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Sitagliptin/metformin

Phase 3

Type 2 Diabetes Mellitus | Small molecule | Metabolic |Merck & Company, Inc.|Last Updated: Sep 23, 2022

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials33
Total Enrollment27,984
FDA Designations
No designations recorded
Clinical Trials (33)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02536248Sitagliptin Therapy and Kinetics of Inflammatory MarkersPHASE3 COMPLETED 20Aug 1, 2015Oct 31, 2017May 13, 20201 Canada
NCT02791490A Study of the Safety and Efficacy of Sitagliptin Addition During Metformin Up-titration (MK-0431-848)PHASE3 COMPLETED 458Jun 16, 2016Feb 1, 2018Feb 28, 2019 -
NCT02738879Randomized Sitagliptin Withdrawal Study (MK-0431-845)PHASE3 COMPLETED 746May 9, 2016Jan 30, 2018Feb 25, 2019 -
NCT02577016Double-blind Sitagliptin Add-on Study in Japanese Participants With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Ipragliflozin (MK-0431J-842)PHASE3 COMPLETED 141Nov 5, 2015Nov 18, 2016Aug 31, 2018 -
NCT02532855A Study to Assess the Addition of Sitagliptin to Metformin Compared With the Addition of Dapagliflozin to Metformin in Participants With Type 2 Diabetes Mellitus (T2DM) and Mild Renal Impairment Who Have Inadequate Glycemic Control on Metformin With or Without a Sulfonylurea (MK-0431-838)PHASE3 COMPLETED 614Oct 20, 2015Oct 10, 2017Nov 20, 2018 -
NCT01702298A Study to Assess the Safety and Tolerability of Sitagliptin/Simvastatin Fixed-dose Combination (FDC) in Participants With Type 2 Diabetes Mellitus With Inadequate Glycemic Control on Metformin Monotherapy (MK-0431D-312)PHASE3 COMPLETED 42Dec 7, 2012May 29, 2013Aug 24, 2018 -
NCT01590797A Study in China Evaluating the Safety and Efficacy of Adding Sitagliptin to Stable Therapy With Insulin With or Without Metformin in Participants With Type 2 Diabetes Mellitus (T2DM) (MK-0431-254)PHASE3 COMPLETED 467Jul 10, 2012Jun 25, 2014Aug 17, 2018 -
NCT01590771A Study in China Evaluating the Safety and Efficacy of Adding Sitagliptin to Stable Therapy With Sulfonylurea With or Without Metformin in Participants With Type 2 Diabetes Mellitus (T2DM) (MK-0431-253)PHASE3 COMPLETED 498Jul 9, 2012Jun 24, 2014Aug 17, 2018 -
NCT01545388Metformin Add-on Regimen Comparison Study in Japanese Participants With Type 2 Diabetes Mellitus (MK-0431A-136)PHASE3 COMPLETED 337Feb 23, 2012Mar 12, 2013Aug 22, 2018 -
NCT01462266Study of Sitagliptin for the Treatment of Type 2 Diabetes Mellitus With Inadequate Glycemic Control on Insulin (MK-0431-260)PHASE3 COMPLETED 660Jan 13, 2012Jun 7, 2013Aug 17, 2018 -
NCT01760447A Pooled Analysis of the Safety and Efficacy of MK-0431A and MK-0431A XR in Pediatric Participants With Type 2 Diabetes Mellitus With Inadequate Glycemic Control on Metformin Therapy (Alone or in Combination With Insulin) (MK-0431A-170/MK-0431A-289)PHASE3 COMPLETED 223Dec 7, 2011Sep 17, 2019Sep 23, 2022 -
NCT01177384Clinical Trial to Evaluate the Safety and Efficacy of the Addition of Sitagliptin in Participants With Type 2 Diabetes Mellitus Receiving Acarbose Monotherapy (MK-0431-130)PHASE3 COMPLETED 380Jan 25, 2011Mar 25, 2013Aug 16, 2018 -
NCT01076088Safety and Efficacy of Co-Administration of Sitagliptin and Metformin in China (MK-0431-121)PHASE3 COMPLETED 744Nov 15, 2010Dec 24, 2012May 23, 2017 -
NCT01189890Safety and Efficacy of Sitagliptin Compared With Glimepiride in Elderly Participants With Type 2 Diabetes Mellitus (MK-0431-251)PHASE3 COMPLETED 480Aug 16, 2010Oct 31, 2012Jun 5, 2017 -
NCT01340768Study to Compare Sitagliptin Versus Sulfonylurea Treatment During Ramadan Fasting in Patients With Type 2 Diabetes (MK-0431-262)PHASE3 COMPLETED 870Jun 22, 2010Sep 21, 2011Jun 5, 2017 -
NCT01076075A Study to Evaluate the Safety and Efficacy of Sitagliptin 100 mg in Participants With Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control (MK-0431-229)PHASE3 COMPLETED 427Jun 3, 2010Jan 19, 2012Jun 5, 2017 -
NCT00885352Sitagliptin (MK-0431) vs. Placebo in Patients With Inadequate Glycemic Control on Metformin With Pioglitazone (MK-0431-128)PHASE3 COMPLETED 313Apr 15, 2009Nov 10, 2010May 23, 2017 -
NCT00790205Sitagliptin Cardiovascular Outcomes Study (MK-0431-082)PHASE3 COMPLETED 14,671Dec 10, 2008Mar 30, 2015Nov 23, 2021 -
NCT00813995A Study to Test the Safety and Efficacy of Adding Sitagliptin in Patients With Type 2 Diabetes Mellitus (MK0431-074)PHASE3 COMPLETED 395Dec 9, 2008Aug 9, 2010May 12, 2017 -
NCT00722371MK0431 and Pioglitazone Co-Administration Factorial Study in Patients With Type 2 Diabetes Mellitus (0431-102 AM2)PHASE3 COMPLETED 1,615Sep 5, 2008Mar 25, 2011May 12, 2017 -
NCT00541450A Study to Evaluate the Efficacy and Safety of Sitagliptin and MK0431A in Comparison to a Commonly Used Medication in Patients With Type 2 Diabetes (0431-068)(COMPLETED)PHASE3 COMPLETED 492Jan 15, 2008Jan 16, 2010May 12, 2017 -
NCT00449930Sitagliptin Comparative Study in Patients With Type 2 Diabetes (0431-049)PHASE3 COMPLETED 1,050Mar 1, 2007Jul 25, 2008May 11, 2017 -
NCT00395343Sitagliptin Added-on to Insulin Study (0431-051)PHASE3 COMPLETED 641Dec 11, 2006Oct 13, 2008May 12, 2017 -
NCT00372060MK0431 (Sitagliptin) Pioglitazone Add-on Study for Patients With Type 2 Diabetes Mellitus (0431-055)(COMPLETED)PHASE3 COMPLETED 134Aug 21, 2006Feb 5, 2008May 12, 2017 -
NCT00350779Sitagliptin Metformin/PPARg Agonist Combination Therapy Add-on (0431-052)PHASE3 COMPLETED 262Jun 12, 2006Jun 11, 2008May 12, 2017 -
NCT00541775Safety/Efficacy of Sitagliptin in Patient w/ Type 2 Diabetes (0431-801)PHASE3 COMPLETED 273Jun 1, 2006Mar 1, 2007Aug 24, 2015 -
NCT00289848MK0431 Monotherapy Study in Patients With Type 2 Diabetes Mellitus (0431-040)PHASE3 COMPLETED 530Mar 1, 2006Mar 1, 2007Jun 15, 2015 -
NCT00127192A Study of an Investigational Drug Sitagliptin for Type 2 Diabetes Mellitus (0431-044)PHASE2 COMPLETED 363Jul 1, 2005Mar 1, 2006Jun 15, 2015 -
NCT01557504A Study to Assess the Pharmacokinetics and the Ability for Pediatric Participants With Type 2 Diabetes to Swallow MK-0431A XR Tablets (MK-0431A-296)PHASE1 COMPLETED 25Jul 18, 2012Apr 29, 2014Oct 28, 2020 -
NCT01582308A Study Comparing the Pharmacokinetic and Pharmacodynamic Profiles for Sitagliptin, Saxagliptin and Vildagliptin in Participants With Type 2 Diabetes Mellitus (T2DM) (MK-0431-142)PHASE1 COMPLETED 22Jun 21, 2012Dec 14, 2012May 30, 2017 -
NCT00888238A Method to Evaluate Glucose-Dependent Insulin Secretion in Healthy Males (MK-0431-179)PHASE1 COMPLETED 12May 12, 2009Jul 21, 2009Jun 26, 2018 -
NCT00830076A Study of the Effects of Co-Administration of Sitagliptin (MK-0431) and Metformin on Incretin Hormone Concentrations (MK-0431-110)PHASE1 COMPLETED 18Dec 2, 2008May 14, 2009May 15, 2017 -
NCT00929201Sitagliptin/Metformin Fed Bioequivalence Study (0431A-080)PHASE1 COMPLETED 61Jan 1, 2008May 1, 2008Aug 13, 2015 -
Unlock Drug Trial Details
Study Endpoints
Primary Endpoints
Measurement of C-reactive Protein Production Rate With Stable Isotope During Postprandial Period
6 weeks
Change From Baseline in Hemoglobin A1C at Week 20
Baseline and Week 20

