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Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Doses of KQ-791 in Diabetes Mellitus

Primary Purpose

Diabetes Mellitus, Type 2

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
KQ-791
Placebo
Sponsored by
Kaneq Bioscience Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 2

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Have a diagnosis of Type 2 Diabetes Mellitus (T2DM)
  • Be an adult between the ages of 18 (19 for Lincoln site) and 70 years
  • Female participants must be of non-childbearing potential, and must be either 1) postmenopausal with amenorrhea for at least 1 year prior to the first dose and Follicle Stimulating Hormone (FSH) serum levels consistent with postmenopausal status, or 2) have undergone one of the following sterilization procedures at least 6 months prior to the first dose:

    • hysteroscopic sterilization
    • bilateral tubal ligation or bilateral salpingectomy
    • hysterectomy
    • bilateral oophorectomy
  • Non-vasectomized males must agree to use a condom with spermicide or abstain from sexual intercourse during the study until 100 days beyond the last dose of study drug. (No restrictions are required for a vasectomized male provided his vasectomy has been performed 4 months or more prior to first dosing. A male who has been vasectomized less than 4 months prior to first dosing must follow the same restrictions as a non-vasectomized male)
  • Males must agree to not donate sperm during the study and for 100 days following the last dose
  • Have an HbA1c value between 7.0-10.0%
  • Be on a stable treatment regimen of metformin, with or without diet/exercise, for at least 8 weeks
  • Weigh 60 kilograms (kg) or more at screening and have a body mass index (BMI) greater than or equal to (≥) 25.0 and less than or equal to (≤) 40.0 kilograms/meters squared (kg/m2)
  • Have laboratory test results within the normal range for T2DM population, or with abnormalities deemed clinically insignificant. Urine protein levels must be within normal limits
  • Absence of active diabetic retinopathy (Stage 2 or greater by the International Clinical Disease Severity Scale for Diabetic Retinopathy)
  • Are willing to comply with specific dietary restrictions (that is, [i] able to fast overnight for at least 8-12 hours on several days and [ii] able to consume the standard meals provided during specified confinement days)
  • Have given written consent to allow collection of samples for Peripheral Blood Mononuclear Cells (PBMC) analysis and for possible biomarkers/safety analysis
  • Have given written informed consent approved by the institutional review board (IRB) governing the site

Exclusion Criteria:

  • Are currently enrolled in a clinical trial involving an investigational product or off-label use of a drug or device, or are concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study
  • Participated (defined as the last dose of study drug) within 30 days prior to dosing in a clinical trial involving an investigational product or non-approved use of a drug with a short half-life or within 5 half-lives of an investigational product with a half-life longer than 6 days
  • - Have a (QTcF) greater than (>) 450 milliseconds (msec), or clinical significant hypokalemia, a family history of long QT syndrome or any abnormality in the 12-lead Electrocardiogram (ECG)
  • Abnormal blood pressure (sitting) defined as diastolic blood pressure > 95 or less than (<) 50 millimeter of mercury (mmHg) and/or systolic blood pressure > 160 or < 90 mmHg
  • Have a history or presence of cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, hematological, or neurological disorders capable of significantly altering the absorption, metabolism, or elimination of drugs
  • Show evidence of regular use of known drugs of abuse and/or positive findings on urinary drug screening
  • Evidence of human immunodeficiency virus (HIV) infection, hepatitis B, hepatitis C and/or positive results at screening for the respective antibodies for HIV, hepatitis B surface antigen (HBsAg), or hepatitis C antibodies (HCV)
  • Have anemia that would interfere with the trial or have donated ≥500 mL of blood within 56 days before the first dose or have donated plasma within 7 days before the first dose or provided any blood donation within last 30 days
  • Have an average weekly alcohol intake that exceeds 14 units per week (males) and 7 units per week (females) [1 unit = 12 ounces (oz) or 360 mL of beer, 5 oz or 150 mL of wine, or 1.5 oz or 45 mL of distilled spirits] or are unwilling to stop alcohol consumption 48 hours prior to the first dosing and throughout the study
  • Consume more than 10 cigarettes per day or the equivalent or are unable or unwilling to adhere to restricted smoking policies
  • Have had >1 episode of documented severe hypoglycemia within last 6 months or are currently diagnosed as having hypoglycemia unawareness
  • Have any of the following clinical laboratory test results:

    • estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (impaired renal function)
    • alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels > 1.5 times (x) the upper limit of normal (ULN)
    • triglycerides (TG) > 500 milligrams/deciliter (mg/dL)
  • Have used insulin or other glycemic control medications, except metformin, for diabetic control within 3 months
  • Intend to use non-steroidal anti-inflammatory drugs (except aspirin) and drugs known to prolong QT interval, herbal products, or vitamin supplements that change glucose levels. The following medications are allowed for participants:

