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sitagliptin/metformin /

Phase 3

Type 2 Diabetes | Small molecule | Metabolic |Merck & Company, Inc.|Last Updated: May 30, 2017

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-BlindCONTROLLEDDMCBiomarker
Total Trials7
Total Enrollment467
FDA Designations
No designations recorded
Clinical Trials (7)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01034111A Local Experiential Study With Sitagliptin (an Antihyperglycemic Drug) in 30 Patients With Type 2 Diabetes Mellitus (0431-178)PHASE3 COMPLETED 30Mar 1, 2010Oct 4, 2010May 30, 2017 -
NCT00411411Long Term Effects of DPP-IV Inhibitor Treatment in Patients With Type 2 DiabetesPHASE3 COMPLETED 49Feb 1, 2007Mar 1, 2009Aug 13, 20141 Denmark
NCT00305604Study of Sitagliptin in Older Type 2 Diabetics (0431-047)(COMPLETED)PHASE3 COMPLETED 206Mar 8, 2006Mar 12, 2008May 11, 2017 -
NCT01093794Bioequivalence Study of Sitagliptin/Metformin Combination Tablet (MK0431A-122)PHASE1 COMPLETED 28Apr 1, 2010Jun 1, 2010Jul 28, 2015 -
NCT00730275A Study to Assess the Pharmacokinetics, Safety and Tolerability of Sitagliptin in Adolescents (0431-081)PHASE1 COMPLETED 35Jul 18, 2008Feb 14, 2011May 12, 2017 -
NCT00541229Sitagliptin Dose Comparison Study in Patients With Type 2 Diabetes (MK-0431-077)(COMPLETED)PHASE1 COMPLETED 103Aug 24, 2007Jul 1, 2008May 12, 2017 -
NCT00975052A Study of the Effects of Sitagliptin (MK0431) and Metformin on Incretin Hormone Concentrations (0431-050)(COMPLETED)PHASE1 COMPLETED 16Jan 1, 2006Mar 1, 2006Aug 19, 2015 -
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Study Endpoints
Primary Endpoints
Safety and Tolerability of Sitagliptin After 4 Weeks of Treatment
4 weeks

Safety \& tolerability were measured in terms of the # of participants with \>=1 adverse event (AE), \>=1 drug-related AE, \>=1 serious AE (SAE), or discontinued treatment due to an AE. SAEs included events occurring after initiation of glycemic rescue therapy. AE is defined as any unfavorable/unintended change in structure, function, or chemistry of the body temporally associated with the use of SPONSOR's product. SAE is defined as any AE that results in death, is life-threatening, an overdose, causes or prolongs in-patient hospitalization, or considered medically significant by the investigator.

the Relative Increase in Meal-induced Total GLP-1 Secretion
12 weeks

Patients will be followed for 12 weeks with three meal test examinations; before treatment, after 1 week of treatment and after 12 weeks of treatment. Primary outcome is AUC GLP-1 (pM x 120 as stated).

Restoration of the Insulinotropic Effect of GIP
12 weeks

Restoration of the insulinotropic effect of GIP measured as the relative increase in GIP induced amplification of the late phase insulin secretion (AUC) response to glucose. Patients will be followed for 12 weeks with examinations after 1 and after 12 weeks of treatment.

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

Change from baseline at Week 24 is defined as Week 24 minus Week 0.

Area Under the Curve (AUC(0-t)) for Sitagliptin
baseline through 72 hours postdose

AUC (0-t) is the area under the curve for the plot showing plasma concentration against time from time zero to the time of the last quantifiable concentration for sitagliptin 50 mg, metformin 500 mg and metformin 850 mg.

Cmax for Sitagliptin and Metformin
baseline through 72 hours postdose

Cmax is the peak serum concentration of a therapeutic drug after administration; and is used to determine the rate and extent of drug absorption. Cmax is reported for sitagliptin 50 mg, metformin 500 mg and metformin 850 mg.

Number of Participants Who Experienced at Least One Adverse Event
Pre-study through 10 to 14 days following administration of study drug
Area Under the Concentration-time Curve (AUC) From Time 0 to Infinity Following a Single Dose of Sitagliptin
Pre-dose through 72 hours post-dose

Serum samples were used to determine the AUC from time 0 to infinity for sitagliptin. The placebo group is not included in the table below; this outcome measure only evaluated the sitagliptin groups.

24-hour Weighted Mean Glucose (WMG)
Day 7 of Treatment Period I. Due to a carry-over effect that was observed between treatment periods, efficacy results are presented from Treatment Period I only.

The 24-hour WMG was calculated as the area under the 24-hour glucose curve (AUC(0-24 hr)) divided by 24 using linear trapezoidal method.

