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Safety and Efficacy Study of Mini-Dose Glucagon (G-Pen Mini) in Patients With Type 1 Diabetes

Primary Purpose

Hypoglycemia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
G-Pen Mini™ (glucagon injection)
Sponsored by
Xeris Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypoglycemia focused on measuring Hypoglycemia, Glucagon, Diabetes

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female subjects on insulin infusion pump therapy for treatment of type 1 diabetes
  2. Between the ages of 18 and 50 years of age, inclusive, at Screening.
  3. Females of childbearing potential with a negative serum pregnancy test prior at screening and negative urine pregnancy tests prior to the Treatment visits, using an approved forms of contraception for the duration of participation in the study (i.e. until after last dose).
  4. Male subjects are required to use a condom and another of the methods of contraception in #3 above starting at Randomization and for the duration of the study.
  5. Hemoglobin A1c (HbA1c) < 9.0 %.
  6. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
  7. Subjects must be willing and able to comply with scheduled visits, treatment, laboratory tests and study procedures.

Exclusion Criteria:

  1. Clinical evidence of microvascular complication(s) other than mild microalbuminuria or history of mild non-proliferative retinopathy
  2. Any chronic diseases or illness that interferes with glucose metabolism, except for T1DM, or medications other than hypothyroidism on appropriate thyroid hormone replacement.
  3. Blood pressure (BP) readings at Screening where Systemic BP <90 or >140 mm Hg, and Diastolic BP <50 or >90 mm Hg.
  4. Cardiovascular event within 6 months prior to screening such as unstable angina, acute coronary syndrome, myocardial infarction, therapeutic coronary procedure (e.g., stent placement, Percutaneous Transluminal Coronary Angioplasty (PTCA), Coronary Artery By-pass Grafting (CABG)), stroke or transient ischemic attack.
  5. Study participants who are pregnant at Screening.
  6. Breast feeding must be discontinued if a subject wishes to participate in this study.
  7. Positive test for hepatitis B, hepatitis C, or HIV found at Screening.
  8. Positive urine drug test for illicit drugs at Screening.
  9. History of allergies to glucagon, glucagon-like products or to any of the excipients in the investigational formulation.
  10. Known presence of hereditary problems of glycogen storage disease, galactose and /or lactose intolerance
  11. Administration of glucagon more than once within the three (3) months prior to Screening
  12. Subjects with any of the following abnormalities in clinical laboratory tests at Screening, confirmed by a single repeat, if necessary:

    • Hemoglobin (Hb) below the lower limits of normal for the laboratory
    • Total bilirubin above the upper limits of normal for the laboratory
    • Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) above the upper limits of normal for the laboratory
    • Creatinine above the upper limits of normal for the laboratory
  13. History of regular alcohol consumption as defined by alcohol intake in a quantity exceeding 7 drinks per week for females or 14 drinks per week for males, where 1 drink = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of hard liquor.
  14. Participation in other studies involving administration of an investigational drug or device within 30 days or 5 half-lives, whichever is longer, before screening for the current study and during participation in the current study
  15. Whole blood donation of 1 pint (500 mL) within 8 weeks prior to Screening. Donations of plasma, packed red blood cells, platelets or quantities less than 500 mL are allowed at investigator discretion.
  16. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.

Sites / Locations

  • Baylor College of Medicine, Children's Nutritional Research Center, Texas Children's Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

G-Pen Mini™ (glucagon injection) 75 ug

G-Pen Mini™ (glucagon injection) 150 ug

G-Pen Mini™ (glucagon injection) 300 ug

Arm Description

G-Pen Mini™ (glucagon injection), two 75 microgram subcutaneous injections given approximately 4-5 hours apart

G-Pen Mini™ (glucagon injection), two 150 microgram subcutaneous injections given approximately 4-5 hours apart

G-Pen Mini™ (glucagon injection), two 300 microgram subcutaneous injections given approximately 4-5 hours apart

