Trial Outcomes & Findings for A Study of BMS-512148 (Dapagliflozin) in Patients With Type 2 Diabetes and Inadequately Controlled Hypertension on an Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker (NCT NCT01137474)
NCT ID: NCT01137474
Last Updated: 2017-01-26
Results Overview
Seated BP was to be measured at every visit. Data after rescue medication was excluded. The patient first rested for at least 10 minutes in the seated position. Seated blood BP was determined from the mean of 3 replicated measurements obtained at least 1 minute apart. However, if the 3 consecutive seated BP readings were not within 8 mm Hg of each other, an additional 2 BP readings were to be obtained (total=5) and incorporated into the calculated mean for systolic BP and diastolic BP. For the initial BP recording, BP was measured in both arms. If the BP was higher in 1 arm, that arm was used for BP measurement. If there was no difference in BP measurements between arms, the dominant arm was used for all future BP measurements. All randomized participants who received at least 1 dose of study drug and who had nonmissing baseline and at least 1 postbaseline value during the double-blind treatment period were used for analysis. SD=standard deviation.
COMPLETED
PHASE3
2996 participants
From Baseline to Week 12
2017-01-26
Participant Flow
This study was originally designed with 2 additional double-blind treatment arms, dapagliflozin 2.5 and 5 mg, but randomization of new patients into these arms stopped with implementation of Protocol Amendment 8 on 1-11-11. Patients randomized to dapagliflozin 2.5 or 5 mg remained on their blinded medication until study completion.
Of 2996 participants enrolled, 944 were randomized and received double-blind treatment.
Participant milestones
| Measure |
Placebo
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
Dapagliflozin, 2.5 mg (Randomized Before Protocol Amendment 8)
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 2.5 mg, daily with a morning meal.
|
Dapagliflozin, 5 mg (Randomized Before Protocol Amendment 8)
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 5 mg, daily with a morning meal.
|
Dapagliflozin 10 mg
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
|---|---|---|---|---|
|
Overall Study
STARTED
|
311
|
166
|
165
|
302
|
|
Overall Study
Received Treatment
|
311
|
166
|
165
|
302
|
|
Overall Study
COMPLETED
|
287
|
154
|
158
|
281
|
|
Overall Study
NOT COMPLETED
|
24
|
12
|
7
|
21
|
Reasons for withdrawal
| Measure |
Placebo
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
Dapagliflozin, 2.5 mg (Randomized Before Protocol Amendment 8)
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 2.5 mg, daily with a morning meal.
|
Dapagliflozin, 5 mg (Randomized Before Protocol Amendment 8)
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 5 mg, daily with a morning meal.
|
Dapagliflozin 10 mg
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
|---|---|---|---|---|
|
Overall Study
Adverse Event
|
3
|
5
|
1
|
3
|
|
Overall Study
Withdrawal by Subject
|
7
|
2
|
6
|
9
|
|
Overall Study
No longer met study criteria
|
6
|
1
|
0
|
5
|
|
Overall Study
Lost to Follow-up
|
5
|
1
|
0
|
2
|
|
Overall Study
Lack of Efficacy
|
0
|
0
|
0
|
2
|
|
Overall Study
Other
|
3
|
1
|
0
|
0
|
|
Overall Study
Pregnancy
|
0
|
1
|
0
|
0
|
|
Overall Study
Administrative reason by sponsor
|
0
|
1
|
0
|
0
|
Baseline Characteristics
A Study of BMS-512148 (Dapagliflozin) in Patients With Type 2 Diabetes and Inadequately Controlled Hypertension on an Angiotensin-Converting Enzyme Inhibitor or Angiotensin Receptor Blocker
Baseline characteristics by cohort
| Measure |
Placebo
n=311 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
Dapagliflozin, 2.5 mg (Randomized Before Protocol Amendment 8)
n=166 Participants
Participants with type 2 diabetes and inadequate glycemic control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 2.5 mg, daily with a morning meal.
|
Dapagliflozin, 5 mg (Randomized Before Protocol Amendment 8)
n=165 Participants
Participants with type 2 diabetes and inadequate glycemic control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 5 mg, daily with a morning meal.