    • drugs for treatment of hypertension or lipid disorders (except bile acid resins, niacin or fish oils), platelet inhibitors, and on stable dose for 12 weeks prior to first dose
    • thyroid replacement therapy, proton pump inhibitors, antidepressants, antihistamines, regularly taken over-the-counter (OTC) and anti-emetics that do not cause a corrected QT interval (QTc) prolongation, provided such drugs are not specifically excluded
    • hormonal replacement therapy

Sites / Locations

  • Celerion
  • Clinical Pharmacology of Miami, Inc.
  • Orlando Clinical Research Center
  • Celerion

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

KQ-791 Dose 1

KQ-791 Dose 2

KQ-791 Dose 3

Placebo

Arm Description

Single loading dose on day 1, followed by single doses on days 8, 15, 22, 29

Single loading dose on day 1, followed by a daily dose for 28 days

Single loading dose on day 1 or days 1-2, followed by a daily dose for 28 days

Multiple ascending doses matching KQ-791 dose

Outcomes

Primary Outcome Measures

Difference in the Change From Baseline in Fasting Blood Glucose Between KQ-791 and Placebo
Data table is change from baseline in Fasting Blood Glucose. Statistical Analysis includes results for difference in Change from baseline in Fasting Blood Glucose Between KQ-791 and Placebo.
Number of Participants With One or More Treatment-Emergent Adverse Events

Secondary Outcome Measures

Change From Baseline in the Quantitative Insulin Sensitivity Check Index (QUICKI)
QUICKI = 1/(log FPG + log FPI) where FPG = fasting plasma glucose (mg/dL); FPI = fasting plasma insulin (estimated based on fasting serum insulin; (μIU/mL)). Lower numbers reflect greater insulin resistance.
Change From Baseline in the Insulin Sensitivity Index (ISI)
Insulin sensitivity index (ISI) composite using Matsuda's whole body insulin sensitivity, ISI [composite] = 10000/√[(FPG x FPI)x(Mean Glucose 0-120min in MMTT x Mean Insulin 0-120 min in MMTT)] where MMTT is a mixed meal tolerance test, Hour 0=just prior dosing. Lower values indicate greater insulin resistance.
Change From Baseline in Beta Cell Function
Evaluated as beta index = (Insulin Area Under the Effect Curve (AUEC) in MMTT/Glucose AUEC in MMTT)
Change From Baseline in Disposition Index
Disposition Index evaluated as beta index x ISI [composite]. Lower values of the disposition index suggests loss of function of beta cells.
Change From Baseline in the Hepatic Insulin Resistance Index
Hepatic Insulin Resistance Index will be evaluated as Glucose AUEC from zero to 30 minutes (AUEC0-30min) in MMTT x Insulin AUEC0-30 min in MMTT
Change From Baseline in 7-point Average Blood Glucose
The 7-points measured were just prior to each meal and 90 minutes after the start of the meal and approximately bedtime.
Change From Baseline in Postprandial Glucose
Change From Baseline in HbA1c
Area Under the Plasma Concentration-Time Curve From Time Zero to 24-hours Post-Dose (AUC0-24)
Maximum Observed Plasma Concentration (Cmax)
Time of the Maximum Measured Plasma Concentration (Tmax)
Area Under the Plasma Concentration Versus Time Curve (AUCtau)
Maximum Observed Plasma Concentration at Steady-state (Cmax_ss)
Time of the Maximum Measured Plasma Concentration at Steady-state (Tmax_ss)
Apparent Terminal Elimination Half-life (t1/2)
Accumulation Index (AI)
Based on AUC (RacAUC), where RacAUC is the ratio of AUC during a dosing interval following the last dose over the loading dose (first dose)

Full Information

First Posted
May 13, 2015
Last Updated
November 14, 2019
Sponsor
Kaneq Bioscience Limited
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1. Study Identification

Unique Protocol Identification Number
NCT02445911
Brief Title
Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Doses of KQ-791 in Diabetes Mellitus
Official Title
Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Oral Doses of KQ-791 in Subjects With Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
February 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Kaneq Bioscience Limited

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will consist of multiple ascending oral doses in up to 3 groups, for 29 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
81 (Actual)

