Obesity
Conditions
Keywords
Obesity, Dapagliflozin, Exenatide, Combination treatment, Type 2 diabetes
Brief summary
Obesity is a medical condition which increases the risk of other diseases, such as type 2 diabetes and cardiovascular disease. Obesity-related risk factors for the development of other metabolic diseases include unstable glucose levels and high blood pressure. Dapagliflozin and exenatide are both approved worldwide for treatment of patients with Type 2 Diabetes. Dapagliflozin works by lowering glucose levels by inhibiting the renal reabsorption of glucose and thereby promoting its urinary excretion and energy loss and thereby reduction in body fat. Exenatide exhibits many of the same glucose-lowering actions of that of a naturally occurring hormone and leads to weight loss mainly via reduced energy intake, most likely via a central effect on appetite regulation. The purpose of this exploratory study is to investigate if a combination treatment with dapagliflozin and exenatide have a synergistic effect on weight loss in non-diabetic obese subjects. Subjects will be treated for 24 weeks with either active combination treatment or placebo (non-active treatment). Neither study personnel nor subjects will know what treatment is given. All subjects completing the 24-week double-blind study and who are willing and eligible will be offered to enter a 28-week open-label extension study. All subjects entering the extension study will receive unblinded active study treatment for an additional 28 weeks. Thus the total treatment period for subjects entering the extension study will be 52 weeks.
Interventions
DRUGDapagliflozin
Oral use
DRUGExenatide
Powder and solvent for suspension for injection, prolonged release suspension. Subcutaneous use.
DRUGPlacebo
Oral and Subcutaneous use.
Sponsors
Uppsala University Hospital
AstraZeneca
Uppsala University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Provision of signed informed consent prior to any study specific procedures. 2. Female and/or male aged 18 to 70 years with body mass index (BMI) (measured as body weight (kg)/(height (m))2) 30 to 45 kg/m2. 3. Female subjects must meet all of the following criteria: 1. Not breastfeeding 2. Negative pregnancy test result (human chorionic gonadotropin, beta subunit \[beta hCG\]) at Visit 1 (Enrolment) (not applicable to hysterectomized females). 3. If of childbearing potential (including perimenopausal women who have had a menstrual period within 1 year), must practice and be willing to continue to practice one of the following highly effective birth control methods during the entire duration of the study: * Diaphragm or partner use of condom in combination with combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation: * Oral * Intravaginal * Transdermal * Diaphragm or partner use of condom in combination with progestogen-only hormonal contraception associated with inhibition of ovulation: * Oral * Injectable * Implantable * Placement of an intrauterine device * Placement of an intrauterine hormone-releasing system * Bilateral tubal occlusion * Vasectomised partner (provided that the partner is the sole sexual partner of the female subject and that the vasectomised partner has received medical assessment of the surgical success) * Sexual abstinence (defined as refraining from heterosexual intercourse) 4. Must practice appropriate birth control as stated above for 10 weeks after the last dose of study medication
Exclusion criteria
1. Involvement in the planning and/or conduct of the study. 2. Previous enrolment in the present study. 3. Participation in another clinical study with an Investigational Product during the last 3 months prior to Visit 1. 4. History of any clinically significant disease, disorder or condition which, in the opinion of the investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study. 5. Previously diagnosed diabetes mellitus; or fasting P-glucose ≥7.0 mmol/L at Visit 1 confirmed by one more measurement; or P-glucose ≥11.1 mmol/L at 120 min of the oral glucose tolerance test (OGTT) at Visit 1 confirmed by one more measurement. Note: Subjects with a fasting P-glucose of ≥7.0 mmol/L at Visit 1 or ≥11.1 mmol/L at 120 min of the OGTT at Visit 1 may be offered an extra visit before Visit 2 for a second fasting P-glucose measurement. If P-glucose is still ≥7.0 mmol/L at the second measurement, the subject will be excluded. 6. Any clinically significant abnormalities in physical examination or clinical chemistry results as judged by the investigator. The following specific
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Body weight (kg) | From randomization to 24 weeks | To assess the efficacy of dapagliflozin 10 mg once daily and exenatide 2 mg once weekly in combination compared to placebo on body weight after 24 weeks of treatment in obese subjects |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Body weight (%) | From randomization to 24 weeks | To assess the efficacy of dapagliflozin 10 mg once daily and exenatide 2 mg once weekly in combination compared to placebo on body weight after 24 weeks of treatment in obese subjects |
Other
| Measure | Time frame | Description |
|---|---|---|
| 3 h oral glucose tolerance test, frequently sampled for insulin sensitivity and secretion indices. Changes in glucose, glucagon, glycerol, free fatty acids, insulin and C-peptide. | From enrolment to 24 weeks | To assess the efficacy of dapagliflozin 10 mg once daily and exenatide 2 mg once weekly in combination compared to placebo on glucose tolerance, insulin secretion, insulin sensitivity and lipolysis regulation. |
| Changes in total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, diastolic blood pressure, systolic blood pressure, pulse, waist circumference and waist-hip ratio. | From enrolment to 24 weeks | To assess the efficacy of dapagliflozin 10 mg once daily and exenatide 2 mg once weekly in combination compared to placebo on blood lipid profile, blood pressure and other anthropometric measurements. |
| Proportion of subjects with at least 10% reduction in weight and proportion of subjects with at least 5% reduction in weight. | From randomization to 24 weeks | To assess the proportion of subjects responding to treatment with dapagliflozin 10 mg once daily and exenatide 2 mg once weekly in combination when compared to placebo, with respect to change in body weight |
| Adverse events /serious adverse events, vital signs and collection of clinical chemistry/haematology parameters. | From enrolment to 24 weeks | To evaluate the safety and tolerability of dapagliflozin 10 mg once daily and once weekly 2 mg exenatide in combination in obese non-diabetic subjects. |
| Obesity-related genotypes and pharmacogenetics. | From enrolment to 24 weeks | To collect and store DNA for future exploratory research of genes/genetic variation that is related to obesity or to treatment response to dapagliflozin in combination with exenatide. |
| Changes in body fat (%), liver fat (%), liver volume (l), total liver fat (l), visceral adipose tissue (l), subcutaneous adipose tissue (l), total adipose tissue (l) and total lean tissue (l). | From randomization to 24 weeks | To assess the efficacy of dapagliflozin 10 mg once daily and exenatide 2 mg once weekly in combination compared to placebo on total body fat mass, total lean body mass, percentage liver fat, visceral fat mass and subcutaneous fat mass. |
Countries
Sweden
Outcome results
None listed