Lantus Versus NPH: Comparison in Insulin Naive People Not Adequately Controlled With at Least One Oral Anti Diabetics (OAD) Treatment (LANCELOT)

Sanofi

Status and phase: Completed; Phase 4

Conditions: Diabetes Mellitus, Type 2

Treatments: Drug: human insulin [NPH]; Drug: Insulin Glargine (HOE901) [Lantus]; Drug: Glimepiride

Study type: Interventional

Funder types: Industry

Identifiers

NCT00949442

LANTU_C_02762

EUDRACT #: 2007-006640-22

Details and patient eligibility

About

Primary Objective:

To demonstrate the superiority of insulin glargine over insulin NPH (Neutral Protamin Hagedornon) the change in HbA1c from baseline to the end of the treatment period.

Secondary Objective:

To compare between treatment groups:

• Plasma glucose (fasting, nocturnal) over time,
• Changes from baseline in HbA1c over time,
• Percentage of patients who reach the target of HbA1c <7 and <6.5,
• Use of prandial insulin as rescue medication at month 6,
• Incidence and rate of hypoglycemia (symptomatic diurnal and nocturnal, asymptomatic and severe),
• Daily dose of insulin,
• Change in body weight from baseline,
• Evolution of 8-point plasma-glucose (PG) profiles,
• Overall safety,
• Patient reported outcomes (treatment satisfaction).

Enrollment: 708 patients

Sex: All

Ages: 30 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

• Insulin-naïve type 2 diabetes mellitus
• Type 2 diabetes mellitus diagnosed for at least 1 year
• Treated with at least one OAD (Metformin [daily dose of at least 1000mg], Sulfonylurea, glinides or alpha-glucosidase inhibitor) at stable dose for at least 3 months.
• HbA1c > or = 7.0% and < or = 10.5%
• BMI < 40 kg/m²
• Ability and willingness to perform plasma glucose monitoring using the sponsor-provided glucose meter and patient diary at home
• Informed consent obtained in writing at enrolment into the study
• Willingness and ability to comply with the study protocol

Exclusion criteria:

• Treatment with GLP-1 agonists or with DPP-IV inhibitors in the 3 months prior to study entry
• Treatment with TZD as monotherapy
• Diabetes mellitus other than Type 2 (e.g. secondary to pancreatic disorders, drugs or chemical agents intake...)
• Active proliferative retinopathy, as defined by a photocoagulation or vitrectomy occurrence in the 6 months prior to visit 1, or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgical treatment during the study (an optic fundus examination should have been performed within the 2 years prior to study entry)
• Impaired renal function: serum creatinine > or =1.5 mg/dL (> or = 133µmol/L) or > or = 1.4 mg/dL (> or = 124 µmol/L) in men and women, respectively
• History of sensitivity to the study drugs or to drugs with a similar chemical structure
• Impaired hepatic function (ALT and/or AST > 3 x upper limit of normal range)
• Pregnant or lactating women (women of childbearing potential must have a negative pregnancy test at study entry and a medically approved contraception method),
• Treatment with systemic corticosteroids within the 3 months prior to study entry or likelihood of requiring treatments during the study which are not permitted.
• Treatment with an investigational product in the 30 days prior to visit 1
• Alcohol or drug abuse in the last year
• Presence of any condition (medical, psychological, social or geographical), current or anticipated that the Investigator feels would compromise the patient's safety or limit the patient successful participation in the study (including night shift worker)

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

708 participants in 2 patient groups

1

Experimental group

Description:

Before randomization (common with arm 2): 2 weeks of Screening phase: Oral Anti Diabetics (OAD) 2 weeks of Run-In phase: switch of OAD (Sulfonylurea (except Glimepiride), glinides or alpha-glucosidase inhibitor) to Glimepiride After randomization: 36 weeks of study treatment phase: Insulin Glargine + OAD(s) at stable dose

Treatment:

Drug: Insulin Glargine (HOE901) [Lantus]

Drug: Glimepiride

2

Active Comparator group

Description:

Before randomization (common with arm 1): 2 weeks of Screening phase: Oral Anti Diabetics (OAD) 2 weeks of Run-In phase: switch of OAD (Sulfonylurea (except Glimepiride), glinides or alpha-glucosidase inhibitor) to Glimepiride After randomization: 36 weeks of study treatment phase: NPH + OAD(s) at stable dose

Treatment:

Drug: Glimepiride

Drug: human insulin [NPH]