AzTrials
AzTrials

DiabetesPhase 4Full STEP™NCT01165684

Efficacy and Safety of Basal-bolus Therapy, Comparing Stepwise Addition of Insulin Aspart Versus Complete Basal-bolus Regimen

A Phase 4 study testing insulin aspart and insulin detemir in people with Diabetes and Diabetes Mellitus, Type 2, run by Novo Nordisk A/S at 67 sites in 7 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This trial is conducted in Europe, and North and South America. The aim of this clinical trial is to investigate if the two treatments are equally effective. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetes, Diabetes Mellitus, Type 2
What is being tested?
insulin aspart and insulin detemir
Could I receive a placebo?
No, everyone receives an active treatment
How many people
401 participants
Where
67 sitesin 7 countries
Study dates
Oct 2010to Apr 2012
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Type 2 diabetes (diagnosed clinically) for at least 12 months
  • Basal insulin treatment (NPH once or twice daily, insulin glargine once daily or insulin detemir once daily) for at least 6 months
  • HbA1c: 7.0-9.0 % (both inclusive) by central laboratory analysis (one retest analysed at the central laboratory within a week is permitted with the result of the last sample being conclusive)
  • BMI (Body Mass Index) less than 40.0 kg/m^2

Who cannot join

  • Previous use of pre-mix or bolus insulin (allowed is previous use of bolus insulin only in case of a hospitalisation or a severe condition requiring intermittent use of bolus insulin for less than 14 consecutive days, but not during the last 6 months prior to screening visit (Visit 1)
  • Use of GLP-1 (Glucagon-like peptide-1) receptor agonists or pramlintide within the last 6 months prior to prior to screening visit (Visit 1)
  • Anticipated change in concomitant medication known to interfere significantly with glucose metabolism (e.g. systemic corticosteroids, beta-blockers, MAO (Monoamine oxidase) inhibitors, etc.)
  • Cardiovascular disease, within the last 12 months prior to screening visit (Visit 1), defined as: stroke; decompensated heart failure New York Heart Association (NYHA) class III or IV; myocardial infarction; unstable angina pectoris; or coronary arterial bypass graft or angioplasty
  • Uncontrolled treated/untreated severe hypertension (systolic blood pressure sitting at least 180 millimetre (mm) mercury (Hg) and/or diastolic blood pressure at least 100 mmHg). For Argentina: systolic blood pressure sitting at least 150 mmHg and/or diastolic blood pressure at least 90 mmHg
  • Impaired liver function, defined as ALAT (Alanine aminotransferase) at least 2.5 times upper limit of normal (one retest analysed at the central laboratory within a week is permitted with the result of the last sample being conclusive)
Show all 10Show fewer
  • Impaired renal function defined as serum creatinine above 135 micromol/L (above 1.5 mg/dL) for males and above 110 micromol/L (above 1.2 mg/dL) for females; and, if required by the locally applicable metformin label, glomerular filtration rate below 60 ml/min, calculated by the Cockroft \& Gault formula). One retest within a week is permitted with the result of the last sample being conclusive
  • Recurrent severe hypoglycaemia (more than 1 severe hypoglycaemic episode, during the last 12 months) or hypoglycaemic unawareness as judged by the Investigator or hospitalisation for diabetic ketoacidosis during the previous 6 months
  • Proliferative retinopathy or maculopathy requiring treatment according to the Investigator
  • Treatment with OADs (Oral anti-diabetic drug) contraindicated or unapproved for combination treatment with insulin (according to local OAD label)

Trial locations and contacts

67 sites in 7 countries.

