GETGOAL-S: GLP-1 Receptor Agonist Lixisenatide in Patients With Type 2 Diabetes for Glycemic Control and Safety Evaluation, on Top of Sulfonylurea

Sponsor
Sanofi (Industry)
Overall Status
Completed
CT.gov ID
NCT00713830
Collaborator
(none)
859
16
2
30
53.7
1.8

Study Details

Study Description

Brief Summary

The purpose of this study is to evaluate the benefits and risks of lixisenatide (AVE0010), in comparison to placebo, as an add-on treatment to sulfonylurea without or with metformin, over a period of 24 weeks of treatment, followed by an extension.

The primary objective is to assess the effects of lixisenatide when added to sulfonylurea with or without metformin on glycemic control in terms of glycosylated hemoglobin (HbA1c) reduction (absolute change) at Week 24.

The secondary objectives are to assess the effects of lixisenatide on percentage of patients reaching HbA1c less than (<) 7 percent (%); percentage of patients reaching HbA1c less than or equal to (<=) 6.5%; body weight; fasting plasma glucose (FPG); beta-cell function assessed by homeostasis model assessment (HOMA) beta; 2-hour postprandial plasma glucose (PPG), glucagon, insulin, proinsulin, and C-peptide after a standardized meal challenge test in a sub-study in all patients in selected centers; to evaluate safety, tolerability, pharmacokinetics (PK) and anti-lixisenatide antibody development.

Condition or Disease Intervention/Treatment Phase
Phase 3

Detailed Description

Patients who complete the 24-week main double-blind treatment would undergo a variable double-blind extension treatment, which ends for all patients at approximately the scheduled date of Week 76 visit (Visit 25) for the last randomized patient.

Study Design

Study Type:
Interventional
Actual Enrollment :
859 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Participant, Investigator)
Primary Purpose:
Treatment
Official Title:
A Randomized, Double-blind, Placebo-controlled, 2-arm Parallel-group, Multicenter 24-week Study Followed by an Extension Assessing the Efficacy and Safety of AVE0010 on Top of a Sulfonylurea in Patients With Type 2 Diabetes Not Adequately Controlled With Sulfonylurea
Study Start Date :
Jul 1, 2008
Actual Primary Completion Date :
Jan 1, 2011
Actual Study Completion Date :
Jan 1, 2011

Arms and Interventions

Arm Intervention/Treatment
Experimental: Lixisenatide

2-step initiation regimen of lixisenatide: 10 microgram (mcg) once daily (QD) for 1 week, followed by 15 mcg QD for 1 week, then 20 mcg QD up to the end of treatment.

Drug: Lixisenatide (AVE0010)
Self administered by subcutaneous injections once daily within the hour preceding breakfast.

Device: Pen auto-injector
Other Names:
  • OptiClik®
  • Drug: Sulfonylurea
    Sulfonylurea to be continued at maximum effective dose according to local labeling up to end of treatment.

    Drug: Metformin
    Metformin if given to be continued at stable dose (at least 1.5 gram per day [except at least 0.75 gram per day in Japan and 1.0 gram per day in South Korea]) up to the end of treatment.

    Placebo Comparator: Placebo

    2-step initiation regimen of volume matching placebo: 10 mcg QD for 1 week, followed by 15 mcg QD for 1 week, then 20 mcg QD up to the end of treatment.

    Drug: Placebo
    Self administered by subcutaneous injections once daily within the hour preceding breakfast.

    Device: Pen auto-injector
    Other Names:
  • OptiClik®
  • Drug: Sulfonylurea
    Sulfonylurea to be continued at maximum effective dose according to local labeling up to end of treatment.

    Drug: Metformin
    Metformin if given to be continued at stable dose (at least 1.5 gram per day [except at least 0.75 gram per day in Japan and 1.0 gram per day in South Korea]) up to the end of treatment.

    Outcome Measures

    Primary Outcome Measures

    1. Absolute Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 24 [Baseline, Week 24]

      Absolute change = HbA1c value at Week 24 minus HbA1c value at baseline. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in Modified Intent-to-Treat (mITT) population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    Secondary Outcome Measures

    1. Change From Baseline in 2-Hour Postprandial Plasma Glucose (PPG) at Week 24 [Baseline, Week 24]

      The 2-hour PPG blood sample was drawn 2 hours after start of a standardized meal (standardized meal challenge test performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    2. Change From Baseline in Fasting Plasma Glucose (FPG) at Week 24 [Baseline, Week 24]

      Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 1 day after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    3. Change From Baseline in Body Weight at Week 24 [Baseline, Week 24]

      Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    4. Change From Baseline in Beta-cell Function Assessed by HOMA-beta at Week 24 [Baseline, Week 24]

      Beta cell function was assessed by HOMA-beta. HOMA-beta blood samples were drawn during a standardized meal challenge test (performed in selected sites). HOMA-beta (% of normal beta cells function) = (20 multiplied by fasting plasma insulin [micro unit per milliliter]) divided by (FPG [mmol/L] minus 3.5). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    5. Change From Baseline in Fasting Glucagon and 2-hour Postprandial Glucagon at Week 24 [Baseline, Week 24]

