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.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

2996 participants

Primary outcome timeframe

From Baseline to Week 12

Results posted on

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

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

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

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 12

Population: 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

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 12

Population: 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

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 12

Population: 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

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 12

Population: 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

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 12

Population: 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

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 12

Population: 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

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

Serious events: 4 serious events
Other events: 0 other events
Deaths: 0 deaths

Dapagliflozin, 2.5 mg (Randomized Before Protocol Amendment 8)

Serious events: 3 serious events
Other events: 0 other events
Deaths: 0 deaths

Dapagliflozin, 5 mg (Randomized Before Protocol Amendment 8)

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Dapagliflozin 10 mg

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

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

AstraZeneca

Clinical Trial Transparency

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