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A Study to Evaluate the Safety and Effectiveness of DM199 in Healthy Subjects and Type 2 Diabetes Patients

Primary Purpose

Diabetes Type 2

Status
Completed
Phase
Phase 1
Locations
Netherlands
Study Type
Interventional
Intervention
DM199
Placebo
Sponsored by
DiaMedica Therapeutics Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Type 2 focused on measuring type 2 diabetes, diabetes mellitus, type 2 diabetes mellitus, HbA1c, blood glucose, glucose control, DiaMedica, DM-199, DM199, recombinant human tissue kallikrein-1, tissue kallikrein-1

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Status : Parts A and C: healthy subjects

    • Parts B and D: type 2 diabetes mellitus patients :
  2. Body Mass Index : Parts A and C: 18.0 - 30.0 kg/m2

    • Parts B and D: 25.0 - 35.0 kg/m2
  3. HbA1c : Parts B and D: at screening between 6.5% and 9.0%, inclusive for patients using one oral anti-diabetic medication, and between 6.0% and 8.5%, inclusive for patients using two or more oral anti-diabetic medications
  4. Fasting blood glucose : Parts B and D: within 7.5-13.5 mmol/L, inclusive at entry into the clinical research center (Day -1 for Part B or Day -2 for Part D)
  5. Women of childbearing potential agree to use an appropriate contraceptive method (hormonal, IUD, or diaphragm) until 90 days after the follow-up visit. For males: willingness to use adequate contraception from entry in the clinical research center until 90 days after the follow-up visit
  6. Medical history without clinically significant abnormalities
  7. Parts B and D: Taking a stable dose of one or more oral anti-diabetic medications, such as metformin, sulphonylurea or any other orally administered glucose lowering medication (except for thiazolidinediones) for at least 3 months prior to screening. Receiving no other chronic medications, including dietary supplements, that alter blood glucose control.
  8. Parts A and C: Resting supine blood pressure of 140/90 mmHg or lower and higher than 90/50mmHg at screening, and showing no clinically relevant deviations as judged by the Principal Investigator
  9. Parts B and D: Resting supine blood pressure of 160/100 mmHg or lower and higher than 90/50mmHg at screening, and showing no clinically relevant deviations as judged by the Principal Investigator

Exclusion Criteria:

  1. Evidence of clinically relevant pathology
  2. Pregnancy or lactation
  3. For healthy volunteers: use of concomitant medication, except for acetaminophen (paracetamol), which is allowed up to 3 days before entry into the clinical research center (after that time the use of a limited amount of acetaminophen is permitted after consultation with the Principal Investigator). Multivitamins and vitamin C are allowed up to 7 days before entry into the clinical research center. All other medication (including over the counter medication, health supplements, and herbal remedies such as St. John's Wort extract) must have been stopped at least 14 days prior to entry into the clinical research center.
  4. Participation in a drug study within 60 days prior to drug administration. Participation in more than 3 other drug studies (for men) / more than 2 other drug studies (for women) in the 10 months preceding the start of this study)
  5. Positive drug screen (opiates, methadone, cocaine, amphetamines, cannabinoids, barbiturates, benzodiazepines, tricyclic antidepressants and alcohol)
  6. Intake of more than 24 units of alcohol per week (one unit of alcohol equals approximately 250 mL of beer, 100 mL of wine or 35 mL of spirits)
  7. Positive screen on HBsAg, anti-HCV or anti-HIV 1/2
  8. Illness within 7 days prior to (the first) drug administration
  9. Serum creatinine > upper limit of the normal (ULN) range

    Additional Exclusion Criteria Specific to Type 2 Diabetes Mellitus Patients (Part B and Part D)

  10. The use of insulin and thiazolidinediones for type 2 diabetes mellitus 3 months prior to screening is not allowed.
  11. The use of angiotensin converting enzyme (ACE) inhibitors 1 month prior to screening is not allowed.
  12. History of diabetic ketoacidosis or hyperosmolar coma
  13. Advanced diabetic complications, including neuropathy, nephropathy, retinopathy or other symptoms

Sites / Locations

  • PRA

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Placebo Comparator

Placebo Comparator

Placebo Comparator

Arm Label

Part A - SAD in healthy subjects

Part B - SAD in type 2 diabetic patients

Part C - MAD in healthy subjects

Part D - POC in type 2 diabetes patients

Part A - Healthy subjects SAD placebo

Part B - Type 2 diabetic patients SAD placebo

Part C - Healthy subjects MAD placebo

Part D - Type 2 diabetic patients POC placebo

Arm Description

A randomized, double-blinded, placebo-controlled, single ascending dose (SAD) study in healthy male and/or female subjects. Subjects will receive DM199 subcutaneously (sc).

