Efficacy of FDC Regimen of Dapagliflozin/Metformin Compared to Co-administered Dual Therapy on Glycemic Control, Satisfaction and Adherence in Chinese Patients With T2DM

Last updated: February 24, 2025
Sponsor: AstraZeneca
Overall Status: Active - Not Recruiting

Phase

4

Condition

Diabetes Mellitus, Type 2

Treatment

Xigduo (Dapagliflozin and Metformin hydrochloride extended-release) tablets

Dapagliflozin tablets and Metformin HCl extended-release tablets

Clinical Study ID

NCT06327815
D1690L00149
  • Ages 18-80
  • All Genders

Study Summary

Study D1690L00149 is a 24-week, multicentre, randomized, parallel, interventional, non-inferiority, open-label study designed to compare the FDC Regimen of Dapagliflozin/Metformin XR with the Dapagliflozin co-administered with Metformin XR in glycemic lowering control, satisfaction and adherence in Chinese patients with T2DM.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Age and Informed Consent

  1. Patient must be 18 to 80 (years of age inclusive), at the time of signing theICF(s). Type of Patient and Disease Characteristics

  2. Newly diagnosed T2DM (WHO diagnostic criteria 1999) ≤ 1 year with medicine treatmentnaïve.

  3. HbA1c 7.5%-10% at screening by local lab and HbA1c 7.5-10% at pre-randomizationvisit (by central laboratory).

  4. BMI ≥19 and ≤40 kg/m2 at screening. Other Inclusion Criteria

  5. Capable of giving signed informed consent as described in Appendix A which includescompliance with the requirements and restrictions listed in the ICF and in thisprotocol.

Exclusion

Exclusion Criteria:

Medical Conditions

  1. Congestive heart failure NYHA classes III or IV or major cardiovascular eventswithin 6 months before screening. (Significant cardiovascular history within thepast 6 months prior to screening defined as: myocardial infarction, coronaryangioplasty or bypass graft(s), valvular disease or repair, unstable anginapectoris, transient ischemic attack, or cerebrovascular accident.)

  2. Patients with clinically apparent hepatobiliary disease, including but not limitedto chronic active hepatitis and/or severe hepatic insufficiency. ALT or AST > 3xULN, or serum TB >34.2 μmol/L (>2 mg/dL).

  3. Patients with eGFR< 45 mL/min per 1.73 m².

  4. Diagnosis or history of acute metabolic diabetic complications such as ketoacidosisor hyperglycemic hyperosmolar state, or diabetes insipidus within the past 6 months.

  5. For women only - currently pregnant (confirmed with positive pregnancy test) orbreastfeeding.

  6. Participation in any other study that included drug treatment during the past 3months before enrolment. Diagnostic Assessments

  7. Patients with a known hypersensitivity to Dapa/Met or any of the excipients of theproduct.

  8. Diagnosis or history of:

  9. Chronic pancreatitis within past 6 months or idiopathic acute pancreatitiswithin past 4 weeks.

  10. Gastrointestinal disease including gastroenterostomy, enterectomy, roemheldsyndrome, severe hernia, intestinal obstruction, intestinal ulcer within past 6months.

  11. Genetic galactose intolerance, lapp lactase deficiency and glucose-galactosemalabsorption.

  12. Medullary thyroid carcinoma within past 5 years.

  13. Organ transplant or AIDS within the past 6 months.

  14. Alcohol abuse or illegal drug abuse within the past 12 months.

  15. Laser treatment for proliferative retinopathy within 6 months.

  16. Stress condition, such as surgery, serious trauma, etc., within past 6 months,or plan to undergo a surgery during study period.

  17. Chronic oxygen deficiency diseases, such as pulmonary emphysema, pulmonaryheart disease within past 6 months.

  18. T1DM, diabetes resulting from pancreatic injury or secondary forms of diabetes,eg, acromegaly or Cushing's syndrome. Other Exclusions

  19. Subject is, in the judgment of the Investigator, unlikely to comply with theprotocol or has any severe concurrent medical or psychological condition that mayaffect the interpretation of study results.

  20. Involvement in the planning and/or conduct of the study (applies to both AstraZenecastaff and/or staff at the study site).

