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Afrezza Safety and Pharmacokinetics Study in Pediatric Patients

Primary Purpose

Type 1 Diabetes Mellitus

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Afrezza
Sponsored by
Mannkind Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes Mellitus

Eligibility Criteria

4 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion criteria :

  1. Written or oral assent from the pediatric subject and written informed consent from the parent(s) or legal guardian and a witness, as required by both state and federal laws and the local Institutional Review Board;
  2. Children aged ≥4 and ≤17 years (enrolled sequentially into 3 age cohorts: 13 to 17, 8 to 12, and 4 to 7 years);
  3. Clinical diagnosis of T1DM and using insulin for at least 1 year;
  4. Currently receiving a regimen of basal/bolus insulin administered by MDI for at least 6 weeks prior to enrollment;
  5. Subjects with pre-breakfast self monitored blood glucose values between 80 and 250 mg/dL for 5 of 7 documented daily readings obtained in the week prior to Visit 2 (readings to be taken using glucometer provided at Screening Visit 1) and reported via the e Diary;
  6. Subjects on a regimen of insulin via continuous SC insulin infusion may be enrolled if they satisfy all other enrollment criteria and are willing to convert to MDI for the duration of the study, beginning 6 weeks prior to enrollment. They must continue to meet all enrollment criteria after converting to the MDI regimen;
  7. Total daily insulin dose ≤1.5 units/kg/day with a minimum of 3 units of RAA at every meal.
  8. Hemoglobin A1c (HbA1c) ≥7.0% to <10.0% at the time of screening;
  9. Fasting serum C-peptide ≤0.3 ng/mL;
  10. Forced expiratory volume in 1 second (FEV1) ≥70% of National Health and Nutrition Examination Survey (NHANES) III predicted for children ≥8 years of age or Wang predicted for children <8 years of age;
  11. Forced vital capacity ≥70% of NHANES III predicted for children ≥8 years of age or Wang predicted for children <8 years of age;
  12. Females of childbearing potential, must use "highly effective" methods of contraception throughout conduct of the trial

Exclusion criteria:

  1. Body mass index below 25th or above 95th percentile for age and gender according to Centers for Disease Control and Prevention growth charts;
  2. History of physician diagnosis of asthma or any other clinically important pulmonary disease, or use of any medications to treat such conditions within the last year;
  3. Allergy or known hypersensitivity for AFREZZA or to drugs with similar chemical structure;
  4. Unstable diabetes control, defined as 2 or more episodes of severe hypoglycemia (i.e., an episode associated with a seizure, coma, or loss of consciousness) or any hospitalization or emergency room visit for poor diabetes control, ketoacidosis, hypoglycemia, or hyperglycemia within the preceding 3 months from screening;
  5. Serum creatinine ≥ the upper limit of normal for age;
  6. Respiratory tract infection within 30 days before screening or between screening and initiation of treatment period; subject may return 4 weeks after resolution of the infection for rescreening;
  7. Evidence of any complication of diabetes (proliferative retinopathy, autonomic neuropathy, nephropathy, etc), or likelihood of requiring laser photocoagulation, vitrectomy, or other specific treatment for diabetic retinopathy in the coming year;
  8. Smoking of tobacco or other substances or positive urine cotinine testing (>100 ng/mL);
  9. Positive urine drug screen;
  10. Positive urine pregnancy test for female subjects of childbearing potential;
  11. Inability to perform study procedures including pulmonary function testing;
  12. Exposure to any investigational product(s) in the past 3 months or 5 half-lives, whichever is more;
  13. History of eating disorder;
  14. Any disease or exposure to any medication which, in the judgment of the principal Investigator, may impact glucose metabolism;
  15. Any concurrent medical or major psychiatric condition that makes the subject unsuitable for the clinical study or impairs the subject's ability to participate in the study.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sites / Locations

  • Children's Hospital Los Angeles
  • Barbara Davis Center for Childhood Diabetes
  • Yale University Hospital
  • University of Florida
  • USF Diabetes Center
  • Atlanta Diabetes Associates
  • Van Meter Pediatric Endocrinology, P.C.
  • Emory University Children's Center
  • Indiana University, Riley Hospital for Children
  • Barry J. Reiner, MD, LLC
  • Diabetes, Obesity, Cardiovascular Clinical Specialists (DOCS)
  • Children's Hospital of Philadelphia
  • Le Bonheur Children's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Afrezza (Technosphere Insulin)

Arm Description

Individualized dose of Afrezza (Technosphere Insulin) for each patient at each meal (breakfast, lunch, and dinner) for 30 days. During the trial, all patients will receive multiple injections of basal long acting insulin, in general at bedtime every day.

Outcomes

Primary Outcome Measures

Insulin Maximum Observed Concentration (Cmax)
Insulin Cmax after a dose of Afrezza

Secondary Outcome Measures

Insulin Time to Reach Cmax (Tmax)
Insulin Tmax after a dose of Afrezza
Insulin Area Under Concentration Time Curve (AUC)
Insulin AUC after a dose of Afrezza
Assessment of Fumaryl Diketopiperazine (FDKP) Elimination Half-life (t1/2)
FDKP (inert carrier excipient) calculated half life t1/2

Full Information

First Posted
August 17, 2015
Last Updated
March 11, 2021
Sponsor
Mannkind Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT02527265
Brief Title
Afrezza Safety and Pharmacokinetics Study in Pediatric Patients
Official Title
Open-label, Single-arm, Multiple-dose Safety, Titration, and Pharmacokinetic Trial of Afrezza® in Pediatric Patients Ages 4 to 17 Years With Type 1 Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
March 2021
Overall Recruitment Status
Completed
Study Start Date
September 28, 2017 (Actual)
Primary Completion Date
March 17, 2020 (Actual)
Study Completion Date
June 25, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mannkind Corporation

