Recent Updates
Recently added Catalysts

exenatide

Phase 3

Type 2 Diabetes Mellitus | Small molecule | Metabolic |AstraZeneca PLC|Last Updated: Sep 15, 2015

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
Premium
Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
Premium
Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDBiomarker
Total Trials16
Total Enrollment4,436
FDA Designations
No designations recorded
Clinical Trials (16)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT00960661A Trial Comparing Two Therapies: Basal Insulin/Glargine, Exenatide and Metformin Therapy (BET) or Basal Insulin/Glargine, Bolus Insulin Lispro and Metformin Therapy (BBT) in Subjects With Type 2 DiabetesPHASE3 COMPLETED 1,036Sep 1, 2009Aug 1, 2012Apr 7, 201595 Argentina, Belgium +16
NCT00603239Safety and Efficacy of Exenatide in Patients With Type 2 Diabetes Using a Thiazolidinedione or a Thiazolidinedione and MetforminPHASE3 COMPLETED 165Jan 1, 2008Jul 1, 2009Apr 7, 201525 United States, Canada +3
NCT00516074A Study to Assess the Effect of Exenatide Treatment on Mean 24-Hour Heart Rate in Patients With Type 2 DiabetesPHASE3 COMPLETED 54Sep 1, 2007Apr 1, 2008Apr 7, 20156 Canada, Netherlands
NCT00516048An Exploratory Study of the Effect of Treatment Interruption on Safety of Exenatide in Patients With Type 2 DiabetesPHASE3 COMPLETED 58Aug 1, 2007Apr 1, 2008Apr 7, 201513 Australia, Canada +3
NCT00359762Exenatide Versus Glimepiride in Patients With Type 2 DiabetesPHASE3 COMPLETED 1,029Sep 1, 2006Mar 1, 2011Sep 15, 2015114 Austria, Czechia +12
NCT00375492Effect on Weight Loss of Exenatide Versus PlaceboPHASE3 COMPLETED 196Sep 1, 2006Feb 1, 2008Apr 7, 201510 United States
NCT00381342Safety and Efficacy of Exenatide as MonotherapyPHASE3 COMPLETED 233Sep 1, 2006Sep 1, 2007Feb 23, 201519 United States, India +3
NCT00308139Effects of Exenatide Long-Acting Release on Glucose Control and Safety in Subjects With Type 2 Diabetes Mellitus(DURATION - 1)PHASE3 COMPLETED 303Apr 1, 2006Aug 1, 2014Aug 26, 201525 United States, Canada
NCT00324363Safety and Efficacy of Exenatide in Patients With Type 2 Diabetes Using Metformin or Sulfonylureas and MetforminPHASE3 COMPLETED 466Jan 1, 2006Apr 1, 2007Feb 23, 201514 China, India +2
NCT00097500Effects of Exenatide and Insulin Glargine in Subjects With Type 2 DiabetesPHASE3 COMPLETED 69Sep 1, 2004Dec 1, 2009Apr 7, 20153 Finland, Netherlands +1
NCT00099619Comparing Exenatide and Insulin Glargine in Type 2 Diabetes Patients for Whom Insulin is the Next Appropriate TherapyPHASE3 COMPLETED 138Sep 1, 2004Aug 1, 2005Feb 23, 201526 Australia, Greece +4
NCT00099320Safety and Efficacy of Exenatide in Patients With Type 2 Diabetes Using Thiazolidinediones or Thiazolidinediones and MetforminPHASE3 COMPLETED 182May 1, 2004Aug 1, 2005Feb 23, 201551 United States, Canada +1
NCT01876849An Open-Label Study Examining the Long-Term Safety of Exenatide Given Twice Daily to Patients With Type 2 Diabetes MellitusPHASE3 COMPLETED 275Dec 1, 2003Jul 1, 2008Feb 24, 20151 United States
NCT00382239A Study to Assess the Effect on Glucose Control and Safety and Tolerability of LY2148568 In Japanese Patients With Type 2 DiabetesPHASE2 COMPLETED 153Sep 1, 2006May 1, 2007Feb 23, 201514 Japan
NCT00241423Effect of Exenatide on 24-Hour Blood Glucose Profile Compared With Placebo in Patients With Type 2 DiabetesPHASE2 COMPLETED 30Oct 1, 2005Jun 1, 2007Feb 23, 20152 United States
NCT00099333Study of the Safety of Substituting Exenatide for Insulin in Patients Using Insulin and Oral Antidiabetic AgentsPHASE2 COMPLETED 49Feb 1, 2004Aug 1, 2005Feb 23, 20155 United States
Unlock Drug Trial Details
Study Endpoints
Primary Endpoints
Change in Glycosylated Hemoglobin (HbA1c) From Baseline to Week 30
Baseline, 30 weeks

Change in HbA1c from baseline following 30 weeks of therapy (i.e. HbA1c at week 30 minus HbA1c at baseline).

Change in Glycosylated Hemoglobin (HbA1c)
baseline and 26 weeks

Change in HbA1c from baseline to endpoint after 26 weeks of treatment (i.e., HbA1c at endpoint minus HbA1c at baseline)

Change in Mean 24-hour Heart Rate From Baseline to Endpoint
12 weeks

Change from baseline to endpoint in average heart rate measured over 24 hours by an ambulatory blood pressure monitor.

