Thiazolidinedione Intervention With Vitamin D Evaluation (TIDE)

GlaxoSmithKline (GSK)

Status and phase

Terminated

Phase 4

Conditions

Diabetes Mellitus, Type 2

Treatments

Drug: placebo

Dietary Supplement: Placebo

Drug: pioglitazone

Drug: rosiglitazone

Dietary Supplement: Vitamin D

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT00879970

111960

Details and patient eligibility

About

This study will answer two separate questions.

The first question is to test the cardiovascular effects of long-term treatment with rosiglitazone or pioglitazone when used as part of standard of care compared to similar standard of care without rosiglitazone or pioglitazone in patients with type 2 diabetes who have a history of or are at risk for cardiovascular disease.

The second question will compare the effects of long-term supplementation of vitamin D on death and cancer

Enrollment

1,332 patients

Sex

All

Ages

50+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Men or women with: a) newly detected type 2 diabetes based on a fasting plasma glucose greater than or equal to 7.0 mmol/l (126 mg/dL) or a 2 hour plasma glucose (FPG) greater than or equal to 11.1 mmol/l (200 mg/dL) on an oral glucose tolerance test, or b) a history of type 2 diabetes
Hemoglobin A1c (A1C) 6.5-9.5% inclusive (for assays with upper limit of normal of 6%) within one month of screening
Age ≥ 50 years and evidence of vascular disease defined as ≥1of:
- prior myocardial infarction
- prior stroke
- coronary, carotid or peripheral artery revascularization ≥ 4 years earlier
- previous documented myocardial ischemia on either an exercise stress test or on any cardiac imaging, or previous unstable angina with ECG changes or cardiac enzyme elevation OR
Age ≥ 55 years and evidence of subclinical vascular disease defined as ≥1 of:
- microalbuminuria or proteinuria
- history of treated or untreated hypertension with left ventricular hypertrophy by electrocardiogram (ECG) or echocardiogram
  - 50% stenosis on any imaging of coronary, carotid or lower extremity arteries
- ankle/brachial index <0.9 OR
Age ≥ 60 years and at least 2 of the following cardiovascular disease risk factors:
- current tobacco use
- LDL-c ≥3.4 mmol/L (130 mg/dL) or on a lipid lowering medication
- HDL-c < 1.0 mmol/L (40 mg/dL) for men and < 1.3 mmol/L (50 mg/dL) for women or triglycerides ≥ 2.3 mmol/L (200 mg/dL)
- BP lowering medication use or untreated SBP ≥ 140 mmHg or DBP ≥ 95 mmHg
- Waist to hip ratio > 1.0 for men and > 0.8 for women
On no insulin and on less than or equal to 2 anti-diabetes drugs where at least one drug is at or below the half-maximal dose (as indicated in the MOP) with stable dosing for 10 weeks prior to screening

Exclusion criteria

Type 1 diabetes
Current need for insulin treatment
Symptomatic hyperglycemia requiring immediate therapy in the judgment of the physician
An acute cardiovascular event within 30 days prior to randomization
Symptomatic heart failure (i.e. New York Heart Association class II or higher) or any episode of previous pulmonary edema or known ejection fraction < 0.4 or current use of loop diuretics
Any fracture within the past 1 year
Currently planned coronary, carotid or peripheral artery revascularization or cardiac valve surgery
Coronary, carotid or peripheral artery revascularization within the 4 years prior to screening in the absence of angina, MI, or stroke in the intervening period
End stage renal disease requiring renal replacement therapy
Receiving drug therapy to treat liver disease
A diagnosis of cancer (other than superficial squamous, basal cell skin cancer, or adequately treated cervical carcinoma in situ) in the past 3 years or current treatment for the active cancer (other than prophylactic)
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level > 2.5 times the upper limit of normal
A prior heart transplant or awaiting a heart transplant
Previous or current hypercalcemia, hyperparathyroidism, osteomalacia or other contraindication for vitamin D therapy
Regular use of or indication for greater than 400IU of vitamin D daily
Clinically or medically unstable with expected survival < 1 year
Unwillingness to permit sites to contact their primary physicians to communicate information about the study and the participant's data
Any other factor likely to limit protocol compliance or reporting of adverse events
Inability to discontinue a TZD (if taking one) in the judgement of the physician/investigator
Contraindications to or history of hypersensitivity to the investigational products
History of renal stones within the past 2 years
Participation in another clinical trial of an investigational agent

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

Quadruple Blind

1,332 participants in 5 patient groups, including a placebo group

pioglitazone

Active Comparator group

Description:

PIO tablet was administered in the dose of 30 milligrams (mg) OD initially and could be titrated to a maximum dose of 45 mg at or after the 6-month visit. After 1 year of treatment, the dose of PIO was increased to 45 mg OD for the duration of 5.5 years.

Treatment:

Drug: pioglitazone

rosiglitazone

Active Comparator group

Description:

RSG tablet was administered in the dose of 4 mg OD initially and could be titrated to a maximum dose of 8 mg at or after the 6-month visit. After 1 year of treatment, the dose of RSG was increased to 8 mg OD for the duration of 5.5 years.

Treatment:

Drug: rosiglitazone

TZD placebo

Placebo Comparator group

Description:

Matching placebo tablet was administered once a day (OD) for the duration of 5.5 years

Treatment:

Drug: placebo

Vitamin D

Active Comparator group

Description:

Active comparator