A randomized, partially double-blinded, placebo-controlled, sequential SAD study in male and/or female type 2 diabetes mellitus patients. Subjects will receive DM199 subcutaneously (sc).

A randomized, double-blinded, placebo-controlled, 14-day multiple ascending dose (MAD) study in healthy male and/or female subjects each. Subjects will receive sequential doses of DM199 sc for 14 days.

A randomized, double-blinded, placebo-controlled, 28-day multiple-dose proof of concept (POC) study in male and/or female type 2 diabetes mellitus patients. Subjects will receive doses of DM199 sc for 28 days.

A randomized, double-blinded, placebo-controlled, single ascending dose (SAD) study in healthy male and/or female subjects. Subjects will receive placebo subcutaneously (sc).

A randomized, partially double-blinded, placebo-controlled, sequential SAD study in male and/or female type 2 diabetes mellitus patients. Subjects will receive placebo subcutaneously (sc).

A randomized, double-blinded, placebo-controlled, 14-day multiple ascending dose (MAD) study in healthy male and/or female subjects each. Subjects will receive placebo sc for 14 days.

A randomized, double-blinded, placebo-controlled, 28-day multiple-dose proof of concept (POC) study in male and/or female type 2 diabetes mellitus patients. Subjects will receive placebo sc for 28 days.

Outcomes

Primary Outcome Measures

Safety and tolerability of single and multiple subcutaneous doses of DM199
Number of participants with adverse events in the single and multiple ascending dose studies.
Determine the pharmacokinetic of DM199 after single and multiple doses
Determine the plasma pharmacokinetic profile of DM199 after administration of single and multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients. Measure plasma DM199 levels in individual participants.

Secondary Outcome Measures

Determine the effect of DM199 on glucose homeostasis in healthy volunteers and type 2 diabetes mellitus patients
Determine the effect of DM199 on glucose homeostasis (via fasting glucose and HbA1c levels), standardized meal tolerance test, C-peptide, fructosamine, GLP-1 (active and total), glucagon, adiponectin and lipids measurements, and homeostatic model assessment of insulin resistance/beta cell function (HOMA) determination in type 2 diabetes mellitus patients
Assess formation of ADA to DM199
Assess the formation of antibodies to DM199 after administration of multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients
Determine changes in immune cell populations by FACS analysis.
Determine changes in immune cell populations by fluorescence-activated cell sorting analysis following multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients

Full Information

First Posted
April 23, 2013
Last Updated
December 17, 2014
Sponsor
DiaMedica Therapeutics Inc
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1. Study Identification

Unique Protocol Identification Number
NCT01845064
Brief Title
A Study to Evaluate the Safety and Effectiveness of DM199 in Healthy Subjects and Type 2 Diabetes Patients
Official Title
A Double-Blinded, Placebo-Controlled, Single-Dose and Multiple-Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics and Proof of Concept of DM199 in Healthy Subjects and Patients With Type 2 Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
December 2014
Overall Recruitment Status
Completed
Study Start Date
April 2013 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
DiaMedica Therapeutics Inc

