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Kaartweergave

A Study of Insulin Efsitora Alfa (LY3209590) Compared to Glargine in Adult Participants With Type 2 Diabetes Who Are Starting Basal Insulin for the First Time (QWINT-1) Fase 3 795 Dosis-escalatie

Afgerond
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De klinische studie NCT05662332 (QWINT-1) onderzocht behandeling bij Type 2 diabetes, T2D. Deze Fase 3 interventioneel studie is nu afgerond. Er werd gestreefd naar inclusie van 795 deelnemers vanaf 14 januari 2023. De studie werd geleid door Eli Lilly en was gepland te worden voltooid op 19 juli 2024. Laatste update op ClinicalTrials.gov: 6 augustus 2025.
Beknopte samenvatting
The main purpose of this study is to determine the efficacy and safety of insulin efsitora alfa (LY3209590) administered weekly using a fixed dose escalation compared to insulin glargine in adults with type 2 diabetes (T2D) who are starting basal insulin therapy for the first time.
Officiële titel

A Phase 3, Parallel-Design, Open-Label, Randomized Control Study to Evaluate the Efficacy and Safety of LY3209590 Administered Weekly Using a Fixed Dose Escalation Compared to Insulin Glargine in Insulin-Naïve Adults With Type 2 Diabetes

Aandoeningen
Type 2 diabetesT2D
Publicaties
Wetenschappelijke artikelen en onderzoekspapers gepubliceerd over deze klinische studie:
Andere studie-ID's
  • QWINT-1
  • 18261
  • I8H-MC-BDCW (Overige identificatiecode) (Eli Lilly and Company)
NCT-ID
Startdatum (Werkelijk)
2023-01-14
Laatste update geplaatst
2025-08-06
Verwachte einddatum
2024-07-19
Inschrijving (Geschat)
795
Studietype
Interventioneel
FASE
Fase 3
Status
Afgerond
Primaire doel
Behandeling
Toewijzing
Gerandomiseerd
Interventiemodel
Parallel
Blindering
Geen (Open-label)
Armen / Interventies
Deelnemersgroep/StudiearmInterventie/Behandeling
ExperimenteelInsulin Efsitora Alfa
Participants received Insulin Efsitora Alfa (insulin efsitora; 500 U/ml) administered subcutaneously (SC) once weekly (QW) for 52 weeks, with titration using fixed-doses 100 U, 150 U, 250 U, and 400 U.
Insulin Efsitora Alfa
Administered SC
Actieve comparatorInsulin Glargine
Participants received insulin glargine (100 U/ml) administered SC once daily (QD) for 52 weeks with titration by standard sliding-scale dose adjustments.
Insulin Glargine
Administered SC
Primaire uitkomst
UitkomstmaatBeschrijving van de uitkomstmaatTijdsbestek
Change From Baseline in Hemoglobin A1c (HbA1c) [Noninferiority Analysis]
HbA1c is the glycated fraction of hemoglobin A. HbA1c is measured to identify average plasma glucose concentration over the last 2-3 months. Least Squares (LS) Mean was determined using ANCOVA model with Baseline + Country + GLP-1 RA Use at Randomization Flag + Treatment (Type III sum of squares) as variables. Missing data at Week 52 were imputed by return-to-baseline multiple imputation approach.
Baseline, Week 52
Secundaire uitkomst
UitkomstmaatBeschrijving van de uitkomstmaatTijdsbestek
Change From Baseline in HbA1c [Superiority]
HbA1c is the glycated fraction of hemoglobin A. HbA1c is measured to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) Mean was determined using ANCOVA model with Baseline + Country + GLP-1 RA Use at Randomization Flag + Treatment (Type III sum of squares) as variables. Missing data at Week 52 were imputed by return-to-baseline multiple imputation approach.
Baseline, Week 52
Change From Baseline in Fasting Glucose
Change from baseline in fasting blood glucose measured by self-monitoring blood glucose (SMBG). LS mean was determined using ANCOVA model with Variable = Baseline + Country + GLP-1 RA Use at Baseline + Hemoglobin A1c Stratum at Baseline + Treatment (Type III sum of squares).
Baseline, Week 52
Basal Insulin Dose at Week 52
The insulin dose was recorded daily or weekly in an electronic diary. The average weekly basal insulin dose at Week 52 was reported. LS mean was determined using MMRM model with Baseline + Hemoglobin A1c Stratum at Baseline + Country + GLP-1 RA use at Randomization + Treatment + Time + Treatment\*Time (Type III sum of squares) as variables.
