BEGIN™: Comparison of NN1250 With Insulin Glargine in Subjects With Type 2 Diabetes

Sponsor
Novo Nordisk A/S (Industry)
Overall Status
Completed
CT.gov ID
NCT01068678
Collaborator
(none)
460
99
2
9
4.6
0.5

Study Details

Study Description

Brief Summary

This trial is conducted in Africa, Asia, Europe, and North America. The aim of this clinical trial is to compare the efficacy and safety of NN1250 (insulin degludec (IDeg)) with insulin glargine (IGlar) in subjects with type 2 diabetes currently treated with metformin alone or with metformin combined with an oral anti-diabetic drug (OAD) qualifying for intensified treatment.

Condition or Disease Intervention/Treatment Phase
  • Drug: insulin degludec
  • Drug: insulin glargine
Phase 3

Study Design

Study Type:
Interventional
Actual Enrollment :
460 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Trial Comparing Efficacy and Safety of NN1250 and Insulin Glargine in Subjects With Type 2 Diabetes (BEGIN™: EASY AM)
Study Start Date :
Feb 1, 2010
Actual Primary Completion Date :
Nov 1, 2010
Actual Study Completion Date :
Nov 1, 2010

Arms and Interventions

Arm Intervention/Treatment
Experimental: IDeg 3 times weekly (3TW)

Drug: insulin degludec
Injected subcutaneously (under the skin) three times weekly. Dose was individually adjusted.

Active Comparator: IGlar OD

Drug: insulin glargine
Injected subcutaneously (under the skin) once daily. Dose was individually adjusted.

Outcome Measures

Primary Outcome Measures

  1. Change in Glycosylated Haemoglobin (HbA1c) [Week 26]

    Change from baseline in HbA1c after week 26

Secondary Outcome Measures

  1. Change in Body Weight [Week 26]

    Change from baseline in body weight after week 26

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Insulin naïve subject (allowed are: previous short term insulin treatment up to 14 days; Treatment during hospitalisation or during gestational diabetes is allowed for periods longer than 14 days)

  • Current treatment: metformin monotherapy or metformin in any combination with insulin secretagogues (sulphonylurea (SU) or glinide), DPP-4 inhibitor, alpha-glucosidase-inhibitor (acarbose) with unchanged dosing for at least three months prior to Visit 1 with the minimum doses stated: -Metformin: alone or in combination (including fixed combination) 1500 mg daily or maximum tolerated dose (at least 1000 mg daily) -Insulin secretaguogue (sulfonylurea or glinide): minimum half of the daily maximal dose according to local labelling -DPP-4 inhibitor: minimum half of the daily maximal dose according to local labelling -alpha-glucosidase-inhibitor (acarbose): minimum half of the daily maximal dose or maximum tolerated dose

  • HbA1c 7.0-10.0 % (both inclusive) by central laboratory analysis

  • Body Mass Index (BMI) below or equal to 45.0 kg/m^2

Exclusion Criteria:
  • Use within the last 3 months prior to Visit 1 of: thiazoledinediones, exenatide or liraglutide

  • Cardiovascular disease, within the last 6 months prior to Visit 1, defined as: stroke; decompensated heart failure New York Heart Association (NYHA) class III or IV; myocardial infarction; unstable angina pectoris; or coronary arterial bypass graft or angioplasty

  • Uncontrolled treated/untreated severe hypertension (systolic blood pressure at least 180 millimetre (mm) mercury (Hg) and/or diastolic blood pressure at least 100 mmHg)

  • Pregnancy, breast-feeding, the intention of becoming pregnant or not using adequate contraceptive measures according to local requirements (for UK: adequate contraceptive measures are defined as established use of oral, injected or implanted hormonal methods of contraception, sterilisation, intrauterine device or intrauterine system, or consistent use of barrier methods)

  • Cancer and medical history of cancer hereof (except basal cell skin cancer or squamous cell skin cancer)

