Cardiovascular Diseases, Chronic Kidney Disease, Obesity, Overweight, Overweight or Obesity, Type 2 Diabetes
Conditions
Brief summary
The main purpose of this study is to determine safety and efficacy of orforglipron compared with insulin glargine in participants with type 2 diabetes and obesity or overweight at increased cardiovascular risk. The study will last approximately 2 years may include up to 27 visits.
Interventions
Administered orally once daily
Administered SC once daily
Sponsors
Study design
Eligibility
Inclusion criteria
* Have been diagnosed with type 2 diabetes mellitus (T2DM) * Are at least 18 years of age or legal age of consent in the jurisdiction in which the study is taking place, whichever is older. * Have HbA1c at screening * ≥7.0% and ≤10.5% if background diabetes medication does not include a sulfonylurea, or * ≥7.5% and ≤10.5% if background diabetes medication includes a sulfonylurea. * Are on stable treatment of at least 1 and no more than 3 oral antihyperglycemic drugs for at least 90 days before screening. Antihyperglycemic drugs may include metformin, SGLT-2 inhibitors, and/or sulfonylureas * Have increased risk for cardiovascular (CV) events due to: * Coronary heart disease * Peripheral arterial disease, presumed to be of atherosclerotic origin * Cerebrovascular disease, presumed to be of atherosclerotic origin * Chronic kidney disease (CKD) * Congestive heart failure (CHF) New York Heart Association (NYHA) functional classification II to III * Are of stable weight (± 5%) for at least 90 days prior to screening * Have a BMI ≥25 kilograms per meter squared (kg/m2) at screening
Exclusion criteria
* Have type 1 diabetes mellitus * Have had chronic or acute pancreatitis any time prior to screening * Currently receiving or planning to receive treatment for diabetic retinopathy and/or macular edema (e.g. laster photocoagulation or intravitreal injections of anty-VEGF inhibitors * Have a known clinically significant gastric emptying abnormality * Have acute or chronic hepatitis, signs and symptoms of any other liver disease, or blood alanine transaminase (ALT) or aspartate aminotransferase (AST) enzyme level ≥5.0 times the upper limit of normal (ULN) for the reference range, as determined by the central laboratory * Have had any of the following within 60 days prior to screening: acute myocardial infarction, cerebrovascular accident (stroke), or hospitalization for congestive heart failure * Have an eGFR \<15 mL/min/1.73 m2 as determined at screening * Have a family (first-degree relative) or personal history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 * Have been taking any other diabetes medicines other than metformin, SGLT-2 inhibitors, and/or sulfonylureas during the last 90 days * Have used any weight loss drugs, including herbal or nutritional supplements, within 90 days of screening
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to First Occurrence of Any Major Adverse Cardiovascular Event (MACE-4) [Myocardial Infarction (MI), Stroke, Hospitalization for Unstable Angina, or Cardiovascular (CV) Death] | Baseline to End of the Study (Approximate Maximum 104 Weeks) | Time to First Occurrence of Any MACE-4 (Myocardial Infarction (MI), Stroke, Hospitalization for Unstable Angina, or Cardiovascular \[CV\] Death) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to First Occurrence of Any MACE-3 Event (MI, Stroke, or CV death) | Baseline to End of the Study (Approximately 104 Weeks) | Time to First Occurrence of Any MACE-3 Event (MI, Stroke, or CV death) |
| Change from Baseline in Hemoglobin A1c (HbA1c) | Baseline, Week 52 | Change from Baseline in HbA1c |
| Change from Baseline in Fasting Serum Glucose | Baseline, Week 52 | Change from Baseline in Fasting Serum Glucose |
| Change from Baseline in Daily Average 7-point Self-monitoring Blood Glucose (SMBG) Profile | Baseline, Week 52 | Change from Baseline in Daily Average 7-point SMBG |
| Percentage of Participants with HbA1c Target Values Less Than (<)7.0% (53 mmol/mol) | Week 52 | Percentage of Participants with HbA1c Target Values \<7.0% (53 mmol/mol) |
| Change from Baseline in Body Weight | Baseline, Week 52 | Change from Baseline in Body Weight |
| Percent Change from Baseline Body Weight | Week 52 | Percent Change from Baseline Body Weight |
| Change from Baseline in Short Form 36 Version 2 (SF-36v2) Acute Form Domain Score | Baseline, Week 52 | The SF-36v2 acute form is a 36-item generic, participant completed measure designed to assess 8 domains: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Scores of each domain are measured by T-scores, with a mean of 50 and standard deviation of 10; higher scores indicate better levels of function and/or better health. |
| Pharmacokinetics (PK): Plasma Serum Concentrations of Orforglipron | Baseline through Week 52 | PK will be estimated based on the population PK model. |
Countries
Argentina, Austria, Brazil, Czechia, Germany, Greece, India, Italy, Mexico, Puerto Rico, Romania, Slovakia, South Korea, Spain, Turkey (Türkiye), United States
Contacts
Eli Lilly and Company