Hemoglobin A1C is a blood marker used to report average blood glucose levels over prolonged periods of time. Percentage A1C is the ratio of glycated hemoglobin to total hemoglobin x 100. The change from baseline represents the Week 20 A1C value minus the Week 0 (baseline) A1C value.

Percentage of Participants Who Experienced at Least One Adverse Event (AE)
Up to 22 weeks

An adverse event (AE) is any untoward medical occurrence in a study participant administered a pharmaceutical product that does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not related to the medicinal product.

Percentage of Participants Who Discontinued Study Drug Due to an Adverse Event
Up to 20 weeks

An adverse event (AE) is any untoward medical occurrence in a study participant administered a pharmaceutical product that does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not related to the medicinal product.

Change From Baseline in A1C at Week 30
Baseline and Week 30

A1C is blood marker used to report average blood glucose levels over prolonged periods of time. Percentage A1C is the ratio of glycated hemoglobin to total hemoglobin x 100. Thus, this change from baseline reflects the Week 30 A1C minus the Week 0 A1C.

Event Rate of Documented Symptomatic Hypoglycemia With Blood Glucose ≤70 mg/dL (≤3.9 mmol/L)
Up to 30 weeks

Documented symptomatic hypoglycemia is defined as an event during which typical symptoms of hypoglycemia are accompanied by a measured (e.g., by fingerstick) plasma glucose concentration ≤70 mg/dL (≤3.9 mmol/L). The event rate was the total number of events divided by follow-up time (participant-years), including multiple events from the same participant.

Percentage of Participants Who Discontinued Study Drug Due to an AE
Up to 30 weeks

An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Percentage of Participants Who Experienced One or More Adverse Events (AEs)
Up to 32 weeks

An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Change From Baseline in HbA1c at Week 24
Baseline and Week 24

HbA1c is measured as percent. Thus, this change from baseline reflects the Week 24 HbA1c percent minus the Week 0 HbA1c percent. Statistical analysis based on a constrained longitudinal data analysis (cLDA) model with terms for treatment, time, prior use of AHAs, the interactions of treatment by time, time by prior use of AHAs, and treatment by time by prior use of AHAs with the constraint that the mean baseline is the same for both treatment groups.

Change From Baseline in A1C at Week 24
Baseline and Week 24

A1C is blood marker used to report average blood glucose levels over prolonged periods of time. Percentage A1C is the ratio of glycated hemoglobin to total hemoglobin x 100. Thus, this change from baseline reflects the Week 24 A1C minus the Week 0 A1C.

Percentage of Participants Who Experienced One or More Adverse Events
Up to 26 weeks

An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product. The AE does not have to have a causal relationship with this treatment. The AE can include any unfavourable and unintended sign, symptom, or disease or any worsening (change in frequency and/or intensity) of a preexisting condition that is temporally associated with the use of the pharmaceutical product.

Change From Baseline in Fasting Plasma Glucose (FPG)
Baseline and Week 6

Change from baseline in FPG at Week 6 based on longitudinal data analysis (LDA) model including both baseline and post-baseline measurements as response variable and term time.

Percentage of Participants Who Experienced at Least One Adverse Event
Up to 8 weeks (including 14 days after final dose of study drug)

An adverse event is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the Sponsor's product, whether or not considered related to the use of the product.

Number of Participants Who Discontinued Study Drug Due to an Adverse Event
Up to 6 weeks

Participants who were discontinued from study drug due to an adverse event during the 6 weeks of treatment.

Change From Baseline in Hemoglobin A1C (HbA1C) Levels at Week 24 in Participants Receiving Insulin Alone or in Combination With Metformin
Baseline and Week 24
Number of Participants With One or More Adverse Events
Up to Week 26

An adverse event (AE) is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Number of Participants Discontinuing Study Medication Due to an AE
Up to Week 24

An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Change From Baseline in A1C Levels at Week 24 in Participants Receiving Sitagliptin and Sulfonylurea Alone or in Combination With Metformin
Baseline and Week 24

A1C was measured as a percent. This change from baseline reflects the A1C percent at Week 24 minus the A1C percent at Week 0.