Contacts and Locations

Locations

Site City State Country Postal Code
1 Novo Nordisk Investigational Site Northridge California United States 91325
2 Novo Nordisk Investigational Site Palm Springs California United States 92262
3 Novo Nordisk Investigational Site Paramount California United States 90723
4 Novo Nordisk Investigational Site Santa Ana California United States 92704
5 Novo Nordisk Investigational Site Spring Valley California United States 91978
6 Novo Nordisk Investigational Site Tustin California United States 92780
7 Novo Nordisk Investigational Site Melbourne Florida United States 32901
8 Novo Nordisk Investigational Site Atlanta Georgia United States 30318
9 Novo Nordisk Investigational Site Columbus Georgia United States 31909
10 Novo Nordisk Investigational Site Perry Georgia United States 31069
11 Novo Nordisk Investigational Site Olympia Fields Illinois United States 60461
12 Novo Nordisk Investigational Site Avon Indiana United States 46123
13 Novo Nordisk Investigational Site Fishers Indiana United States 46038-1862
14 Novo Nordisk Investigational Site Franklin Indiana United States 46131-9121
15 Novo Nordisk Investigational Site Indianapolis Indiana United States 46254
16 Novo Nordisk Investigational Site Muncie Indiana United States 47304
17 Novo Nordisk Investigational Site Des Moines Iowa United States 50314
18 Novo Nordisk Investigational Site Lexington Kentucky United States 40503
19 Novo Nordisk Investigational Site Paducah Kentucky United States 42003
20 Novo Nordisk Investigational Site Hyattsville Maryland United States 20782
21 Novo Nordisk Investigational Site Rockville Maryland United States 20852
22 Novo Nordisk Investigational Site Interlochen Michigan United States 49643
23 Novo Nordisk Investigational Site Jackson Mississippi United States 39216
24 Novo Nordisk Investigational Site Chesterfield Missouri United States 63017
25 Novo Nordisk Investigational Site St. Peters Missouri United States 63376
26 Novo Nordisk Investigational Site Billings Montana United States 59101
27 Novo Nordisk Investigational Site Lincoln Nebraska United States 68521
28 Novo Nordisk Investigational Site Hamilton New Jersey United States 08619
29 Novo Nordisk Investigational Site Toms River New Jersey United States 08755-8050
30 Novo Nordisk Investigational Site Syracuse New York United States 13210
31 Novo Nordisk Investigational Site West Seneca New York United States 14224
32 Novo Nordisk Investigational Site Durham North Carolina United States 27710
33 Novo Nordisk Investigational Site Winston Salem North Carolina United States 27103
34 Novo Nordisk Investigational Site Canton Ohio United States 44718
35 Novo Nordisk Investigational Site Cleveland Ohio United States 44115
36 Novo Nordisk Investigational Site Dayton Ohio United States 45439
37 Novo Nordisk Investigational Site Mentor Ohio United States 44060
38 Novo Nordisk Investigational Site Pottstown Pennsylvania United States 19464
39 Novo Nordisk Investigational Site Upper St.Clair Pennsylvania United States 15241
40 Novo Nordisk Investigational Site Charleston South Carolina United States 29455
41 Novo Nordisk Investigational Site Greer South Carolina United States 29651
42 Novo Nordisk Investigational Site Simpsonville South Carolina United States 29681
43 Novo Nordisk Investigational Site Nashville Tennessee United States 37203
44 Novo Nordisk Investigational Site Amarillo Texas United States 79106
45 Novo Nordisk Investigational Site Arlington Texas United States 76014-2010
46 Novo Nordisk Investigational Site Dallas Texas United States 75231
47 Novo Nordisk Investigational Site Fort Worth Texas United States 76113
