Phase 4
N=249
Study of Management of Pasireotide-induced Hyperglycemia in Adult Patients With Cushing's Disease or Acromegaly
Cushing's Disease · Acromegaly
Bottom Line
View on ClinicalTrials.gov: NCT02060383 ↗Enrolled (actual)
249
Serious AEs
8.8%
Results posted
May 2019
Primary outcome: Primary: Change in HbA1c From Randomization to Approximately 16 Weeks — -0.12; 0.26; 0.33; 0.45 Hba1c percentage
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- Pasireotide s.c. (Drug); Sitagliptin (Drug); Liraglutide (Drug); Insulin (Drug); Pasireotide LAR (Drug); Metformin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Feb 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change in HbA1c From Randomization to Approximately 16 Weeks |
-0.12; 0.26; 0.33; 0.45; -0.25; 0.19 | — |
| SECONDARY Change in HbA1c From Randomization (R) Over Time Per Randomized Arm |
7.1; 7.1; 0.5; 0.5; 0.3; 0.5 | — |
| SECONDARY Change in FPG (Fasting Plasma Glucose) From Randomization Until End of Core Phase |
172.2; 167.9; 4.6; -31.1; -15.0; -28.3 | — |
| SECONDARY Percentage of Participants in the Incretin-based Arm Who Required Anti-diabetic Rescue Therapy With Insulin |
31.6 | — |
| SECONDARY Absolute Change in HbA1c From Baseline to End of Core Phase |
6.3; 6.3; 7.7; 5.7; 5.4; 0.8 | — |
| SECONDARY Absolute Change in FPG From Baseline to End of Core Phase |
111.1; 111.8; 157.7; 97.2; 92.2; 22.2 | — |
| SECONDARY Percentage of Participants With ≤ 0.3% HbA1c Increase to End of Core Phase |
73.7; 65.1 | — |
Summary
The study was designed to investigate the optimal management of hyperglycemia developed during pasireotide treatment in participants with Cushing's disease or Acromegaly, which was not manageable with metformin.
This was a Phase IV, multi-center, randomized, open-label study. Eligible patients started pasireotide subcutaneously (s.c.) for Cushing's disease and pasireotide LAR (long-acting release) for Acromegaly.
Participants being treated with pasireotide s.c or LAR at screening were eligible as long as they met protocol criteria during the screening period. If previously normo-glycemic participants experienced an increase in their fasting blood glucose and met the criteria for diabetes while on pasireotide, they started anti-diabetic treatment using metformin. If they continued to have elevated blood glucose above target on metformin within the first 16 weeks, they were randomized in a 1:1 ratio to receive treatment with incretin based therapy or insulin for approximately 16 weeks.
Participants who continued to receive clinical benefit after completing the Core Phase could enter an optional Extension Phase if pasireotide was not commercially available in their country or a local access program was not available to provide drug. Patients continued in the Extension Phase until the last participant randomized in the Core Phase completed 16 weeks of treatment post-randomization.
Eligibility Criteria
Inclusion Criteria
- Patients greater than or equal to 18 years old
- Confirmed diagnosis of Cushing's disease or acromegaly
Exclusion Criteria
- Patients who require surgical intervention
- Patients receiving DPP-4 inhibitors or GLP-1 receptor agonists within 4 weeks prior to study entry
- HbA1c > 10 % at screening
- Known hypersensitivity to somatostatin analogues Other protocol-defined inclusion/exclusion criteria may apply.
Data sourced from ClinicalTrials.gov (NCT02060383). 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.