Week 52
Rate Per Year of Hypoglycemia Events
Rate of Composite Level 2 and 3 Hypoglycemia Events were reported. Hypoglycemia with glucose \<54 mg/dL (Level 2) or Severe Hypoglycemia confirmed by the investigator to be an event that required assistance for treatment (Level 3) was reported. A severe hypoglycemic event is characterized by altered mental or physical status requiring assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions for the treatment of hypoglycemia. Group mean was reported and determined by Negative binomial model using Number of episodes = Hemoglobin A1c at Baseline (%) + Treatment, with log (exposure in days/365.25) as an offset variable.
Baseline up to Week 52
Percentage of Participants With Hypoglycemia Events (Incidence)
Incidence of hypoglycemic episodes is defined as 100 multiplied by the number of participants experiencing a hypoglycemic episode divided by the number of participants exposed to the study drug. Incidence of Composite Level 2 and 3 Hypoglycemia Events was reported. Hypoglycemic episodes are defined as an event that is associated with reported signs and symptoms of hypoglycemia with glucose \<54 mg/dL (Level 2) or severe hypoglycemia confirmed by the investigator to be an event that required assistance for treatment (Level 3). A severe hypoglycemic event is characterized by altered mental or physical status requiring assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions for the treatment of hypoglycemia.
Week 52
Rate Per Year of Nocturnal Hypoglycemia Events
The event rate of participant-reported clinically significant glucose \<54 mg/dL (3.0 mmol/L) or severe nocturnal hypoglycemia that occurs at night and presumably during sleep between midnight and 6:00 AM), measured during treatment period up to week 52. Group mean is reported here. Group mean is determined by Negative Binomial Model using Number of episodes = .Hemoglobin A1c at Baseline (%) + Treatment, with log (exposure in days/365.25) as an offset variable.
Baseline up to Week 52
Percentage of Participants With Nocturnal Hypoglycemia Events (Incidence)
Incidence of nocturnal hypoglycemic episodes is defined as 100 multiplied by the number of participants experiencing a hypoglycemic episode divided by the number of participants exposed to the study drug. Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking. The event rate of participant-reported clinically significant glucose \<54 mg/dL (3.0 mmol/L) or severe nocturnal hypoglycemia that occurs at night and presumably during sleep between midnight and 6:00 AM), measured during treatment period up to week 52..
Week 52
Change From Baseline in Body Weight
Change from baseline in body weight was reported. LS mean was determined using ANCOVA model with Variable = Baseline + Country + GLP-1 RA Use at Baseline + Hemoglobin A1c Stratum at Baseline + Treatment (Type III sum of squares).
Baseline, Week 52
Change From Baseline in Treatment-Related Impact Measure - Diabetes (TRIM-D) Total Score
The TRIM-D is a self-administered instrument, which assesses the impact of diabetes treatment on participants' functioning and well-being across available diabetes treatments. The TRIM-D consists of 28 items, each assessed on a 5-point scale. The TRIM-D questionnaire consists of 5 sub-domains. Treatment Burden (6 items) Daily Life (5 items) Diabetes Management (5 items), Compliance (4 items), and Psychological Health (8 items), where each question is scored on a 1-5-point scale with a higher score indicating a better health state (less negative impact). Mean TRIM-D individual sub-domain scores and total scores are later transformed to a 0-100 scale for analysis. LS mean change in scores from baseline to 52 weeks for total score are presented here. LS mean was determined using MMRM model with BASELINE + Hemoglobin A1c Stratum at Baseline + Country + GLP-1 RA. Use at Randomization + Treatment + Time + Treatment\*Time(Type III sum of squares) as variables.