Outcomes

Primary Outcome Measures

Serious Adverse Events
Number of serious adverse events (SAEs) per treatment

Secondary Outcome Measures

Glucagon Cmax (Fasting)
Pharmacokinetic parameter: Maximum concentration of glucagon
Glucagon Cmax (Post-insulin)
Pharmacokinetic parameter: Maximum concentration of glucagon
Glucagon Area Under the Curve (AUC) (Fasting)
Pharmacokinetic parameter: Area under the glucagon concentration curve from 0 to 120 minutes
Glucagon AUC (Post-insulin)
Pharmacokinetic parameter: Area under the glucagon concentration curve from 0 to 120 minutes
Glucagon Tmax (Fasting)
Pharmacokinetic parameter: Time to reach maximum concentration of glucagon
Glucagon Tmax (Post-insulin)
Pharmacokinetic parameter: Time to reach maximum concentration of glucagon
Glucose Cmax (Fasting)
Pharmacodynamic parameter: Maximum concentration of glucose
Glucose Cmax (Post-insulin)
Pharmacodynamic parameter: Maximum concentration of glucose
Glucose AUC (Fasting)
Pharmacodynamic parameter: baseline adjusted area under the glucagon concentration curve from 0 to 120 minutes
Glucose AUC (Post-insulin)
Pharmacodynamic parameter: baseline adjusted area under the glucose concentration curve from 0-120 minutes
Glucose Tmax (Fasting)
Pharmacodynamic parameter: Time to reach maximum concentration of glucose
Glucose Tmax (Post-insulin)
Pharmacodynamic parameter: Time to reach maximum concentration of glucose

Full Information

First Posted
March 4, 2014
Last Updated
March 10, 2018
Sponsor
Xeris Pharmaceuticals
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Emissary International LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02081014
Brief Title
Safety and Efficacy Study of Mini-Dose Glucagon (G-Pen Mini) in Patients With Type 1 Diabetes
Official Title
A Randomized, Phase 2a, Blinded, 3-Way Crossover Dose-Ranging Study With G-Pen Mini™ (Glucagon Injection) to Evaluate Safety, Tolerability, Pharmacokinetics and Pharmacodynamics in Patients With Type 1 Diabetes Mellitus (T1DM)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
March 2014 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xeris Pharmaceuticals
Collaborators
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Emissary International LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to demonstrate that mini-doses of stable liquid glucagon (G-Pen Mini) produced by Xeris Pharmaceuticals are safe and effective as a treatment for mild to moderate hypoglycemia, a complication of diabetes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypoglycemia
Keywords
Hypoglycemia, Glucagon, Diabetes

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
Participant
Allocation
Randomized
Enrollment
13 (Actual)