|
Dapagliflozin 10 mg
n=302 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Total
n=944 Participants
Total of all reporting groups
|
|---|---|---|---|---|---|
|
Age, Customized
Younger than 65 years
|
259 Participants
n=99 Participants
|
141 Participants
n=107 Participants
|
142 Participants
n=206 Participants
|
260 Participants
n=7 Participants
|
802 Participants
n=31 Participants
|
|
Age, Customized
65 years and older to younger than 75 years
|
46 Participants
n=99 Participants
|
25 Participants
n=107 Participants
|
21 Participants
n=206 Participants
|
42 Participants
n=7 Participants
|
134 Participants
n=31 Participants
|
|
Age, Customized
75 years and older
|
6 Participants
n=99 Participants
|
0 Participants
n=107 Participants
|
2 Participants
n=206 Participants
|
0 Participants
n=7 Participants
|
8 Participants
n=31 Participants
|
|
Gender
Female
|
140 Participants
n=99 Participants
|
76 Participants
n=107 Participants
|
76 Participants
n=206 Participants
|
123 Participants
n=7 Participants
|
415 Participants
n=31 Participants
|
|
Gender
Male
|
171 Participants
n=99 Participants
|
90 Participants
n=107 Participants
|
89 Participants
n=206 Participants
|
179 Participants
n=7 Participants
|
529 Participants
n=31 Participants
|
|
Race/Ethnicity, Customized
White
|
241 Participants
n=99 Participants
|
105 Participants
n=107 Participants
|
108 Participants
n=206 Participants
|
239 Participants
n=7 Participants
|
693 Participants
n=31 Participants
|
|
Race/Ethnicity, Customized
Black or African American
|
14 Participants
n=99 Participants
|
11 Participants
n=107 Participants
|
8 Participants
n=206 Participants
|
12 Participants
n=7 Participants
|
45 Participants
n=31 Participants
|
|
Race/Ethnicity, Customized
Asian
|
54 Participants
n=99 Participants
|
49 Participants
n=107 Participants
|
49 Participants
n=206 Participants
|
49 Participants
n=7 Participants
|
201 Participants
n=31 Participants
|
|
Race/Ethnicity, Customized
Other
|
2 Participants
n=99 Participants
|
1 Participants
n=107 Participants
|
0 Participants
n=206 Participants
|
2 Participants
n=7 Participants
|
5 Participants
n=31 Participants
|
|
Body Mass Index
Less than 25 kg/m^2
|
28 Participants
n=99 Participants
|
20 Participants
n=107 Participants
|
18 Participants
n=206 Participants
|
34 Participants
n=7 Participants
|
100 Participants
n=31 Participants
|
|
Body Mass Index
25 kg/m^2 to 30 kg/m^2
|
131 Participants
n=99 Participants
|
67 Participants
n=107 Participants
|
63 Participants
n=206 Participants
|
95 Participants
n=7 Participants
|
356 Participants
n=31 Participants
|
|
Body Mass Index
30 kg/m^2 and greater
|
152 Participants
n=99 Participants
|
79 Participants
n=107 Participants
|
84 Participants
n=206 Participants
|
173 Participants
n=7 Participants
|
488 Participants
n=31 Participants
|
PRIMARY outcome
Timeframe: From Baseline to Week 12Population: This study originally had 2 additional arms-dapagliflozin 2.5 and 5 mg-but randomization to these arms stopped when Protocol Amendment 8 (1-11-11) was implemented. Because endpoints focused only on 10-mg and placebo data, only patients in these arms who received study drug and who had nonmissing baseline and Week 12 values were included.
Seated BP was to be measured at every visit. Data after rescue medication was excluded. The patient first rested for at least 10 minutes in the seated position. Seated blood BP was determined from the mean of 3 replicated measurements obtained at least 1 minute apart. However, if the 3 consecutive seated BP readings were not within 8 mm Hg of each other, an additional 2 BP readings were to be obtained (total=5) and incorporated into the calculated mean for systolic BP and diastolic BP. For the initial BP recording, BP was measured in both arms. If the BP was higher in 1 arm, that arm was used for BP measurement. If there was no difference in BP measurements between arms, the dominant arm was used for all future BP measurements. All randomized participants who received at least 1 dose of study drug and who had nonmissing baseline and at least 1 postbaseline value during the double-blind treatment period were used for analysis. SD=standard deviation.
Outcome measures
| Measure |
Dapagliflozin 10 mg
n=280 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Placebo
n=279 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
|---|---|---|
|
Adjusted Mean Change From Baseline in Seated Systolic Blood Pressure (BP) at Week 12
|
-10.40 mm Hg
Standard Error 0.8822
|
-7.34 mm Hg
Standard Error 0.8812
|
PRIMARY outcome
Timeframe: From Baseline to Week 12Population: This study originally had 2 additional arms-dapagliflozin 2.5 and 5 mg-but randomization to these arms stopped when Protocol Amendment 8 (1-11-11) was implemented. Because endpoints focused only on 10-mg and placebo data, only patients in these arms who received study drug and who had nonmissing baseline and Week 12 values were included.