Number of Participants Who Experienced an Adverse Event
Up to 26 weeks

An adverse event is any untoward medical occurrence in a participant administered study drug which does not necessarily have a causal relationship with the treatment. Adverse events may include the onset of new illness and the exacerbation of pre-existing conditions.

Change From Baseline to Week 24 in Hemoglobin A1c (HbA1c)
Baseline and Week 24

Based on a constrained longitudinal data analysis (cLDA) model with terms for treatment, other prior antihyperglycemic agent (AHA) therapy status other than sitagliptin (yes/no), study drug regimen (just before meal/after meal), sitagliptin dosage (50 mg/100 mg), time and the interaction of time by treatment, time by other prior AHA therapy status, time by study drug regimen, time by sitagliptin dosage and study drug regimen by sitagliptin dosage, with a constraint that the mean baseline is the same for all treatment groups.

Change From Baseline in Daily Insulin Dose at Week 24
Baseline and Week 24

Change in daily insulin dose following 24 weeks of therapy (i.e., daily insulin dose at Week 24 minus daily insulin dose at baseline)

Change From Baseline in A1C at Week 20
Baseline and Week 20

Glycated hemoglobin (A1C) is a blood marker used to report average blood glucose levels over prolonged periods of time. Percentage A1C is the ratio of glycated hemoglobin to total hemoglobin x 100. Mean change from baseline at Week 20 was estimated from a longitudinal data analysis model.

Number of Participants Who Experienced ≥1 Adverse Event During Weeks 0-20
Up to Week 20

The number of participants experiencing ≥1 adverse event during Weeks 0-20 was reported. An adverse event is defined as any untoward medical occurrence in a person administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.

Number of Participants Who Discontinued Study Drug Due to Experiencing an Adverse Event During Weeks 0-20
Up to Week 20

The number of participants who discontinued from study drug due to an adverse event during Weeks 0-20 was reported. An adverse event is defined as any untoward medical occurrence in a person administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.

Number of Participants Who Experienced ≥1 Adverse Event During Weeks 0-56
Up to approximately Week 56

The number of participants experiencing ≥1 adverse event during Weeks 0-56 were reported. An adverse event is defined as any untoward medical occurrence in a person administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.

Number of Participants Who Discontinued Study Drug Due to Experiencing an Adverse Event During Weeks 0-54
Up to Week 54

The number of participants who discontinued from study drug due to an adverse event during Weeks 0-54 was reported. An adverse event is defined as any untoward medical occurrence in a person administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.

Change From Baseline in Hemoglobin A1c (A1C) at Week 24
Baseline and Week 24

A1C is measured as a percent. Thus, this change from baseline reflects the Week 24 A1C percent minus the Week 0 A1C percent. Efficacy analyses treated data as missing after the initiation of rescue therapy.

Number of Participants Who Experienced at Least One Adverse Event
Up to Week 24 + 14 Day Post-Study Follow-up
Least Squares (LS) Mean Change From Baseline in Hemoglobin A1c (HbA1c) at Week 30
Baseline and Week 30

Participant whole blood samples were collected at baseline and Week 30 to determine the LS mean HbA1c change from baseline. HbA1c is a measure of the percentage of glycated hemoglobin in the blood and provides an indication of participant blood glucose control in the 2 to 3 months prior to the evaluation.

Number of Participants With an Adverse Event of Symptomatic Hypoglycemia Up to Week 30
Up to Week 30

Symptomatic hypoglycemia was defined as an episode with clinical symptoms attributed to hypoglycemia, without regard to glucose level. Participants were instructed to complete the Hypoglycemia Assessment Log (HAL) for any symptomatic episodes he or she believed represent hypoglycemia. If a fingerstick glucose was obtained before or shortly (i.e., within a few minutes) after treating, the value was recorded in the HAL. In addition, participants were instructed to record in the HAL any fingerstick glucose values ≤70 mg/dL (≤3.9 mmol/L) regardless of the presence of clinical symptoms.

Number of Participants Experiencing An Adverse Event (AE)
Up to Week 30

An AE was defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study treatment, whether or not considered related to the use of the treatment administered.

Number of Participants Discontinuing Study Treatment Due to An AE
Up to Week 30

An AE was defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally associated with the use of the study treatment, whether or not considered related to the use of the treatment administered.

Percentage of Participants With at Least One Symptomatic Hypoglycemic Event
Up to 30 days (Day 1 through last day of Ramadan)

Symptomatic hypoglycemic events were based on the participants own self-reported symptoms (for example, but not limited to the following: faintness, headache, confusion, anxiety, sweating, tremor, palpitations, nausea, pallor, dizziness, hunger, sudden behavioral change).

Change From Baseline in Hemoglobin A1C (%) at Week 24
Baseline and Week 24

Change from baseline reflects the Week 24 value minus the baseline value. A1C represents the percentage of glycosylated hemoglobin.

Number of Participants With One or More Adverse Events (AEs) - Week 0 to Week 54
Week 0 to Week 54
Number of Participants Discontinuing Study Drug Due to An Adverse Event
Week 0 to Week 54
Change From Baseline in Hemoglobin A1c (A1C) at Week 26
Baseline and Week 26

Change from baseline reflects the Week 26 value minus the baseline value. A1C represents the percentage of glycosylated hemoglobin.

Percentage of Participants With First Confirmed Cardiovascular (CV) Event of Major Adverse Cardiovascular Event (MACE) Plus (Per Protocol Population)
Up to 5 years

Primary composite CV endpoint of MACE plus which includes CV-related death, nonfatal MI, nonfatal stroke, or unstable angina requiring hospitalization.

Percentage of Participants With First Confirmed CV Event of Major Adverse Cardiovascular Event (MACE) Plus (Intent to Treat Population)
Up to 5 years

Primary composite CV endpoint of MACE plus which includes CV-related death, nonfatal MI, nonfatal stroke, or unstable angina requiring hospitalization.

Change From Baseline in A1C at Week 54
Baseline and Week 54

A1C represents the percentage of glycosylated hemoglobin.

Change in Hemoglobin A1c (A1C) in the Sita/Met Fixed-Dose Combination (FDC) or Pioglitazone Groups at 40 Weeks
Baseline to 40 weeks

The change in A1C, compared to baseline for the Sita/Met FDC and the pioglitazone groups at Week 40. A1C represents percentage of glycosylated hemoglobin.