48 Novo Nordisk Investigational Site Houston Texas United States 77074
49 Novo Nordisk Investigational Site Houston Texas United States 77095
50 Novo Nordisk Investigational Site Irving Texas United States 75061-2210
51 Novo Nordisk Investigational Site Plano Texas United States 75024
52 Novo Nordisk Investigational Site San Antonio Texas United States 78224
53 Novo Nordisk Investigational Site Salt Lake City Utah United States 84107
54 Novo Nordisk Investigational Site Fredericksburg Virginia United States 22408-2674
55 Novo Nordisk Investigational Site Richmond Virginia United States 23225-4017
56 Novo Nordisk Investigational Site Virginia Beach Virginia United States 23462
57 Novo Nordisk Investigational Site Menomonee Falls Wisconsin United States 53051-4049
58 Novo Nordisk Investigational Site Calgary Alberta Canada T3C 3P1
59 Novo Nordisk Investigational Site Edmonton Alberta Canada T5J 3N4
60 Novo Nordisk Investigational Site Winnipeg Manitoba Canada R3E 3P4
61 Novo Nordisk Investigational Site St. John's Newfoundland and Labrador Canada A1A 3R5
62 Novo Nordisk Investigational Site Halifax Nova Scotia Canada B3H 2Y9
63 Novo Nordisk Investigational Site London Ontario Canada N6A 4V2
64 Novo Nordisk Investigational Site Mississauga Ontario Canada L5M 2V8
65 Novo Nordisk Investigational Site Sarnia Ontario Canada N7T 4X3
66 Novo Nordisk Investigational Site Sudbury Ontario Canada P3E 1Y8
67 Novo Nordisk Investigational Site Toronto Ontario Canada M3J 1N2
68 Novo Nordisk Investigational Site Toronto Ontario Canada M4N 3M5
69 Novo Nordisk Investigational Site Toronto Ontario Canada M4P 1P2
70 Novo Nordisk Investigational Site Mirabel Quebec Canada J7J 2K8
71 Novo Nordisk Investigational Site Sherbrooke Quebec Canada J1G 5K2
72 Novo Nordisk Investigational Site St John's Canada A1B 3V6
73 Novo Nordisk Investigational Site Brandys nad Labem Czech Republic 250 01
74 Novo Nordisk Investigational Site Mlada Boleslav Czech Republic 293 50
75 Novo Nordisk Investigational Site Ostrava Czech Republic 707 02
76 Novo Nordisk Investigational Site Prague Czech Republic 120 00
77 Novo Nordisk Investigational Site Trutnov Czech Republic 541 01
78 Novo Nordisk Investigational Site Petah-Tikva Israel 49372
79 Novo Nordisk Investigational Site Rehovot Israel 76100
80 Novo Nordisk Investigational Site Rishon Le Zion Israel 75650
81 Novo Nordisk Investigational Site Tel Hashomer Israel 52621
82 Novo Nordisk Investigational Site Zefat Israel 13100
83 Novo Nordisk Investigational Site Manati Puerto Rico 00674
84 Novo Nordisk Investigational Site Bratislava Slovakia 811 08
85 Novo Nordisk Investigational Site Kosice Slovakia 04-001
86 Novo Nordisk Investigational Site Moldava nad Bodvou Slovakia 045 01
87 Novo Nordisk Investigational Site Nove Zamky Slovakia 940 59
88 Novo Nordisk Investigational Site Presov Slovakia 080 01
89 Novo Nordisk Investigational Site Johannesburg Gauteng South Africa 2198
90 Novo Nordisk Investigational Site Durban KwaZulu-Natal South Africa 4091
91 Novo Nordisk Investigational Site Aberdeen United Kingdom AB25 1LD
92 Novo Nordisk Investigational Site Aldershot United Kingdom GU12 5BA
93 Novo Nordisk Investigational Site Birmingham United Kingdom B9 5SS
94 Novo Nordisk Investigational Site Chippenham United Kingdom SN15 2SB
95 Novo Nordisk Investigational Site Exeter United Kingdom EX2 5AX
96 Novo Nordisk Investigational Site Guildford United Kingdom GU2 7XX
97 Novo Nordisk Investigational Site Nuneaton United Kingdom CV10 7DJ
98 Novo Nordisk Investigational Site Portsmouth United Kingdom PO6 3LY
99 Novo Nordisk Investigational Site Watford United Kingdom WD18 0HB

