Pancreatic beta-cell dysfunction REStorEd by Rosiglitazone and Valsartan Effects: a 52-week randomised controlled factorial study in subjects with impaired fasting glucose and/or impaired glucose tolerance
ISRCTN | ISRCTN42786336 |
---|---|
DOI | https://doi.org/10.1186/ISRCTN42786336 |
Secondary identifying numbers | N/A |
- Submission date
- 28/09/2006
- Registration date
- 28/09/2006
- Last edited
- 08/07/2013
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Plain English summary of protocol
Not provided at time of registration
Contact information
Dr M Diamant
Scientific
Scientific
VU University Medical Center
Department of Endocrinology
Diabetes Center
De Boelelaan 1117
P.O. Box 7057
Amsterdam
1081 HV
Netherlands
Phone | +31 (0)20 4440534 |
---|---|
m.diamant@vumc.nl |
Study information
Study design | Randomised controlled trial |
---|---|
Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Not specified |
Study type | Treatment |
Scientific title | |
Study acronym | PRESERVE TRIAL |
Study objectives | Type two diabetes is cause by progressive beta-cell dysfunction against a background of obesity and insulin resistance in susceptible individuals. Peroxisome Proliferator-Activated Receptor (PPAR) gamma-mediated mechanisms are involved in the regulation of important processes that may protect the pancreatic beta-cell. Local pancreatic and systemic activation of the Renin-Angiotensin System (RAS), as frequently observed in people with obesity/insulin resistance, may be harmful to the pancreatic beta-cell causing beta-cell dysfunction and beta-cell apoptosis. Treatment of subjects at high risk to develope type two diabetes, including those with impaired fasting glucose and/or impaired glucose tolerance (with/without a familiy history of diabetes) with a PPAR gamma agonist and/or an angiotensin II receptor blocker may improve beta-cell function. |
Ethics approval(s) | Ethics approval received from the local medical ethics committee |
Health condition(s) or problem(s) studied | Impaired glucose metabolism |
Intervention | Participants will be randomised into one of the following four treatment groups for a 52-week intervention: 1. Rosiglitazone 8 mg daily and valsartan-placebo 2. Valsartan 320 mg daily and rosiglitazone-placebo 3. Rosiglitazone 8 mg daily and valsartan 320 mg daily 4. Rosiglitazone-placebo and valsartan-placebo Further information as of 10/07/12: The decision was made not to initiate the rosiglitazone arm because of the reported potential cardiovascular risks associated with rosiglitazone. |
Intervention type | Drug |
Pharmaceutical study type(s) | |
Phase | Not Specified |
Drug / device / biological / vaccine name(s) | Rosiglitazone and Valsartan |
Primary outcome measure | To compare beta-cell function, as reflected by the first phase insulin secretion corrected for insulin sensitivity and/or the arginine-stimulated insulin secretion, both co-primary endpoints as measured during the eu-hyperglycemic clamp procedure, following 52 weeks of rosiglitazone, valsartan or rosiglitazone combined with valsartan in subjects with IFG (with and without a family history of DM2) and/or IGT. |
Secondary outcome measures | To compare the effects of 52 weeks of rosiglitazone, valsartan or rosiglitazone combined with valsartan in subjects with IFG (with and without a family history of DM2) and/or IGT with respect to: 1. Fasting plasma glucose 2. Second phase insulin secretion in response to hyperglycemia during the hyperglycemic clamp test 3. All the above-mentioned beta-cell function parameters at 12 weeks after discontinuation of therapy to assess durability/disease modifying effects 4. The conversion from Normal Glucose Tolerance (NGT) to IGT or diabetes (as evaluated by an oral glucose tolerance test) 5. HbA1c, fasting blood glucose and lipid/lipoprotein concentrations 6. Insulin sensitivity assessed during the euglycemic clamp test 7. Safety and tolerability, including assessments of hypoglycemic events, blood pressure, and urinary albumin excretion rate |