Change in Hemoglobin A1c (A1C) in Participants Treated With Sitagliptin or Pioglitazone at 12 Weeks
Baseline to 12 weeks

The change in A1C compared to baseline was measured for the participants treated with sitagliptin or pioglitazone at Week 12. Sitagliptin was the only intervention administered to the Sita/Met FDC group during this phase. A1c represents percentage of glycosylated hemoglobin.

Change From Baseline in Hemoglobin A1c (HbA1c) at Week 24
Baseline and 24 weeks

HbA1c is measured as a percent. Thus, this change from baseline reflects the Week 24 HbA1c percent minus the Week 0 HbA1c percent.

Change From Baseline in Hemoglobin A1c (HbA1c ) at Week 12
12 Weeks

Change from the baseline measurement, where the baseline measurement was obtained at randomization (0 week) before receiving study medication.

Change From Baseline in HbA1c (Hemoglobin A1C) at Week 18
Baseline and 18 Weeks

HbA1c is measured as a percent. Thus, this change from baseline reflects the Week 18 HbA1c percent minus the Week 0 HbA1c percent.

Hemoglobin A1C (A1C) at Week 18
Baseline and 18 Weeks

A1C is measured as percent. Thus, this change from baseline reflects the Week 18 A1C percent minus the Week 0 A1C percent. The study hypothesis comparison was between sitagliptin versus placebo.

Change From Baseline in Hemoglobin A1c (HbA1c) at Week 18
Baseline and Week 18

A1C was measured as a percent. Thus, this change from baseline reflects the Week 18 A1C percent minus the Week 0 A1C percent.

Change From Baseline in HbA1c at Week 12
Baseline and Week 12

HbA1c is measured as a percent. Thus, this change from baseline reflects the Week 12 HbA1c percent minus the Week 0 HbA1c percent.

Number of Participants Who Successfully Swallowed Study Medication (Med) on Day 2
Day 2

The Swallowing Ability Questionnaire was completed on Day 2 after the participant received two matching placebo tablets (excluding marking) following consumption of a low- to moderate-fat meal in pediatric participants aged 10 to 17 years. The questionnaire consisted of five parts: could only swallow study med with help, easy to start swallowing study med, easy to swallow study med, felt like study med got stuck in throat, and had to swallow study med more than once. The number of participants who strongly agreed or agreed in each of the five parts is reported.

Number of Participants Who Successfully Swallowed Study Med on Day 4
Day 4

The Swallowing Ability Questionnaire was completed on Day 4 after the participant received two matching placebo tablets (excluding marking) following consumption of a low- to moderate-fat meal in pediatric participants aged 10 to 17 years. The questionnaire consisted of five parts: could only swallow study med with help, easy to start swallowing study med, easy to swallow study med, felt like study med got stuck in throat, and had to swallow study med more than once. The number of participants who strongly agreed or agreed in each of the five parts is reported.

Number of Participants Who Successfully Swallowed Study Med on Day 6
Day 6

The Swallowing Ability Questionnaire was completed on Day 6 after the participant received two matching placebo tablets (excluding marking) following consumption of a low- to moderate-fat meal in pediatric participants aged 10 to 17 years. The questionnaire consisted of five parts: could only swallow study med with help, easy to start swallowing study med, easy to swallow study med, felt like study med got stuck in throat, and had to swallow study med more than once. The number of participants who strongly agreed or agreed in each of the five parts is reported.

Number of Participants Who Successfully Swallowed Study Med on Day 9
Day 9

The Swallowing Ability Questionnaire was completed on Day 9 after the participant received two matching placebo tablets (excluding marking) following consumption of a low- to moderate-fat meal in pediatric participants aged 10 to 17 years. The questionnaire consisted of five parts: could only swallow study med with help, easy to start swallowing study med, easy to swallow study med, felt like study med got stuck in throat, and had to swallow study med more than once. The number of participants who strongly agreed or agreed in each of the five parts is reported.

Area Under the Curve 0 to Last (AUC 0-last) of Sitagliptin Following Single Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 48, and 72 hours post-dose

In this study, metformin products were withheld 24 hours (hrs) prior to sitagliptin/metformin XR administration and were permitted to re-initiate 24 hrs post study drug administration. Owing to resumption of therapeutic metformin administration 24 hrs after sitagliptin/metformin XR administration for all participants, metformin pharmacokinetic analyses were restricted to maximum plasma concentration (Cmax), time to maximum plasma concentration (Tmax) and area under the curve 0 to 24 hrs (AUC0-24hr). Therefore, metformin arm is not included in this endpoint.

AUC 0-24 of Sitagliptin Following Single Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 hours post-dose

Due different units of measure for sitagliptin and metformin, metformin data are presented in another endpoint.

AUC 0-24 of Metformin Following Single Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, and 24 hours post-dose

In this study, metformin products were withheld 24 hours prior to sitagliptin/metformin XR administration and were permitted to re-initiate 24 hours post study drug administration. Due different units of measure for sitagliptin and metformin, sitagliptin data are presented in another endpoint.

Area Under the Curve 0 to Infinity (AUC 0-∞) of Sitagliptin Following Single Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 48, and 72 hours post-dose

In this study, metformin products were withheld 24 hours prior to sitagliptin/metformin XR administration and were permitted to re-initiate 24 hours post study drug administration. Owing to resumption of therapeutic metformin administration 24 hours after sitagliptin/metformin XR administration for all participants, metformin pharmacokinetic analyses were restricted to Cmax, Tmax and AUC0-24hr. Therefore, metformin arm is not included in this endpoint.

Cmax of Sitagliptin Following Single Dose Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 48, and 72 hours post-dose

Due different units of measure for sitagliptin and metformin, metformin data are presented in another endpoint.

Cmax of Metformin Following Single Dose Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 48, and 72 hours post-dose

In this study, metformin products were withheld 24 hours prior to sitagliptin/metformin XR administration and were permitted to re-initiate 24 hours post study drug administration. Due different units of measure for sitagliptin and metformin, sitagliptin data are presented in another endpoint.

Tmax of Sitagliptin and Metformin Following Single Dose Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 48, and 72 hours post-dose

In this study, metformin products were withheld 24 hours prior to sitagliptin/metformin XR administration and were permitted to re-initiate 24 hours post study drug administration.

Apparent Terminal Half Life (t1/2) of Sitagliptin Following Single Dose Administration of Sitagliptin/Metformin XR
Pre-dose, and 1, 2, 3, 4, 5, 6, 7, 8, 10, 12, 24, 48, and 72 hours post-dose

In this study, metformin products were withheld 24 hours prior to sitagliptin/metformin XR administration and were permitted to re-initiate 24 hours post study drug administration. Owing to resumption of therapeutic metformin administration 24 hours after sitagliptin/metformin XR administration for all participants, metformin pharmacokinetic analyses were restricted to Cmax, Tmax and AUC0-24hr. Therefore, metformin arm is not included in this endpoint.

