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Equivalence of A Stable Liquid Glucagon Formulation With Freshly Reconstituted Lyophilized Glucagon

Primary Purpose

Type 1 Diabetes

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Xeris glucagon
Lilly glucagon
Sponsored by
Steven J. Russell, MD, PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes focused on measuring bionic pancreas, artificial pancreas, insulin, glucagon, clamp

Eligibility Criteria

21 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 21 to 80 years old with type 1 diabetes for at least one year.
  • Diabetes managed using an insulin infusion pump using rapid-acting insulin such as insulin aspart (NovoLog), insulin lispro (Humalog), and insulin glulisine (Apidra) for at least one week prior to enrollment.

Exclusion Criteria:

  • Unable to provide informed consent.
  • Unable to comply with study procedures.
  • Current participation in another diabetes-related clinical trial that, in the judgment of the principle investigator, will compromise the results of the clamp study or the safety of the subject.
  • Pregnancy (positive urine HCG), breast feeding, plan to become pregnant in the immediate future, or sexually active without use of contraception.
  • End stage renal disease on dialysis (hemodialysis or peritoneal dialysis).
  • Hemoglobin < 11.5 gm/dl.
  • History of pheochromocytoma. Fractionated metanephrines will be tested in patients with history increasing the risk for a catecholamine secreting tumor (paroxysms of tachycardia, pallor, or headache; personal or family history of MEN 2A, MEN 2B, neurofibromatosis, or von Hippel-Lindau disease; episodic or treatment of refractory hypertension, defined as requiring 4 or more medications to achieve normotension).
  • History of adverse reaction to glucagon (including allergy) besides nausea, vomiting, or headache.
  • Inadequate venous access as determined by study nurse or physician at time of screening.
  • Liver failure or cirrhosis.
  • Any other factors that, in the judgment of the principal investigator, would interfere with the safe completion of the study procedures.

Sites / Locations

  • Massachusetts General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Xeris glucagon

Lilly glucagon

Arm Description

Xeris glucagon 50 micrograms, subcutaneous injection

Lilly glucagon 30 micrograms, subcutaneous injection

Outcomes

Primary Outcome Measures

Tmax
tmax for Xeris vs. Lilly (non-inferiority)

Secondary Outcome Measures

AOCGIR
Area over the curve for glucose infusion rate in the hour following administration (AOCGIR) for Xeris vs. Lilly (non-inferiority)
GIRmin
Minimal glucose infusion rate (GIRmin) for Xeris vs. Lilly (non-inferiority)
t½Max
Glucagon t½max for Xeris vs. Lilly (non-inferiority)
Injection Pain
Quantitation of adverse events related to glucagon injection for Xeris vs. Lilly: -average Injection pain on a 10 cm standard VAS: 0 = no pain, 10 = worst imaginable pain reported immediately after injection of glucagon
Injection Site Erythema
Quantitation of adverse events related to glucagon injection for Xeris vs. Lilly: -Injection site erythema or other local reaction, maximum diameter within 1 hour of injection
Maximal Nausea
Quantitation of adverse events related to glucagon injection for Xeris vs. Lilly: -Maximal nausea within 1 hour of injection on a 10 cm VAS: no nausea = 0, vomiting = 10
Dermal Response (Draize Scale for Erythema and Eschar Formation)
Average grade on the erythema and eschar formation portion of the Draize scale for dermal response (0 being the lowest, 4 being the highest)
Dermal Response (Draize Scale Grade for Edema Formation)
Average grade on the edema formation portion of the Draize scale for dermal response (0 being the lowest, 4 being the highest)

Full Information

First Posted
December 16, 2013
Last Updated
September 17, 2019
Sponsor
Steven J. Russell, MD, PhD
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1. Study Identification

Unique Protocol Identification Number
NCT02018627
Brief Title
Equivalence of A Stable Liquid Glucagon Formulation With Freshly Reconstituted Lyophilized Glucagon
Official Title
Equivalence of A Stable Liquid Glucagon Formulation With Freshly Reconstituted Lyophilized Glucagon
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
April 2014 (undefined)
Primary Completion Date
August 2, 2018 (Actual)
Study Completion Date
August 2, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Steven J. Russell, MD, PhD

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will test the hypothesis that micro-doses of Xerisol Glucagon (Xeris Pharmaceuticals) will be non-inferior by pharmacokinetic and pharmacodynamic criteria vs. micro-doses of Glucagon for Injection (Eli Lilly).
Detailed Description
This study will test the hypothesis that micro-doses of a new formulation of stable glucagon, Xerisol Glucagon (Xeris Pharmaceuticals), will be non-inferior by pharmacokinetic and pharmacodynamic criteria vs. micro-doses of a freshly reconstituted formulation of glucagon that has poor stability in solution, Glucagon for Injection (Eli Lilly).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes
Keywords
bionic pancreas, artificial pancreas, insulin, glucagon, clamp