Treatment-emergent Antibody Status (Maximum Titer Level Experienced)
24 weeks

Patients who experienced specified treatment-emergent antibody status at any point during the study (grouped by maximum titer level experienced)

Incidence of Potentially Immune-related Treatment-emergent Adverse Events
24 weeks

Number of patients experiencing a potentially immune-related treatment-emergent adverse event at any point during the study

Number of Patients With Treatment Failure
Baseline to end of Period II (up to 4.5 years)

Treatment failure is defined as one of the following:1. HbA1c exceeding 9% at any visit after the initial 3 months of treatment (i.e., earliest at Month 6), on the maximally tolerated dose of antidiabetic agents. 2. HbA1c exceeding 7% at 2 consecutive visits 3 months apart, after the initial 6 months of treatment (i.e., earliest at Month 9), on the maximally tolerated dose of antidiabetic agents.

Time to Treatment Failure
Baseline to end of Period II (up to 4.5 years)

Treatment failure is defined as one of the following:1. HbA1c exceeding 9% at any visit after the initial 3 months of treatment (i.e., earliest at Month 6), on the maximally tolerated dose of antidiabetic agents. 2. HbA1c exceeding 7% at 2 consecutive visits 3 months apart, after the initial 6 months of treatment (i.e., earliest at Month 9), on the maximally tolerated dose of antidiabetic agents.

Change From Baseline in Body Weight
Baseline, Week 24

Change in body weight from baseline (Week 0) after 24 weeks of treatment (i.e., weight at week 24 minus weight at week 0). Body weight measured in kilograms (k).

Change in HbA1c (glycosylated hemoglobin) from Baseline to Week 24
Baseline, Week 24

Change in HbA1c from Baseline to Week 24

Change in HbA1c From Baseline to Week 30
Day -3, Week 30

Absolute change in HbA1c from Baseline (Day -3) to Week 30 \[Week 30 - Baseline\]

Sub-study Relative Bioavailability of Exenatide When Administered Using the Exenatide Once Weekly Dual Chambered Pen and the Exenatide Once Weekly Single Dose Tray (Single Dose Tray-11 Weekly Doses Switch to Dual Chamber Pen-11 Weekly Dose)
Week 22

Measure by Geometric mean ratio (GMR) of plasma exenatide average steady state concentration Css,avg at Visit 11-14 to Visit 24-27 with 90% confidence interval

To test the hypothesis that exenatide (before morning and evening meals) produces a greater decrease in HbA1c than placebo in patients with type 2 diabetes and inadequate glycemic control taking metformin alone or metformin and sulfonylureas.
16 weeks
Beta-cell Function After 52 Weeks of Therapy
Baseline (week -2) and 52 weeks

Treatment effect on beta-cell function as measured by the ratio of Week 52 arginine-stimulated insulin secretion during a hyperglycemic clamp(specifically, the incremental AUC of insulin with respect to basal value over a 10 min period \[i.e., clamp time 290 min to 300 min\]) to that at baseline (i.e., the ratio is calculated as arginine-stimulated insulin secretion at week 52 divided by arginine-stimulated insulin secretion at baseline \[week -2\]).

Change in HbA1c (glycosylated hemoglobin) from the baseline of the first period (16-weeks of exenatide or insulin) to the end of each 16-week period.
Baseline, Week 16, Week 32

Change in HbA1c from Baseline to the end of each 16-week period. There is one 16-week period of exenatide treatment and one 16-week period of insulin glargine.

Change in HbA1c (glycosylated hemoglobin) from Baseline to Week 16, and if measured, any visits in between
Baseline, Week 4, Week 8, Week 12, Week 16

Change in HbA1c from Baseline (Visit 3) to study termination at Week 16, and at all study visits in between

Change from Baseline to Week 16 in fasting serum glucose (FSG) and glucose
Baseline, Week 16

Change from Baseline to Week 16 in FSG and glucose measured at different times throughout the day derived from 7-point self-monitored glucose (SMG) profile (glucose measurements before and 2 hours after the start of the morning, midday, and evening meals, and at bedtime)

Long-term safety of twice-daily exenatide treatment, as defined by the occurrence of adverse events.
128 weeks (average treatment period)

Visits for this study occur at 6-mo (±2 wk) intervals until exenatide is approved for marketing.