Number of Participants Who Experienced an Adverse Event (AE)
Up to 23 days (including approximately 10 to 14 days after the last dose of study drug)

An AE was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or diseases that emerges or worsens relative to baseline during a clinical study with an Investigational Medicinal Product (IMP), regardless of causal relationship and even if no IMP has been administered.

Number of Participants Who Experienced an Abnormal Vital Sign Value
Up to 23 days (including approximately 10 to 14 days after the last dose of study drug)

Vital sign measurements included blood pressure, heart rate, respiratory rate, and oral temperature.

Number of Participants Who Discontinued Study Drug Due to an AE
Up to 9 days

An AE was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or diseases that emerges or worsens relative to baseline during a clinical study with an IMP, regardless of causal relationship and even if no IMP has been administered.

Percent Inhibition of Dipeptidyl Peptidase IV (DPP-4) Activity at Trough
24 hours following the final morning dose on Day 5

Percent inhibition of DPP-4 activity at 24 hours after the Day 5 morning dose (i.e., at trough) was determined by analysis of blood samples collected from the study participants.

Insulin Secretion Rate (ISR) During 190 - 340 Minutes Post-dose
190 minutes to 340 minutes

ISR was estimated by the deconvolution of peripheral C-peptide concentrations using a 2-compartment model that utilizes population C-peptide kinetic parameters.

Incremental Post-prandial 4-hour Weighted Mean Active Glucagon-like Peptide-1 (GLP-1) Plasma Concentrations
6 hours postdose (4 hours postmeal) on Day 2

Meal was given 2 hours postdose. Blood samples for determination of active GLP-1 concentration were collected (4 hours postmeal) on Day 2 in each treatment period.

Plasma Area Under the Curve (AUC(0 to Infinity)) for Metformin
Predose and 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 32, 48, and 72 hours postdose

Serum samples were used to determine the AUC from time 0 to infinity for metformin.