Baseline, Week 52
Change From Baseline in Diabetes Treatment Satisfaction Questionnaire - Change Version (DTSQ-c)
The DTSQ-c is a validated, patient-reported questionnaire designed to assess perceived changes in satisfaction with diabetes treatment over time. It is especially useful in clinical trials comparing a new treatment to a previous one. The DTSQ-c includes 8 items, each scored on a 7-point Likert scale ranging from -3 (Much less satisfied) to +3 (Much more satisfied). A score of 0 indicates no change in perception. This outcome reports three domains: (1) Perceived frequency of hypoglycaemia - lower scores reflect fewer perceived episodes; (2) Perceived frequency of hyperglycaemia - lower scores reflect fewer perceived episodes; (3) Treatment satisfaction -Aggregated score from the remaining 6 items assessing satisfaction with treatment, convenience, flexibility, understanding, and willingness to continue. A higher scores indicating greater improvement in satisfaction. Total score range: -18 to +18.
Baseline, Week 52
Percentage of Participants Reporting Treatment Experience Using the Simplicity of Diabetes Treatment Questionnaire (SIM-Q) Single Medication Status Version
The SIM-Q is a brief 10-item measure developed to assess the simplicity and complexity of treatment for T2D. This version of the instrument assesses the simplicity and complexity of a single medication. Only the last 2 questions/items of the SIM-Q were completed by the study participants: 1. "How simple or complex is your medication treatment for diabetes?" 2. "Overall, how simple or complex is it to manage your diabetes, including medication, checking your blood glucose levels, diet, and any other aspects of diabetes treatment?" Participants were asked to provide responses to the study intervention at Week 52. Each item is scored on a 5-point scale ranging from "Very complex" to "Very simple." Higher scores indicate a more favorable (simpler) treatment experience.
Week 52
Change From Baseline in Diabetes Injection Device Experience Questionnaire (DID-EQ) in Device Characteristics
DID-EQ is a validated, self-administered, 10-item PRO instrument designed to assess participants' perceptions of diabetes injection delivery systems.This outcome measure reports only the Device Characteristics Subscale, which includes Items 1 through 7. These items evaluate specific features of injection devices such as: * Ease of preparation * Comfort during injection * Portability * Discreetness * Confidence in dose delivery * Ease of learning to use * Satisfaction with device features Each item is rated on a 4-point Likert scale: Strongly Disagree, Disagree, Agree, Strongly Agree. Responses are transformed to a 0-100 scale, where 0 represents most negative perception and 100 represents the most positive perception.Higher scores indicate more favorable perceptions of the injection device. LS Mean determined using ANCOVA model with Country + GLP-1 RA Use at Randomization + HbA1c Stratum at Baseline + Treatment + Time + Treatment\*Time (Type III sum of squares) as variables.
Baseline, Week 52
Percentage of Participants in Treatment Experience in Diabetes Injection Device Experience Questionnaire (DID-EQ) (3-Global Items)
The DID-EQ is a validated, self-administered, 10-item PRO instrument designed to assess participants' perceptions of diabetes injection delivery systems. This outcome measure specifically reports the summary of DID-EQ scores for the 3 global items: * Item 8: Overall satisfaction with the injection device * Item 9: Ease of use of the injection device * Item 10: Convenience of the injection device Each item is rated on a 4-point Likert scale: * Strongly Disagree * Disagree * Agree * Strongly Agree Responses are transformed to a 0-100 scale, where: * 0 = Most negative perception * 100 = Most positive perception Higher scores indicate more favorable perceptions of the injection device's global characteristics.
Week 52
Geschiktheidscriteria

