Trial Outcomes & Findings for Effects of Linagliptin on Endothelial Function (NCT NCT02350478)

NCT ID: NCT02350478

Last Updated: 2020-05-15

Results Overview

Endothelium-dependent FMD following reactive hyperaemia was examined in the brachial artery according to the guidelines described by Coretti et al (J Am Coll Cardiol. 2002;39(2):257-65). FMD-diameter is calculated as the average of the three diameter measurements following reactive hyperaemia. FMD was calculated as the percent change in diameter compared to baseline. Flow-mediated dilation is reported such as "percentage of change in diameter (%)".

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

49 participants

Primary outcome timeframe

12 weeks

Results posted on

2020-05-15

Participant Flow

Participant milestones

Participant milestones
Measure
Linagliptin
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Overall Study
STARTED
25
24
Overall Study
COMPLETED
20
23
Overall Study
NOT COMPLETED
5
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Linagliptin
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Overall Study
Lost to Follow-up
5
1

Baseline Characteristics

Effects of Linagliptin on Endothelial Function

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Total
n=43 Participants
Total of all reporting groups
Age, Continuous
63.3 years
STANDARD_DEVIATION 7.8 • n=99 Participants
63.3 years
STANDARD_DEVIATION 8.7 • n=107 Participants
63.3 years
STANDARD_DEVIATION 8.2 • n=206 Participants
Sex: Female, Male
Female
5 Participants
n=99 Participants
4 Participants
n=107 Participants
9 Participants
n=206 Participants
Sex: Female, Male
Male
15 Participants
n=99 Participants
19 Participants
n=107 Participants
34 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
White
20 Participants
n=99 Participants
23 Participants
n=107 Participants
43 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
Austria
20 participants
n=99 Participants
23 participants
n=107 Participants
43 participants
n=206 Participants
Blood pressure systolic (mmHg)
134 mmHg
STANDARD_DEVIATION 17 • n=99 Participants
128 mmHg
STANDARD_DEVIATION 18 • n=107 Participants
131 mmHg
STANDARD_DEVIATION 18 • n=206 Participants
Blood pressure diastolic (mmHg)
79 mmHg
STANDARD_DEVIATION 14 • n=99 Participants
78 mmHg
STANDARD_DEVIATION 10 • n=107 Participants
79 mmHg
STANDARD_DEVIATION 12 • n=206 Participants
Low density lipoprotein (mg/dl)
66 mg/dl
STANDARD_DEVIATION 31 • n=99 Participants
76 mg/dl
STANDARD_DEVIATION 43 • n=107 Participants
71 mg/dl
STANDARD_DEVIATION 37 • n=206 Participants
Triglycerides (mg/dl)
145 mg/dl
n=99 Participants
122 mg/dl
n=107 Participants
128 mg/dl
n=206 Participants
HbA1c (mmol/mol)
50.5 mmol/mol
n=99 Participants
51 mmol/mol
n=107 Participants
51 mmol/mol
n=206 Participants
Fasting blood glucose
136 mg/dl
STANDARD_DEVIATION 41 • n=99 Participants
123 mg/dl
STANDARD_DEVIATION 26 • n=107 Participants
135 mg/dl
STANDARD_DEVIATION 35 • n=206 Participants
Aspartate-Aminotransferase (U/L)
33.5 U/l
STANDARD_DEVIATION 14 • n=99 Participants
27.6 U/l
STANDARD_DEVIATION 8.3 • n=107 Participants
30.4 U/l
STANDARD_DEVIATION 11.6 • n=206 Participants
Alanine-Aminotransferase (U/L)
40.4 U/l
STANDARD_DEVIATION 25 • n=99 Participants
29 U/l
STANDARD_DEVIATION 12.7 • n=107 Participants
34.4 U/l
STANDARD_DEVIATION 20.1 • n=206 Participants
Creatinine (mg/dL)
1.0 mg/dl
STANDARD_DEVIATION 0.3 • n=99 Participants
1.0 mg/dl
STANDARD_DEVIATION 0.2 • n=107 Participants
1.0 mg/dl
STANDARD_DEVIATION 0.3 • n=206 Participants
estimated glomerular filtration rate (ml/min)
76.7 ml/min
STANDARD_DEVIATION 16.1 • n=99 Participants
80.8 ml/min
STANDARD_DEVIATION 18.0 • n=107 Participants
78.9 ml/min
STANDARD_DEVIATION 17.0 • n=206 Participants
c-reactive protein (mg/L)
3.8 mg/dl
STANDARD_DEVIATION 4.2 • n=99 Participants
7.6 mg/dl
STANDARD_DEVIATION 20.4 • n=107 Participants
5.8 mg/dl
STANDARD_DEVIATION 15.2 • n=206 Participants
Urine albumine´(mg/L)
51.8 mg/l
STANDARD_DEVIATION 68.1 • n=99 Participants
30.3 mg/l
STANDARD_DEVIATION 43.4 • n=107 Participants
40.8 mg/l
STANDARD_DEVIATION 57.1 • n=206 Participants
n-terminal-proBNP (pg/ml)
419 pg/ml
STANDARD_DEVIATION 528 • n=99 Participants
228 pg/ml
STANDARD_DEVIATION 452 • n=107 Participants
317 pg/ml
STANDARD_DEVIATION 492 • n=206 Participants