67 sites in 7 countries

United States33 sites
  • Novo Nordisk Investigational Site

    Altoona, Pennsylvania, 16602

  • Novo Nordisk Investigational Site

    Atlanta, Georgia, 30308-2253

  • Novo Nordisk Investigational Site

    Beavercreek, Ohio, 45432

  • Novo Nordisk Investigational Site

    Birmingham, Alabama, 35216

  • Novo Nordisk Investigational Site

    Brooklyn Center, Minnesota, 55430

  • Novo Nordisk Investigational Site

    Chicago, Illinois, 60616

  • Novo Nordisk Investigational Site

    Dallas, Texas, 75235-6233

  • Novo Nordisk Investigational Site

    Dayton, Ohio, 45439

  • Novo Nordisk Investigational Site

    Fresno, California, 93720

  • Novo Nordisk Investigational Site

    Greer, South Carolina, 29651

  • Novo Nordisk Investigational Site

    Hialeah, Florida, 33012

  • Novo Nordisk Investigational Site

    Indianapolis, Indiana, 46254

  • Novo Nordisk Investigational Site

    Jacksonville, Florida, 32204

  • Novo Nordisk Investigational Site

    Jefferson City, Missouri, 65109

  • Novo Nordisk Investigational Site

    Kettering, Ohio, 45429

  • Novo Nordisk Investigational Site

    Kissimmee, Florida, 34741

  • Novo Nordisk Investigational Site

    Las Vegas, Nevada, 89148

  • Novo Nordisk Investigational Site

    Lawrenceville, New Jersey, 08648

  • Novo Nordisk Investigational Site

    Mesa, Arizona, 85206

  • Novo Nordisk Investigational Site

    Metairie, Louisiana, 70002

  • Novo Nordisk Investigational Site

    Miami, Florida, 33136

  • Novo Nordisk Investigational Site

    Miami, Florida, 33165

  • Novo Nordisk Investigational Site

    New Windsor, New York, 12553

  • Novo Nordisk Investigational Site

    Newport News, Virginia, 23606

  • Novo Nordisk Investigational Site

    Philadelphia, Pennsylvania, 19107

  • Novo Nordisk Investigational Site

    Plantation, Florida, 33313

  • Novo Nordisk Investigational Site

    Port Charlotte, Florida, 33952

  • Novo Nordisk Investigational Site

    Rockville, Maryland, 20852

  • Novo Nordisk Investigational Site

    Roswell, Georgia, 30076

  • Novo Nordisk Investigational Site

    Salt Lake City, Utah, 84102

  • Novo Nordisk Investigational Site

    Salt Lake City, Utah, 84107

  • Novo Nordisk Investigational Site

    Scottsdale, Arizona, 85251

  • Novo Nordisk Investigational Site

    Springfield, Massachusetts, 01199

Other trials in United States

Canada12 sites
  • Novo Nordisk Investigational Site

    Calgary, Alberta, T2N 4L7

  • Novo Nordisk Investigational Site

    Chatham, Ontario, N7L 1C1

  • Novo Nordisk Investigational Site

    Coquitlam, British Columbia, V3K 3P4

  • Novo Nordisk Investigational Site

    Gatineau, Quebec, J8V 2P5

  • Novo Nordisk Investigational Site

    Kingston, Ontario, K7L 2V7

  • Novo Nordisk Investigational Site

    Lachine, Quebec, H8S 2E4

  • Novo Nordisk Investigational Site

    Langley, British Columbia, V3A 4H9

  • Novo Nordisk Investigational Site

    Mirabel, Quebec, J7J 2K8

  • Novo Nordisk Investigational Site

    Montreal, Quebec, H2W 1R7

  • Novo Nordisk Investigational Site

    Montreal, Quebec, H3T 1E2

  • Novo Nordisk Investigational Site

    Vancouver, British Columbia, V5Z 1M9

  • Novo Nordisk Investigational Site

    Victoria, British Columbia, V8V 3N7

Other trials in Canada

Argentina7 sites
  • Novo Nordisk Investigational Site

    Buenos Aires, B1636DSU

  • Novo Nordisk Investigational Site

    Buenos Aires, B1704ETD

  • Novo Nordisk Investigational Site

    Buenos Aires, C1250AAN

  • Novo Nordisk Investigational Site

    Buenos Aires, C1425AGC

  • Novo Nordisk Investigational Site

    Caba, C1440AAD

  • Novo Nordisk Investigational Site

    Córdoba, X5006IKK

  • Novo Nordisk Investigational Site

    Mendoza, 5500

Other trials in Argentina

Brazil5 sites
  • Novo Nordisk Investigational Site

    Campinas, 13084-971

  • Novo Nordisk Investigational Site

    Goiânia, Goiás, 74043-011

  • Novo Nordisk Investigational Site

    Porto Alegre, 90035-170

  • Novo Nordisk Investigational Site

    Rio de Janeiro, Rio de Janeiro, 20211-340

  • Novo Nordisk Investigational Site

    São Paulo, São Paulo, 01244-030

Other trials in Brazil

France5 sites
  • Novo Nordisk Investigational Site

    Marseille, 13009

  • Novo Nordisk Investigational Site

    Narbonne, 11108

  • Novo Nordisk Investigational Site

    Saint-Herblain, 44800

  • Novo Nordisk Investigational Site

    Sète, 34200

  • Novo Nordisk Investigational Site

    Vénissieux, 69200

Other trials in France

Slovenia4 sites
  • Novo Nordisk Investigational Site

    Brežice, 8250

  • Novo Nordisk Investigational Site

    Kranj, 4000

  • Novo Nordisk Investigational Site

    Novo Mesto, 8000

  • Novo Nordisk Investigational Site

    Trbovlje, 1420

Other trials in Slovenia

North Macedonia1 site
  • Novo Nordisk Investigational Site

    Skopje, 1000

Other trials in North Macedonia

About this study

Official title: A Randomised, Controlled, Open Label, Multicentre, Multinational, Treat-to-target Trial Investigating the Efficacy and Safety of Intensification With Addition of Bolus Insulin Aspart in Subjects With Type 2 Diabetes Inadequately Controlled on Basal Insulin With or Without Oral Anti-diabetic Drugs: Step-wise Addition Versus Complete Basal-bolus Therapy

This trial is conducted in Europe, and North and South America. The aim of this clinical trial is to investigate if the two treatments are equally effective.

