NCT04796428

Brief Summary

Three SGLT2i were commercially available in Italy at the time the trial was designed: canagliflozin, dapagliflozin, and empagliflozin. Preliminary evidence suggests that the higher dose canagliflozin (300 mg/day) might exert a stronger glucose-lowering effect than dapagliflozin or empagliflozin. The clinical relevance of this putative difference is however unknown. On the other side, the use of canagliflozin, but not empagliflozin and dapagliflozin, has been associated with an increased risk of some adverse events, namely bone fractures and lower limb amputations. Currently, the available information on the efficacy and safety of SGLT2i in elderly (70+ years) patients with type 2 diabetes are is very scant. Thus, a compelling need now exists of comparing efficacy and safety of the commercially available SGLT2i in a population of frail patients at high risk of cardiovascular and renal diseases.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
1,167

participants targeted

Target at P75+ for phase_4 diabetes-mellitus-type-2

Timeline
Completed

Started Jun 2021

Typical duration for phase_4 diabetes-mellitus-type-2

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 1, 2021

Completed
11 days until next milestone

First Posted

Study publicly available on registry

March 12, 2021

Completed
4 months until next milestone

Study Start

First participant enrolled

June 30, 2021

Completed
2.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2023

Completed
Last Updated

March 12, 2021

Status Verified

March 1, 2021

Enrollment Period

2.5 years

First QC Date

March 1, 2021

Last Update Submit

March 10, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Primary Objective

    The primary objective is to compare the proportion of patients treated with each SGLT2i drug, who achieve the individualized HbA1c target without level-2 hypoglycaemia.

    Up to 24 months

Secondary Outcomes (8)

  • Secondary Objectives - HbA1c

    Up to 24 months

  • Secondary Objectives - body weight

    Up to 24 months

  • Secondary Objectives - systolic blood pressure

    Up to 24 months

  • Secondary Objectives - e-GFR

    Up to 24 months

  • Secondary Objectives - urinary albumin excretion rate

    Up to 24 months

  • +3 more secondary outcomes

Other Outcomes (9)

  • Safety Objectives

    Up to 24 months

  • Safety Objectives

    Up to 24 months

  • Safety Objectives

    Up to 24 months

  • +6 more other outcomes

Study Arms (3)

canagliflozin

ACTIVE COMPARATOR

100 mg (or 50/850 mg and 50/1000 mg of the fixed association with metformin) or 300 mg (or the 150/850 mg and the 150/1000 mg fixed association with metformin).

Drug: Canagliflozin

dapagliflozin

ACTIVE COMPARATOR

10 mg (or 5/850 mg and 5/1000 mg of the fixed association with metformin; or 10/5 mg of the fixed dapagliflozin / saxagliptin combination)

Drug: Dapagliflozin

empagliflozin

ACTIVE COMPARATOR

10 mg (or 5/850 mg and 5/1000 mg of the fixed association with metformin; or 5/5 mg of the empagliflozin / linagliptin combination) or 25 mg (or the 12.5/850 mg and the 12.5/1000 mg fixed association with metformin; or the 12.5/5 mg empagliflozin / linagliptin combination).

Drug: Empagliflozin

Interventions

Canagliflozin If the patient is already on metformin, the fixed combination Canagliflozin / Metformin can be used.

canagliflozin

Dapagliflozin If the patient is already on metformin, the fixed combination dapagliflozin / metformin can be used. If the patient is already on a DPP-4 inhibitor, the fixed dose combination dapagliflozin / saxagliptin can be used.

dapagliflozin

If the patient is already on metformin, the fixed combination empagliflozin / metformin can be used. If the patient is already on a DPP-4 inhibitor, the fixed dose combination empagliflozin / linagliptin can be used.

empagliflozin

Eligibility Criteria

Age70 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsOlder Adult (65+)

You may qualify if:

  • Type 2 diabetes
  • Age 70+ years
  • Male or female
  • Prevalent cardiovascular disease (symptomatic or asymptomatic) or eGFR \<90 ml/min/1.73 m2 and above the lower limit for initiation of SGLT2i according to label (currently eGFR \<60 ml/min/1.73 m2)
  • HbA1c above individualized target
  • Indication to add SGLT2i

You may not qualify if:

  • Age \>90 years
  • Estimated life expectancy \<1 year
  • Very high risk of genitourinary tract infections (\>2 events in the last 6 months)
  • Recent weight loss (\>5% in \<6 months)
  • Inability to provide informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Diabetes Mellitus, Type 2

Interventions

Canagliflozindapagliflozinempagliflozin

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

ThiophenesSulfur CompoundsOrganic ChemicalsHeterocyclic Compounds, 1-RingHeterocyclic CompoundsGlucosidesGlycosidesCarbohydrates

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 1, 2021

First Posted

March 12, 2021

Study Start

June 30, 2021

Primary Completion

December 31, 2023

Study Completion

December 31, 2023

Last Updated

March 12, 2021

Record last verified: 2021-03

Data Sharing

IPD Sharing
Will not share