Phase 3
Completed N=200
Study to Assess Safety & Efficacy of Sitagliptin as Initial Oral Therapy for Treatment of Type 2 Diabetes Mellitus in Pediatric Participants. (MK-0431-083)
Source: ClinicalTrials.gov NCT01485614 ↗Enrolled (actual)
200
Serious AEs
10.5%
Results posted
Dec 2020
Primary outcomePrimary: Change From Baseline in Hemoglobin A1C (A1C) at Week 20 — -0.13; -0.02; -1.03; 0.57 Percentage
◆ Published Evidence
Established
32citations · ~8 / year
A randomized clinical trial of the efficacy and safety of sitagliptin as initial oral therapy in youth with type 2 diabetes.
Summary
The purpose of the study is to assess the safety of the addition of sitagliptin, and its effect on hemoglobin A1c (A1C) in pediatric participants 10-17 years of age with type 2 diabetes mellitus (T2DM) with inadequate glycemic control. The primary hypothesis for this study is that sitagliptin reduces A1C more than placebo after 20 weeks of treatment.
Linked Publications
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A randomized clinical trial of the efficacy and safety of sitagliptin as initial oral therapy in youth with type 2 diabetes.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline in Hemoglobin A1C (A1C) at Week 20 |
-0.13; -0.02; -1.03; 0.57 | — |
| PRIMARY Baseline Glycated Hemoglobin (A1C) for the Placebo (Pooled) Arm |
7.58 | — |
| PRIMARY Change From Baseline In A1C at Week 20 (Analysis of Selected Arms: Sitagliptin and Placebo (Pooled)) |
-0.01; 0.18 | = 0.448 |
| PRIMARY Number of Participants Who Experienced ≥1 Adverse Event During Weeks 0-56 |
73; 67; 7; 4 | — |
| PRIMARY Percentage of Participants Who Experienced ≥1 Adverse Event During Weeks 0-56 (Analysis of Selected Arms: Sitagliptin and Placebo/Metformin) |
76.8; 74.4 | — |
| PRIMARY Number of Participants Who Discontinued Study Drug Due to an Adverse Event During Weeks 0-54 |
5; 1; 0; 0 | — |
| PRIMARY Percentage of Participants Who Discontinued Study Drug Due to an Adverse Event During Weeks 0-54 (Analysis of Selected Arms: Sitagliptin and Placebo/Metformin) |
5.3; 1.1 | — |
| SECONDARY Change From Baseline in A1C at Week 54 |
-0.19; -0.90; -0.70; -0.50 | — |
| SECONDARY Percentage of Participants With A1C at Goal (<7.0%) at Week 20 |
49.5; 37.8; 77.8; 20.0 | — |
| SECONDARY Percentage of Participants With A1C at Goal (<7.0%) at Week 20 (Analysis of Selected Arms: Sitagliptin and Placebo (Pooled)) |
49.5; 36.8 | = 0.374 |
| SECONDARY Percentage of Participants With A1C at Goal (<6.5%) at Week 20 |
30.5; 23.3; 66.7; 20.0 | — |
| SECONDARY Percentage of Participants With A1C at Goal (<6.5%) at Week 20 (Analysis of Selected Arms: Sitagliptin and Placebo (Pooled)) |
30.5; 23.2 | = 0.639 |
| SECONDARY Percentage of Participants With A1C at Goal (<7.0%) at Week 54 |
28.4; 40.0; 33.3; 20.0 | — |
| SECONDARY Percentage of Participants With A1C at Goal (<6.5%) at Week 54 |
20.0; 35.6; 22.2; 20.0 | — |
| SECONDARY Change From Baseline in Fasting Plasma Glucose (FPG) at Week 20 |
9.98; 7.59; -19.88; 57.67 | — |
| SECONDARY Baseline Fasting Plasma Glucose (FPG) for the Placebo (Pooled) Arm |