Study Design

Total Participants: 632
Treatment Group(s): 2
Primary Treatment: Xigduo (Dapagliflozin and Metformin hydrochloride extended-release) tablets
Phase: 4
Study Start date:
March 15, 2024
Estimated Completion Date:
June 30, 2025

Study Description

The past 30 years have witnessed significant increases in the prevalence of type 2 diabetes mellitus (T2DM) in China. China now is estimated 114 million people with diabetes, T2DM accounts for more than 90% of the overall population with diabetes in China. A large proportion of diabetes is undiagnosed in China: in the 2007-2008 national survey among adult population over 20 years, patient with newly diagnosed diabetes accounted for 60% of total diabetes population. In the Healthy China 2030 Plan, approved by the State Council and the Party's Central Committee, diabetes, along with cancer, hypertension, and cardiovascular diseases, are listed as the four major non-communicable diseases (NCDs) for which the goal is to "control the prevalence and reduce the probability of early death". Metformin hydrochloride is the primary biguanide medication currently used in China's medical practice. Sodium-glucose cotransporter 2 (SGLT2) inhibitors used to be considered as second-line treatment after Metformin in patients with T2DM. But according to the American Diabetes Association (ADA) 2023 Standards of Medical Care in Diabetes, SGLT2 inhibitors are now recommended to be started at the time of diagnosis as the first-line medications, for high-risk individuals with atherosclerotic cardiovascular disease (ASCVD), heart failure (HF) or chronic kidney disease (CKD). Compared with stepwise therapy, early combination therapy may provide earlier and greater reductions in HbA1c and thus achievement of glycemic target. In addition, SGLT2 inhibitors provide cardiorenal protection both in patients with and without T2DM, that goes beyond glycemic control, hence the recommendation by guidelines to implement SGLT2 inhibitors. But early combination therapy is not fully implemented into clinical practice in China. International and CDS guidelines recommends encourage using fixed-dose combination (FDC) to have better adherence, which is associated with lower HbA1c, lower cost and less need for acute care. But in practice, FDC is not popular in China because of many reasons. One of the main arguments is that physicians think FDC lacks flexibility. Compelling evidence has shown that the co-administration of Dapagliflozin and Metformin extended-release (XR) tablets is superior to either of the monotherapy efficacy (Dapagliflozin or Metformin XR). Xigduo XR combines those two anti-hyperglycemic medicinal products with different and complementary mechanisms of action to improve glycemic control in patients with T2DM. Bioequivalence was demonstrated between FDC regimen and coadministered Dapagliflozin and Metformin HCl XR tablets. This dosage of Dapagliflozin 10 mg/Metformin hydrochloride XR 1000 mg FDC (Xigduo XR) has no clinical evidence except that bioequivalence study in China, and there are no combination therapy data available either for Chinese people. (Metformin XR usual dose is 1500-2000mg/d). Moreover, there is no head-to-head study comparing Dapa/Met FDC and co-administration therapies to the extra benefits of FDC.

Connect with a study center

  • Research Site

    Beijing, 100076
    China

    Site Not Available

  • Research Site

    Changsha, 410005
    China

    Site Not Available

  • Research Site

    Changshu, 215500
    China

    Site Not Available

  • Research Site

    Chengdu, 610072
    China

    Site Not Available

  • Research Site

    Chongqing, 402260
    China

    Site Not Available

  • Research Site

    Chuxiong, 675000
    China

    Site Not Available

  • Research Site

    Dalian, 116001
    China

    Site Not Available

  • Research Site

    Dingzhou, 562100
    China

    Site Not Available

  • Research Site

    Fuyang, 236400
    China

    Site Not Available

  • Research Site

    Guangzhou, 510515
    China

    Site Not Available

  • Research Site

    Guiyang, 550044
    China

    Site Not Available

  • Research Site

    Hefei, 230012
    China

    Site Not Available

  • Research Site

    Jiangyin, 214400
    China

    Site Not Available

  • Research Site

    Jiyuan, 459003
    China

    Site Not Available

  • Research Site

    Kunming, 650032
    China

    Site Not Available

  • Research Site

    Nanchang, 330006
    China

    Site Not Available

  • Research Site

    Nanning,
    China

    Site Not Available

  • Research Site

    Nantong, 226001
    China

    Site Not Available

  • Research Site

    Panjin, 124000
    China

    Site Not Available

  • Research Site

    Qingdao, 266200
    China

    Site Not Available

  • Research Site

    Quanzhou, 362000
    China

    Site Not Available

  • Research Site

    Rui'an, 325200
    China

    Site Not Available

  • Research Site

    Shenzhen, 518101
    China

    Site Not Available

  • Research Site

    Suzhou, 215500
    China

    Site Not Available

  • Research Site

    Taiyuan, 030001
    China

    Site Not Available

  • Research Site

    Tianjin, 300134
    China

    Site Not Available

  • Research Site

    Wei Fang, 261035
    China

    Site Not Available

  • Research Site

    Wenzhou, 325000
    China

    Site Not Available

  • Research Site

    Wuhan, 430010
    China

    Site Not Available

  • Research Site

    Yibin, 610500
    China

    Site Not Available

  • Research Site

    Zhengzhou, 450052
    China

    Site Not Available

  • Research Site

    Zhuji, 311899
    China

    Site Not Available

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