      The fasting glucagon and the 2-hour postprandial glucagon blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    6. Change From Baseline in Fasting Plasma Insulin (FPI) and 2-hour Postprandial Plasma Insulin at Week 24 [Baseline, Week 24]

      The fasting plasma insulin and the 2-hour postprandial plasma insulin blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    7. Change From Baseline in Fasting Proinsulin and 2-hour Postprandial Proinsulin at Week 24 [Baseline, Week 24]

      The fasting Proinsulin and the 2-hour postprandial Proinsulin blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    8. Change From Baseline in Fasting C-peptide and 2-hour Postprandial C-peptide at Week 24 [Baseline, Week 24]

      The fasting C-peptide and the 2-hour postprandial C-peptide blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy.For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    9. Percentage of Patients With Glycosylated Hemoglobin (HbA1c) Level Less Than 7% at Week 24 [Week 24]

      The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    10. Percentage of Patients With Glycosylated Hemoglobin (HbA1c) Level Less Than or Equal to 6.5% at Week 24 [Week 24]

      The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    11. Percentage of Patients Requiring Rescue Therapy During Main 24-Week Period [Baseline up to Week 24]

      Routine fasting self-monitored plasma glucose (SMPG) and central laboratory FPG (and HbA1c after week 12) values were used to determine the requirement of rescue medication. If fasting SMPG value exceeded the specified limit for 3 consecutive days, the central laboratory FPG (and HbA1c after week 12) were performed. Threshold values - from baseline to Week 8: fasting SMPG/FPG >270 milligram/deciliter (mg/dL) (15.0 mmol/L), from Week 8 to Week 12: fasting SMPG/FPG >240 mg/dL (13.3 mmol/L), and from Week 12 to Week 24: fasting SMPG/FPG >200 mg/dL (11.1 mmol/L) or HbA1c >8.5%. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    Other Outcome Measures

    1. Change From Baseline in Glucose Excursion at Week 24 [Baseline, Week 24]

      Glucose excursion = 2-hour PPG minus plasma glucose 30 minutes prior to the standardized meal test (performed in selected sites), before study drug administration. Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    2. Change From Baseline in Fasting Proinsulin-to-insulin Ratio and 2-hour Postprandial Proinsulin-to-insulin Ratio at Week 24 [Baseline, Week 24]

      The fasting proinsulin-to-insulin ratio and 2-hour postprandial proinsulin-to-insulin ratio were measured during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    3. Percentage of Patients With at Least 5% Weight Loss From Baseline at Week 24 [Baseline, Week 24]

      The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.

    4. Number of Patients With Symptomatic Hypoglycemia and Severe Symptomatic Hypoglycemia [First dose of study drug up to 3 days after the last dose administration, for up to 120 weeks]

      Symptomatic hypoglycemia was an event with clinical symptoms that were considered to result from a hypoglycemic episode with an accompanying plasma glucose less than 60 mg/dL (3.3 mmol/L) or associated with prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration if no plasma glucose measurement was available. Severe symptomatic hypoglycemia was symptomatic hypoglycemia event in which the patient required the assistance of another person and was associated with either a plasma glucose level below 36 mg/dL (2.0 mmol/L) or prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration, if no plasma glucose measurement was available.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Type 2 diabetes mellitus, diagnosed for at least 1 year before screening visit, insufficiently controlled with a sulfonylurea alone or a sulfonylurea in association with metformin
    Exclusion Criteria:
    • HbA1c less than (<) 7% or greater than (>) 10% at screening

    • At the time of screening age less than legal age of majority

    • Pregnant or breastfeeding women or women of childbearing potential with no effective contraceptive method

    • Type 1 diabetes mellitus

    • Sulfonylurea less than the maximum effective dose according to local labeling

    • Sulfonylurea not at a stable (unchanged) dose for at least 3 months prior to screening

    • In case of treatment with metformin in association with sulfonylurea, no stable (unchanged) treatment with metformin of at least 1.5 gram per day (except at least 0.75 gram per day in Japan and at least 1.0 gram per day in South Korea), for at least 3 months prior to screening visit

    • FPG at screening >250 milligram per deciliter (mg/dL) (>13.9 millimole per liter [mmol/L])

    • History of hypoglycemia unawareness

    • Body mass index less than or equal to (<=) 20 kilogram per square meter (kg/m^2)

    • Weight change of >5 kg during the 3 months preceding the screening visit

    • History of unexplained pancreatitis, chronic pancreatitis, pancreatectomy, stomach/gastric surgery, inflammatory bowel disease

    • History of metabolic acidosis, including diabetic ketoacidosis within 1 year prior to screening

    • Hemoglobinopathy or hemolytic anemia, receipt of blood or plasma products within 3 months prior to the time of screening

    • Within the last 6 months prior to screening, history of myocardial infarction, stroke, or heart failure requiring hospitalization

    • Known history of drug or alcohol abuse within 6 months prior to the time of screening

    • Cardiovascular, hepatic, neurological, endocrine disease, active malignant tumor or other major systemic disease or patients with short life expectancy making implementation of the protocol or interpretation of the study results difficult, history or presence of clinically significant diabetic retinopathy, history or presence of macular edema likely to require laser treatment within the study period