138.8 | — |
| SECONDARY Change From Baseline in FPG at Week 20 (Analysis of Selected Arms: Sitagliptin and Placebo (Pooled)) |
7.2; 5.7 | = 0.849 |
| SECONDARY Change From Baseline in FPG at Week 54 |
-3.03; -4.52; -29.92; 3.00 | — |
| SECONDARY Change From Baseline in 2-Hour Post-meal Glucose (PMG) at Week 20 |
-2.9; 2.1; -6.8; 63.5 | — |
| SECONDARY Change From Baseline in 2-hour PMG at Week 54 |
-1.7; -16.8; -39.7; -28.0 | — |
| SECONDARY Change From Baseline in 2-hour Incremental PMG at Week 20 |
1.5; 0.7; 0.8; 12.5 | — |
| SECONDARY Change From Baseline in 2-Hour Incremental PMG at Week 54 |
-0.6; -26.6; -31.3; -32.0 | — |
| SECONDARY Change From Baseline in Insulin at Week 20 for Participants Not on Background Insulin |
1.59; -3.91; -7.25; -1.23 | — |
| SECONDARY Change From Baseline in Insulin at Week 54 For Participants Not on Background Insulin |
-9.65; -6.64; -20.50; -9.95 | — |
| SECONDARY Change From Baseline in Proinsulin at Week 20 For Participants Not on Background Insulin |
0.91; -10.88; 12.57; -1.33 | — |
| SECONDARY Change From Baseline in Proinsulin at Week 54 For Participants Not on Background Insulin |
-10.62; -16.13; -23.30; -0.50 | — |
| SECONDARY Change From Baseline in Proinsulin/Insulin Ratio at Week 20 for Participants Not on Background Insulin |
0.02; 0.02; -0.03; -0.19 | — |
| SECONDARY Change From Baseline in Proinsulin/Insulin Ratio at Week 54 For Participants Not on Background Insulin |
0.02; -0.03; -0.01; 0.02 | — |
| SECONDARY Change From Baseline in Homeostatic Model Assessment of β-cell Function (HOMA-β) at Week 20 For Participants Not on Background Insulin |
15.72; -53.23; -1757.50; -64.78 | — |
| SECONDARY Change From Baseline in HOMA-β at Week 54 For Participants Not on Background Insulin |
-41.15; -63.88; -1860.69; -121.48 | — |
| SECONDARY Change From Baseline in Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) at Week 20 For Participants Not on Background Insulin |
-0.50; -0.86; -4.46; 2.58 | — |
| SECONDARY Change From Baseline in HOMA-IR at Week 54 For Participants Not on Background Insulin |
-6.13; -1.30; -15.18; -2.21 | — |
| SECONDARY Change From Baseline in Glucose 3-Hour Total Area Under the Curve (AUC) at Week 20 |
-49.3; 2.0; 18.6; 191.0 | — |
| SECONDARY Change From Baseline in Insulin 3-hour AUC at Week 20 |
-14.5; -32.8; 141.7; -145.6 | — |
| SECONDARY Change From Baseline in C-peptide 3-Hour AUC at Week 20 |
-1.8; -0.1; 5.9; -6.4 | — |
| SECONDARY Change From Baseline in Insulin 3-Hour AUC/ Glucose 3-Hour AUC Ratio at Week 20 |
0.0; -0.1; 0.2; -0.2 | — |
| SECONDARY Change From Baseline in Glucose Excursion 3-Hour AUC at Week 20 |
-43.5; 10.8; 39.8; 46.2 | — |
| SECONDARY Change From Baseline in Insulin Excursion 3-Hour AUC at Week 20 |
-12.4; -19.4; 87.5; -82.8 | — |
| SECONDARY Change From Baseline in C-peptide Excursion 3-Hour AUC at Week 20 |
-1.1; -0.4; 4.1; -4.8 | — |
| SECONDARY Change From Baseline in Insulin Excursion 3-Hour AUC/Glucose Excursion 3-Hour AUC Ratio at Week 20 |
2.2; 7.2; -2.5; 1.4 | — |