HbA1c was measured as percent of hemoglobin by a central laboratory. All randomized participants who received at least 1 dose of study drug and who had nonmissing baseline and at least 1 postbaseline value during the double-blind treatment period were used for analysis. SD=standard deviation.
Outcome measures
| Measure |
Dapagliflozin 10 mg
n=279 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Placebo
n=278 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
|---|---|---|
|
Adjusted Mean Change From Baseline in Hemoglobin (HbA1c) at Week 12
|
-0.10 Percent
Standard Error 0.0631
|
-0.56 Percent
Standard Error 0.0633
|
SECONDARY outcome
Timeframe: From Baseline to Week 12Population: This study originally had 2 additional arms-dapagliflozin 2.5 and 5 mg-but randomization to these arms stopped when Protocol Amendment 8 (1-11-11) was implemented. Because endpoints focused only on 10-mg and placebo data, only patients in these arms who received study drug and who had nonmissing baseline and Week 12 values were included.
Ambulatory blood pressure monitoring was performed twice during the study, at baseline and at the end of study, for a duration of 24-hrs each time. If the patient met the criteria for rescue due to hypertension, a second monitoring was performed prior to the first dose of rescue medication. Initiation of the 24-hr ambulatory blood pressure monitoring began between 6 and 11 am to ensure trough blood pressure measurements were obtained. Patients were instructed to withhold all medication on the morning of the study visit and to bring their medications to the visit with them.
Outcome measures
| Measure |
Dapagliflozin 10 mg
n=263 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Placebo
n=267 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
|---|---|---|
|
Adjusted Mean Change From Baseline in 24-Hour Ambulatory Systolic Blood Pressure at Week 12 (Last Observation Carried Forward)
|
-6.73 mm Hg
Standard Error 1.2427
|
-9.62 mm Hg
Standard Error 1.2277
|
SECONDARY outcome
Timeframe: From Baseline to Week 12Population: This study originally had 2 additional arms-dapagliflozin 2.5 and 5 mg-but randomization to these arms stopped when Protocol Amendment 8 (1-11-11) was implemented. Because endpoints focused only on 10-mg and placebo data, only patients in these arms who received study drug and who had nonmissing baseline and Week 12 values were included.
All randomized participants who received at least 1 dose of study drug and who had nonmissing baseline and at least 1 postbaseline value during the double-blind treatment period were used for analysis.
Outcome measures
| Measure |
Dapagliflozin 10 mg
n=279 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Placebo
n=280 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
|---|---|---|
|
Adjusted Mean Change From Baseline in Seated Diastolic Blood Pressure at Week 12
|
-4.79 mm Hg
Standard Error 0.5418
|
-5.79 mm Hg
Standard Error 0.5425
|
SECONDARY outcome
Timeframe: From Baseline to Week 12Population: This study originally had 2 additional arms-dapagliflozin 2.5 and 5 mg-but randomization to these arms stopped when Protocol Amendment 8 (1-11-11) was implemented. Because endpoints focused only on 10-mg and placebo data, only patients in these arms who received study drug and who had nonmissing baseline and Week 12 values were included.
Ambulatory blood pressure monitoring was performed twice during the study, at baseline and at the end of study, for a duration of 24 hours each time. If the patient met the criteria for rescue due to hypertension, a second monitoring was performed prior to the first dose of rescue medication. Initiation of the 24-hour ambulatory blood pressure monitoring began between 6 and 11 am to ensure trough blood pressure measurements were obtained. Patients were instructed to withhold all medication on the morning of the study visit and to bring their medications to the visit with them.
Outcome measures
| Measure |
Dapagliflozin 10 mg
n=263 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Placebo
n=267 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
|---|---|---|
|
Adjusted Mean Change in 24-Hour Ambulatory Diastolic Blood Pressure at Week 12 (Last Observation Carried Forward [LOCF])
|
-5.53 mm Hg
Standard Error 0.8458
|
-6.15 mm Hg
Standard Error 0.8353
|
SECONDARY outcome
Timeframe: From Baseline to Week 12Population: This study originally had 2 additional arms-dapagliflozin 2.5 and 5 mg-but randomization to these arms stopped when Protocol Amendment 8 (1-11-11) was implemented. Because endpoints focused only on 10-mg and placebo data, only patients in these arms who received study drug and who had nonmissing baseline and Week 12 values were included.
