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Phase 3 Completed N=200 Randomized Double-blind Treatment

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.
Pediatric diabetes · 2022 · Likely link

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

  • A randomized clinical trial of the efficacy and safety of sitagliptin as initial oral therapy in youth with type 2 diabetes.
    Pediatric diabetes · 2022 · 32 citations · Likely link

Outcome Measures

OutcomeResultp-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.
View full record on ClinicalTrials.gov →

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.

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