Leeftijd van deelnemers
Volwassene, Oudere volwassene
Minimumleeftijd
18 Years
Geslachten die in aanmerking komen voor de studie
Allen
  • Have a diagnosis of T2D according to the World Health Organization criteria.
  • Have an HbA1c of 7.0% to 10.0%, inclusive, at screening.
  • Are on a stable treatment of at least 1 antihyperglycemic medication, for at least 3 months prior to screening, and willing to continue the stable treatment for the duration of the study.
  • Are insulin naive

Exceptions:

  • short-term insulin treatment for a maximum of 14 days, prior to screening, and
  • prior insulin treatment for gestational diabetes.

  • Have a diagnosis of type 1 diabetes (T1D), latent autoimmune diabetes, or specific type of diabetes other than T2D, for example, monogenic diabetes, diseases of the exocrine pancreas, or drug induced or chemical-induced diabetes.
  • Have a history of >1 episode of ketoacidosis or hyperosmolar state or coma requiring hospitalization within 6 months prior to screening.
  • Have had severe hypoglycemia episodes within 6 months prior to screening.
  • Have known hemoglobinopathy, hemolytic anemia or sickle cell anemia, or any other traits of hemoglobin abnormalities known to interfere with the measurement of HbA1c.
  • Have had New York Heart Association Class IV heart failure or any of these cardiovascular conditions within 3 months prior to screening
  • acute myocardial infarction
  • cerebrovascular accident (stroke), or
  • coronary bypass surgery.
  • Have had gastric bypass (bariatric) surgery, restrictive bariatric surgery, for example Lap-Band, or sleeve gastrectomy within 1 year prior to screening
  • Have had significant weight gain or loss within 3 months prior to screening, for example, ≥5%.
Geen contactgegevens beschikbaar
71 Studielocaties in 4 landen

Alabama

Cahaba Research, Birmingham, Alabama, 35242, United States
Syed Research Consultants Llc, Sheffield, Alabama, 35660, United States

California

AMCR Institute, Escondido, California, 92025, United States
Velocity Clinical Research, Gardena, Gardena, California, 90247, United States
National Research Institute - Huntington Park, Huntington Park, California, 90255, United States
National Research Institute - Wilshire, Los Angeles, California, 90057, United States
Diabetes Associates Medical Group, Orange, California, 92868, United States
Encompass Clinical Research, Spring Valley, California, 91978, United States
Millennium Clinical Trials, Thousand Oaks, California, 93065, United States
University Clinical Investigators, Inc., Tustin, California, 92780, United States
Diablo Clinical Research, Inc., Walnut Creek, California, 94598, United States

Colorado

University of Colorado Anschutz Medical Campus, Aurora, Colorado, 80045, United States

Connecticut

Chase Medical Research, LLC, Waterbury, Connecticut, 06708, United States

Florida

Clinical Research of West Florida, Inc. (Clearwater), Clearwater, Florida, 33765, United States
Suncoast Research Group, Miami, Florida, 33135, United States
Clinical Research of West Florida, Tampa, Florida, 33606, United States

Georgia

Center for Advanced Research & Education, Gainesville, Georgia, 30501, United States

Hawaii

Pacific Diabetes & Endocrine Center, Honolulu, Hawaii, 96813, United States

Illinois

Central Illinois Diabetes and Clinical Research a Division of Prairie Education and Research Cooperative, Springfield, Illinois, 62711, United States

Indiana

American Health Network of Indiana, LLC - Franklin, Franklin, Indiana, 46131, United States
American Health Network of Indiana, LLC - Muncie, Muncie, Indiana, 47304, United States

Iowa

Iowa Diabetes and Endocrinology Research Center, West Des Moines, Iowa, 50265, United States

Michigan

Arcturus Healthcare , PLC, Troy Internal Medicine Research Division, Troy, Michigan, 48098, United States

Missouri

Clinvest Research LLC, Springfield, Missouri, 65807, United States

Nebraska

University Of Nebraska Medical Center, Omaha, Nebraska, 68198-4130, United States

New York

Mid Hudson Medical Research, New Windsor, New York, 12553, United States
Meridian Clinical Research, LLC, Vestal, New York, 13850, United States

Oklahoma

Intend Research, LLC, Norman, Oklahoma, 73069, United States

Pennsylvania

Decpa, Llc, Feasterville-Trevose, Pennsylvania, 19053, United States
Office 18, Pittsburgh, Pennsylvania, 15236, United States