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Xeris glucagon
Arm Type
Experimental
Arm Description
Xeris glucagon 50 micrograms, subcutaneous injection
Arm Title
Lilly glucagon
Arm Type
Active Comparator
Arm Description
Lilly glucagon 30 micrograms, subcutaneous injection
Intervention Type
Drug
Intervention Name(s)
Xeris glucagon
Intervention Description
The subject is given an injection of xeris glucagon
Intervention Type
Drug
Intervention Name(s)
Lilly glucagon
Intervention Description
The subject is given an injection of lilly glucagon
Primary Outcome Measure Information:
Title
Tmax
Description
tmax for Xeris vs. Lilly (non-inferiority)
Time Frame
every 2 minutes for 1 hour post-dose of each glucagon
Secondary Outcome Measure Information:
Title
AOCGIR
Description
Area over the curve for glucose infusion rate in the hour following administration (AOCGIR) for Xeris vs. Lilly (non-inferiority)
Time Frame
every 2 minutes for 1 hour post-dose of each glucagon
Title
GIRmin
Description
Minimal glucose infusion rate (GIRmin) for Xeris vs. Lilly (non-inferiority)
Time Frame
every 2 minutes for 1 hour post-dose of each glucagon
Title
t½Max
Description
Glucagon t½max for Xeris vs. Lilly (non-inferiority)
Time Frame
every 2 minutes for 1 hour post-dose of each glucagon
Title
Injection Pain
Description
Quantitation of adverse events related to glucagon injection for Xeris vs. Lilly: -average Injection pain on a 10 cm standard VAS: 0 = no pain, 10 = worst imaginable pain reported immediately after injection of glucagon
Time Frame
immediately after injection
Title
Injection Site Erythema
Description
Quantitation of adverse events related to glucagon injection for Xeris vs. Lilly: -Injection site erythema or other local reaction, maximum diameter within 1 hour of injection
Time Frame
within 1 hour of injection
Title
Maximal Nausea
Description
Quantitation of adverse events related to glucagon injection for Xeris vs. Lilly: -Maximal nausea within 1 hour of injection on a 10 cm VAS: no nausea = 0, vomiting = 10
Time Frame
within 1 hour of injection
Title
Dermal Response (Draize Scale for Erythema and Eschar Formation)
Description
Average grade on the erythema and eschar formation portion of the Draize scale for dermal response (0 being the lowest, 4 being the highest)
Time Frame
within 1 hour of injection
Title
Dermal Response (Draize Scale Grade for Edema Formation)
Description
Average grade on the edema formation portion of the Draize scale for dermal response (0 being the lowest, 4 being the highest)
Time Frame
within 1 hour of injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 21 to 80 years old with type 1 diabetes for at least one year. Diabetes managed using an insulin infusion pump using rapid-acting insulin such as insulin aspart (NovoLog), insulin lispro (Humalog), and insulin glulisine (Apidra) for at least one week prior to enrollment. Exclusion Criteria: Unable to provide informed consent. Unable to comply with study procedures. Current participation in another diabetes-related clinical trial that, in the judgment of the principle investigator, will compromise the results of the clamp study or the safety of the subject. Pregnancy (positive urine HCG), breast feeding, plan to become pregnant in the immediate future, or sexually active without use of contraception. End stage renal disease on dialysis (hemodialysis or peritoneal dialysis). Hemoglobin < 11.5 gm/dl. History of pheochromocytoma. Fractionated metanephrines will be tested in patients with history increasing the risk for a catecholamine secreting tumor (paroxysms of tachycardia, pallor, or headache; personal or family history of MEN 2A, MEN 2B, neurofibromatosis, or von Hippel-Lindau disease; episodic or treatment of refractory hypertension, defined as requiring 4 or more medications to achieve normotension). History of adverse reaction to glucagon (including allergy) besides nausea, vomiting, or headache. Inadequate venous access as determined by study nurse or physician at time of screening. Liver failure or cirrhosis. Any other factors that, in the judgment of the principal investigator, would interfere with the safe completion of the study procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven J Russell, MD, PhD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States

12. IPD Sharing Statement

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Equivalence of A Stable Liquid Glucagon Formulation With Freshly Reconstituted Lyophilized Glucagon

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