Official Protocol Title: A Phase IV, Multicenter, Randomized, Placebo-Controlled, Parallel-Group, Double-Blind Trial and Subsequent Open-Label, Extension Trial to Assess the Safety and Efficacy of Addition of Omarigliptin in Japanese Patients with Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Insulin Monotherapy in Addition to Diet and Exercise Therapy NCT number: NCT02906709 Document Date: 10-Mar-2017 Product: MK -3102 1 Protocol/Amendment No.: 039-01 THIS PROTOCOL AND ALL OF THE INFORMATION RELATING TO IT ARE CONFIDENTIAL AND PROPRIETARY PROPERTY OF MERCK SHARP & DOHME CORP., A SUBSIDIARY OF MERCK & CO., INC., WHITEHOUSE STATION, NJ, U.S.A. SPONSOR: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. (hereafter referred to as the Sponsor or Merck) One Merck Drive P.O. Box 100 Whitehouse Station, New Jersey, 08889-0100, U.S.A. Protocol-specific Sponsor Contact information can be found in the Investigator Trial File Binder (or equivalent). TITLE: A Phase IV, Multicenter, Randomized, Placebo-Controlled, Parallel-Group, Double-Blind Trial and Subsequent Open-Label, Extension Trial to Assess the Safety and Efficacy of Addition of Omarigliptin in Japanese Patients with Type 2 Diabetes Mellitus Who Have Inadequate Glycemic Control on Insulin Monotherapy in Addition to Diet and Exercise Therapy EudraCT NUMBER: Not Applicable MK-3102-039-01 Final Protocol 10-Mar-2017 04MKJ4 Confidential Product: MK-3102 2 Protocol/Amendment No.: 039-01 TABLE OF CONTENTS SUMMARY OF CHANGES................................................................................................ 10 1.0 TRIAL SUMMARY.................................................................................................. 11 2.0 TRIAL DESIGN........................................................................................................ 11 2.1 Trial Design ........................................................................................................... 11 2.2 Trial Diagram........................................................................................................ 13 3.0 OBJECTIVE(S) & HYPOTHESIS(ES).................................................................. 14 3.1 Primary Objective(s) & Hypothesis(es) .............................................................. 14 3.2 Secondary Objective(s) & Hypothesis(es)........................................................... 14 4.0 BACKGROUND & RATIONALE.......................................................................... 14 4.1 Background ........................................................................................................... 14 4.1.1 Pharmaceutical and Therapeutic Background .................................................... 15 4.2 Rationale................................................................................................................ 16 4.2.1 Rationale for the Trial and Selected Subject Population .................................... 16 4.2.2 Rationale for Dose Selection/Regimen ............................................................... 17 4.2.2.1 Rationale for the Use of Placebo ................................................................. 17 4.2.2.1.1 Rationale for the use of placebo for the pre-treatment period .............. 17 4.2.2.1.2 Rationale for the use of placebo for the treatment period..................... 17 4.2.2.2 Rationale for Duration of Treatment Period ................................................ 17 4.2.3 Rationale for Endpoints ...................................................................................... 18 4.2.3.1 Efficacy Endpoints....................................................................................... 18 4.2.3.2 Safety Endpoints .......................................................................................... 18 4.2.3.3 Future Biomedical Research ........................................................................ 18 4.3 Benefit/Risk ........................................................................................................... 18 5.0 METHODOLOGY ................................................................................................... 19 5.1 Entry Criteria........................................................................................................ 19 5.1.1 Diagnosis/Condition for Entry into the Trial ...................................................... 19 5.1.2 Subject Inclusion Criteria.................................................................................... 19 5.1.3 Subject Exclusion Criteria .................................................................................. 22 MK-3102-039-01 Final Protocol 10-Mar-2017 04MKJ4 Confidential Product: MK-3102 3 Protocol/Amendment No.: 039-01 5.2 Trial Treatment(s) ................................................................................................ 26 5.2.1 Dose Selection .................................................................................................... 27 5.2.1.1 Dose Selection (Preparation) ....................................................................... 27 5.2.2 Timing of Dose Administration .......................................................................... 27 5.2.2.1 Administration of study medication............................................................. 27 5.2.2.2 Timing of Dosing of Pre-Treatment Period, and Treatment Period Medication on Days of Study Visits............................................................ 28 5.2.2.3 Handling of Missed Doses ........................................................................... 28 5.2.3 Trial Blinding...................................................................................................... 28 5.3 Randomization or Treatment Allocation............................................................ 28 5.4 Stratification.......................................................................................................... 29 5.5 Concomitant Medications/Vaccinations (Allowed & Prohibited) .................... 29 5.5.1 Prohibited medications........................................................................................ 29 5.5.2 Limited Concomitant Medications ..................................................................... 30 5.6 Rescue Medications & Supportive Care ............................................................. 30 5.6.1 Rescue treatment (up-titration of insulin) ........................................................... 30 5.6.2 Down-titration of insulin..................................................................................... 31 5.7 Diet/Activity/Other Considerations..................................................................... 31 5.7.1 Diet therapy......................................................................................................... 31 5.7.2 Exercise therapy.................................................................................................. 31 5.7.3 Insulin therapy .................................................................................................... 31 5.8 Subject Withdrawal/Discontinuation Criteria ................................................... 32 5.9 Subject Replacement Strategy............................................................................. 34 5.10 Beginning and End of the Trial ........................................................................... 35 5.11 Clinical Criteria for Early Trial Termination ................................................... 35 6.0 TRIAL FLOW CHART ........................................................................................... 36 7.0 TRIAL PROCEDURES ........................................................................................... 39 7.1 Trial Procedures ................................................................................................... 39 7.1.1 Administrative Procedures.................................................................................. 39 7.1.1.1 Informed Consent......................................................................................... 39 7.1.1.1.1 General Informed Consent.................................................................... 39 MK-3102-039-01 Final Protocol 10-Mar-2017 04MKJ4 Confidential Product: MK-3102 4 Protocol/Amendment No.: 039-01 7.1.1.1.2 Consent and Collection of Specimens for Future Biomedical Research................................................................................................ 39 7.1.1.2 Inclusion/Exclusion Criteria ........................................................................ 40 7.1.1.2.1 Contraception........................................................................................ 40 7.1.1.3 Subject Identification Card .......................................................................... 40 7.1.1.4 Medical History ........................................................................................... 40 7.1.1.5 Prior and Concomitant Medications Review ............................................... 40 7.1.1.5.1 Prior Medications.................................................................................. 40 7.1.1.5.2 Concomitant Medications ..................................................................... 41 7.1.1.6 Assignment of Screening Number ............................................................... 41 7.1.1.7 Assignment of Treatment/Randomization Number ..................................... 41 7.1.1.8 Trial Compliance (Medication/Diet/Activity/Other)