Type 2 Diabetes Mellitus MedDRA version: 20.0 Level: PT Classification code 10067585 Term: Type 2 diabetes mellitus System Organ Class: 10027433 - Metabolism and nutrition disorders
Conditions
Sponsors
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Subjects = 40 years of age at the time of the initial Screening visit (V1) with a diagnosis of T2DM in accordance with American Diabetes Association (ADA) guidelines.13 2. HbA1c at the Screening visit (V1) of 7.0 10.5% (53 91 mmol/mol) on stable allowable AHA(s) or on no background AHA for at least 8 weeks prior to the Screening visit (V1). 3. Body Mass Index (BMI) =18.0 kg/m2. 4. Subjects must have evidence or a history of atherosclerosis involving the coronary, cerebral or peripheral vascular systems as follows (must have at least one of the following a-d): a. Coronary artery disease as indicated by a history of presumed spontaneous myocardial infarction (hospitalized with final diagnosis of myocardial infarction, excluding peri-procedural or definite secondary myocardial infarction [eg, due to profound anemia or hypertensive emergency, troponin increase in sepsis] in which the most recent event occurred at least 3 months (90 days) prior to the Screening visit (V1); OR b. Coronary artery disease as indicated by a history of coronary revascularization through either a Percutaneous Coronary Intervention (PCI) at least 3 months (90 days) prior to the Screening visit (V1) or Coronary Artery Bypass Graft (CABG) at least 3 months (90 days) prior to the Screening visit (V1); OR c. Ischemic (presumed thrombotic) cerebrovascular disease as indicated by a history of ischemic stroke (hospitalized with a final diagnosis of non hemorrhagic stroke [includes completion of a standard evaluation for stroke in an acute care facility or stroke clinic without hospital admission] with the most recent event occurring at least 3 months (90 days) prior to the Screening visit (V1) or a history of carotid revascularization at least 3 months (90 days) prior to the Screening visit (V1); OR d. Peripheral arterial disease as indicated by: 1. Angiographically documented peripheral vascular disease; or 2. Resting ankle/brachial index (ABI) of <0.85 (measured by a certified vascular laboratory) plus symptoms of claudication; or 3. Amputation, peripheral bypass, or peripheral angioplasty of the extremities secondary to ischemia occurring at least 3 months (90 days) prior to the Screening visit (V1). 5. There is adequate documentation of the objective evidence that the subject has established vascular disease such as investigational site's medical records, copies of such records from other institutions, or a letter from a referring physician that specifically states the diagnosis and date of the most recent occurrence of the qualifying event(s) or procedure(s). 6. Subject meets one of the following criteria (a, b or c): a. Is a male; b. Is a female not of reproductive potential defined as one who (See Section 4.4.4.1 and Section 4.4.4.2 for reference on childbearing potential): 1. Is postmenopausal: defined as at least 12 months with no menses in women =45 years of age. or 2. Has had a hysterectomy and/or bilateral oophorectomy, or had bilateral tubal ligation or occlusion at least 6 weeks prior to the Screening visit (V1). c. Is a female of reproductive potential and: 1. Agrees to remain abstinent from heterosexual activity (if this form of birth
Exclusion criteria
Exclusion criteria: 1. Subjects who had been previously randomized into this trial 2. Subjects experiencing a cardiovascular event (eg, myocardial infarction or stroke) or undergoing coronary angioplasty or peripheral intervention procedure between the Screening visit V1 and randomization 3. Subjects undergoing any cardiovascular surgery (eg, valvular surgery) within 3 months (90 days) of the Screening visit V1 4. Subjects with any planned coronary revascularization or peripheral intervention procedure or other cardiovascular surgery 5. Subjects with New York Heart Association (NYHA) Class IV heart failure at the Screening visit V1 6. Mean value for triplicate screening sitting systolic blood pressure >160 mm Hg and/or diastolic blood pressure >90 mm Hg after at least a 5 minute seated rest at the Screening visit V1, confirmed via 1 repeat triplicate set at the Screening visit V1 if deemed necessary. For subjects with a mean triplicate value of sitting systolic blood pressure >160 mm Hg and/or diastolic blood pressure >90 mm Hg after at least a 5 minute seated rest at the Screening visit V1 the investigator or the treating physician is allowed to adjust background blood pressure medication(s) to lower blood pressure values in order for the subject to be re-assessed