A Preliminary Study of the Efficacy and Safety of MK-8521 for Type 2 Diabetes (MK-8521-004)

Merck Sharp & Dohme (MSD)

Status and phase: Terminated; Phase 2

Conditions: Type II Diabetes Mellitus

Treatments: Drug: Metformin; Drug: MK-8521; Drug: Liraglutide; Drug: Placebo

Study type: Interventional

Funder types: Industry

Identifiers

NCT02492763

8521-004

MK-8521-004 (Other Identifier)

Details and patient eligibility

About

This is a multicenter randomized, double-blind, placebo- and active-controlled (liraglutide; Victoza®), parallel-group, clinical trial of MK-8521 in participants with type 2 diabetes mellitus (T2DM) with inadequate glycemic control while on a stable dose of metformin (≥1000 mg/day).

The trial will include a 1-week screening period; at least an 8-week antihyperglycemic agent (AHA) washout period, if required; a 14-week blinded therapy period (which includes single-blind run-in and double-blind therapy); and a 14-day post-treatment visit, 2 weeks after the last dose of investigational product.

The primary hypothesis of the trial is that MK-8521 provides greater reduction in hemoglobin A1C relative to placebo after 12 weeks of once-daily administration in participants with T2DM with inadequate glycemic control on metformin monotherapy.

Enrollment: 176 patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Have T2DM in accordance with American Diabetes Association guidelines
• Be on metformin monotherapy (>-1000 mg/day: metformin IR or metformin XR) for at least 12 weeks prior to study start with a hemoglobin A1C (A1C) >-7.5 and <-10.5% OR Be on dual therapy with metformin (>-1000 mg/day: dose stable for at least 4 weeks prior to study start) with an A1C of >-7.0% and <-10.0% and a second AHA and be willing to washout the second AHA. Allowable AHAs are dipeptidyl peptidase 4 (DPP-4 inhibitors), alpha-glucosidase inhibitors, sulfonylureas, and glinides.
• Have a body mass index (BMI) ≥23 kg/m^2 and ≤40 kg/m^2
• Is a female who is not of reproductive potential, or is a female of reproductive potential who agrees to avoid becoming pregnant: while receiving study drug and for 14 days after the last dose of study drug

Exclusion criteria

• Have a history of type 1 diabetes or a history of diabetic ketoacidosis
• Has a history of other specific types of diabetes (e.g., genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical-induced, and post-organ transplant)
• Has been treated with any gut-derived incretin hormone glucagon-like peptide 1 (GLP-1) receptor agonist (e.g. Byetta™, Victoza™ or investigational agents) within the last 6 months or has had GLP-1 receptor agonist discontinued due to gastrointestinal intolerance or lack of efficacy. Note: treatment with a GLP-1 receptor agonist that was discontinued >6 months prior to study start is not an exclusion if the GLP-1 receptor agonist was discontinued for reasons other than gastrointestinal intolerance or lack of efficacy.
• Has a history of clinically significant gastrointestinal disorder (including diabetic gastroparesis; irritable bowel disease; recurrent episodes of nausea, vomiting, diarrhea and abdominal pain)
• Has a history of clinically significant and active, immunological, respiratory, genitourinary or major neurological (including stroke, transient ischemic attack and chronic seizures) abnormalities or diseases
• Has a history of cardiovascular disease (including diabetic cardiomyopathy) or significant cardiac condition (including a history of myocardial infarction, stable or unstable angina, arterial revascularization, pathologic, symptomatic or sustained tachyarrhythmia [e.g. atrial fibrillation, sustained supraventricular tachycardia, symptomatic non-sustained supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, Wolf-Parkinson-White syndrome, congenital long QT syndrome, etc.]) or heart failure
• Has a family history of medullary carcinoma of the thyroid or multiple endocrine neoplasm type-2 syndrome
• Has active diabetic proliferative retinopathy or a history of maculopathy
• Has human immunodeficiency virus (HIV)
• Has a medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic hepatitis B or C (assessed by medical history), primary biliary cirrhosis, or active symptomatic gallbladder disease
• Is on a weight loss medication or has undergone bariatric surgery
• Has a history of acute or chronic pancreatitis of any etiology
• Had an event of severe hypoglycemia with neuroglycopenia in the past 12 months
• Has a positive urine pregnancy test
• Is pregnant or breast-feeding, or is planning to conceive during the trial, including 14 days following the last dose of investigational product
• Routinely consumes >1 alcoholic drinks per day or >7 alcoholic drinks per week or engages in binge drinking
• Routinely consumes ≥480mg /day caffeine in caffeinated beverages (1 cup of coffee contains approximately 120 mg of caffeine
• Is taking a beta blocker or medications with sympathomimetic activity (e.g. pseudoephedrine, phenylpropanolamine, etc.)
• Is currently a user of nicotine or nicotine containing products or does not agree to refrain from using nicotine during the trial, including 14 days following the last dose of investigational product
• Is currently a user of any illicit drugs (including any marijuana use) or has a history of drug (including alcohol) abuse within approximately 5 years
• has other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or blinded investigational product administration

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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176 participants in 4 patient groups, including a placebo group

MK-8521 300 μg

Experimental group

Description:

Participants receive double-blind MK-8521 300 μg daily (QD), subcutaneously, over 12 weeks.

Treatment:

Drug: Metformin

Drug: Placebo

Drug: MK-8521

MK-8521 180 μg

Experimental group

Description:

Participants receive double-blind MK-8521 180 μg QD, subcutaneously, over 12 weeks.

Treatment:

Drug: Metformin

Drug: Placebo

Drug: MK-8521

Placebo

Placebo Comparator group

Description:

Participants receive matching double-blind placebo, QD over 12 weeks.

Treatment:

Drug: Metformin

Drug: Placebo

Liraglutide 1.8 mg

Active Comparator group

Description:

Participants receive open-label 1.8 mg of liraglutide, QD, subcutaneously, over 12 weeks.

Treatment:

Drug: Metformin

Drug: Liraglutide