Secondary Endpoints
Measurement of Serum Amyloid A Production Rate With Stable Isotope During Postprandial Period
6 weeks
Measurement of L-selectin Production Rate With Stable Isotope During Postprandial Period
6 weeks
Measurement of ICAM-1 Production Rate With Stable Isotope During Postprandial Period
6 weeks
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelCROSSOVER
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Sitagliptin first, then PlaceboEXPERIMENTALSitagliptin 100 mg/d for 6 weeks Wash-out 14 days Placebo for 6 weeks
Placebo first, then SitagliptinPLACEBO_COMPARATORPlacebo for 6 weeks Wash-out 14 days Sitagliptin 100 mg/d for 6 weeks
SitagliptinEXPERIMENTALParticipants will receive sitagliptin 100 mg once daily for 20 weeks. They will also receive immediate-release metformin (Met-IR), which will be titrated from a baseline dose of 1000 mg/day (500 mg/twice a day \[b.i.d.\]) up to 2000 mg/day (1000 mg/b.i.d.) by Day 15. Participants will also receive glycemic rescue therapy as needed.
PlaceboPLACEBO_COMPARATORParticipants will receive placebo matching sitagliptin once daily for 20 weeks. They will also receive Met-IR, which will be titrated from baseline dose of 1000 mg/day (500 mg/b.i.d.) up to 2000 mg/day (1000 mg/b.i.d.) by Day 15. Participants will also receive glycemic rescue therapy as needed.
Sitagliptin + IpragliflozinEXPERIMENTALSitagliptin, oral, once daily for 24 weeks plus ipragliflozin (base therapy), in addition to diet and exercise.
Placebo + IpragliflozinACTIVE_COMPARATORPlacebo to sitagliptin, oral, once daily for 24 weeks plus ipragliflozin (base therapy), in addition to diet and exercise.
DapagliflozinACTIVE_COMPARATORParticipants receive dapagliflozin 5 mg once daily plus matching placebo for sitagliptin 100 mg once daily for 4 weeks followed by dapagliflozin 10 mg once daily plus matching placebo for sitagliptin 100 mg once daily for 20 weeks. Participants continue pre-study metformin (at least 1500 mg daily) alone or in combination with a sulfonylurea agent (at a dose of ≥ 50% maximum labeled dose in the country of the investigational site) throughout the duration of the study.
Sitagliptin 100 mg/simvastatin 40 mg FDCEXPERIMENTALSitagliptin 100 mg/simvastatin 40 mg FDC once daily in the evening for 6 weeks. Participants will continue pre-study dose of metformin \>=1000 mg per day.
Metformin 500 mg q.d.EXPERIMENTALParticipants will receive sitagliptin daily (continuing their pre-study dose), 2 metformin 250 mg tablets in the morning and 1 matching placebo tablet in the evening.
Metformin 250 mg b.i.d.EXPERIMENTALParticipants will receive sitagliptin daily (continuing their pre-study dose), 1 metformin 250 mg tablet and 1 matching placebo tablet in the morning and 1 metformin 250 mg tablet in the evening.
Sitagliptin/MetforminEXPERIMENTALParticipants received one tablet of sitagliptin/metformin and one tablet of metformin-placebo, administered twice daily prior to the morning and evening meals, for up to 20 weeks in the base study alone, or for up to 54 weeks if the participant also entered the extension study. Participants in this arm were enrolled in protocol MK-0431A-170.
MetforminPLACEBO_COMPARATORParticipants received one tablet of metformin and one tablet of placebo to sitagliptin/metformin, administered twice daily prior to the morning and evening meals, for up to 20 weeks in the base study alone, or for up to 54 weeks if the participant also entered the extension study. Participants in this arm were enrolled in protocol MK-0431A-170.
Sitagliptin/Metformin XREXPERIMENTALParticipants received two tablets of sitagliptin/metformin XR and two tablets of metformin XR placebo, administered once daily with a meal, for up to 54 weeks. Participants in this arm were enrolled in protocol MK-0431A-289.
Metformin XRPLACEBO_COMPARATORParticipants received two tablets of metformin XR and two tablets of placebo to sitagliptin/metformin XR, administered once daily with a meal, for up to 54 weeks. Participants in this arm were enrolled in protocol MK-0431A-289.
Sitagliptin 50 mg + metformin 500 mgEXPERIMENTALSitagliptin 50 mg and metformin 500 mg twice a day for 24 weeks.
Sitagliptin 50 mg + metformin 850 mgEXPERIMENTALSitagliptin 50 mg and metformin 850 mg twice a day for 24 weeks.
Metformin 500 mgACTIVE_COMPARATORMetformin 500 mg twice daily for 24 weeks.
Metformin 850 mgACTIVE_COMPARATORMetformin 850 mg twice daily for 24 weeks.
Sitagliptin 100 mgEXPERIMENTALSitagliptin 100 mg once daily for 24 weeks.
GlimepirideACTIVE_COMPARATORGlimepiride 1-6 mg QD
Sulfonylurea TherapyACTIVE_COMPARATORUsual sulfonylurea therapy with or without metformin
placebo/pioglitazoneACTIVE_COMPARATORPhase A (Weeks 0-24): placebo to Sitagliptin 100 mg; Phase B (Weeks 24-54): placebo to Sitagliptin 100 mg + pioglitazone 30 mg
Pioglitazone 15 mgEXPERIMENTAL -
Pioglitazone 30 mgEXPERIMENTAL -
Pioglitazone 45 mgEXPERIMENTAL -
Sitagliptin 100 mg/ Pioglitazone 15 mgEXPERIMENTAL -
Sitagliptin 100 mg/ Pioglitazone 30 mgEXPERIMENTAL -
Sitagliptin 100 mg/ Pioglitazone 45 mgEXPERIMENTAL -
Sita/Met FDCEXPERIMENTALIn Phase A (Treatment Day 1 to Week 12), participants were administered 100 mg once daily (q.d.) of sitagliptin and matching placebo to 15 mg pioglitazone q.d. for 6 weeks followed by matching placebo to 30 mg pioglitazone for the next 6 weeks. In Phase B (Treatment Week 12-Week 40), participants were switched to the Sita/Met Fixed-Dose Combination (FDC) at a dose of 50/500 mg twice a day (b.i.d.), which was increased to 50/1000 mg b.i.d. over a period of 4 weeks; as well as matching placebo to 45 mg pioglitazone.
PioglitazoneACTIVE_COMPARATORIn Phase A (Treatment Day 1 up to Week 12), randomized participants in the pioglitazone group were administered 15 mg q.d. of pioglitazone and matching placebo to sitagliptin. At Week 6, participants were up-titrated to 30 mg pioglitazone q.d. In Phase B (Treatment Week 12 to Week 40), participants were administered 45 mg pioglitazone q.d.; as well as matching placebo to Sita/Met FDC (50/500 increased to 50/1000 b.i.d. after 4 weeks).
1EXPERIMENTALDrug
2ACTIVE_COMPARATORActive comparator
RosiglitazoneACTIVE_COMPARATORrosiglitazone 8 mg
3EXPERIMENTAL50 mg QD 12-week
4EXPERIMENTAL100 mg QD 12-week
5EXPERIMENTAL200 mg QD 12-week
Sitagliptin/metformin XR followed by placeboEXPERIMENTALDay 1 (Period 1): participants will receive a single dose of two sitagliptin/metformin XR tablets with a low- to moderate-fat meal (breakfast). Days 2-4 (Period 1): participants will receive a single dose of two matching placebo tablets. Days 5-9 (Period 2): participants will receive a single dose of two matching placebo tablets with the evening meal.
Placebo onlyPLACEBO_COMPARATORDays 1-4 (Period 1): participants will receive a single dose of two matching placebo tablets. Days 5-9 (Period 2): participants will receive a single dose of two matching placebo tablets with the evening meal.
Treatment Sequence 1EXPERIMENTALSitagliptin 100 mg in Period 1 followed by saxagliptin 5 mg in Period 2 followed by vildagliptin 50 mg BID in Period 3 followed by placebo in Period 4 followed by vildagliptin 50 mg in Period 5
Treatment Sequence 2EXPERIMENTALSaxagliptin 5 mg in Period 1 followed by vildagliptin 50 mg in Period 2 followed by placebo in Period 3 followed by sitagliptin 100 mg in Period 4 followed by vildagliptin 50 mg BID in Period 5