| SECONDARY Change From Baseline in Glucose 3-Hour AUC at Week 54 |
-21.1; -36.0; -73.1; -63.3 | — |
| SECONDARY Change From Baseline in Insulin 3-Hour AUC at Week 54 |
-43.2; -253.9; -37.8; -184.4 | — |
| SECONDARY Change From Baseline in C-peptide 3-Hour AUC at Week 54 |
-0.1; -6.1; 1.7; -8.9 | — |
| SECONDARY Change From Baseline in Insulin 3-Hour AUC/Glucose 3-Hour AUC Ratio at Week 54 |
-0.1; -0.6; -0.0; -0.3 | — |
| SECONDARY Change From Baseline in Glucose Excursion 3-Hour AUC at Week 54 |
-30.7; -50.1; -49.0; -74.0 | — |
| SECONDARY Change From Baseline in Insulin Excursion 3-Hour AUC at Week 54 |
-103.8; -198.5; -40.2; -116.6 | — |
| SECONDARY Change From Baseline in C-Peptide Excursion 3-Hour AUC at Week 54 |
-1.8; -5.2; 0.9; -5.9 | — |
| SECONDARY Change From Baseline in Insulin Excursion 3-Hour AUC/Glucose Excursion 3-Hour AUC Ratio at Week 54 |
4.1; 3.7; -2.7; 1.4 | — |
| SECONDARY Percentage of Participants Initiating Glycemic Rescue Therapy by Week 20 |
5.3; 11.1; 0.0; 40.0 | — |
| SECONDARY Percentage of Participants Initiating Glycemic Rescue Therapy by Week 54 |
35.8; 28.9; 11.1; 80.0 | — |
| SECONDARY Change From Baseline in Body Mass Index (BMI) at Week 20 |
0.0; -0.7; -0.8; -1.7 | — |
| SECONDARY Change From Baseline in BMI at Week 54 |
-0.4; -1.0; -0.6; -0.3 | — |
| SECONDARY Mean Percent Change of Peripheral Blood Mononuclear Cells Expressing CD26 From Baseline at Week 20 |
4.06; -1.78; 4.89; 14.57 | — |
| SECONDARY Mean Percent Change of Peripheral Blood Mononuclear Cells Expressing CD26 From Baseline at Week 54 |
4.74; 4.27; 12.63; -5.30 | — |
| SECONDARY Change From Baseline in Calcitonin at Week 20 - Females |
-0.1; -2.0; 0.0; 0.0 | — |
| SECONDARY Change From Baseline in Calcitonin at Week 54 - Females |
-1.0; -1.9; 0.0; 0.3 | — |
| SECONDARY Change From Baseline in Calcitonin at Week 20 - Males |
0.2; -0.2; -1.6; 0.5 | — |
| SECONDARY Change From Baseline in Calcitonin at Week 54 - Males |
0.1; -0.3; 0.0; 1.4 | — |
| SECONDARY Change From Baseline in Urine N-terminal Cross-linking Telopeptide of Bone Collagen [u-NTx]/Creatinine Ratio at Week 20 - Females |
-28.7; -41.2; -98.0; 12.7 | — |
| SECONDARY Change From Baseline u-NTx/Creatinine Ratio at Week 20 - Males |
-30.9; -69.8; 62.0; -29.0 | — |
| SECONDARY Change From Baseline in u-NTx/Creatinine Ratio at Week 54 - Females |
-88.4; -61.2; -80.3; -17.0 | — |
| SECONDARY Change From Baseline in u-NTx/Creatinine Ratio at Week 54 - Males |
-78.2; -102.4; -30.0 | — |
| SECONDARY Change From Baseline in Bone-Specific Alkaline Phosphatase at Week 20 - Females |
-6.0; -4.2; -9.7; 10.7 | — |
| SECONDARY Change From Baseline in Bone-Specific Alkaline Phosphatase at Week 54 - Females |
-20.0; -13.5; -14.9; -6.9 | — |
| SECONDARY Change From Baseline in Bone-Specific Alkaline Phosphatase at Week 20 - Males |
-2.2; 0.1; -7.1; 4.7 | — |
| SECONDARY Change From Baseline in Bone-Specific Alkaline Phosphatase at Week 54 - Males |
-16.2; -15.0; -1.3; -15.3 | — |
| SECONDARY Percent Change From Baseline in Insulin-like Growth Factor-1 (IGF-1) at Week 20 - Females |
