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A Study to Evaluate Safety, Pharmacokinetics, and Pharmacodynamics of a Single Dose of SAR438544 in Comparison to Glucagon in Type 1 Diabetes Mellitus Patients Under Induced Hypoglycemia

Primary Purpose

Type 1 Diabetes Mellitus

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
SAR438544
r-glucagon
insulin
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Type 1 Diabetes Mellitus

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria :

  • Male or female patients, between 18 and 60 years of age, inclusive, with T1DM for at least one year, as defined by the American Diabetes Association (ADA).
  • Total (basal+short acting) daily insulin dose of <1.2 U/kg/day.
  • Body weight between 50.0 and 110 kg, inclusive, the body mass index (BMI) between 18.5 and 30.0 kg/m^2, inclusive.
  • Fasting serum C-peptide <0.3 nmol/L.
  • Glycohemoglobin (HbA1c) ≤75 mmol/mol (≤9%).
  • Stable insulin regimen for at least 2 months prior to study and self-monitoring of blood glucose before screening visit.
  • Certified as otherwise healthy for T1DM by assessment of medical history and physical examination (cardiovascular system, chest and lungs, thyroid, abdomen, nervous system, skin and mucosae, and musculoskeletal system), unless the Investigator considers any abnormality to be clinically irrelevant and not interfering with the conduct of the study.
  • Female subject must use a double contraception method, including a highly effective method of birth control, except if she has undergone sterilization defined as tubal occlusion, hysterectomy, bilateral salpingectomy, bilateral oophorectomy, and bilateral tubal ligation at least 3 months earlier or is postmenopausal.

The accepted double contraception methods include the use of intrauterine device or hormonal contraception started at least 30 days prior to the screening start and continued for at least 3 months after IMP dosing in addition to one of the following contraceptive options: (1) condom plus spermicide; (2) diaphragm plus spermicide or cervical/vault cap plus spermicide. Menopause is defined as being amenorrheic for at least 2 years with plasma follicle-stimulating hormone (FSH) level >30 UI/L in women older than 40 years of age.

  • Having given written informed consent prior to undertaking any study-related procedure.
  • Not under any administrative or legal supervision.
  • Male subject, whose partners are of childbearing potential (including lactating women), must accept to use, during sexual intercourse, a double contraception method according to the following algorithm: (condom, diaphragm or cervical cap, plus spermicide) plus (intra-uterine device or hormonal contraceptive) from the inclusion up to 3 months after the last dosing (except if sterilized).
  • Male subject whose partners are pregnant must use during sexual intercourse a condom from the inclusion up to 3 months after the last dosing.
  • Male subject has agreed not to donate sperm from the inclusion up to 3 months after the last dosing.

Exclusion criteria:

  • Any history or presence of clinically relevant cardiovascular (includes ischemia, atrioventricular (AV) block; arrhythmias), pulmonary, gastrointestinal, hepatic, renal, metabolic (apart from T1DM), hematological, neurological, osteomuscular, articular, psychiatric, systemic, ocular, gynecologic (if female), or infectious disease, or signs of acute illness.
  • Severe hypoglycemia resulting in coma/seizures or requiring assistance of another person, and/or hospitalization for diabetic ketoacidosis in the last 6 months before screening visit.
  • Frequent severe headaches and/or migraine, recurrent nausea and/or vomiting (more than twice a month).
  • Blood loss (>300 mL) within 3 months before inclusion.
  • Symptomatic postural hypotension, irrespective of the decrease in blood pressure (BP), or asymptomatic postural hypotension defined as a decrease in systolic BP ≥20 mmHg within 3 minutes when changing from supine to standing position.
  • Presence or history of drug hypersensitivity, or allergic disease diagnosed and treated by a physician.
  • Likelihood of requiring treatment during the study period with drugs not permitted by the clinical study protocol.
  • If female, pregnancy (defined as positive beta-human chorionic gonadotropin [β-HCG] blood test), breast-feeding at screening and before any treatment periods (defined as positive β-HCG urine test).
  • Any patient who, in the judgment of the Investigator, is likely to be noncompliant during the study, or unable to cooperate because of a language problem or poor mental development.
  • Positive result on any of the following tests: hepatitis B surface antigen (HBs Ag), anti-hepatitis C virus (HCV) Abs, anti-human immunodeficiency virus 1 (HIV1) and anti-HIV2 Abs, and HIV1 Ag.
  • Positive result on urine drug screen (amphetamines/methamphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, opiates).
  • Positive alcohol breath test.
  • Known hypersensitivity to glucagon, lactose or any other constituent in GlucaGen^® HypoKit and SAR438544 or Novolin^®R and their excipients.
  • Any contraindication from the use of glucagon:
  • Pheochromocytoma
  • Insulinoma and glucagonoma

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

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Active Comparator

    Experimental

    Arm Label

    SAR438544 dose 1

    Glucagon

    SAR438544 Optional Dose

    Arm Description

    Single dose of SAR438544 given SC under fasting conditions and under induced hypoglycemia. Novolin^®R will be used to induce hypoglycemia.

    Single dose of glucagon given SC under fasting conditions and under induced hypoglycemia. Novolin^®R will be used to induce hypoglycemia.

    Optional lower, intermediate, or higher dose of SAR438544 given SC under fasting conditions and under induced hypoglycemia. Novolin^®R will be used to induce hypoglycemia.