Overall study start date | 01/10/2006 |
Completion date | 01/01/2010 |
Eligibility
Participant type(s) | Patient |
---|---|
Age group | Adult |
Sex | Both |
Target number of participants | 144 |
Key inclusion criteria | 1. Male and female subjects (aged 35 to 70 years) 2. Impaired Fasting Glucose (IFG): fasting plasma glucose 6.1 or higher and less than 7.0 mmol/l, or fasting plasma glucose 5.6 or higher and less than 7.0 mmol/l) and a family history of Diabetes Mellitus type two (DM2) (i.e. first and second degree [i.e. grandparents] relatives) 3. Impaired Glucose Tolerance (IGT): two hour plasma glucose during 75 g oral glucose tolerance test 7.8-11.1 mmol/l |
Key exclusion criteria | Drug use: 1. Current use of Angiotensin-Converting Enzyme Inhibitors (ACE-I), Angiotensin Receptor Blockers (ARB) and/or Thiazolidinediones (TZDs) and inability to discontinue these drugs 2. Known hypersensitivity to any of the study drugs 3. Prior use of blood glucose lowering medications except during pregnancy 4. Use of systemic glucocorticoids or niacin Cardiovascular co-morbidities: 1. Ejection fraction known to be less than 40% or congestive heart failure, or existing clinical Cardio-Vascular (CV) disease: a. previous Myocardial Infarction [MI] or stroke b. angina with either more than 50% stenosis in more than or equal to two major coronary arteries, or ST depression of more than or equal to 2 mm, or a positive nuclear test, or previous coronary angioplasty, stent or bypass c. previous limb bypass or vessel angioplasty or angiographic evidence of more than 50% stenosis, or intermittent claudication with an ankle/arm pressure less than or equal to 0.8 2. Uncontrolled hypertension requiring ACE-I or ARB Other Criteria: 1. History of diabetes (except gestational DM) or on anti-diabetic medication 2. Renal or Hepatic Disease: a. renal artery stenosis b. creatinine clearance less than 40 ml/min or serum creatinine 200 umol/l or higher c. clinical proteinuria (one or above, positive proteinuria on dipstick or 300 mg and above albuminuria/day, in the absence of urine) d. measured Alanine Transferase (ALT) 2.5 or more times the upper limit of normal e. active liver disease including jaundice, chronic hepatitis, previous liver transplant 3. Major illness with life expectancy of less than five years or that may interfere with participation 4. Use of another experimental drug 5. Pregnant or unwilling to use reliable contraception (fertile women will have a pregnancy test prior to randomisation) 6. Major psychiatric disorder 7. Diseases and medications that affect glucose tolerance (e.g. pheochromocytoma, Cushings syndrome, acromegaly, steroid-dependent asthma, protease inhibitors, anti-psychotics) 8. Unwillingness to be randomised or sign informed consent) 9. Known uncontrolled substance abuse 10. Inability to understand study information and/or communicate with clinic staff |
Date of first enrolment | 01/10/2006 |
Date of final enrolment | 01/01/2010 |
Locations
Countries of recruitment
- Netherlands
Study participating centre
VU University Medical Center
Amsterdam
1081 HV
Netherlands
1081 HV
Netherlands
Sponsor information
VU University Medical Center (The Netherlands)
Hospital/treatment centre
Hospital/treatment centre
Van der Boechorststraat 7
Amsterdam
1081 BT
Netherlands
https://ror.org/00q6h8f30 |
Funders
Funder type
Industry
Novartis Pharma B.V. (The Netherlands)
No information available
GlaxoSmithKline (The Netherlands)
Government organisation / For-profit companies (industry)
Government organisation / For-profit companies (industry)
- Alternative name(s)
- GlaxoSmithKline plc., GSK plc., GSK
- Location
- United Kingdom
Results and Publications
Intention to publish date | |
---|---|
Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration |
IPD sharing plan |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
---|---|---|---|---|---|
Results article | further results | 01/05/2012 | Yes | No | |
Results article | results | 01/09/2012 | Yes | No | |
Results article | results | 01/05/2013 | Yes | No |