    • Uncontrolled or inadequately controlled hypertension at the time of screening with a resting systolic blood pressure (SBP) or diastolic blood pressure (DBP) >180 millimeter of mercury (mmHg) or >95 mmHg, respectively

    • Laboratory findings at the time of screening: aspartate aminotransferase, alanine aminotransferase, or alkaline phosphatase: >2 times upper limit of the normal (ULN) laboratory range; amylase and/or lipase: >3 times ULN; total bilirubin: >1.5 times ULN (except in case of Gilbert's syndrome); hemoglobin <11 gram/deciliter and/or neutrophils <1500 per cubic millimeter (mm3) and/or platelets <100 000/mm3; positive test for Hepatitis B surface antigen and/or Hepatitis C antibody

    • Any clinically significant abnormality identified on physical examination, laboratory tests or vital signs at the time of screening that in the judgment of the Investigator or any sub investigator precludes safe completion of the study or constrains efficacy assessment

    • Patients who are considered by the Investigator or any sub investigator as inappropriate for this study for any reason (for example, impossibility to meet specific protocol requirements, such as scheduled visits, being able to do self-injections, likelihood of requiring treatment during the screening phase and treatment phase with drugs not permitted by the clinical study protocol, Investigator or any sub investigator, pharmacist, study coordinator, other study staff or relative thereof directly involved in the conduct of the protocol)

    • Patients with condition/concomitant diseases making them non-evaluable for the efficacy assessment

    • Use of oral or injectable antidiabetic or hypoglycemic agents other than sulfonylurea and metformin (for example, alpha glucosidase inhibitor, thiazolidinedione, rimonabant, exenatide, dipeptidyl-peptidase 4 (DPP-4) inhibitors, insulin) within 3 months prior to the time of screening

    • Use of systemic glucocorticoids (excluding topical application or inhaled forms) for 1 week or more within 3 months prior to the time of screening

    • Use of any investigational drug within 3 months prior to study

    • Any previous treatment with lixisenatide (for example, participation in a previous study with lixisenatide)

    • Renal impairment defined with serum creatinine >1.4 mg/dL in women and serum creatinine >1.5 mg/dL in men (applicable only for patients with metformin treatment)

    • End-stage renal disease as defined by a serum creatinine clearance of <15 milliliter/minute (calculated by the Cockcroft and Gault formula) and/or patients on dialysis (if no treatment with metformin)

    • Clinically relevant history of gastrointestinal disease associated with prolonged nausea and vomiting, including, but not limited to gastroparesis and gastroesophageal reflux disease requiring medical treatment, within 6 months prior to the time of screening

    • Allergic reaction to any glucagon like peptide-1 (GLP-1) agonist in the past (for example, exenatide, liraglutide) or to metacresol

    • Additional exclusion criteria at the end of the run-in phase: informed consent withdrawal; lack of compliance during the single-blind placebo run-in phase (>2 injections missed); and patient with any adverse event which precludes the inclusion in the study, as assessed by the investigator

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Sanofi-Aventis Administrative Office Bridgewater New Jersey United States 08807
    2 Sanofi-Aventis Administrative Office Sofia Bulgaria
    3 Sanofi-Aventis Administrative Office Praha Czech Republic
    4 Sanofi-Aventis Administrative Office Cairo Egypt
    5 Sanofi-Aventis Administrative Office Berlin Germany
    6 Sanofi-Aventis Administrative Office Mumbai India
    7 Sanofi-Aventis Administrative Office Natanya Israel
    8 Sanofi-Aventis Administrative Office Tokyo Japan
    9 Sanofi-Aventis Administrative Office Seoul Korea, Republic of
    10 Sanofi-Aventis Administrative Office Gouda Netherlands
    11 Sanofi-Aventis Administrative Office Bucuresti Romania
    12 Sanofi-Aventis Administrative Office Moscow Russian Federation
    13 Sanofi-Aventis Administrative Office Taipei Taiwan
    14 Sanofi-Aventis Administrative Office Bangkok Thailand
    15 Sanofi-Aventis Administrative Office Megrine Tunisia
    16 Sanofi-Aventis Administrative Office Istanbul Turkey

    Sponsors and Collaborators

    • Sanofi

    Investigators

    • Study Director: Clinical Sciences & Operations, Sanofi

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Sanofi
    ClinicalTrials.gov Identifier:
    NCT00713830
    Other Study ID Numbers:
    • EFC6015
    • EudraCT 2007-005881-11
    First Posted:
    Jul 14, 2008
    Last Update Posted:
    Dec 14, 2016
    Last Verified:
    Oct 1, 2016
    Keywords provided by Sanofi
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details The study was conducted at 136 centers in 16 countries between July 08, 2008 and January 14, 2011. The overall duration of treatment was at least 76 weeks (24 weeks main double-blind treatment; variable double-blind extension treatment).
    Pre-assignment Detail A total of 1438 participants were screened of which 579 (40.3%) were screen failures; main reason for screen failure was glycosylated hemoglobin (HbA1c) values being out of the defined protocol range (greater than or equal to 7% and less than or equal to 10%). A total of 859 participants were randomized.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo: 10 microgram (mcg) once daily (QD) subcutaneously for 1 week, followed by 15 mcg QD for 1 week, then 20 mcg QD up to the end of treatment. 2-step initiation regimen of lixisenatide: 10 mcg QD subcutaneously for 1 week, followed by 15 mcg QD for 1 week, then 20 mcg QD up to the end of treatment.
    Period Title: Overall Study
    STARTED 286 573
    Modified Intent-to-Treat(mITT)Population 286 570
    Safety Population 285 574
    Subgroup for Standardized Meal Test 155 313
    COMPLETED 204 396
    NOT COMPLETED 82 177