8. Arms, Groups, and Interventions

Arm Title
KQ-791 Dose 1
Arm Type
Experimental
Arm Description
Single loading dose on day 1, followed by single doses on days 8, 15, 22, 29
Arm Title
KQ-791 Dose 2
Arm Type
Experimental
Arm Description
Single loading dose on day 1, followed by a daily dose for 28 days
Arm Title
KQ-791 Dose 3
Arm Type
Experimental
Arm Description
Single loading dose on day 1 or days 1-2, followed by a daily dose for 28 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Multiple ascending doses matching KQ-791 dose
Intervention Type
Drug
Intervention Name(s)
KQ-791
Intervention Description
Capsules administered orally
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Capsules administered orally
Primary Outcome Measure Information:
Title
Difference in the Change From Baseline in Fasting Blood Glucose Between KQ-791 and Placebo
Description
Data table is change from baseline in Fasting Blood Glucose. Statistical Analysis includes results for difference in Change from baseline in Fasting Blood Glucose Between KQ-791 and Placebo.
Time Frame
Baseline to Day 29
Title
Number of Participants With One or More Treatment-Emergent Adverse Events
Time Frame
Baseline to Day 29
Secondary Outcome Measure Information:
Title
Change From Baseline in the Quantitative Insulin Sensitivity Check Index (QUICKI)
Description
QUICKI = 1/(log FPG + log FPI) where FPG = fasting plasma glucose (mg/dL); FPI = fasting plasma insulin (estimated based on fasting serum insulin; (μIU/mL)). Lower numbers reflect greater insulin resistance.
Time Frame
Baseline to Day 29
Title
Change From Baseline in the Insulin Sensitivity Index (ISI)
Description
Insulin sensitivity index (ISI) composite using Matsuda's whole body insulin sensitivity, ISI [composite] = 10000/√[(FPG x FPI)x(Mean Glucose 0-120min in MMTT x Mean Insulin 0-120 min in MMTT)] where MMTT is a mixed meal tolerance test, Hour 0=just prior dosing. Lower values indicate greater insulin resistance.
Time Frame
Baseline to Day 29
Title
Change From Baseline in Beta Cell Function
Description
Evaluated as beta index = (Insulin Area Under the Effect Curve (AUEC) in MMTT/Glucose AUEC in MMTT)
Time Frame
Baseline to Day 29
Title
Change From Baseline in Disposition Index
Description
Disposition Index evaluated as beta index x ISI [composite]. Lower values of the disposition index suggests loss of function of beta cells.
Time Frame
Baseline to Day 29
Title
Change From Baseline in the Hepatic Insulin Resistance Index
Description
Hepatic Insulin Resistance Index will be evaluated as Glucose AUEC from zero to 30 minutes (AUEC0-30min) in MMTT x Insulin AUEC0-30 min in MMTT
Time Frame
Baseline to Day 29
Title
Change From Baseline in 7-point Average Blood Glucose
Description
The 7-points measured were just prior to each meal and 90 minutes after the start of the meal and approximately bedtime.
Time Frame
Baseline to Day 29
Title
Change From Baseline in Postprandial Glucose
Time Frame
Baseline to Day 29
Title
Change From Baseline in HbA1c
Time Frame
Baseline to Day 29
Title
Area Under the Plasma Concentration-Time Curve From Time Zero to 24-hours Post-Dose (AUC0-24)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose
Title
Maximum Observed Plasma Concentration (Cmax)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose
Title
Time of the Maximum Measured Plasma Concentration (Tmax)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose
Title
Area Under the Plasma Concentration Versus Time Curve (AUCtau)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose; Day 3, 8, 15, 22, 29, and up to 24 hours post-dose on Day 29
Title
Maximum Observed Plasma Concentration at Steady-state (Cmax_ss)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose; Day 3, 8, 15, 22, 29, and up to 24 hours post-dose on Day 29
Title
Time of the Maximum Measured Plasma Concentration at Steady-state (Tmax_ss)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose; Day 3, 8, 15, 22, 29, and up to 24 hours post-dose on Day 29
Title
Apparent Terminal Elimination Half-life (t1/2)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose; Day 3, 8, 15, 22, 29, and up to 24 hours post-dose on Day 29
Title
Accumulation Index (AI)
Description
Based on AUC (RacAUC), where RacAUC is the ratio of AUC during a dosing interval following the last dose over the loading dose (first dose)
Time Frame
Pre-dose, 0.5, 1, 2, 4, 8, 12, and 24 hours post-dose; Day 3, 8, 15, 22, 29, and up to 24 hours post-dose on Day 29