PRIMARY outcome

Timeframe: 12 weeks

Endothelium-dependent FMD following reactive hyperaemia was examined in the brachial artery according to the guidelines described by Coretti et al (J Am Coll Cardiol. 2002;39(2):257-65). FMD-diameter is calculated as the average of the three diameter measurements following reactive hyperaemia. FMD was calculated as the percent change in diameter compared to baseline. Flow-mediated dilation is reported such as "percentage of change in diameter (%)".

Outcome measures

Outcome measures
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Changes in Endothelial Function (FMD - Flow Mediated Dilatation) From Baseline to 12 Weeks
0.4 percentage of change in diameter (%)
Standard Deviation 4.8
-0.5 percentage of change in diameter (%)
Standard Deviation 3.0

SECONDARY outcome

Timeframe: 12 weeks

Arginine, ornithine and citrulline will be measured in serum samples with a conventional usual amino acid analysis technique, involving separation of amino acids by ion exchange chromatography followed by postcolumn continuous reaction with ninhydrin. Global arginine bioavailability ratio (GABR) will be calculated by L-arginine divided by the sum of (L-ornithine plus L-citrulline). The arginine to ornithine ratio will be calculated by dividing L-arginine by L-ornithine levels.

Outcome measures

Outcome measures
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Changes in Global Arginine Bioavailability Ratio (Ratio of Arginine to [Ornithine + Citrulline]) and Arginine to Ornithine Ratio From Baseline to 12 Weeks
Global Arginine Bioavailabilty Ratio (%)
-0.11 Ratio
Standard Deviation 0.35
-0.06 Ratio
Standard Deviation 0.39
Changes in Global Arginine Bioavailability Ratio (Ratio of Arginine to [Ornithine + Citrulline]) and Arginine to Ornithine Ratio From Baseline to 12 Weeks
Arginine to ornithine ratio (%)
-0.13 Ratio
Standard Deviation 0.45
-0.05 Ratio
Standard Deviation 0.53

SECONDARY outcome

Timeframe: 12 weeks

Soluble cell adhesion molecules-1 (sICAM-1) of endothelial function from baseline to 12 weeks

Outcome measures

Outcome measures
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Changes in Biochemical Markers (sICAM-1)
-15 ng/ml
Interval -272.0 to 103.0
-21 ng/ml
Interval -134.0 to 310.0

SECONDARY outcome

Timeframe: 12 weeks

The Area under the curve was calculated for glucose, insulin and for the free fatty acids based on the trapezoidal rule with baseline value as the mean of the values at time points -5 and 0 minutes. The Meal Tolerance Test (MTT) was performed after an overnight fast (apart from water). A pre-meal blood sample will be taken (-5mins) and then all subjects will be asked to drink Fortimel compact (10 kcal/kg) over a period of 2-4 mins (time 0 mins). During the mixed meal test further blood samples will be taken at 15, 30, 60, and 120 minutes. All samples will be used for the determination of glucose, insulin and free fatty acids. The blood at each time point will be placed into a fluoride oxalate tube (1ml) for plasma glucose and into a serum tube for insulin and free fatty acids.