Being tested
insulin aspart, insulin detemir
Medical subject headings
Diabetes Mellitus, Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • insulin aspartDrug

    Insulin aspart added stepwise according to the largest meal following an evaluation of HbA1c.

    Doses individually adjusted.

  • insulin aspartDrug

    Insulin aspart added before each main meal. Doses individually adjusted.

  • insulin detemirDrug

    Insulin detemir as basal insulin, adminstered once daily. Doses individually adjusted.

Study groups in NCT01165684
Study groupRoleWhat they receive
Step-wiseExperimentalNot described
Receives: Drug: insulin aspart; Drug: insulin detemir
Basal-bolusActive comparatorNot described
Receives: Drug: insulin aspart; Drug: insulin detemir

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Glycosylated Haemoglobin (HbA1c) From Baseline to Week 32

    Estimated mean change from baseline in HbA1c after 32 Weeks of treatment

    Measured: Week 0, Week 32

Secondary outcomes (14)
  1. Change in Glycosylated Haemoglobin (HbA1c) From Baseline to Week 10

    Estimated mean change from baseline in HbA1c after 10 Weeks of treatment

    Measured: Week 0, Week 10

  2. Change in Glycosylated Haemoglobin (HbA1c) From Baseline to Week 21

    Estimated mean change from baseline in HbA1c after 21 Weeks of treatment

    Measured: Week 0, Week 21

  3. Proportion of Subjects Reaching Glycosylated Haemoglobin (HbA1c) Below 7.0% at Week 10

    Proportion of subjects reaching HbA1c below 7.0% at Week 10

    Measured: Week 10

  4. Proportion of Subjects Reaching Glycosylated Haemoglobin (HbA1c) Below 7.0% at Week 21

    Proportion of subjects reaching HbA1c below 7.0% at Week 21

    Measured: Week 21

  5. Proportion of Subjects Reaching Glycosylated Haemoglobin (HbA1c) Below 7.0% at Week 32

    Proportion of subjects reaching HbA1c below 7.0% at Week 32

    Measured: Week 32

  6. Fasting Plasma Glucose (FPG) at Week 10

    Mean FPG at Week 10

    Measured: Week 10

  7. Fasting Plasma Glucose (FPG) at Week 21

    Mean FPG at Week 21

    Measured: Week 21

  8. Fasting Plasma Glucose (FPG) at Week 32

    Estimated Mean FPG at Week 32

    Measured: Week 32

  9. Mean Plasma Glucose Increment Over 3 Meals (Breakfast, Lunch and Dinner) at Week 10

    Mean plasma glucose increment over 3 meals (breakfast, lunch and dinner) at Week 10

    Measured: Week 10

  10. Mean Plasma Glucose Increment Over 3 Meals (Breakfast, Lunch and Dinner) at Week 21

    Mean plasma glucose increment over 3 meals (breakfast, lunch and dinner) at Week 21

    Measured: Week 21

  11. Mean Plasma Glucose Increment Over 3 Meals (Breakfast, Lunch and Dinner) at Week 32

    Estimated mean plasma glucose increment over 3 meals (breakfast, lunch and dinner) at Week 32

    Measured: Week 32

  12. Body Weight at Week 32

    Estimated mean body weight after 32 Weeks of treatment

    Measured: Week 32

  13. Body Mass Index (BMI) at Week 32

    Estimated mean BMI after 32 Weeks of treatment

    Measured: Week 32

  14. Hypoglycaemic Episodes (Rate of All Treatment Emergent Hypoglycaemia Episodes)

    A hypoglycaemic episode was defined as treatment emergent if the onset of the episode was on or after the first day of exposure to randomised treatment and no later than 1 day after the last day of randomised treatment.

    Measured: Week 0 to Week 32

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jul 2010 (estimated)
  2. Study startOct 2010
  3. Primary completionApr 2012
  4. Study completionApr 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
401 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01165684
Sponsor's protocol ID
ANA-3786
Other IDs
2010-018974-19, U1111-1116-0908
Acronym
Full STEP™
Status last verified
Jan 2017
First submitted
16 Jul 2010
Last updated
17 Feb 2017
Data monitoring committee
No

Publications

  • Rodbard HW, Visco VE, Andersen H, Hiort LC, Shu DH. Treatment intensification with stepwise addition of prandial insulin aspart boluses compared with full basal-bolus therapy (FullSTEP Study): a randomised, treat-to-target clinical trial. Lancet Diabetes Endocrinol. 2014 Jan;2(1):30-7. doi: 10.1016/S2213-8587(13)70090-1. Epub 2013 Sep 25.

    PubMed 24622667

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing insulin aspart and insulin detemir in people with Diabetes and Diabetes Mellitus, Type 2, run by Novo Nordisk A/S at 67 sites in 7 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 67 sites in United States, Canada, Argentina, Brazil, France and 2 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Jun 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Glycosylated Haemoglobin (HbA1c) From Baseline to Week 32 (time frame: Week 0, Week 32). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01165684, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2017.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in