    Baseline Characteristics

    Arm/Group Title Placebo Lixisenatide Total
    Arm/Group Description 2-step initiation regimen of volume matching placebo: 10 mcg QD subcutaneously for 1 week, followed by 15 mcg QD for 1 week, then 20 mcg QD up to the end of treatment. 2-step initiation regimen of lixisenatide: 10 mcg QD subcutaneously for 1 week, followed by 15 mcg QD for 1 week, then 20 mcg QD up to the end of treatment. Total of all reporting groups
    Overall Participants 285 574 859
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    57.8
    (10.1)
    57.0
    (9.8)
    57.2
    (9.9)
    Sex: Female, Male (Count of Participants)
    Female
    135
    47.4%
    290
    50.5%
    425
    49.5%
    Male
    150
    52.6%
    284
    49.5%
    434
    50.5%
    Race/Ethnicity, Customized (participants) [Number]
    Race: Caucasian/White
    151
    53%
    297
    51.7%
    448
    52.2%
    Race: Black
    9
    3.2%
    17
    3%
    26
    3%
    Race: Asian/Oriental
    125
    43.9%
    260
    45.3%
    385
    44.8%
    Ethnicity: Hispanic
    5
    1.8%
    18
    3.1%
    23
    2.7%
    Ethnicity: Non Hispanic
    280
    98.2%
    556
    96.9%
    836
    97.3%
    Glycosylated Hemoglobin (HbA1c) (percentage of hemoglobin) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [percentage of hemoglobin]
    8.21
    (0.84)
    8.28
    (0.86)
    8.25
    (0.85)
    2-Hour Postprandial Plasma Glucose (PPG) (millimole per liter (mmol/L)) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [millimole per liter (mmol/L)]
    16.44
    (3.74)
    16.69
    (4.02)
    16.60
    (3.92)
    Fasting Plasma Glucose (FPG) (mmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [mmol/L]
    9.29
    (2.37)
    9.67
    (2.24)
    9.55
    (2.29)
    Body Weight (kilogram (kg)) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [kilogram (kg)]
    84.42
    (22.83)
    82.30
    (21.76)
    83.00
    (22.13)
    Homeostasis Model Assessment for Beta-cell Function (HOMA-beta) (percentage of normal beta cells function) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [percentage of normal beta cells function]
    36.43
    (39.43)
    34.28
    (69.82)
    34.99
    (61.39)
    Fasting glucagon (nanogram per liter (ng/L)) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [nanogram per liter (ng/L)]
    0.89
    (0.55)
    0.83
    (0.43)
    0.85
    (0.47)
    2-hour postprandial glucagon (ng/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [ng/L]
    102.27
    (39.37)
    97.83
    (31.94)
    99.31
    (34.60)
    Fasting plasma insulin (FPI) (picomole per liter (pmol/L)) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [picomole per liter (pmol/L)]
    66.89
    (63.92)
    61.34
    (52.63)
    63.18
    (56.61)
    2-hour postprandial plasma insulin (pmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [pmol/L]
    281.26
    (243.56)
    259.44
    (182.64)
    266.76
    (205.09)
    Fasting proinsulin (pmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [pmol/L]
    34.39
    (32.61)
    33.35
    (27.43)
    33.69
    (29.17)
    2-hour postprandial proinsulin (pmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [pmol/L]
    61.73
    (46.48)
    62.12
    (44.80)
    61.99
    (45.31)
    Fasting C-peptide (mmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [mmol/L]
    0.89
    (0.55)
    0.83
    (0.43)
    0.85
    (0.47)
    2-hour postprandial C-peptide (mmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [mmol/L]
    2.12
    (1.05)
    1.99
    (0.90)
    2.03
    (0.95)
    Glucose Excursion (mmol/L) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [mmol/L]
    6.84
    (3.78)
    6.99
    (3.71)
    6.94
    (3.73)
    Fasting proinsulin-to-insulin ratio (ratio) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [ratio]
    0.62
    (0.36)
    0.70
    (0.57)
    0.67
    (0.51)
    2-hour postprandial proinsulin-to-insulin ratio (ratio) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [ratio]
    0.30
    (0.22)
    0.32
    (0.24)
    0.31
    (0.23)