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have a diagnosis of Type 2 Diabetes Mellitus (T2DM) Be an adult between the ages of 18 (19 for Lincoln site) and 70 years Female participants must be of non-childbearing potential, and must be either 1) postmenopausal with amenorrhea for at least 1 year prior to the first dose and Follicle Stimulating Hormone (FSH) serum levels consistent with postmenopausal status, or 2) have undergone one of the following sterilization procedures at least 6 months prior to the first dose: hysteroscopic sterilization bilateral tubal ligation or bilateral salpingectomy hysterectomy bilateral oophorectomy Non-vasectomized males must agree to use a condom with spermicide or abstain from sexual intercourse during the study until 100 days beyond the last dose of study drug. (No restrictions are required for a vasectomized male provided his vasectomy has been performed 4 months or more prior to first dosing. A male who has been vasectomized less than 4 months prior to first dosing must follow the same restrictions as a non-vasectomized male) Males must agree to not donate sperm during the study and for 100 days following the last dose Have an HbA1c value between 7.0-10.0% Be on a stable treatment regimen of metformin, with or without diet/exercise, for at least 8 weeks Weigh 60 kilograms (kg) or more at screening and have a body mass index (BMI) greater than or equal to (≥) 25.0 and less than or equal to (≤) 40.0 kilograms/meters squared (kg/m2) Have laboratory test results within the normal range for T2DM population, or with abnormalities deemed clinically insignificant. Urine protein levels must be within normal limits Absence of active diabetic retinopathy (Stage 2 or greater by the International Clinical Disease Severity Scale for Diabetic Retinopathy) Are willing to comply with specific dietary restrictions (that is, [i] able to fast overnight for at least 8-12 hours on several days and [ii] able to consume the standard meals provided during specified confinement days) Have given written consent to allow collection of samples for Peripheral Blood Mononuclear Cells (PBMC) analysis and for possible biomarkers/safety analysis Have given written informed consent approved by the institutional review board (IRB) governing the site Exclusion Criteria: Are currently enrolled in a clinical trial involving an investigational product or off-label use of a drug or device, or are concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study Participated (defined as the last dose of study drug) within 30 days prior to dosing in a clinical trial involving an investigational product or non-approved use of a drug with a short half-life or within 5 half-lives of an investigational product with a half-life longer than 6 days - Have a (QTcF) greater than (>) 450 milliseconds (msec), or clinical significant hypokalemia, a family history of long QT syndrome or any abnormality in the 12-lead Electrocardiogram (ECG) Abnormal blood pressure (sitting) defined as diastolic blood pressure > 95 or less than (<) 50 millimeter of mercury (mmHg) and/or systolic blood pressure > 160 or < 90 mmHg Have a history or presence of cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, hematological, or neurological disorders capable of significantly altering the absorption, metabolism, or elimination of drugs Show evidence of regular use of known drugs of abuse and/or positive findings on urinary drug screening Evidence of human immunodeficiency virus (HIV) infection, hepatitis B, hepatitis C and/or positive results at screening for the respective antibodies for HIV, hepatitis B surface antigen (HBsAg), or hepatitis C antibodies (HCV) Have anemia that would interfere with the trial or have donated ≥500 mL of blood within 56 days before the first dose or have donated plasma within 7 days before the first dose or provided any blood donation within last 30 days Have an average weekly alcohol intake that exceeds 14 units per week (males) and 7 units per week (females) [1 unit = 12 ounces (oz) or 360 mL of beer, 5 oz or 150 mL of wine, or 1.5 oz or 45 mL of distilled spirits] or are unwilling to stop alcohol consumption 48 hours prior to the first dosing and throughout the study Consume more than 10 cigarettes per day or the equivalent or are unable or unwilling to adhere to restricted smoking policies Have had >1 episode of documented severe hypoglycemia within last 6 months or are currently diagnosed as having hypoglycemia unawareness Have any of the following clinical laboratory test results: estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (impaired renal function) alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels > 1.5 times (x) the upper limit of normal (ULN) triglycerides (TG) > 500 milligrams/deciliter (mg/dL) Have used insulin or other glycemic control medications, except metformin, for diabetic control within 3 months Intend to use non-steroidal anti-inflammatory drugs (except aspirin) and drugs known to prolong QT interval, herbal products, or vitamin supplements that change glucose levels. The following medications are allowed for participants: drugs for treatment of hypertension or lipid disorders (except bile acid resins, niacin or fish oils), platelet inhibitors, and on stable dose for 12 weeks prior to first dose thyroid replacement therapy, proton pump inhibitors, antidepressants, antihistamines, regularly taken over-the-counter (OTC) and anti-emetics that do not cause a corrected QT interval (QTc) prolongation, provided such drugs are not specifically excluded hormonal replacement therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Email: daniel.bouthillier@Kaneq.ca
Organizational Affiliation
Kaneq Bioscience
Official's Role
Study Director
Facility Information:
Facility Name
Celerion
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85283
Country
United States
Facility Name
Clinical Pharmacology of Miami, Inc.
City
Miami
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
Orlando Clinical Research Center
City
Orlando
State/Province
Florida
ZIP/Postal Code
32809
Country
United States
Facility Name
Celerion
City
Lincoln
State/Province
Nebraska
ZIP/Postal Code
68502
Country
United States

12. IPD Sharing Statement

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Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of Multiple Ascending Doses of KQ-791 in Diabetes Mellitus

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