Change in HbA1c (glycosylated hemoglobin) from Baseline to Week 12
Baseline, Week 12

Assess dose response effect on glucose control as measured by HbA1c among four doses (2.5 μg, 5 μg, 10 μg, and placebo) of subcutaneous injection of exenatide, twice daily before meals in the morning and evening, for 12 weeks

Time-averaged serum glucose during a 24-hour period
Every half-hour to hour for 24 hours
Change in HbA1c (glycosylated hemoglobin) from Baseline to Week 16
Baseline, Week 16

Change in HbA1c from Baseline study termination (Week 16)

Secondary Endpoints
Percentage of Participants Achieving HbA1C < 7.0%
Week 30
Percent of Participants Achieving HbA1c ≤ 6.5%.
Week 30
Change in Fasting Blood Glucose (FBG) From Baseline to Week 30.
Baseline, Week 30
Unlock Study Endpoints
Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Exenatide (BET)EXPERIMENTALBasal Insulin/Glargine, Exenatide and Metformin Therapy (BET)
Insulin Lispro (BBT)ACTIVE_COMPARATORBasal Insulin/Glargine, Bolus Insulin Lispro and Metformin Therapy (BBT)
Exenatide twice daily (BID)EXPERIMENTAL -
PlaceboPLACEBO_COMPARATOR -
Exenatide ArmEXPERIMENTALThis arm will receive 5mcg exenatide for 4 weeks, and then 10mcg exenatide for the remaining 8 weeks of the study.
Placebo ArmPLACEBO_COMPARATORThis arm will receive placebo injection (volume equivalent to the exenatide injection in the experimental arm).
Exenatide:Treatment-Emergent Antibody NegativeEXPERIMENTALThis arm will receive 5mcg exenatide for 4 weeks, followed by 10mcg exenatide for 20 weeks.
Exenatide:Treatment-Emergent Antibody PositiveEXPERIMENTALThis arm will receive 5mcg exenatide for 4 weeks, followed by 10mcg exenatide for 20 weeks.
ExenatideEXPERIMENTAL -
GlimepirideACTIVE_COMPARATOR -
Group AEXPERIMENTAL -
Group BPLACEBO_COMPARATOR -
Exenatide 5 mcg/exenatide 5 mcgEXPERIMENTALExenatide 5 mcg; then exenatide 5 mcg
Exenatide 5 mcg/exenatide 10 mcgEXPERIMENTALExenatide 5 mcg, then exenatide 10 mcg
Exenatide Once WeeklyEXPERIMENTALSubcutaneous injection (SC), once a week of long acting release (LAR) exenatide.
Exenatide Twice DailyACTIVE_COMPARATORsubcutaneous injection (SC), twice a day for the first 30 weeks, followed by exenatide LAR SC injection weekly for the remainder of the study. Sub-study: Exenatide 2 mg subcutaneous injection, Administered Using the Exenatide Once Weekly Single-Dose Tray , once a week for 11 visits, switch to Exenatide 2 mg subcutaneous injection, Administered Using the Dual chamber pen device. Exenatide 2mg SC injection administered using the Dual chamber pen device.
Insulin Glargine ArmACTIVE_COMPARATORInsulin Glargine and Metformin
exenatide/insulin glargineEXPERIMENTALArm that first receives exenatide, then crosses over to insulin glargine
Insulin glargine/exenatideEXPERIMENTALArm that first receives insulin glargine, then crosses over to exenatide
Exenatide 2.5 mcg/exenatide 2.5 mcgEXPERIMENTAL -
Placebo/placeboPLACEBO_COMPARATOR -
InsulinACTIVE_COMPARATORThe subjects will remain on their current insulin therapy. Subjects will also remain on their existing oral diabetic therapy.
Interventions
NameTypeDescription
exenatideDRUGsubcutaneous injection, 5mcg (4 weeks) followed by 10mcg (26 weeks), twice a day
insulin lisproDRUGtitrated based on pre-meal glucose level; three times a day
MetforminDRUG -
Insulin/ GlargineDRUG -
placeboDRUGsubcutaneous injection, volume equivalent to 5 mcg or 10 mcg of active drug, twice a day
glimepirideDRUGoral tablet (titrated to maximally tolerated dose), once daily
exenatide, long acting releaseDRUG -
Insulin glargineDRUGsubcutaneous injection, once a day, titrated as necessary in order to meet defined blood glucose targets
exenatide/insulin glargineDRUGSubcutaneously injected exenaide 10 mcg twice daily for 16 weeks; then insulin glargine subcutaneously injected once daily for 16 weeks given in a dose that varies for individuals to achieve target glucose levels
insulin glargine/exenatideDRUGSubcutaneously injected insulin glargine subcutaneously injected once daily for 16 weeks given in a dose that varies for individuals to achieve target glucose levels; then exenaide 10 mcg twice daily for 16 weeks
exenatide (LY2148568)DRUGsubcutaneous injection twice daily, 5 mcg for 4 weeks, then 10 mcg for 8 weeks
InsulinDRUGInsulin will be taken according to the subject's current regimen
Unlock Study Design Details
Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites95

Inclusion Criteria: * Have been taking a basal insulin Glargine, at dose of ≥ 20 units/day, for at least 3 months prior to study start. * Have been taking basal insulin Glargine at dose of ≥ 20 units/day, in combination with 1 of the following oral antidiabetic medication (OAM) regimens, for at lea...

Countries:ArgentinaBelgiumEstoniaFinlandFranceGermanyGreeceItalyMexicoNetherlandsPortugalPuerto RicoRomaniaRussiaSouth KoreaSpainSwedenUnited KingdomUnited StatesCanadaSouth AfricaAustraliaHungaryAustriaCzechiaIrelandIsraelPolandSwitzerlandIndiaChinaTaiwanJapan
Unlock Eligibility Criteria