    Outcome Measures

    1. Primary Outcome
    Title Absolute Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 24
    Description Absolute change = HbA1c value at Week 24 minus HbA1c value at baseline. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in Modified Intent-to-Treat (mITT) population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population:all randomized patients who received at least 1 dose;had baseline,at least 1 post-baseline efficacy assessment, irrespective of compliance with study protocol/procedures. Last observation carried forward used. Number of patients analyzed=patients with baseline and at least 1 post-baseline HbA1c assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 274 544
    Least Squares Mean (Standard Error) [percentage of hemoglobin]
    -0.10
    (0.071)
    -0.85
    (0.061)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Placebo, Lixisenatide
    Comments To detect a difference of 0.5% (or 0.4%) in change from baseline to Week 24 in HbA1c between lixisenatide and placebo, 570 patients in lixisenatide arm and 285 in placebo arm would provide a power of 99% (or 98%) assuming common standard deviation of 1.3% with a 2-sided test at 5% significance level.
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments Statistical testing: 2-sided at significance level=0.05. Analysis of co-variance (ANCOVA) included treatment arms, randomization strata of screening HbA1c (<8.0, >=8.0%), metformin use (yes, no), country as fixed effects, baseline HbA1c as covariate.
    Method ANCOVA
    Comments
    Method of Estimation Estimation Parameter Least squares (LS) mean difference
    Estimated Value -0.74
    Confidence Interval (2-Sided) 95%
    -0.867 to -0.621
    Parameter Dispersion Type: Standard Error of the Mean
    Value: 0.063
    Estimation Comments
    2. Secondary Outcome
    Title Change From Baseline in 2-Hour Postprandial Plasma Glucose (PPG) at Week 24
    Description The 2-hour PPG blood sample was drawn 2 hours after start of a standardized meal (standardized meal challenge test performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using last observation carried forward (LOCF). Here, number of patients analyzed = patients with baseline and at least 1 post-baseline 2-hour PPG assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 120 249
    Least Squares Mean (Standard Error) [mmol/L]
    -0.21
    (0.489)
    -6.19
    (0.408)
    3. Secondary Outcome
    Title Change From Baseline in Fasting Plasma Glucose (FPG) at Week 24
    Description Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 1 day after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population. Missing data was imputed using LOCF. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline FPG assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 283 564
    Least Squares Mean (Standard Error) [mmol/L]
    -0.36
    (0.161)
    -0.99
    (0.139)
    4. Secondary Outcome
    Title Change From Baseline in Body Weight at Week 24
    Description Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population. Missing data was imputed using LOCF. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline body weight assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 278 554
    Least Squares Mean (Standard Error) [kilogram]
    -0.93
    (0.234)
    -1.76
    (0.202)
    5. Secondary Outcome
    Title Change From Baseline in Beta-cell Function Assessed by HOMA-beta at Week 24
    Description Beta cell function was assessed by HOMA-beta. HOMA-beta blood samples were drawn during a standardized meal challenge test (performed in selected sites). HOMA-beta (% of normal beta cells function) = (20 multiplied by fasting plasma insulin [micro unit per milliliter]) divided by (FPG [mmol/L] minus 3.5). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using LOCF. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline HOMA-beta assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 116 241
    Least Squares Mean (Standard Error) [% of normal beta cells function]
    6.63
    (5.663)
    4.83
    (4.686)
    6. Other Pre-specified Outcome
    Title Change From Baseline in Glucose Excursion at Week 24
    Description Glucose excursion = 2-hour PPG minus plasma glucose 30 minutes prior to the standardized meal test (performed in selected sites), before study drug administration. Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using last observation carried forward (LOCF). Here, number of patients analyzed = patients with baseline and at least 1 post-baseline glucose excursion assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 120 249
    Least Squares Mean (Standard Error) [mmol/L]
    0.35
    (0.432)
    -5.22
    (0.360)
    7. Secondary Outcome
    Title Change From Baseline in Fasting Glucagon and 2-hour Postprandial Glucagon at Week 24
    Description The fasting glucagon and the 2-hour postprandial glucagon blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using LOCF. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline glucagon assessment during on-treatment period and 'n' = patients with baseline and at least 1 post-baseline assessment for the specified category.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 114 238
    Fasting glucagon (n=111, 238)
    2.03
    (2.566)
    -2.10
    (2.081)
    2-hour postprandial glucagon (n=114, 234)
    -1.19
    (2.999)
    -23.33
    (2.500)
    8. Secondary Outcome
    Title Change From Baseline in Fasting Plasma Insulin (FPI) and 2-hour Postprandial Plasma Insulin at Week 24
    Description The fasting plasma insulin and the 2-hour postprandial plasma insulin blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using LOCF. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline plasma insulin assessment during on-treatment period and 'n' = patients with baseline and at least 1 post-baseline assessment for the specified category.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 120 244
    FPI (n=117, 242)
    1.42
    (6.587)
    -4.03
    (5.445)
    2-hour postprandial plasma insulin (n=120, 244)
    -2.22
    (18.754)
    -67.67
    (15.944)
    9. Secondary Outcome
    Title Change From Baseline in Fasting Proinsulin and 2-hour Postprandial Proinsulin at Week 24
    Description The fasting Proinsulin and the 2-hour postprandial Proinsulin blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using LOCF. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline proinsulin assessment during on-treatment period and 'n' = patients with baseline and at least 1 post-baseline assessment for the specified category.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 97 205
    Fasting proinsulin (n=97, 205)
    -1.05
    (1.983)
    -6.33
    (1.671)
    2-hour postprandial proinsulin (n=93, 193)
    3.55
    (4.200)
    -4.20
    (3.550)
    10. Other Pre-specified Outcome
    Title Change From Baseline in Fasting Proinsulin-to-insulin Ratio and 2-hour Postprandial Proinsulin-to-insulin Ratio at Week 24
    Description The fasting proinsulin-to-insulin ratio and 2-hour postprandial proinsulin-to-insulin ratio were measured during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data imputed using LOCF. Number of patients analyzed=patients with baseline and at least 1 post-baseline proinsulin-to-insulin ratio assessment during on-treatment period and 'n'= patients with baseline and at least 1 post-baseline assessment for the specific category.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 95 199
    Fasting proinsulin-to-insulin ratio (n=95, 199)
    -0.04
    (0.049)
    -0.13
    (0.043)
    2-hour postprandial ratio (n=92, 190)
    0.01
    (0.060)
    0.16
    (0.053)
    11. Secondary Outcome
    Title Change From Baseline in Fasting C-peptide and 2-hour Postprandial C-peptide at Week 24
    Description The fasting C-peptide and the 2-hour postprandial C-peptide blood samples were drawn during a standardized meal challenge test (performed in selected sites). Change was calculated by subtracting baseline value from Week 24 value. The on-treatment period for this efficacy variable is time from the first dose of study drug and up to last dosing day of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy.For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    Subgroup for standardized meal test in mITT population. Missing data was imputed using LOCF. here. number of patients analyzed = patients with baseline and at least 1 post-baseline C-peptide assessment during on-treatment period and 'n' = patients with baseline and at least 1 post-baseline assessment for the specified category.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 119 248
    Fasting C-peptide (n=117, 244)
    -0.06
    (0.038)
    -0.07
    (0.031)
    2-hour postprandial C-peptide (n=119, 248)
    -0.14
    (0.087)
    -0.37
    (0.072)
    12. Secondary Outcome
    Title Percentage of Patients With Glycosylated Hemoglobin (HbA1c) Level Less Than 7% at Week 24
    Description The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline HbA1c assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 274 544
    Number [percentage of participants]
    13.5
    4.7%
    36.4
    6.3%
    13. Secondary Outcome
    Title Percentage of Patients With Glycosylated Hemoglobin (HbA1c) Level Less Than or Equal to 6.5% at Week 24
    Description The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline HbA1c assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 274 544
    Number [percentage of participants]
    4.7
    1.6%
    19.3
    3.4%
    14. Other Pre-specified Outcome
    Title Percentage of Patients With at Least 5% Weight Loss From Baseline at Week 24
    Description The on-treatment period for this efficacy variable is time from the first dose of study drug and up to 3 days after the last dose of study drug, on or before Visit 12 (Week 24) or Day 169 if Visit 12 is not available, and before the introduction of rescue therapy. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline, Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population. Here, number of patients analyzed = patients with baseline and at least 1 post-baseline body weight assessment during on-treatment period.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 278 554
    Number [percentage of participants]
    7.2
    2.5%
    14.4
    2.5%
    15. Secondary Outcome
    Title Percentage of Patients Requiring Rescue Therapy During Main 24-Week Period
    Description Routine fasting self-monitored plasma glucose (SMPG) and central laboratory FPG (and HbA1c after week 12) values were used to determine the requirement of rescue medication. If fasting SMPG value exceeded the specified limit for 3 consecutive days, the central laboratory FPG (and HbA1c after week 12) were performed. Threshold values - from baseline to Week 8: fasting SMPG/FPG >270 milligram/deciliter (mg/dL) (15.0 mmol/L), from Week 8 to Week 12: fasting SMPG/FPG >240 mg/dL (13.3 mmol/L), and from Week 12 to Week 24: fasting SMPG/FPG >200 mg/dL (11.1 mmol/L) or HbA1c >8.5%. For a patient to be included in mITT population, both baseline and at least 1 post baseline assessment for at least 1 efficacy variable, were required.
    Time Frame Baseline up to Week 24