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
DM199 (recombinant human tissue kallikrein-1) is a new investigational compound that may eventually be used for the treatment of Diabetes Mellitus Type 2. This is the first time that this compound is being given to humans. The purpose of the study is to investigate to what extent DM199 is safe and tolerated. Further, it will be investigated how quickly and to what extent DM99 is absorbed and eliminated from the body (this is called pharmacokinetics). In addition, the effect of the compound on the body will be investigated (this is called pharmacodynamics). This study is not intended to improve anyone's health, but is necessary for the further development of DM199. The study consists of 4 parts. Each part (A, B, C and D) will consist of one or several periods. The research will be conducted in healthy male and female volunteers (Part A and C) and in male and female type 2 diabetes mellitus patients (Part B and D).
Detailed Description
DM199 (recombinant human tissue kallikrein-1) is being developed as a new biological treatment for type 2 diabetes mellitus. This is a first-in-human study for DM199 and is a 4-part, single center study in healthy subjects and type 2 diabetes mellitus patients. Part A will be a randomized, double-blinded, placebo-controlled, single ascending dose (SAD) study in healthy male and/or female subjects. Subjects will receive DM199 or placebo subcutaneously (sc). Part B will be a randomized, partially double-blinded, placebo-controlled, sequential SAD study in male and/or female type 2 diabetes mellitus patients. Part C will be a randomized, double-blinded, placebo-controlled, 14-day multiple ascending dose (MAD) study in healthy male and/or female subjects each. Subjects will receive sequential doses of DM-199 or placebo sc for 14 days. Part D will be a randomized, double-blinded, placebo-controlled, 28-day multiple-dose proof of concept (POC) study in male and/or female type 2 diabetes mellitus patients. Subjects will receive parallel doses of DM199 or placebo sc for 28 days. The primary objective is to evaluate the safety and tolerability of single and multiple subcutaneous doses of DM199 in healthy subjects and type 2 diabetes mellitus patients. Another objective is to determine the plasma pharmacokinetic profile of DM199 after administration of single and multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients. Secondary objectives include determining the effect of DM199 on glucose homeostasis (via fasting glucose and HbA1c levels), standardized meal tolerance test, C-peptide, fructosamine, GLP-1 (active and total), glucagon, adiponectin and lipids measurements, and homeostatic model assessment of insulin resistance/beta cell function (HOMA) determination in type 2 diabetes mellitus patients; assessing the formation of antibodies to DM199 after administration of multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients; and determining changes in immune cell populations by fluorescence-activated cell sorting analysis following multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Type 2
Keywords
type 2 diabetes, diabetes mellitus, type 2 diabetes mellitus, HbA1c, blood glucose, glucose control, DiaMedica, DM-199, DM199, recombinant human tissue kallikrein-1, tissue kallikrein-1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
98 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part A - SAD in healthy subjects
Arm Type
Experimental
Arm Description
A randomized, double-blinded, placebo-controlled, single ascending dose (SAD) study in healthy male and/or female subjects. Subjects will receive DM199 subcutaneously (sc).
Arm Title
Part B - SAD in type 2 diabetic patients
Arm Type
Experimental
Arm Description
A randomized, partially double-blinded, placebo-controlled, sequential SAD study in male and/or female type 2 diabetes mellitus patients. Subjects will receive DM199 subcutaneously (sc).
Arm Title
Part C - MAD in healthy subjects
Arm Type
Experimental
Arm Description
A randomized, double-blinded, placebo-controlled, 14-day multiple ascending dose (MAD) study in healthy male and/or female subjects each. Subjects will receive sequential doses of DM199 sc for 14 days.
Arm Title
Part D - POC in type 2 diabetes patients
Arm Type
Experimental
Arm Description
A randomized, double-blinded, placebo-controlled, 28-day multiple-dose proof of concept (POC) study in male and/or female type 2 diabetes mellitus patients. Subjects will receive doses of DM199 sc for 28 days.
Arm Title
Part A - Healthy subjects SAD placebo
Arm Type
Placebo Comparator
Arm Description
A randomized, double-blinded, placebo-controlled, single ascending dose (SAD) study in healthy male and/or female subjects. Subjects will receive placebo subcutaneously (sc).
Arm Title
Part B - Type 2 diabetic patients SAD placebo
Arm Type
Placebo Comparator
Arm Description
A randomized, partially double-blinded, placebo-controlled, sequential SAD study in male and/or female type 2 diabetes mellitus patients. Subjects will receive placebo subcutaneously (sc).
Arm Title
Part C - Healthy subjects MAD placebo
Arm Type
Placebo Comparator
Arm Description
A randomized, double-blinded, placebo-controlled, 14-day multiple ascending dose (MAD) study in healthy male and/or female subjects each. Subjects will receive placebo sc for 14 days.
Arm Title
Part D - Type 2 diabetic patients POC placebo
Arm Type
Placebo Comparator
Arm Description
A randomized, double-blinded, placebo-controlled, 28-day multiple-dose proof of concept (POC) study in male and/or female type 2 diabetes mellitus patients. Subjects will receive placebo sc for 28 days.
Intervention Type
Drug
Intervention Name(s)
DM199
Other Intervention Name(s)
recombinant human tissue kallikrein-1, tissue kallikrein-1
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Safety and tolerability of single and multiple subcutaneous doses of DM199
Description
Number of participants with adverse events in the single and multiple ascending dose studies.
Time Frame
Up to 13 days after final dose
Title
Determine the pharmacokinetic of DM199 after single and multiple doses
Description
Determine the plasma pharmacokinetic profile of DM199 after administration of single and multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients. Measure plasma DM199 levels in individual participants.
Time Frame
Up to 3 days after final dose
Secondary Outcome Measure Information:
Title
Determine the effect of DM199 on glucose homeostasis in healthy volunteers and type 2 diabetes mellitus patients
Description
Determine the effect of DM199 on glucose homeostasis (via fasting glucose and HbA1c levels), standardized meal tolerance test, C-peptide, fructosamine, GLP-1 (active and total), glucagon, adiponectin and lipids measurements, and homeostatic model assessment of insulin resistance/beta cell function (HOMA) determination in type 2 diabetes mellitus patients
Time Frame
Part C, Day -1 and 14; Part D, Days -1, 14 and 28
Title
Assess formation of ADA to DM199
Description
Assess the formation of antibodies to DM199 after administration of multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients
Time Frame
Part C, Day -1 and 42; Part D, Day -1 and 35
Title
Determine changes in immune cell populations by FACS analysis.
Description
Determine changes in immune cell populations by fluorescence-activated cell sorting analysis following multiple doses of DM199 in healthy subjects and type 2 diabetes mellitus patients
Time Frame
Part C, Day -1 and 15; Part D, Day -1 and 29

