lipoprotein size.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in small low-density lipoprotein size.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in medium-small low-density lipoprotein size.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in very-small low-density lipoprotein size.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in mean low-density lipoprotein size.
Time frame: Months 6, 12, 18, and Final Visit
Change from baseline in apolipoproteins A1 and B.
Time frame: Months 12 and Final Visit
Change from baseline in atherosclerosis marker plasminogen activator inhibitor 1.
Time frame: Months 6, 12, and Final Visit
Change from baseline in atherosclerosis marker fibrinogen.
Time frame: Months 6, 12, and Final Visit
Change from baseline in inflammation marker Interleukin-6.
Time frame: Months 6, 12, and Final Visit
Change from baseline in inflammation marker C-reactive protein.
Time frame: Months 6, 12, and Final Visit