    Outcome Measure Data

    Analysis Population Description
    mITT population.
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 286 570
    Number [percentage of participants]
    12.6
    4.4%
    4.0
    0.7%
    16. Other Pre-specified Outcome
    Title Number of Patients With Symptomatic Hypoglycemia and Severe Symptomatic Hypoglycemia
    Description Symptomatic hypoglycemia was an event with clinical symptoms that were considered to result from a hypoglycemic episode with an accompanying plasma glucose less than 60 mg/dL (3.3 mmol/L) or associated with prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration if no plasma glucose measurement was available. Severe symptomatic hypoglycemia was symptomatic hypoglycemia event in which the patient required the assistance of another person and was associated with either a plasma glucose level below 36 mg/dL (2.0 mmol/L) or prompt recovery after oral carbohydrate, intravenous glucose, or glucagon administration, if no plasma glucose measurement was available.
    Time Frame First dose of study drug up to 3 days after the last dose administration, for up to 120 weeks

    Outcome Measure Data

    Analysis Population Description
    Safety population included all randomized patients who were exposed to at least 1 dose of study drug, regardless of the amount of treatment administered.The one patient in the placebo group who received Lixisenatide was analyzed in the Lixisenatide group
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    Measure Participants 285 574
    Symptomatic hypoglycemia
    51
    17.9%
    127
    22.1%
    Severe symptomatic hypoglycemia
    1
    0.4%
    2
    0.3%