Weighted average active GLP-1 (glucagonlike peptide-1) concentrations
4 hours after the postdose meal
Secondary Endpoints
Change From Baseline in Fasting Plasma Glucose at Week 4
Baseline and Week 4
Examination of GLP-2, Somatostatin, Glucagon, Peptide-YY and Two Glycaemic Control Parameters (HbA1c and Fasting Plasma Glucose)
12 weeks
Change From Baseline in FPG (Fasting Plasma Glucose) at Week 24
Baseline and Week 24
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Study Design & Arms
AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
SitagliptinEXPERIMENTALSitagliptin as add-on therapy to a stable dose of metformin
PlaceboPLACEBO_COMPARATORPlacebo treatment, administered as tablets.
JanuviaEXPERIMENTALActive treatment
1ACTIVE_COMPARATORsitagliptin
2PLACEBO_COMPARATORPlacebo
1. Sit + Met500 / SitMet500 FDC / SitMet850 FDC / Sit + Met850EXPERIMENTALParticipants were administered treatment in the following sequence with a minimum 7 day washout period between treatments: * Co-administration of 50 mg sitagliptin and 500 mg metformin * sitagliptin/metformin 50 mg/500 mg FDC tablet * sitagliptin/metformin 50 mg/850 mg FDC tablet * Co-administration of 50 mg sitagliptin and 850 mg metformin
2. SitMet500 FDC / Sit + Met850 / Sit + Met500 / SitMet850 FDCEXPERIMENTALParticipants were administered treatment in the following sequence with a minimum 7 day washout period between treatments: * sitagliptin/metformin 50 mg/500 mg FDC tablet * Co-administration of 50 mg sitagliptin and 850 mg metformin * Co-administration of 50 mg sitagliptin and 500mg metformin * sitagliptin/metformin 50 mg/850 mg FDC tablet
3. Sit + Met850 / SitMet850 FDC / SitMet500 FDC / Sit + Met500EXPERIMENTALParticipants were administered treatment in the following sequence with a minimum 7 day washout period between treatments: * Co-administration of 50 mg sitagliptin and 850 mg metformin * sitagliptin/metformin 50 mg/850 mg FDC tablet * sitagliptin/metformin 50 mg/500 mg FDC tablet * Co-administration of 50 mg sitagliptin and 500mg metformin
4. SitMet850 FDC / Sit + Met500 / Sit + Met850 / SitMet500 FDCEXPERIMENTALParticipants were administered treatment in the following sequence with a minimum 7 day washout period between treatments: * sitagliptin/metformin 50 mg/850 mg FDC tablet * Co-administration of 50 mg sitagliptin and 500 mg metformin * Co-administration of 50 mg sitagliptin and 850 mg metformin * sitagliptin/metformin 50 mg/500 mg FDC tablet
Sitagliptin 50 mgEXPERIMENTALParticipants were randomized to sitagliptin 50 mg
Sitagliptin 100 mgEXPERIMENTALParticipants were randomized to sitagliptin 100 mg
Sitagliptin 200 mgEXPERIMENTALParticipants were randomized to a single dose of sitagliptin 200 mg
Placebo to sitagliptinPLACEBO_COMPARATORParticipants were randomized to matching placebo to sitagliptin 50 mg, 100 mg, or 200 mg
3PLACEBO_COMPARATORPlacebo
AACTIVE_COMPARATORSitagliptin alone
BACTIVE_COMPARATORMetformin alone
CEXPERIMENTALSitagliptin and metformin concomitantly
DPLACEBO_COMPARATORPlacebo
Interventions
NameTypeDescription
Sitagliptin phosphateDRUGSitagliptin 100 mg tablet by mouth once daily for 4 weeks.
MetforminDRUGStable dose of metformin tablet(s) by mouth (at least 1000 mg/day) for 4 weeks.
JanuviaDRUG200 mg t.i.d
PlaceboDRUGPlacebo
Comparator: PlaceboDRUGsitagliptin matching placebo for up to a 24-wk treatment period.
Co-administration of 50 mg sitagliptin and 500 mg metforminDRUGCo-administration of 50 mg sitagliptin and 500 mg China-sourced metformin as individual tablets with 240 ml water on Day 1 of the relevant treatment period (Sit + Met500) after fasting for at least 10 hours.
sitagliptin/metformin 50 mg/500 mg tabletDRUGSingle dose administration of the final marketing image (FMI) sitagliptin/metformin 50 mg/500 mg fixed-dose combination (FDC) tablet with 240 ml water on Day 1 of the relevant treatment period (SitMet850 FDC) after fasting for at least 10 hours.
Co-administration of 50 mg sitagliptin and 850 mg metforminDRUGCo-administration of 50 mg sitagliptin and 850 mg China sourced metformin as individual tablets with 240 ml water on Day 1 of the relevant treatment period (Sit + Met850) after fasting for at least 10 hours.
sitagliptin/metformin 50 mg/850 mg tabletDRUGSingle dose administration of the FMI sitagliptin/metformin 50 mg/850 mg FDC tablet with 240 ml water on Day 1 of the relevant treatment period (SitMet850 FDC) after fasting for at least 10 hours.
Comparator: matching placeboDRUGParticipants will fast 8 hours prior to dosing. All doses will be given with 240 ml of water. Participants received either a single oral dose of matching placebo to sitagliptin 50 mg, 100 mg, or 200 mg.
Comparator: metforminDRUG500 mg twice daily on Day 1 and 1000 mg once daily on Day 2 in one of four treatment periods.
Comparator: sitagliptin and metforminDRUG100 mg sitagliptin once daily and 500 mg metformin twice daily on Day 1 and 100 mg sitagliptin once daily and 1000 mg metformin once daily on Day 2 in one of four treatment periods.
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Eligibility Criteria
Age Range18 Years — 79 Years
SexALL
Healthy VolunteersNo

Inclusion Criteria: * Participants with T2DM failing metformin monotherapy * Between the ages of 18 and 79 Exclusion Criteria: * Participants has a history of type 1 Diabetes Mellitus or ketoacidosis

Countries:Denmark
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