0.5; 11.0; -3.2; 41.4 | — |
| SECONDARY Percent Change From Baseline in IGF-1 at Week 54 - Females |
-1.5; 7.2; -11.9; -13.5 | — |
| SECONDARY Percent Change From Baseline in IGF-1 at Week 20 - Males |
-2.7; 9.3; 7.6; 5.3 | — |
| SECONDARY Percent Change From Baseline in IGF-1 at Week 54 - Males |
-4.9; 29.6; 18.8; -6.8 | — |
| SECONDARY Percent Change From Baseline in Insulin-like Growth Factor Binding Protein 3 (IGF-BP3) at Week 20 - Females |
3.5; 3.8; 8.4; -0.7 | — |
| SECONDARY Percent Change From Baseline in IGF-BP3 at Week 54 - Females |
2.0; 4.5; 11.4; -13.4 | — |
| SECONDARY Percent Change From Baseline in IGF-BP3 at Week 20 - Males |
5.6; 10.2; 3.3; 14.2 | — |
| SECONDARY Percent Change From Baseline in IGF-BP3 at Week 54 - Males |
5.4; 18.2; -2.9; 22.5 | — |
| SECONDARY Growth Velocity at Week 20 - Females |
3.2; 1.9; 5.0; 0.6 | — |
| SECONDARY Growth Velocity at Week 54 - Females |
2.1; 1.2; 2.4; 0.7 | — |
| SECONDARY Growth Velocity at Week 20 - Males |
2.6; 3.6; -1.0; 1.7 | — |
| SECONDARY Growth Velocity at Week 54 - Males |
2.5; 2.8; 1.7; 2.8 | — |
| SECONDARY Skeletal Maturation at Week 20 - Females |
0.6; 0.4; 1.7; -0.8 | — |
| SECONDARY Skeletal Maturation at Week 54 - Females |
1.3; 1.0; 1.3 | — |
| SECONDARY Skeletal Maturation at Week 20 - Males |
1.6; 1.2; 0.4; 2.4 | — |
| SECONDARY Skeletal Maturation at Week 54 - Males |
1.3; 1.3 | — |
| SECONDARY Change From Baseline in Tanner Staging for Genitalia at Week 20 - Males |
0.3; 0.2; 0.0; 0.5 | — |
| SECONDARY Change From Baseline in Tanner Staging for Genitalia at Week 54 - Males |
0.5; 0.6; 0.6 | — |
| SECONDARY Change From Baseline in Tanner Staging for Breasts at Week 20 - Females |
0.2; 0.1; 0.2; 0.3 | — |
| SECONDARY Change From Baseline in Tanner Staging for Breasts at Week 54 - Females |
0.5; 0.4; 0.5; 0.7 | — |
| SECONDARY Change From Baseline in Tanner Stage for Pubic Hair at Week 20 - Females |
0.1; 0.1; 0.2; 0.0 | — |
| SECONDARY Change From Baseline in Tanner Stage for Pubic Hair at Week 54 - Females |
0.5; 0.3; 0.8; 0.3 | — |
| SECONDARY Change From Baseline in Tanner Stage for Pubic Hair at Week 20 - Males |
0.3; 0.2; 0.0; 0.5 | — |
| SECONDARY Change From Baseline in Tanner Stage for Pubic Hair at Week 54 - Males |
0.5; 0.6; 0.5 | — |
| SECONDARY Participants With Worsening in Dental Status at Week 20 |
32; 25; 1; 0; 5; 5 | — |
| SECONDARY Participants With Worsening in Dental Status at Week 54 |
49; 50; 2; 0; 13; 15 | — |
Eligibility Criteria
Inclusion Criteria
- Type 2 Diabetes Mellitus (T2DM)
- Has not received treatment with an antihyperglycemic agent (AHA) for ≥12 weeks prior to the Screening Visit/Visit 1, or is on a stable dose of insulin (without any other AHA) for at least 12 weeks prior to the Screening Visit/Visit 1. At screening, participants on insulin doses that are not stable can have their insulin doses adjusted and be eligible to participate after their dose remains stable for ≥12 weeks, if they meet all other eligibility criteria. In India, only participants on stable doses of insulin will be eligible.