    Adverse Events

    Time Frame First dose of study drug up to 3 days after the last dose administration, for up to 120 weeks
    Adverse Event Reporting Description Median exposure to study treatment was 617 and 610 days in placebo and lixisenatide treatment arms, respectively. The analysis was performed on safety population, defined as all randomized patients who were exposed to at least 1 dose of study drug, regardless of the amount of treatment administered. The one patient in the placebo group who received Lixisenatide was analyzed in the Lixisenatide group
    Arm/Group Title Placebo Lixisenatide
    Arm/Group Description 2-step initiation regimen of volume matching placebo. 2-step initiation regimen of lixisenatide.
    All Cause Mortality
    Placebo Lixisenatide
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total / (NaN) / (NaN)
    Serious Adverse Events
    Placebo Lixisenatide
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 35/285 (12.3%) 58/574 (10.1%)
    Cardiac disorders
    Acute coronary syndrome 1/285 (0.4%) 1/574 (0.2%)
    Acute myocardial infarction 1/285 (0.4%) 2/574 (0.3%)
    Angina pectoris 2/285 (0.7%) 1/574 (0.2%)
    Angina unstable 1/285 (0.4%) 2/574 (0.3%)
    Atrioventricular block complete 0/285 (0%) 2/574 (0.3%)
    Cardiac failure congestive 0/285 (0%) 1/574 (0.2%)
    Coronary artery disease 1/285 (0.4%) 2/574 (0.3%)
    Coronary artery stenosis 0/285 (0%) 1/574 (0.2%)
    Mitral valve incompetence 0/285 (0%) 1/574 (0.2%)
    Myocardial infarction 1/285 (0.4%) 2/574 (0.3%)
    Congenital, familial and genetic disorders
    Adenomatous polyposis coli 1/285 (0.4%) 0/574 (0%)
    Ear and labyrinth disorders
    Sudden hearing loss 0/285 (0%) 2/574 (0.3%)
    Eye disorders
    Cataract 0/285 (0%) 1/574 (0.2%)
    Cataract nuclear 0/285 (0%) 1/574 (0.2%)
    Vitreous haemorrhage 0/285 (0%) 1/574 (0.2%)
    Gastrointestinal disorders
    Colonic polyp 0/285 (0%) 1/574 (0.2%)
    Diarrhoea 1/285 (0.4%) 1/574 (0.2%)
    Gastritis 0/285 (0%) 1/574 (0.2%)
    Gastrooesophageal reflux disease 0/285 (0%) 1/574 (0.2%)
    Haemorrhoids 0/285 (0%) 1/574 (0.2%)
    Hiatus hernia 0/285 (0%) 1/574 (0.2%)
    Pancreatitis acute 1/285 (0.4%) 1/574 (0.2%)
    Pancreatitis chronic 0/285 (0%) 1/574 (0.2%)
    Reflux oesophagitis 0/285 (0%) 2/574 (0.3%)
    General disorders
    Chest pain 1/285 (0.4%) 1/574 (0.2%)
    Pyrexia 1/285 (0.4%) 0/574 (0%)
    Sudden cardiac death 0/285 (0%) 1/574 (0.2%)
    Hepatobiliary disorders
    Cholecystitis 0/285 (0%) 2/574 (0.3%)
    Cholelithiasis 0/285 (0%) 1/574 (0.2%)
    Hepatitis 0/285 (0%) 1/574 (0.2%)
    Hepatitis acute 1/285 (0.4%) 0/574 (0%)
    Immune system disorders
    Allergy to arthropod sting 0/285 (0%) 1/574 (0.2%)
    Anaphylactic shock 0/285 (0%) 1/574 (0.2%)
    Infections and infestations
    Arthritis bacterial 1/285 (0.4%) 0/574 (0%)
    Cellulitis 2/285 (0.7%) 0/574 (0%)
    Colitis herpes 1/285 (0.4%) 0/574 (0%)
    Leptospirosis 0/285 (0%) 1/574 (0.2%)
    Pneumonia 1/285 (0.4%) 0/574 (0%)
    Pyelonephritis acute 0/285 (0%) 1/574 (0.2%)
    Urinary tract infection 1/285 (0.4%) 2/574 (0.3%)
    Injury, poisoning and procedural complications
    Ankle fracture 1/285 (0.4%) 1/574 (0.2%)
    Contusion 0/285 (0%) 1/574 (0.2%)
    Hand fracture 0/285 (0%) 1/574 (0.2%)
    In-stent coronary artery restenosis 1/285 (0.4%) 0/574 (0%)
    Lower limb fracture 0/285 (0%) 1/574 (0.2%)
    Multiple injuries 0/285 (0%) 1/574 (0.2%)
    Muscle injury 1/285 (0.4%) 0/574 (0%)
    Patella fracture 0/285 (0%) 1/574 (0.2%)
    Periorbital haematoma 0/285 (0%) 1/574 (0.2%)
    Pneumothorax traumatic 0/285 (0%) 1/574 (0.2%)
    Road traffic accident 0/285 (0%) 3/574 (0.5%)
    Investigations
    Blood calcitonin increased 0/285 (0%) 1/574 (0.2%)
    Metabolism and nutrition disorders
    Hyperglycaemia 1/285 (0.4%) 0/574 (0%)
    Hypoglycaemia 1/285 (0.4%) 1/574 (0.2%)