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Status : Parts A and C: healthy subjects Parts B and D: type 2 diabetes mellitus patients : Body Mass Index : Parts A and C: 18.0 - 30.0 kg/m2 Parts B and D: 25.0 - 35.0 kg/m2 HbA1c : Parts B and D: at screening between 6.5% and 9.0%, inclusive for patients using one oral anti-diabetic medication, and between 6.0% and 8.5%, inclusive for patients using two or more oral anti-diabetic medications Fasting blood glucose : Parts B and D: within 7.5-13.5 mmol/L, inclusive at entry into the clinical research center (Day -1 for Part B or Day -2 for Part D) Women of childbearing potential agree to use an appropriate contraceptive method (hormonal, IUD, or diaphragm) until 90 days after the follow-up visit. For males: willingness to use adequate contraception from entry in the clinical research center until 90 days after the follow-up visit Medical history without clinically significant abnormalities Parts B and D: Taking a stable dose of one or more oral anti-diabetic medications, such as metformin, sulphonylurea or any other orally administered glucose lowering medication (except for thiazolidinediones) for at least 3 months prior to screening. Receiving no other chronic medications, including dietary supplements, that alter blood glucose control. Parts A and C: Resting supine blood pressure of 140/90 mmHg or lower and higher than 90/50mmHg at screening, and showing no clinically relevant deviations as judged by the Principal Investigator Parts B and D: Resting supine blood pressure of 160/100 mmHg or lower and higher than 90/50mmHg at screening, and showing no clinically relevant deviations as judged by the Principal Investigator Exclusion Criteria: Evidence of clinically relevant pathology Pregnancy or lactation For healthy volunteers: use of concomitant medication, except for acetaminophen (paracetamol), which is allowed up to 3 days before entry into the clinical research center (after that time the use of a limited amount of acetaminophen is permitted after consultation with the Principal Investigator). Multivitamins and vitamin C are allowed up to 7 days before entry into the clinical research center. All other medication (including over the counter medication, health supplements, and herbal remedies such as St. John's Wort extract) must have been stopped at least 14 days prior to entry into the clinical research center. Participation in a drug study within 60 days prior to drug administration. Participation in more than 3 other drug studies (for men) / more than 2 other drug studies (for women) in the 10 months preceding the start of this study) Positive drug screen (opiates, methadone, cocaine, amphetamines, cannabinoids, barbiturates, benzodiazepines, tricyclic antidepressants and alcohol) Intake of more than 24 units of alcohol per week (one unit of alcohol equals approximately 250 mL of beer, 100 mL of wine or 35 mL of spirits) Positive screen on HBsAg, anti-HCV or anti-HIV 1/2 Illness within 7 days prior to (the first) drug administration Serum creatinine > upper limit of the normal (ULN) range Additional Exclusion Criteria Specific to Type 2 Diabetes Mellitus Patients (Part B and Part D) The use of insulin and thiazolidinediones for type 2 diabetes mellitus 3 months prior to screening is not allowed. The use of angiotensin converting enzyme (ACE) inhibitors 1 month prior to screening is not allowed. History of diabetic ketoacidosis or hyperosmolar coma Advanced diabetic complications, including neuropathy, nephropathy, retinopathy or other symptoms
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Salah Hadi, MD, MSc
Organizational Affiliation
PRA
Official's Role
Principal Investigator
Facility Information:
Facility Name
PRA
City
Zuidlaren
ZIP/Postal Code
9471 GP
Country
Netherlands

12. IPD Sharing Statement

Learn more about this trial

A Study to Evaluate the Safety and Effectiveness of DM199 in Healthy Subjects and Type 2 Diabetes Patients

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