Central laboratory serum uric acid levels will be determined at the Enrollment, Day -28, Day 1, and at Week 4, 8, 12, and 13 visits. All randomized participants who received at least 1 dose of study drug and who had nonmissing baseline and at least 1 postbaseline value during the double-blind treatment period were used for analysis.
Outcome measures
| Measure |
Dapagliflozin 10 mg
n=279 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
Placebo
n=278 Participants
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
|---|---|---|
|
Adjusted Mean Change From Baseline in Serum Uric Acid Levels at Week 12
|
0.05 mg/dL
Standard Error 0.0747
|
-0.27 mg/dL
Standard Error 0.0754
|
Adverse Events
Placebo
Dapagliflozin, 2.5 mg (Randomized Before Protocol Amendment 8)
Dapagliflozin, 5 mg (Randomized Before Protocol Amendment 8)
Dapagliflozin 10 mg
Serious adverse events
| Measure |
Placebo
n=311 participants at risk
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an oral antidiabetic drug (OAD) with or without insulin and an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), received dapagliflozin-matching placebo daily with a morning meal.
|
Dapagliflozin, 2.5 mg (Randomized Before Protocol Amendment 8)
n=166 participants at risk
Participants with type 2 diabetes and inadequate glycemic control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 2.5 mg, daily with a morning meal.
|
Dapagliflozin, 5 mg (Randomized Before Protocol Amendment 8)
n=165 participants at risk
Participants with type 2 diabetes and inadequate glycemic control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 5 mg, daily with a morning meal.
|
Dapagliflozin 10 mg
n=302 participants at risk
Participants with type 2 diabetes and inadequate glycemic and hypertension control while taking an OAD with or without insulin and an ACE inhibitor or ARB, received dapagliflozin, 10 mg, daily with a morning meal.
|
|---|---|---|---|---|
|
Infections and infestations
Mastoiditis
|
0.00%
0/311
|
0.00%
0/166
|
0.00%
0/165
|
0.33%
1/302
|
|
Injury, poisoning and procedural complications
Craniocerebral injury
|
0.00%
0/311
|
0.00%
0/166
|
0.61%
1/165
|
0.00%
0/302
|
|
Injury, poisoning and procedural complications
Fall
|
0.00%
0/311
|
0.00%
0/166
|
0.61%
1/165
|
0.00%
0/302
|
|
Hepatobiliary disorders
Cholecystitis acute
|
0.00%
0/311
|
0.00%
0/166
|
0.61%
1/165
|
0.00%
0/302
|
|
Musculoskeletal and connective tissue disorders
Intervertebral disc disorder
|
0.00%
0/311
|
0.60%
1/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Nervous system disorders
Ischaemic stroke
|
0.32%
1/311
|
0.60%
1/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Injury, poisoning and procedural complications
Lumbar vertebral fracture
|
0.00%
0/311
|
0.60%
1/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Skin and subcutaneous tissue disorders
Subcutaneous emphysema
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Infections and infestations
Abscess intestinal
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Infections and infestations
Appendiceal abscess
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
General disorders
Chest pain
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Injury, poisoning and procedural complications
Rib fracture
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Injury, poisoning and procedural complications
Road traffic accident
|
0.32%
1/311
|
0.60%
1/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Nervous system disorders
Syncope
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Infections and infestations
Appendicitis
|
0.32%
1/311
|
0.00%
0/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Injury, poisoning and procedural complications
Cervical vertebral fracture
|
0.00%
0/311
|
0.60%
1/166
|
0.00%
0/165
|
0.00%
0/302
|
|
Infections and infestations
Otitis media
|
0.00%
0/311
|
0.00%
0/166
|
0.00%
0/165
|
0.33%
1/302
|
|
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Rectal adenoma
|
0.00%
0/311
|
0.00%
0/166
|
0.00%
0/165
|
0.33%
1/302
|
|
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion
|
0.00%
0/311
|
0.60%
1/166
|
0.00%
0/165
|
0.00%
0/302
|
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee Bristol-Myers Squibb Co. agreements with investigators vary; constant is our right to embargo communications regarding trial results prior to public release for a period ≤60 days from submittal for review. We will not prohibit investigators from publishing, but will prohibit the disclosure of previously undisclosed confidential information other than study results, and request postponement of single-center publications until after disclosure of the clinical trial's primary publication.
- Publication restrictions are in place
Restriction type: OTHER