    Musculoskeletal and connective tissue disorders
    Back pain 1/285 (0.4%) 0/574 (0%)
    Intervertebral disc protrusion 2/285 (0.7%) 0/574 (0%)
    Rotator cuff syndrome 0/285 (0%) 1/574 (0.2%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Brain neoplasm benign 0/285 (0%) 1/574 (0.2%)
    Breast cancer 2/285 (0.7%) 0/574 (0%)
    Gastric cancer 0/285 (0%) 1/574 (0.2%)
    Glottis carcinoma 0/285 (0%) 1/574 (0.2%)
    Hepatic neoplasm malignant 1/285 (0.4%) 0/574 (0%)
    Prostate cancer 0/285 (0%) 1/574 (0.2%)
    Rectal cancer 0/285 (0%) 1/574 (0.2%)
    Rectosigmoid cancer 0/285 (0%) 1/574 (0.2%)
    Uterine leiomyoma 1/285 (0.4%) 0/574 (0%)
    Nervous system disorders
    Cerebral infarction 0/285 (0%) 2/574 (0.3%)
    Dizziness 1/285 (0.4%) 0/574 (0%)
    Essential tremor 1/285 (0.4%) 0/574 (0%)
    Ischaemic stroke 1/285 (0.4%) 1/574 (0.2%)
    Lacunar infarction 1/285 (0.4%) 0/574 (0%)
    Transient ischaemic attack 1/285 (0.4%) 2/574 (0.3%)
    VIIth nerve paralysis 1/285 (0.4%) 1/574 (0.2%)
    Psychiatric disorders
    Depression 0/285 (0%) 1/574 (0.2%)
    Schizophrenia simple 0/285 (0%) 1/574 (0.2%)
    Schizophrenia, paranoid type 0/285 (0%) 1/574 (0.2%)
    Renal and urinary disorders
    Calculus ureteric 0/285 (0%) 1/574 (0.2%)
    Calculus urinary 1/285 (0.4%) 0/574 (0%)
    Renal failure acute 0/285 (0%) 1/574 (0.2%)
    Urinary retention 1/285 (0.4%) 0/574 (0%)
    Respiratory, thoracic and mediastinal disorders
    Hiccups 0/285 (0%) 1/574 (0.2%)
    Interstitial lung disease 1/285 (0.4%) 0/574 (0%)
    Surgical and medical procedures
    Coronary angioplasty 0/285 (0%) 2/574 (0.3%)
    Coronary arterial stent insertion 1/285 (0.4%) 0/574 (0%)
    Percutaneous coronary intervention 2/285 (0.7%) 3/574 (0.5%)
    Vascular disorders
    Aortic stenosis 0/285 (0%) 1/574 (0.2%)
    Hypertension 1/285 (0.4%) 0/574 (0%)
    Peripheral arterial occlusive disease 0/285 (0%) 1/574 (0.2%)
    Thrombophlebitis 1/285 (0.4%) 0/574 (0%)
    Other (Not Including Serious) Adverse Events
    Placebo Lixisenatide
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 148/285 (51.9%) 362/574 (63.1%)
    Gastrointestinal disorders
    Constipation 11/285 (3.9%) 30/574 (5.2%)
    Diarrhoea 27/285 (9.5%) 71/574 (12.4%)
    Dyspepsia 4/285 (1.4%) 34/574 (5.9%)
    Nausea 25/285 (8.8%) 161/574 (28%)
    Vomiting 15/285 (5.3%) 61/574 (10.6%)
    Infections and infestations
    Influenza 11/285 (3.9%) 30/574 (5.2%)
    Nasopharyngitis 58/285 (20.4%) 91/574 (15.9%)
    Upper respiratory tract infection 21/285 (7.4%) 43/574 (7.5%)
    Investigations
    Blood glucose decreased 11/285 (3.9%) 30/574 (5.2%)
    Metabolism and nutrition disorders
    Hypoglycaemia 55/285 (19.3%) 140/574 (24.4%)
    Musculoskeletal and connective tissue disorders
    Back pain 12/285 (4.2%) 36/574 (6.3%)
    Nervous system disorders
    Dizziness 18/285 (6.3%) 60/574 (10.5%)
    Headache 20/285 (7%) 44/574 (7.7%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

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

    If no publication has occurred within 12 months of the completion of the study, the Investigator shall have the right to publish/present independently the results of the study. The Investigator shall provide the Sponsor with a copy of any such presentation/publication for comment at least 30 days before any presentation/submission for publication. If requested by the Sponsor, any presentation/submission shall be delayed up to 90 days, to allow the Sponsor to preserve its proprietary rights.

    Results Point of Contact

    Name/Title Trial Transparency Team
    Organization Sanofi
    Phone
    Email Contact-us@sanofi.com
    Responsible Party:
    Sanofi
    ClinicalTrials.gov Identifier:
    NCT00713830
    Other Study ID Numbers:
    • EFC6015
    • EudraCT 2007-005881-11
    First Posted:
    Jul 14, 2008
    Last Update Posted:
    Dec 14, 2016
    Last Verified:
    Oct 1, 2016