8. Arms, Groups, and Interventions

Arm Title
G-Pen Mini™ (glucagon injection) 75 ug
Arm Type
Experimental
Arm Description
G-Pen Mini™ (glucagon injection), two 75 microgram subcutaneous injections given approximately 4-5 hours apart
Arm Title
G-Pen Mini™ (glucagon injection) 150 ug
Arm Type
Experimental
Arm Description
G-Pen Mini™ (glucagon injection), two 150 microgram subcutaneous injections given approximately 4-5 hours apart
Arm Title
G-Pen Mini™ (glucagon injection) 300 ug
Arm Type
Experimental
Arm Description
G-Pen Mini™ (glucagon injection), two 300 microgram subcutaneous injections given approximately 4-5 hours apart
Intervention Type
Drug
Intervention Name(s)
G-Pen Mini™ (glucagon injection)
Other Intervention Name(s)
mini-dose glucagon
Intervention Description
stable, pre-mixed, liquid glucagon for subcutaneous injection
Primary Outcome Measure Information:
Title
Serious Adverse Events
Description
Number of serious adverse events (SAEs) per treatment
Time Frame
From first dose until follow-up call, up to 7 weeks per subject
Secondary Outcome Measure Information:
Title
Glucagon Cmax (Fasting)
Description
Pharmacokinetic parameter: Maximum concentration of glucagon
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 180 minutes post-injection
Title
Glucagon Cmax (Post-insulin)
Description
Pharmacokinetic parameter: Maximum concentration of glucagon
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucagon Area Under the Curve (AUC) (Fasting)
Description
Pharmacokinetic parameter: Area under the glucagon concentration curve from 0 to 120 minutes
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucagon AUC (Post-insulin)
Description
Pharmacokinetic parameter: Area under the glucagon concentration curve from 0 to 120 minutes
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucagon Tmax (Fasting)
Description
Pharmacokinetic parameter: Time to reach maximum concentration of glucagon
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 180 minutes post-injection
Title
Glucagon Tmax (Post-insulin)
Description
Pharmacokinetic parameter: Time to reach maximum concentration of glucagon
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucose Cmax (Fasting)
Description
Pharmacodynamic parameter: Maximum concentration of glucose
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 180 minutes post-injection
Title
Glucose Cmax (Post-insulin)
Description
Pharmacodynamic parameter: Maximum concentration of glucose
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucose AUC (Fasting)
Description
Pharmacodynamic parameter: baseline adjusted area under the glucagon concentration curve from 0 to 120 minutes
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucose AUC (Post-insulin)
Description
Pharmacodynamic parameter: baseline adjusted area under the glucose concentration curve from 0-120 minutes
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection
Title
Glucose Tmax (Fasting)
Description
Pharmacodynamic parameter: Time to reach maximum concentration of glucose
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 180 minutes post-injection
Title
Glucose Tmax (Post-insulin)
Description
Pharmacodynamic parameter: Time to reach maximum concentration of glucose
Time Frame
Approximately 15 and 0 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, and 120 minutes post-injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female subjects on insulin infusion pump therapy for treatment of type 1 diabetes Between the ages of 18 and 50 years of age, inclusive, at Screening. Females of childbearing potential with a negative serum pregnancy test prior at screening and negative urine pregnancy tests prior to the Treatment visits, using an approved forms of contraception for the duration of participation in the study (i.e. until after last dose). Male subjects are required to use a condom and another of the methods of contraception in #3 above starting at Randomization and for the duration of the study. Hemoglobin A1c (HbA1c) < 9.0 %. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study. Subjects must be willing and able to comply with scheduled visits, treatment, laboratory tests and study procedures. Exclusion Criteria: Clinical evidence of microvascular complication(s) other than mild microalbuminuria or history of mild non-proliferative retinopathy Any chronic diseases or illness that interferes with glucose metabolism, except for T1DM, or medications other than hypothyroidism on appropriate thyroid hormone replacement. Blood pressure (BP) readings at Screening where Systemic BP <90 or >140 mm Hg, and Diastolic BP <50 or >90 mm Hg. Cardiovascular event within 6 months prior to screening such as unstable angina, acute coronary syndrome, myocardial infarction, therapeutic coronary procedure (e.g., stent placement, Percutaneous Transluminal Coronary Angioplasty (PTCA), Coronary Artery By-pass Grafting (CABG)), stroke or transient ischemic attack. Study participants who are pregnant at Screening. Breast feeding must be discontinued if a subject wishes to participate in this study. Positive test for hepatitis B, hepatitis C, or HIV found at Screening. Positive urine drug test for illicit drugs at Screening. History of allergies to glucagon, glucagon-like products or to any of the excipients in the investigational formulation. Known presence of hereditary problems of glycogen storage disease, galactose and /or lactose intolerance Administration of glucagon more than once within the three (3) months prior to Screening Subjects with any of the following abnormalities in clinical laboratory tests at Screening, confirmed by a single repeat, if necessary: Hemoglobin (Hb) below the lower limits of normal for the laboratory Total bilirubin above the upper limits of normal for the laboratory Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) above the upper limits of normal for the laboratory Creatinine above the upper limits of normal for the laboratory History of regular alcohol consumption as defined by alcohol intake in a quantity exceeding 7 drinks per week for females or 14 drinks per week for males, where 1 drink = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of hard liquor. Participation in other studies involving administration of an investigational drug or device within 30 days or 5 half-lives, whichever is longer, before screening for the current study and during participation in the current study Whole blood donation of 1 pint (500 mL) within 8 weeks prior to Screening. Donations of plasma, packed red blood cells, platelets or quantities less than 500 mL are allowed at investigator discretion. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Morey W Haymond, MD
Organizational Affiliation
Baylor College of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Baylor College of Medicine, Children's Nutritional Research Center, Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
26861921
Citation
Haymond MW, Redondo MJ, McKay S, Cummins MJ, Newswanger B, Kinzell J, Prestrelski S. Nonaqueous, Mini-Dose Glucagon for Treatment of Mild Hypoglycemia in Adults With Type 1 Diabetes: A Dose-Seeking Study. Diabetes Care. 2016 Mar;39(3):465-8. doi: 10.2337/dc15-2124. Epub 2016 Feb 9.
Results Reference
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Safety and Efficacy Study of Mini-Dose Glucagon (G-Pen Mini) in Patients With Type 1 Diabetes

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