The purpose of this study is to determine the efficacy and safety of SYR-619, once daily (QD), in subjects with type 2 diabetes mellitus who have not achieved glycemic control with diet and exercise, or by taking metformin.
There are approximately 19 million people in the United States who have been diagnosed with diabetes mellitus, of which 90% to 95% is type 2. The prevalence of type 2 diabetes varies among racial and ethnic populations and has been shown to correlate with age, obesity, family history, history of gestational diabetes, and physical inactivity. Over the next decade, a marked increase in the number of adults with diabetes mellitus is expected, placing an ever increasing burden on families and the health care system. SYR-619 is an inhibitor of the dipeptidyl peptidase IV enzyme. Dipeptidyl peptidase IV is thought to be primarily responsible for the in vivo degradation of 2 peptide hormones released in response to nutrient ingestion, namely glucagon-like peptide-1 and glucose-dependent insulinotropic peptide. The aim of this study is to evaluate the dose-response efficacy, safety and tolerability of treatment with SYR-619 in subjects with type 2 diabetes who do not previously achieve adequate glycemic control with lifestyle modification (diet/exercise) or metformin or sulfonylurea oral antidiabetic monotherapy. Individuals who want to participate in this study will be required to provide written informed consent. Study participation is anticipated to be about 14 Weeks. Multiple procedures will occur at each visit which may include fasting, blood collection, urine collection, vital signs including sitting and standing blood pressure and pulse, body height and weight, physical examinations, electrocardiogram.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
82
Change from baseline in glycosylated hemoglobin.
Time frame: Week 12 or Final Visit..
Change from baseline in glycosylated hemoglobin.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Change from baseline in fasting plasma glucose.
Time frame: Weeks: 1, 2, 4, 8 and 12 or Final Visit.
Change from baseline in 1,5 anhydroglucitol.
Time frame: Weeks 2, 4, 8 and 12 or Final Visit.
Change from baseline in proinsulin.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Change from baseline in insulin.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Change from baseline in proinsulin/insulin ratio.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Change from baseline in C-peptide.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Homeostasis model assessment insulin resistance.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Homeostasis model assessment beta-cell function.
Time frame: Weeks 4, 8 and 12 or Final Visit.
Incidence of marked hyperglycemia (fasting plasma glucose ≥200 mg/dL [≥11.10 mmol/L]).
Time frame: Weeks 1, 2, 4, 8 and 12 or Final Visit.
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SYR-619 200 mg, tablets, orally, once daily for up to 12 weeks.
SYR-619 placebo-matching tablets, orally, once daily for up to 12 weeks.
Alogliptin 25 mg, tablets, orally, once daily for up to 12 weeks.
Incidence of rescue.
Time frame: Weeks 1, 2, 4, 8 and 12 or Final Visit.
Clinical response endpoint incidence of glycosylated hemoglobin ≤6.5%.
Time frame: Week 12 or Final Visit.
Clinical response endpoint incidence of glycosylated hemoglobin ≤7.0%.
Time frame: Week 12 or Final Visit.
Clinical response endpoint incidence of glycosylated hemoglobin improvement ≥1.0%.
Time frame: Week 12 or Final Visit.
Clinical response endpoint incidence of glycosylated hemoglobin improvement ≥1.5%.
Time frame: Week 12 or Final Visit.
Clinical response endpoint incidence of glycosylated hemoglobin improvement ≥2.0%.
Time frame: Week 12 or Final Visit.
Fasting lipids (triglycerides, total cholesterol, high-density lipoprotein and low-density lipoprotein cholesterol).
Time frame: Weeks 4, 8, and 12 or Final Visit.
Postprandial area under the concentration-time curve and peak 2-hour values of plasma glucose, insulin and C-peptide during a 3-hour mixed-meal tolerance test in a subset of subjects.
Time frame: Week 12 or Final Visit.
Plasma concentration of SYR-619.
Time frame: Week 8.
Physical examination findings (including a clinical examination of skin and digits).
Time frame: At All Visits
Vital sign measurements.
Time frame: At All Visits
Body temperature measurements.
Time frame: Week 12 or Final Visit.
12-lead electrocardiogram tracings.
Time frame: Week 12 or Final Visit.
Incidence of adverse events.
Time frame: At All Visits
Incidence of hypoglycemia (blood glucose <60 mg/dL [<3.33 mmol/L]) in the presence of symptoms or blood glucose <50 mg/dL [<2.78 mmol/L]) regardless of symptoms).
Time frame: At All Visits
Clinical laboratory evaluations (hematology and serum chemistry).
Time frame: At All Visits
Clinical laboratory evaluation (urinalysis).
Time frame: Week 12 or Final Visit.