Tennessee

WR-Clinsearch, LLC, Chattanooga, Tennessee, 37421, United States

Texas

Private Practice - Dr. Osvaldo A. Brusco, Corpus Christi, Texas, 78414, United States
Dallas Diabetes Research Center, Dallas, Texas, 75230, United States
Prime Revival Research Institute, Flower Mound, Texas, 75028, United States
Endocrine Associates, Houston, Texas, 77004, United States
Endocrine Ips, Pllc, Houston, Texas, 77079, United States
North Hills Family Medicine/North Hills Medical Research, North Richland Hills, Texas, 76180, United States
Texas Valley Clinical Research, Weslaco, Texas, 78596, United States

Washington

Eastside Research Associates, Redmond, Washington, 98052, United States

Buenos Aires

Centro de Investigaciones Metabólicas (CINME), Ciudad Autónoma de Buenos Aire, Buenos Aires, 1056, Argentina
Instituto de Investigaciones Clínicas Mar del Plata, Mar del Plata, Buenos Aires, 7600, Argentina
DIM Clínica Privada, Ramos Mejía, Buenos Aires, 1704, Argentina
Go Centro Medico San Nicolás, San Nicolás de los Arroyos, Buenos Aires, 2900, Argentina

Buenos Air

Asociación de Beneficencia Hospital Sirio Libanés, Buenos Aires, Buenos Air, C1419AHN, Argentina

Ciudad Aut

Stat Research S.A., Buenos Aires, Ciudad Aut, C1023AAB, Argentina
Centro Médico Viamonte, Buenos Aires, Ciudad Aut, C1120AAC, Argentina
Glenny Corp, Buenos Aires, Ciudad Aut, C1430CKE, Argentina
CEMEDIAB, C.a.b.a., Ciudad Aut, C1205AAO, Argentina

Ciudad Autónoma de Buenos Aire

Investigaciones Medicas Imoba Srl, Buenos Aires, Ciudad Autónoma de Buenos Aire, C1056ABH, Argentina
CIPREC, Buenos Aires, Ciudad Autónoma de Buenos Aire, C1061AAS, Argentina
Centro Medico Dra. Laura Maffei- Investigacion Clinica Aplicada, Ciudad Autonoma de Buenos Aire, Ciudad Autónoma de Buenos Aire, C1425AGC, Argentina

Córdoba Province

Centro Medico Privado San Vicente Diabetes, Córdoba, Córdoba Province, 5006, Argentina
Instituto Médico Río Cuarto, Río Cuarto, Córdoba Province, 5800, Argentina

Mendoza Province

CIPADI - Centro Integral de Prevencion y Atencion en Diabetes, Godoy Cruz, Mendoza Province, M5501ARP, Argentina

Santa Fe Province

Instituto Médico Fundación Grupo Colaborativo Rosario Investigación y Prevención Medica, Rosario, Santa Fe Province, 2000, Argentina

Tucumán Province

Clínica Mayo, San Miguel de Tucumán, Tucumán Province, 4000, Argentina
Fundación Respirar, Buenos Aires, C1426ABP, Argentina
CENUDIAB, Ciudad Autónoma de Buenos Aire, C1440AAD, Argentina
Centro de Diagnóstico y Rehabilitación (CEDIR), Santa Fe, 3000, Argentina
Sanatorio Norte, Santiago del Estero, 4200, Argentina

Jalisco

Instituto Jalisciense de Investigacion en Diabetes y Obesidad, Guadalajara, Jalisco, 04460, Mexico
Diseno y Planeacion en Investigacion Medica, Guadalajara, Jalisco, 44130, Mexico

Mexico City

RM Pharma Specialists, Mexico City, Mexico City, 03100, Mexico

Morelos

Instituto de Diabetes, Obesidad y Nutricion, Cuernavaca, Morelos, 62250, Mexico

Nuevo León

Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Monterrey, Nuevo León, 64460, Mexico
Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Monterrey, Nuevo León, 66460, Mexico
Unidad Médica para la Salud Integral, San Nicolás de los Garza, Nuevo León, 66465, Mexico

Yucatán

Medical Care and Research SA de CV, Mérida, Yucatán, 97070, Mexico
Investigacion En Salud Y Metabolismo Sc, Chihuahua City, 31217, Mexico
Ponce Medical School Foundation Inc., Ponce, 00716, Puerto Rico
Latin Clinical Trial Center, San Juan, 00909, Puerto Rico