Treatment Sequence 3EXPERIMENTALVildagliptin 50 mg in Period 1 followed by vildagliptin 50 mg BID in Period 2 followed by sitagliptin 100 mg in Period 3 followed by saxagliptin 5 mg in Period 4 followed by placebo in Period 5
Treatment Sequence 4EXPERIMENTALVildagliptin 50 mg BID in Period 1 followed by placebo in Period 2 followed by saxagliptin 5 mg in Period 3 followed by vildagliptin 50 mg in Period 4 followed by sitagliptin 100 mg in Period 5
Treatment Sequence 5EXPERIMENTALPlacebo in Period 1 followed by sitagliptin 100 mg in Period 2 followed by vildagliptin 50 mg in Period 3 followed by vildagliptin 50 mg BID in Period 4 followed by saxagliptin 5 mg in Period 5
Treatment Sequence 6EXPERIMENTALSitagliptin 100 mg in Period 1 followed by vildagliptin 50 mg in Period 2 followed by saxagliptin 5 mg in Period 3 followed by placebo in Period 4 followed by vildagliptin 50 mg BID in Period 5
Treatment Sequence 7EXPERIMENTALSaxagliptin 5 mg in Period 1 followed by vildagliptin 50 mg BID in Period 2 followed by vildagliptin 50 mg in Period 3 followed by sitagliptin 100 mg in Period 4 followed by placebo in Period 5
Treatment Sequence 8EXPERIMENTALVildagliptin 50 mg in Period 1 followed by placebo in Period 2 followed by vildagliptin 50 mg BID in Period 3 followed by saxagliptin 5 mg in Period 4 followed by sitagliptin 100 mg in Period 5
Treatment Sequence 9EXPERIMENTALVildagliptin 50 mg BID in Period 1 followed by sitagliptin 100 mg in Period 2 followed by placebo in Period 3 followed by vildagliptin 50 mg in Period 4 followed by saxagliptin 5 mg in Period 5
Treatment Sequence 10EXPERIMENTALPlacebo in Period 1 followed by saxagliptin 5 mg in Period 2 followed by sitagliptin 100 mg in Period 3 followed by vildagliptin 50 mg BID in Period 4 followed by vildagliptin 50 mg in Period 5
Sitagliptin/Sitagliptin/PlaceboEXPERIMENTALSitagliptin in 2 of 3 treatment periods and Placebo in 1 of 3 treatment periods
Sitagliptin/Placebo/SitaglipitinEXPERIMENTALSitagliptin in 2 of 3 treatment periods and Placebo in 1 of 3 treatment periods
Placebo/Sitagliptin/SitagliptinEXPERIMENTALSitagliptin in 2 of 3 treatment periods and Placebo in 1 of 3 treatment periods
Sitagliptin + placebo metforminEXPERIMENTAL -
Metformin + placebo sitagliptinEXPERIMENTAL -
Sitagliptin + metforminEXPERIMENTALCo-administration of sitagliptin and metformin
Placebo sitagliptin + placebo metforminPLACEBO_COMPARATORCo-administration of placebo to sitagliptin and placebo to metformin
Sita + Met then Sita/Met FDCACTIVE_COMPARATORParticipants receive sitagliptin (Sita) 50 mg and metformin (Met) 500 mg individual tablets administered concomitantly as a single dose during Period 1 followed by a 7-day washout followed by sitagliptin/metformin (Sita/Met) 50/500 mg FDC tablet administered as a single dose during Period 2.
Sita/Met FDC then Sita + MetACTIVE_COMPARATORParticipants receive sitagliptin/Metformin 50 mg/500 mg FDC tablet administered as a single dose during Period 1 followed by a 7-day washout followed by sitagliptin 50 mg and metformin 500 mg individual tablets administered concomitantly as a single dose during Period 2.
Interventions
NameTypeDescription
SitagliptinDRUGSitagliptin 100 mg/d for 6 weeks
PlaceboDRUGPlacebo for 6 weeks
Metformin IRDRUGAll participants will take Met-IR as background medication. Initially, they will take 1 x 500 mg tablet Met-IR b.i.d. (1000 mg/day). After randomization, all participants will be titrated to 2 x 500 mg tablets of Met-IR b.i.d. (2000 mg/day).
Placebo to sitagliptinDRUGPlacebo to sitagliptin, 100 mg, oral, once daily for 30 weeks
MetforminDRUGAt least 1500 mg/day, oral, twice daily for participants entering the study on immediate-release metformin + sitagliptin or a fixed dose combination (FDC).
Metformin XRDRUGAt least 1500 mg/day, oral, once daily for participants entering the study on extended-release metformin + sitagliptin or a FDC.
Insulin glargineDRUGInsulin glargine (LANTUS®) initiated at 10 units and titrated based on a treat-to-target algorithm to achieve fasting glucose levels of 72-100 mg/dL (4-5.6 mmol/L); administered once daily subcutaneously.
IpragliflozinDRUG50 mg tablet administered orally as background medication
DapagliflozinDRUGDapagliflozin 5 mg or 10 mg oral capsule. Up-titration to dapagliflozin 10 mg daily may be delayed if participant is unable to tolerate up-titration in the opinion of the investigator. Dapagliflozin 10 mg daily may be down-titrated to dapagliflozin 5 mg daily if participant is unable to tolerate the higher dose in the opinion of the investigator.
Matching placebo to sitagliptinDRUGMatching placebo to sitagliptin 100 mg oral tablet
Matching placebo to dapagliflozinDRUGMatching placebo to dapagliflozin 5 mg or 10 mg oral capsule. Up-titration to matching placebo to dapagliflozin 10 mg daily may be delayed if participant is unable to tolerate up-titration in the opinion of the investigator. Matching placebo to dapagliflozin 10 mg daily may be down-titrated to matching placebo to dapagliflozin 5 mg daily if participant is unable to tolerate the higher dose in the opinion of the investigator.
SulfonylureaDRUGThis medication is a standard-of-care medication and is administered in an open-label fashion. The dose of the sulfonylurea agent will be required to be at least 50% of maximum labeled dose, consistent with near maximum efficacy of the sulfonylurea agent.
Sitagliptin 100 mg/simvastatin 40 mg FDCDRUGSitagliptin 100 mg/simvastatin 40 mg FDC tablet administered once daily in the evening for 6 weeks
InsulinBIOLOGICALParticipants can be on on pre-mixed (mixture of rapid- and long-acting insulin) or intermediate- or long-acting insulin at a dose of at least 12 U/day.
GliclazideDRUGParticipants will continue ongoing open-label therapy with gliclazide (dosed according to the China drug label) throughout the study.
GlimepirideDRUGParticipants will continue ongoing open-label therapy with glimepiride (dosed according to the China drug label) throughout the study.
Comparator: PlaceboDRUGPlacebo to sitagliptin once daily for 24 weeks
Sitagliptin plus metforminDRUGParticipants received 2 tablets daily, one taken with a morning meal and one taken with an evening meal, to provide a total daily dose of 100 mg of sitagliptin and 1000 mg, 1700 mg or 2000 mg of metformin. Dosage of metformin was based on each participant's daily metformin dose prior to enrollment.
Placebo to metforminDRUGParticipants received 2 tablets daily, one taken with a morning meal and one taken with an evening meal. Each tablet contained placebo to metformin.
Placebo to sitagliptin plus metforminDRUGParticipants received 2 tablets daily, one taken with a morning meal and one taken with an evening meal. Each tablet contained placebo to sitagliptin plus metformin.
Sitagliptin plus metformin XRDRUGParticipants received 2 tablets daily, both taken together with a meal, to provide a total daily dose of 100 mg of sitagliptin and 1000 mg, 1500 mg or 2000 mg of metformin. Dosage of metformin XR was based on each participant's daily metformin dose prior to enrollment.
Placebo to metformin XRDRUGParticipants received 2 tablets daily, both taken together with a meal. Each tablet contained placebo to metformin XR.
Placebo to sitagliptin plus metformin XRDRUGParticipants received 2 tablets daily, both taken together with a meal. Each tablet contained placebo to sitagliptin plus metformin XR.
Sitagliptin phosphateDRUGSitagliptin, 100 mg tablet once daily, orally for 24 weeks
AcarboseDRUGAcarbose 50 mg or 100 mg tablet, 3 times daily, orally (continuing on the stable dose established prior to screening) for 24 weeks