Sponsors and Collaborators

  • Novo Nordisk A/S

Investigators

  • Study Director: Global Clinical Registry (GCR, 1452), Novo Nordisk A/S

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Novo Nordisk A/S
ClinicalTrials.gov Identifier:
NCT01068678
Other Study ID Numbers:
  • NN1250-3724
  • 2009-011398-33
  • U1111-1113-2412
First Posted:
Feb 15, 2010
Last Update Posted:
Mar 6, 2017
Last Verified:
Jan 1, 2017

Study Results

Participant Flow

Recruitment Details The trial was conducted at 94 sites in 7 countries: Canada (14 sites), Czech Republic (5 sites), Israel (5 sites), Slovakia (5 sites), South Africa (3 sites), United Kingdom (8 sites) and United States (54 sites). In addition, 9 sites (United Kingdom (1 site) and United States (8 sites)) were approved, but did not enroll any subjects.
Pre-assignment Detail
Arm/Group Title IDeg 3TW IGlar OD
Arm/Group Description Insulin degludec (IDeg) 200U/mL given 3 times weekly (Mondays, Wednesdays, Fridays) in the morning with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks. Insulin glargine (IGlar) 100U/mL given once a day (OD), according to the labelling instructions with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks.
Period Title: Overall Study
STARTED 230 230
Exposed 227 229
COMPLETED 192 206
NOT COMPLETED 38 24

Baseline Characteristics

Arm/Group Title IDeg 3TW IGlar OD Total
Arm/Group Description Insulin degludec (IDeg) 200U/mL given 3 times weekly (Mondays, Wednesdays, Fridays) in the morning with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks. Insulin glargine (IGlar) 100U/mL given once a day (OD), according to the labelling instructions with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks. Total of all reporting groups
Overall Participants 229 230 459
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
58.4
(9.9)
57.9
(9.7)
58.1
(9.8)
Sex: Female, Male (Count of Participants)
Female
105
45.9%
93
40.4%
198
43.1%
Male
124
54.1%
137
59.6%
261
56.9%
Glycosylated haemoglobin (HbA1c) (percentage of glycosylated haemoglobin) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [percentage of glycosylated haemoglobin]
8.2
(0.8)
8.3
(0.9)
8.2
(0.8)
Body weight (kg) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [kg]
90.8
(18.6)
95.7
(19.0)
93.3
(18.9)
Fasting Plasma Glucose (mmol/L) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [mmol/L]
9.3
(2.4)
9.6
(2.4)
9.5
(2.4)

Outcome Measures

1. Primary Outcome
Title Change in Glycosylated Haemoglobin (HbA1c)
Description Change from baseline in HbA1c after week 26
Time Frame Week 26

Outcome Measure Data

Analysis Population Description
The Full analysis set (FAS) included all randomised subjects and missing data is imputed using last observation carried forward (LOCF).1 subject was randomised despite being a screening failure.
Arm/Group Title IDeg 3TW IGlar OD
Arm/Group Description Insulin degludec (IDeg) 200U/mL given 3 times weekly (Mondays, Wednesdays, Fridays) in the morning with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks. Insulin glargine (IGlar) 100U/mL given once a day (OD), according to the labelling instructions with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks.
Measure Participants 229 230
Mean (Standard Deviation) [percentage of glycosylated haemoglobin]
-1.00
(0.95)
-1.40
(1.07)
2. Secondary Outcome
Title Change in Body Weight
Description Change from baseline in body weight after week 26
Time Frame Week 26

Outcome Measure Data

Analysis Population Description
The Safety analysis set (SAS) included all subjects who received at least one dose of the investigational product or its comparator. Missing data is imputed using last observation carried forward (LOCF). For 3 subjects baseline values were missing.
Arm/Group Title IDeg 3TW IGlar OD
Arm/Group Description Insulin degludec (IDeg) 200U/mL given 3 times weekly (Mondays, Wednesdays, Fridays) in the morning with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks. Insulin glargine (IGlar) 100U/mL given once a day (OD), according to the labelling instructions with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks.
Measure Participants 227 229
Mean (Standard Deviation) [kg]
0.8
(3.6)
1.0
(3.7)