- An A1C of ≥6.5% and ≤10.0% (For participants on insulin: an A1C ≥7.0% and ≤10.0%).
Exclusion Criteria
- History of type 1 diabetes mellitus, autoimmune diabetes mellitus or has a positive antibody screen for anti-GAD (Glutamic Acid Decarboxylase) or (Islet cell autoantigen) ICA-512.
- Known monogenic diabetes, secondary diabetes, or a genetic syndrome or disorder known to affect glucose tolerance other than diabetes.
- Symptomatic hyperglycemia and/or moderate to large ketonuria and/or positive test for ketonemia requiring immediate initiation of antihyperglycemic therapy.
- Previously taken a DPP-4 (Dipeptidyl peptidase-4) inhibitor (such as sitagliptin, vildagliptin, alogliptin, or saxagliptin) or GLP-1 (Glucagon-like peptide-1) receptor agonist (such as exenatide or liraglutide).
- Hypersensitivity or contraindication (according to the product circular in the country of the investigational site) to metformin.
- Chronic treatment with a medication known to cause weight gain within 30 days of study start or weight loss or increased blood glucose within 8 weeks of study start or treated with an anti-psychotic within the past 12 weeks.
- On a weight loss program and not in the maintenance phase or have undergone bariatric surgery within 12 months prior to study start.
- On or likely to require treatment with ≥14 consecutive days or repeated courses of pharmacologic doses of corticosteroids.
- Undergone a surgical procedure within the prior 4 weeks or has major surgery planned during the study.
- History of congenital heart disease or cardiovascular disease other than hypertension.
- Medical history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic active hepatitis B or C, primary biliary cirrhosis, or symptomatic gallbladder disease.
- Active nephropathy (i.e., nephrotic syndrome or glomerulonephritis).
- Chronic myopathy, mitochondrial disorder, or a progressive neurological or neuromuscular disorder (e.g., polymyositis, or multiple sclerosis).
- Human immunodeficiency virus (HIV) as assessed by medical history.
- Clinically significant hematological disorder (such as aplastic anemia, thrombocytopenia, myeloproliferative or myelodysplastic syndrome).
- Under treatment for hyperthyroidism.
- Exhibits abnormal growth patterns or is being treated with growth hormone.
- History of malignancy or clinically important hematologic disorder.
- History of idiopathic acute pancreatitis or chronic pancreatitis.
- Known history of recreational or illicit drug use, or of alcohol abuse or dependence (within the past year).
- Donated blood products or has had phlebotomy of >10% of estimated total blood volume within 8 weeks of signing informed consent, or intends to donate blood products or receive blood products within the projected duration of the study.
- Pregnant, has a positive urine pregnancy test at Screening Visit/Visit 1, is expecting to conceive within the projected duration of the study, or is breast-feeding.
- Exclusionary laboratory values.
Data sourced from ClinicalTrials.gov (NCT01485614) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.