| Basic information |
| Public title |
Effect of dapagliflozin, the sodium-glucose-cotransporter-2 (SGLT2) inhibitor, on fibroblast growth factor 21 (FGF21), a novel hepatokine and myokine, in Japanese patients of type 2 diabetes |
| Acronym |
Effect of dapagliflozin on FGF21. |
| Scientific Title |
Effect of dapagliflozin, the sodium-glucose-cotransporter-2 (SGLT2) inhibitor, on fibroblast growth factor 21 (FGF21), a novel hepatokine and myokine, in Japanese patients of type 2 diabetes |
| Scientific Title:Acronym |
Effect of dapagliflozin on FGF21. |
| Region |
|
| Assessment |
| Primary outcomes |
Serum FGF21 level (At 0, 12 and 24 weeks after administration) |
| Key secondary outcomes |
Fasting plasma glucose, body weight, waist circumference, blood pressures, visceral fat mass, subcutaneous fat mass, CAVI, leptin, adiponectin, hs-CRP, muscle thickness of six sites of the body using B-mode ultrasound, skeletal muscle mass, % fat, total body water weight ratio, lean body mass, basal metabolic rate, and serum other miokines (myostatin, irisin, IL-6) |
| Eligibility |
| Age-lower limit |
|
| Age-upper limit |
|
| Gender |
Male and Female |
| Key inclusion criteria |
1. Outpatient
2. BMI: more than 22 kg/m2
3. HbA1c(NGSP): 6.5% to less than 9.0%
4. Subject have a diet and exercise therapy
5. Subject have SU/MET/alpha-GI/DPP-IV inhibitor or their combinations |
| Key exclusion criteria |
1.Subjects with secondary obesity associated with endocrine disorders
2.Type 1 diabetes mellitus
3.Subjects with severe ketosis, diabetic coma or precoma
4.Subjects with severe infection, before and after surgery or severe injury
5.Subjects with severe hepatic dysfunction
6.Subjects with moderate or more of renal dysfunction (serum creatinine >= 1.5mg/dl[male], 1.3mg/dl[female]).
7.The subjects within the past 6 months, developed stroke, myocardial infarction, or other serious vascular complications requiring hospitalization
8.Subjects with dehydration, diarrhea, vomiting or gastrointestinal injury
9.Subjects in SGLT-2 inhibitors, insulin formulation, GLP-1 receptor agonist prescription
10.Subjects in TZD, fibrate prescription
11.Subjects in pregnant women, lactating women, the potential or planned are pregnant
12.Subjects with a history of hypersensitivity to SGLT-2 inhibitor
13.Subjects who have been determined to be unsuitable for the attending physician |
| Target sample size |
80 |
| Result |
| URL related to results and publications |
https://onlinelibrary.wiley.com/doi/full/10.1111/jdi.13179 |
| Number of participants that the trial has enrolled |
60 |
| Results |
Bodyweight decreased in the dapagliflozin group, but the changes in SMM were not significant between the groups, thereby elevating the ratio of SMM-to-bodyweight in the dapagliflozin group. Myostatin levels were significantly decreased, and irisin levels showed a nearly significant reduction in the dapagliflozin group compared with the control group, whereas FGF21 levels did not change significantly from baseline to the end of the intervention in both groups. |
| Results date posted |
| 2020 |
Year |
06 |
Month |
19 |
Day |
|
| Results Delayed |
|
| Results Delay Reason |
|
| Date of the first journal publication of results |
|
| Baseline Characteristics |
The characteristics at baseline were balanced between the dapagliflozin (sex: 11/16, age:58.4[13.0], HbA1c:7.5[0.8]) and control groups(sex: 14/13, age:60.7[11.9], HbA1c:7.4[0.9]). |
| Participant flow |
A total of 60 patients were screened, and 54 were randomly assigned to recieve either dapagliflozin in addition to conventional treatment (dapagliflozin group or conventional treatment witout dapagliflozion (control group; n=27 each). In the dapagliflozion arm, 26 patients completed the study, with one dropping out because of study medication-related comlications. In the control arm, 24 patients comleted the study, with one withdrawing and two having a scheduling conflict. |
| Adverse events |
Five adverse events were reported by two patients after randomization. No patient had a serious adverse event requiring hospitalization. One patient in the dapagliflozin group developed dehydration within 1 day of initiation of the drug. The drug was discontinued, and the symptoms improved. One patient in the control group developed hunger, dizziness and cramps within 1 day of initiation of the drug, and finger tumor deterioration within 20 weeks of initiation of the drug. |
| Outcome measures |
Bodyweight decreased in the dapagliflozin group, but the changes in SMM were not significant between the groups, thereby elevating the ratio of SMM-to-bodyweight in the dapagliflozin group. Myostatin levels were significantly decreased, and irisin levels showed a nearly significant reduction in the dapagliflozin group compared with the control group, whereas FGF21 levels did not change significantly from baseline to the end of the intervention in both groups. |
| Plan to share IPD |
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| IPD sharing Plan description |
|
UMIN-CTR Clinical Trial