Outcome measures

Outcome measures
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Changes in the Area Under Curve (AUC) of Glucose, Insulin and C-peptide During the Meal Tolerance Test From Baseline to 12 Weeks
Glucose AUC
-1135 mg*min/dl
Standard Deviation 2619
481 mg*min/dl
Standard Deviation 3185
Changes in the Area Under Curve (AUC) of Glucose, Insulin and C-peptide During the Meal Tolerance Test From Baseline to 12 Weeks
C-peptide AUC
-3 mg*min/dl
Standard Deviation 161
-34 mg*min/dl
Standard Deviation 211
Changes in the Area Under Curve (AUC) of Glucose, Insulin and C-peptide During the Meal Tolerance Test From Baseline to 12 Weeks
Insulin AUC
249 mg*min/dl
Standard Deviation 4766
40 mg*min/dl
Standard Deviation 6357

SECONDARY outcome

Timeframe: 12 weeks

The Area under the curve was calculated for glucose, insulin and for the free fatty acids based on the trapezoidal rule with baseline value as the mean of the values at time points -5 and 0 minutes. The MTT was performed after an overnight fast (apart from water). A pre-meal blood sample will be taken (-5mins) and then all subjects will be asked to drink Fortimel compact (10 kcal/kg) over a period of 2-4 mins (time 0 mins). During the mixed meal test further blood samples will be taken at 15, 30, 60, and 120 minutes. All samples will be used for the determination of glucose, insulin and free fatty acids. The blood at each time point will be placed into a fluoride oxalate tube (1ml) for plasma glucose and into a serum tube for insulin and free fatty acids.

Outcome measures

Outcome measures
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Changes in the Area Under Curve (AUC) of Free Fatty Acids During the Meal Tolerance Test From Baseline to 12 Weeks
2.0 µmol*min/l
Standard Deviation 28.4
-3.1 µmol*min/l
Standard Deviation 18.3

SECONDARY outcome

Timeframe: 12 weeks

Soluble cell adhesion molecules-1 (svCAM-1) of endothelial function from baseline to 12 weeks

Outcome measures

Outcome measures
Measure
Linagliptin
n=20 Participants
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 Participants
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Changes in Biochemical Markers (svCAM-1)
-34 ng/ml
Standard Deviation 84
5 ng/ml
Standard Deviation 130

Adverse Events

Linagliptin

Serious events: 3 serious events
Other events: 2 other events
Deaths: 0 deaths

Placebo

Serious events: 1 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Linagliptin
n=20 participants at risk
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 participants at risk
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Musculoskeletal and connective tissue disorders
discus prolaps
5.0%
1/20 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
0.00%
0/23 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
Infections and infestations
Borreliosis
0.00%
0/20 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
4.3%
1/23 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
Nervous system disorders
Coordinating disorders
5.0%
1/20 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
0.00%
0/23 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
Gastrointestinal disorders
Abdominal pain
5.0%
1/20 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
0.00%
0/23 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).

Other adverse events

Other adverse events
Measure
Linagliptin
n=20 participants at risk
The subjects will receive Linagliptin 5mg (licensed dose for treatment of type 2 diabetes) . Linagliptin: The subject will receive Linagliptin 5mg orally once daily for 12 weeks.
Placebo
n=23 participants at risk
The subjects will receive placebo. Placebo: The subject will receive placebo orally once daily for 12 weeks.
Nervous system disorders
Dorsal pain
5.0%
1/20 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
0.00%
0/23 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
Gastrointestinal disorders
Toothache
5.0%
1/20 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
0.00%
0/23 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
Vascular disorders
Claudicatio intermittens
0.00%
0/20 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
4.3%
1/23 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
Cardiac disorders
Hypotension
0.00%
0/20 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
4.3%
1/23 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
General disorders
Nausea
5.0%
1/20 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).
4.3%
1/23 • Number of events 1 • Adverse events were collected for 16 weeks (12 weeks of intervention and 4 weeks of follow-up).

Additional Information

Assoz.-Prof. Dr. Harald Sourij

Medical University of Graz

Phone: +43316385

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place