Adverse Events

Time Frame Adverse events were collected in a time frame of 26 weeks + 7 days follow up
Adverse Event Reporting Description The safety analysis set includes all subjects who received atleast one dose of investigational product or its comparator. 227 subjects in IDeg 3TW and 229 in IGLar OD were included in the analysis.
Arm/Group Title IDeg 3TW IGlar OD
Arm/Group Description Insulin degludec (IDeg) 200U/mL given 3 times weekly (Mondays, Wednesdays, Fridays) in the morning with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks. Insulin glargine (IGlar) 100U/mL given once a day (OD), according to the labelling instructions with metformin with or without dipeptidyl peptidase-4 (DPP-4) inhibitor treatment for 26 weeks.
All Cause Mortality
IDeg 3TW IGlar OD
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN)
Serious Adverse Events
IDeg 3TW IGlar OD
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 11/227 (4.8%) 4/229 (1.7%)
Cardiac disorders
Angina unstable 2/227 (0.9%) 2 0/229 (0%) 0
Gastrointestinal disorders
Abdominal pain 0/227 (0%) 0 1/229 (0.4%) 1
General disorders
Non-cardiac chest pain 1/227 (0.4%) 1 0/229 (0%) 0
Infections and infestations
Appendicitis 1/227 (0.4%) 1 0/229 (0%) 0
Cellulitis 1/227 (0.4%) 1 0/229 (0%) 0
Diverticulitis 0/227 (0%) 0 1/229 (0.4%) 1
Injury, poisoning and procedural complications
Ankle fracture 1/227 (0.4%) 1 0/229 (0%) 0
Forearm fracture 1/227 (0.4%) 1 0/229 (0%) 0
Incisional hernia 1/227 (0.4%) 1 0/229 (0%) 0
Metabolism and nutrition disorders
Hypoglycaemia 1/227 (0.4%) 1 0/229 (0%) 0
Musculoskeletal and connective tissue disorders
Fibromyalgia 0/227 (0%) 0 1/229 (0.4%) 1
Osteoarthritis 0/227 (0%) 0 1/229 (0.4%) 1
Renal and urinary disorders
Calculus bladder 1/227 (0.4%) 1 0/229 (0%) 0
Renal colic 0/227 (0%) 0 1/229 (0.4%) 1
Vascular disorders
Peripheral arterial occlusive disease 1/227 (0.4%) 2 0/229 (0%) 0
Other (Not Including Serious) Adverse Events
IDeg 3TW IGlar OD
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 69/227 (30.4%) 77/229 (33.6%)
Gastrointestinal disorders
Diarrhoea 16/227 (7%) 17 17/229 (7.4%) 20
Nausea 12/227 (5.3%) 12 15/229 (6.6%) 16
General disorders
Injection site haematoma 11/227 (4.8%) 15 12/229 (5.2%) 12
Infections and infestations
Nasopharyngitis 15/227 (6.6%) 16 17/229 (7.4%) 18
Upper respiratory tract infection 5/227 (2.2%) 5 16/229 (7%) 19
Musculoskeletal and connective tissue disorders
Back pain 14/227 (6.2%) 18 14/229 (6.1%) 21
Nervous system disorders
Headache 26/227 (11.5%) 38 21/229 (9.2%) 26

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

Novo Nordisk maintains the right to be informed of any Investigator plans for publication and to review any scientific paper, presentation, communication or other information concerning the investigation described in this protocol. Any such communication must be submitted in writing to the Novo Nordisk trial manager prior to submission for comments. Comments will be given within four weeks from receipt of the planned communication.

Results Point of Contact

Name/Title Public Access to Clinical Trials
Organization Novo Nordisk A/S
Phone
Email clinicaltrials@novonordisk.com
Responsible Party:
Novo Nordisk A/S
ClinicalTrials.gov Identifier:
NCT01068678
Other Study ID Numbers:
  • NN1250-3724
  • 2009-011398-33
  • U1111-1113-2412
First Posted:
Feb 15, 2010
Last Update Posted:
Mar 6, 2017
Last Verified:
Jan 1, 2017