Comparison of Different Insulin Dosing Algorithms Using Hepatic Directed Vesicle-Insulin Lispro and Insulin Degludec

Diabetes Mellitus, Type 1 Clinical Trial

Official title:

An Exploratory Randomized Open-Label 2-Arm Comparison of Insulin Dosing Algorithms Using Hepatic Directed Vesicle-Insulin Lispro and Insulin Degludec to Determine Optimum Basal Insulin Dosing Regimens in Type 1 Diabetes Mellitus Subjects

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03938740
• Other study ID #: DP 01-2019-01
• Status: Completed
• Phase: Phase 2
• Start date: March 18, 2019
• Est. completion date: March 18, 2020

Study information

• Verified date: March 2020
• Source: Diasome Pharmaceuticals
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Multi-center, open-label, multiple dose safety, tolerability and efficacy study

Description:

This is a 24-week, open-label, multiple dose safety, tolerability and efficacy study. There is a 12-week run-in phase when all subjects receive Insulin Lispro and Insulin Degludec for 12 weeks. After completing the run-in period, subjects then are randomized to a treatment group of either HDV- Insulin lispro + Insulin Degludec (Degludec dose reduced by 40%) or HDV-Insulin lispro+ Insulin Degludec (Degludec dose reduced by 10%) for 12 weeks of treatment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 61
• Est. completion date: March 18, 2020
• Est. primary completion date: December 6, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

1. Male or female of age 18 to 65 years, inclusive.

2. If female of child-bearing potential, must agree for the duration of the study. to use adequate contraceptive measures, such as, intra-uterine device [IUD], oral or injectable contraceptives, or barrier method plus spermicide.

3. Has at Screening been diagnosed as T1DM for at least 12 months.

4. Has at Screening C-peptide =0.8 ng/mL (single retest allowed).

5. Has at Screening been on treatment with rapid analog insulin for the previous six (6) months.

6. Has at Screening willingness to use continuous glucose monitoring (CGM) technology throughout study.

7. Is, for the duration of the study, willing to use insulin lispro as the only analog bolus insulin and insulin degludec as the only basal insulin.

8. Has at Screening a BMI =18.0 kg/m2 and =33.0 kg/m2.

9. Has at Screening HbA1c =6.5% and =8.5%.

Exclusion Criteria:

1. Has known or suspected allergy to any component of any of the study drugs in this trial.

2. Is, at Screening, pregnant or breast-feeding, or intends to become pregnant at any time during the duration of the study.

3. Has, at Screening, as judged by the Site Investigator, a history or current evidence of any of the following complications of diabetes: proliferative retinopathy or maculopathy, severe neuropathy (in particular, autonomic neuropathy), symptomatic gastroparesis.

4. Is, at Screening, judged by the Site Investigator to have a current addiction to alcohol or substances of abuse.

5. Is, at Screening, using one or more drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia (e.g., beta blockers, systemic corticosteroids at pharmacologic doses, cancer chemotherapies.).

6. Has at Screening any of the following findings, unless approved by both the Site Investigator and the Medical Monitor:

• Uncontrolled hypertension, defined as diastolic blood pressure = 100 mmHg and/or systolic blood pressure = 160 mmHg after 5 minutes in the sitting position;

• History of or findings on EKG of cardiac arrhythmia or conduction defect;

• Clinically significant abnormalities on Screening laboratory studies

7. Has, within one (1) month prior to Screening, used either oral anti-diabetic medication or non-insulin anti-diabetic injection therapies (e.g. SGLT-2 inhibitors, pramlintide, GLP-1 agonists, etc.).

8. Has, within one (1) month prior to Screening, received any investigational drug.

9. Has, within two (2) months prior to Screening, used an insulin pump delivery system.

10. Has, within three (3) months prior to Screening, smoked tobacco or used any smokeless tobacco or nicotine delivery system (inhaled, oral or buccal).

11. Has at Screening, as judged by the Site Investigator, any condition (intrinsic or extrinsic) that could reasonably be expected to interfere with trial participation, confound evaluation of the data, or pose additional risk to adhering to the study protocol. Examples of such conditions include but are not limited to:

• Clinically significant active disease of the gastrointestinal, cardiovascular, hepatic, neurological, renal, genitourinary, or hematological systems;

• History of such an illness or disease

• Diminished mental capacity, psychological or behavioral dysfunction, unwilling or resistant to protocol requirements, language barriers

Related Conditions & MeSH terms

• Diabetes Mellitus
• Diabetes Mellitus, Type 1

Intervention

Drug:
• HDV-Insulin Lispro and Insulin Degludec (-40%)
HDV-Insulin Lispro and Insulin Degludec (-40%)
• HDV-Insulin Lispro and Insulin Degludec (-10%)
HDV-Insulin Lispro and Insulin Degludec (-10%)

Locations

Country	Name	City	State
United States	Atlanta Diabetes Associates	Atlanta	Georgia
United States	Barbara Davis Center for Diabetes	Aurora	Colorado
United States	Texas Diabetes & Endocrinology, PA	Austin	Texas
United States	Diabetes & Endocrinology Consultants, PC	Morehead City	North Carolina
United States	Endocrine Research Solutions, Inc.	Roswell	Georgia
United States	Texas Diabetes & Endocrinology, PA	Round Rock	Texas
United States	Mills-Peninsula Medical Center, Diabetes Research Institute	San Mateo	California

Sponsors (1)

Lead Sponsor	Collaborator
Diasome Pharmaceuticals

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Basal, bolus and total insulin doses (UOM=units) during the last 2 weeks of the treatment period	Basal, bolus and total insulin doses (UOM=units) during the last 2 weeks of the treatment period	24 weeks
Primary	Basal/bolus ratios during the last 2 weeks of the treatment period	Basal/bolus ratios during the last 2 weeks of the treatment period	24 weeks