for enrollment eligibility 7. Subject has a clinically significant ECG abnormality at Screening visit V1 that requires further diagnostic evaluation or intervention (eg, new, clinically significant arrhythmia or a conduction disturbance) 8. History of type 1 diabetes mellitus or a history of ketoacidosis 9. History of other specific types of diabetes (eg, genetic syndromes, secondary pancreatic diabetes, diabetes due to endocrinopathies, drug- or chemical induced, and post organ transplant) 10. Subject has active, obstructive uropathy or indwelling urinary catheter 11. Subject has a history of malignancy =5 years prior to signing informed consent, except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer Note 1 A subject with a history of malignancy >5 years prior to signing informed consent should have no evidence of residual or recurrent disease Note 2 A subject with any history of melanoma, leukemia, lymphoma, or renal cell carcinoma is excluded. 12. Subject routinely consumes >2 alcoholic drinks per day or >14 alcoholic drinks per week, or engages in binge drinking Note 1: One alcoholic drink is defined as 5 oz (150 mL) of wine, or 12 oz (350 mL) of beer, or 1.5 oz (50 mL) of 80 proof liquor Note 2: Binge drinking is defined as a pattern of 5 or more alcoholic drinks (male), or 4 or more alcoholic drinks (female) in about 2 hours 13. Any clinically significant malabsorption condition 14. Subjects with a known hypersensitivity or intolerance to any SGLT2 inhibitor 15. Screening fasting plasma or finger stick glucose >270 mg/dL (15 mmol/L), confirmed by a single repeat following counseling on exercise and diet 16. History of one or more severe hypoglycemic episodes within 6 months of Screening V1 or a severe hypoglycemic episode occurring during the interval between the Screening visit V1 and randomization
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: Objective: To demonstrate the non-inferiority of ertugliflozin compared with placebo on the time of first occurrence of the composite endpoint of MACE: cardiovascular death, non-fatal myocardial infarction or non-fatal stroke. Hypothesis: The time to first occurrence of the composite endpoint of MACE in subjects treated with ertugliflozin is non-inferior compared to that in subjects treated with placebo. ; Secondary Objective: Objective: To demonstrate the superiority of ertugliflozin compared with placebo on the time to first occurrence of the composite endpoint of cardiovascular death or hospitalization for heart failure. Objective: To demonstrate the superiority of ertugliflozin compared with placebo on the time to cardiovascular death. Objective: To demonstrate the superiority of ertugliflozin compared with placebo on the time to first occurrence of the composite endpoint of renal death, renal dialysis/transplant, or >=2x increase in baseline serum creatinine. Objective: To assess the effect of ertugliflozin as compared with placebo on the time to first occurrence of: - MACE plus; - Fatal or non-fatal myocardial infarction; - Fatal or non-fatal stroke; - Hospitalization for heart failure; - Individual components of MACE (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke). ; Primary end point(s): The primary cardiovascular endpoint is time to first occurrence of the composite endpoint of MACE ;Timepoint(s) of evaluation of this end point: Assessment according to protocol | — |
Secondary
| Measure | Time frame |
|---|---|
| Timepoint(s) of evaluation of this end point: Assessment according to protocol; Secondary end point(s): • Time to first occurrence of: - Cardiovascular death or hospitalization for heart failure; - Cardiovascular death; - MACE plus; - Fatal or non-fatal myocardial infarction; - Fatal or non-fatal stroke; - Hospitalization for heart failure; - Individual components of MACE (cardiovascular death, non-fatal myocardial infarction, non-fatal stroke). • All-cause mortality • All MACE events (ie, not censored at the time of the first event). • All cardiovascular death or hospitalizations for heart failure (ie, not censored at the time of the first event). • Time to first occurrence of the composite of renal death, renal dialysis/transplant, or >=2x increase in baseline serum creatinine. | — |
Countries
Argentina, Brazil, Bulgaria, Canada, Chile, Colombia, Croatia, Czech Republic, Denmark, Finland, Georgia, Germany, Greece, Hong Kong, Hungary, Israel, Italy, Korea, Republic of, Latvia, Lithuania, Malaysia, Mexico, Netherlands, Peru, Philippines, Poland, Romania, Serbia, Slovakia, South Africa, Spain, Sweden, Taiwan, Thailand, Turkey, Ukraine, United Kingdom
Contacts
Public ContactSenior Director, Clinical Sciences
Pfizer Inc.
Outcome results
None listed