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
Primary Objective: -To assess the safety and tolerability of Afrezza in children ages 4 to 17 years with type 1 diabetes mellitus (T1DM). Secondary Objectives: To assess the ability to titrate the prandial and supplemental doses of Afrezza at each meal. To assess pharmacokinetics (PK) following a prandial dose of Afrezza in children ages 4 to 17 years with T1DM.
Detailed Description
The patients are expected to participate in the study for approximately 6 to 8 weeks from Screening to final follow-up visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Afrezza (Technosphere Insulin)
Arm Type
Experimental
Arm Description
Individualized dose of Afrezza (Technosphere Insulin) for each patient at each meal (breakfast, lunch, and dinner) for 30 days. During the trial, all patients will receive multiple injections of basal long acting insulin, in general at bedtime every day.
Intervention Type
Biological
Intervention Name(s)
Afrezza
Other Intervention Name(s)
Technosphere Insulin
Intervention Description
Pharmaceutical form: powder Route of administration: inhalation
Primary Outcome Measure Information:
Title
Insulin Maximum Observed Concentration (Cmax)
Description
Insulin Cmax after a dose of Afrezza
Time Frame
250 minutes post-dose
Secondary Outcome Measure Information:
Title
Insulin Time to Reach Cmax (Tmax)
Description
Insulin Tmax after a dose of Afrezza
Time Frame
250 minutes post-dose
Title
Insulin Area Under Concentration Time Curve (AUC)
Description
Insulin AUC after a dose of Afrezza
Time Frame
250 minutes post-dose
Title
Assessment of Fumaryl Diketopiperazine (FDKP) Elimination Half-life (t1/2)
Description
FDKP (inert carrier excipient) calculated half life t1/2
Time Frame
Using PK data collected over 250 minutes post-dose of Afrezza

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria : Written or oral assent from the pediatric subject and written informed consent from the parent(s) or legal guardian and a witness, as required by both state and federal laws and the local Institutional Review Board; Children aged ≥4 and ≤17 years (enrolled sequentially into 3 age cohorts: 13 to 17, 8 to 12, and 4 to 7 years); Clinical diagnosis of T1DM and using insulin for at least 1 year; Currently receiving a regimen of basal/bolus insulin administered by MDI for at least 6 weeks prior to enrollment; Subjects with pre-breakfast self monitored blood glucose values between 80 and 250 mg/dL for 5 of 7 documented daily readings obtained in the week prior to Visit 2 (readings to be taken using glucometer provided at Screening Visit 1) and reported via the e Diary; Subjects on a regimen of insulin via continuous SC insulin infusion may be enrolled if they satisfy all other enrollment criteria and are willing to convert to MDI for the duration of the study, beginning 6 weeks prior to enrollment. They must continue to meet all enrollment criteria after converting to the MDI regimen; Total daily insulin dose ≤1.5 units/kg/day with a minimum of 3 units of RAA at every meal. Hemoglobin A1c (HbA1c) ≥7.0% to <10.0% at the time of screening; Fasting serum C-peptide ≤0.3 ng/mL; Forced expiratory volume in 1 second (FEV1) ≥70% of National Health and Nutrition Examination Survey (NHANES) III predicted for children ≥8 years of age or Wang predicted for children <8 years of age; Forced vital capacity ≥70% of NHANES III predicted for children ≥8 years of age or Wang predicted for children <8 years of age; Females of childbearing potential, must use "highly effective" methods of contraception throughout conduct of the trial Exclusion criteria: Body mass index below 25th or above 95th percentile for age and gender according to Centers for Disease Control and Prevention growth charts; History of physician diagnosis of asthma or any other clinically important pulmonary disease, or use of any medications to treat such conditions within the last year; Allergy or known hypersensitivity for AFREZZA or to drugs with similar chemical structure; Unstable diabetes control, defined as 2 or more episodes of severe hypoglycemia (i.e., an episode associated with a seizure, coma, or loss of consciousness) or any hospitalization or emergency room visit for poor diabetes control, ketoacidosis, hypoglycemia, or hyperglycemia within the preceding 3 months from screening; Serum creatinine ≥ the upper limit of normal for age; Respiratory tract infection within 30 days before screening or between screening and initiation of treatment period; subject may return 4 weeks after resolution of the infection for rescreening; Evidence of any complication of diabetes (proliferative retinopathy, autonomic neuropathy, nephropathy, etc), or likelihood of requiring laser photocoagulation, vitrectomy, or other specific treatment for diabetic retinopathy in the coming year; Smoking of tobacco or other substances or positive urine cotinine testing (>100 ng/mL); Positive urine drug screen; Positive urine pregnancy test for female subjects of childbearing potential; Inability to perform study procedures including pulmonary function testing; Exposure to any investigational product(s) in the past 3 months or 5 half-lives, whichever is more; History of eating disorder; Any disease or exposure to any medication which, in the judgment of the principal Investigator, may impact glucose metabolism; Any concurrent medical or major psychiatric condition that makes the subject unsuitable for the clinical study or impairs the subject's ability to participate in the study. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Operations
Organizational Affiliation
Mannkind Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Barbara Davis Center for Childhood Diabetes
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Yale University Hospital
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
USF Diabetes Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Atlanta Diabetes Associates
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Facility Name
Van Meter Pediatric Endocrinology, P.C.
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Facility Name
Emory University Children's Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Indiana University, Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Barry J. Reiner, MD, LLC
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21229
Country
United States
Facility Name
Diabetes, Obesity, Cardiovascular Clinical Specialists (DOCS)
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89113
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Le Bonheur Children's Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38105
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Afrezza Safety and Pharmacokinetics Study in Pediatric Patients

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