Sitagliptin 50 mgDRUGSitagliptin 50 mg tablet twice a day, prior to the morning and evening meal, for 24 weeks.
Metformin 500 mgDRUGMetformin 500 mg tablet twice daily, prior to the morning and evening meal, for 24 weeks.
Sitagliptin 100 mgDRUGSitagliptin 100 mg once daily for 24 weeks.
Metformin 850 mgDRUGMetformin 850 mg tablet twice daily, prior to the morning and evening meal, for 24 weeks.
Placebo to GlimepirideDRUGMatching placebo tablets to glimepiride to allow for blinding.
Comparator: placebo to pioglitazoneDRUGPhase B (Weeks 24-54): placebo to pioglitazone 30 mg once a day for 30 weeks
Comparator: placebo to SitagliptinDRUGPhase A (Weeks 0-24): placebo to Sitagliptin 100 mg once a day for 24 weeks; Phase B (Weeks 24-54): placebo to Sitagliptin once a day for 30 weeks
Comparator: pioglitazoneDRUGPhase B (Weeks 24-54): pioglitazone 30 mg once a day for 30 weeks
Glimepiride or gliclazideDRUGPhase A (Weeks 0-24): stable dose, as prescribed by investigator, of glimepiride or gliclazide; Phase B (Weeks 24-54): stable dose, as prescribed by investigator, of glimepiride or gliclazide
Pioglitazone rescue therapyDRUGPhase A (Weeks 0-24): participants not meeting specific glycemic goals will receive pioglitazone (open label) at a dose determined by the investigator. These participants will not initiate Phase B (Weeks 24-54) double blind pioglitazone.
PioglitazoneDRUGParticipants taking 30 mg or more pioglitazone oral tablet(s) daily at screening in combination with metformin will enter a 4-week dose-stable period followed by a 2-week single-blind run-in and a 26-week treatment period. Participants taking 4 mg or more rosiglitazone oral tablet(s) daily at screening in combination with metformin were to be switched to a corresponding dose of pioglitazone prior to starting a 4-week dose-stable period. Participants who are taking less than 30 mg/day or no pioglitazone at screening will be titrated to a stable dose of at least 30 mg pioglitazone once daily over a maximum of 4 weeks followed by a dose-stable period of 10 weeks, a 2-week single-blind placebo run-in, and a 26-week treatment period. Total treatment with pioglitazone will be up to 42 weeks.
GlipizideDRUGParticipants not meeting specific glycemic controls during the 26-week treatment period will use glipizide oral tablets as rescue therapy. In countries where glipizide is not available, participants will receive a sulfonylurea marketed in that country.
Comparator: Sitagliptin phosphateDRUGAll participants will receive placebo tablets two weeks prior to treatment period. Participants will receive sitagliptin phosphate 100 mg tablets once daily (q.d.) and continue on stable dose of metformin therapy (500 or 850 mg twice daily). Treatment period of 24 weeks.
Pioglitazone hydrochlorideDRUGPioglitazone 15 mg, 30 mg, or 45 mg tablets or capsules (blinded) orally once daily for 54 weeks. Participants randomized to receive pioglitazone 45 mg as monotherapy or in combination with sitagliptin were to start on pioglitazone 30 mg at Week 1 and undergo uptitration to pioglitazone 45 mg at Week 4.
Matching placebo to pioglitazoneDRUGMatching placebo to pioglitazone tablets or capsules orally once daily for 54 weeks.
Comparator: sitagliptin phosphate (sitagliptin)DRUGsitagliptin 100 mg tablet q.d. orally for a 12-wk treatment period
sitagliptin phosphate (+) metformin hydrochlorideDRUGsitagliptin/metformin HCl (Sita/Met) 50/500 mg b.i.d. orally and then 50/1000 mg b.i.d. orally for a 28-wk treatment period
Matching Placebo to Sita/Met FDCDRUGmatching placebo to Sita/Met FDC - 50/500 mg b.i.d. for 4 weeks and then 50/1000 mg b.i.d. orally for a 28-wk treatment period (Week 12 to Week 40).
Comparator: metformin hydrochlorideDRUG(4) Metformin 500mg tablets once daily (q.d.) for a 24-wk treatment period.
Comparator : placebo (unspecified)DRUGsitagliptin 100 mg Pbo tablet qd for a 24-wk treatment period.
Comparator: sitagliptin phosphate (MK0431)DRUGSitagliptin (MK0431) 50 or 100 mg once daily for 40 weeks
Comparator: placebo (unspecified)DRUGPlacebo once daily for 12 weeks
rosiglitazoneDRUGSubjects taking 4mg or greater rosiglitazone at screening will enter a 6 week stable dose period followed by a 54 week treatment period. Subjects who are taking less than 4mg/day or no rosiglitazone at screening will be titrated to a stable dose of at least 4mg over a a maximum of 8 weeks followed by a dose stable period of up to 12 weeks then a 54 week treatment period. Total treatment will be up to 77 weeks.
Comparator: RosiglitazoneDRUGRosiglitazone 8 mg administered as two 4 mg capsules once daily in the morning for up to 18 weeks.
Comparator: MetforminDRUGOpen-label metformin was supplied by the Sponsor as 500, 850, or 1000 mg oral tablets administered at a daily dose of \>= 1500 mg.
Sitagliptin/metformin XRDRUGFixed dose combination tablet of immediate-release sitagliptin 50 mg and extended-release (XR) metformin 1000 mg (total daily dose, sitagliptin 100 mg and metformin XR 2000 mg).
Thyroid hormoneDRUGConcomitant use of thyroid hormone (eg, levothyroxine) is permitted during the study provided the participant has been receiving a stable dose for at least 12 weeks prior to study drug administration and is euthyroid as documented by thyroid stimulating hormone testing at prestudy. Administration of thyroid hormone will be withheld for 24 hours prior to study drug administration and for 24 hours postdose.
Saxagliptin 5 mgDRUGSaxagliptin 5 mg: one saxagliptin 5 mg tablet once daily in the morning following a fast of at least approximately 8 hours on Days 1 through 5 in one out of five treatment periods.
Vildagliptin 50 mgDRUGVildagliptin 50 mg: one vildagliptin 50 mg tablet once daily in the morning following a fast of at least approximately 8 hours on Days 1 through 5 in one out of five treatment periods.
Vildagliptin 50 mg BIDDRUGVildagliptin 50 mg BID: one vildagliptin 50 mg tablet BID (twice daily), once in the morning following a fast of at least approximately 8 hours and once in the evening on Days 1 through 5 in one out of five treatment periods.
metformin hydrochlorideDRUGMetformin 500 mg tablet in the morning and evening on Day 1 and two 500 mg tablets of metformin (total dose 1000 mg) on Day 2 in the morning. There will be a 7-day washout between treatment periods.
Comparator: placebo sitagliptinDRUGPlacebo to sitagliptin 100 mg in the morning on Days 1 and 2. There will be a 7-day washout between treatment periods.
Comparator: placebo metforminDRUGPlacebo to metformin 500 mg tablet in the morning and evening on Day 1 and two placebo to metformin 500 mg tablets (1000 mg total dose) in the morning of Day 2. There will be a 7-day wash out between treatment periods.
Sitagliptin phosphate/metformin hydrochloride FDCDRUGSingle dose sitagliptin/metformin 50/500 mg FDC tablet after consumption of a high-fat meal in one of two treatment periods.
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Eligibility Criteria
Age Range18 Years — 65 Years
SexALL
Healthy VolunteersNo
Study Sites1

Inclusion Criteria: * Males 18 to 65 years of age. * Post-menopausal women under age 65 on stable medical therapy for 6 months before the study (the patient should have demonstrated stable lipid panels) * Women should not be on hormone replacement therapy (no recent starting or stopping) * Type 2 d...

Countries:Canada
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