    Outcomes

    Primary Outcome Measures

    Time to reach a smoothed blood glucose of 70 mg/dL after initial administration of investigational medicinal product

    Secondary Outcome Measures

    Assessment of PD parameter: continuous monitoring of blood glucose levels over a period of 6 hours post-dose
    Assessment of PD parameter: area under plasma concentration of the BG-time curve between IMP dosing and time t (BG-AUC0-t)
    Assessment of PD parameter: BG-maximum concentration (BG-Cmax)
    Assessment of PD parameter: BG-time to Cmax (BG-tmax)
    Assessment of PK parameter (recombinant glucagon and SAR438544): Cmax
    Assessment of PK parameter (recombinant glucagon and SAR438544): tmax
    Assessment of PK parameter (recombinant glucagon and SAR438544): tlast
    Assessment of PK parameter (recombinant glucagon and SAR438544): terminal half-life
    Assessment of PK parameter (recombinant glucagon and SAR438544): area under curve from zero time until the last measurable concentration (AUClast)
    Assessment of PK parameter (recombinant glucagon and SAR438544): AUC
    Assessment of PK parameter (recombinant glucagon and SAR438544): partial AUCs (AUC0-t)
    Number of patients with adverse events
    Time to reach a smoothed blood glucose of 90 mg/dL after initial administration of investigational medicinal product

    Full Information

    First Posted
    December 16, 2015
    Last Updated
    September 1, 2016
    Sponsor
    Sanofi
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02635243
    Brief Title
    A Study to Evaluate Safety, Pharmacokinetics, and Pharmacodynamics of a Single Dose of SAR438544 in Comparison to Glucagon in Type 1 Diabetes Mellitus Patients Under Induced Hypoglycemia
    Official Title
    SAR438544 - Clinical & Exploratory Pharmacology
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2016
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    April 2016 (undefined)
    Primary Completion Date
    November 2016 (Anticipated)
    Study Completion Date
    November 2016 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sanofi

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Primary Objective: To assess the pharmacodynamic response (PD) of a single subcutaneous (SC) dose of SAR438544 versus recombinant glucagon in type 1 diabetes mellitus (T1DM) patients under induced hypoglycemia. Secondary Objective: To assess the safety and tolerability and pharmacokinetics (PK) of a single SC dose of SAR438544 versus recombinant glucagon in T1DM patients under induced hypoglycemia.
    Detailed Description
    The total duration of study per patient is up to 8 weeks with 3 to 28 days screening period, 1 day for treatment for both periods and 7 to 14 days wash out between 2 administrations, and 7 days (+/- 1 day) follow-up after last IMP administration.

    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
    Basic Science
    Study Phase
    Phase 1
    Interventional Study Model
    Crossover Assignment
    Masking
    Double
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    SAR438544 dose 1
    Arm Type
    Experimental
    Arm Description
    Single dose of SAR438544 given SC under fasting conditions and under induced hypoglycemia. Novolin^®R will be used to induce hypoglycemia.
    Arm Title
    Glucagon
    Arm Type
    Active Comparator
    Arm Description
    Single dose of glucagon given SC under fasting conditions and under induced hypoglycemia. Novolin^®R will be used to induce hypoglycemia.
    Arm Title
    SAR438544 Optional Dose
    Arm Type
    Experimental
    Arm Description
    Optional lower, intermediate, or higher dose of SAR438544 given SC under fasting conditions and under induced hypoglycemia. Novolin^®R will be used to induce hypoglycemia.
    Intervention Type
    Drug
    Intervention Name(s)
    SAR438544
    Intervention Description
    Pharmaceutical form:solution Route of administration: subcutaneous
    Intervention Type
    Drug
    Intervention Name(s)
    r-glucagon
    Other Intervention Name(s)
    GlucaGen® HypoKit
    Intervention Description
    Pharmaceutical form:solution Route of administration: subcutaneous
    Intervention Type
    Drug
    Intervention Name(s)
    insulin
    Other Intervention Name(s)
    Novolin® R
    Intervention Description
    Pharmaceutical form:solution Route of administration: intravenous
    Primary Outcome Measure Information:
    Title
    Time to reach a smoothed blood glucose of 70 mg/dL after initial administration of investigational medicinal product
    Time Frame
    Day 1
    Secondary Outcome Measure Information:
    Title
    Assessment of PD parameter: continuous monitoring of blood glucose levels over a period of 6 hours post-dose
    Time Frame
    Day 1
    Title
    Assessment of PD parameter: area under plasma concentration of the BG-time curve between IMP dosing and time t (BG-AUC0-t)
    Time Frame
    Day 1
    Title
    Assessment of PD parameter: BG-maximum concentration (BG-Cmax)
    Time Frame
    Day 1
    Title
    Assessment of PD parameter: BG-time to Cmax (BG-tmax)
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): Cmax
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): tmax
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): tlast
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): terminal half-life
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): area under curve from zero time until the last measurable concentration (AUClast)
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): AUC
    Time Frame
    Day 1
    Title
    Assessment of PK parameter (recombinant glucagon and SAR438544): partial AUCs (AUC0-t)
    Time Frame
    Day 1
    Title
    Number of patients with adverse events
    Time Frame
    Day 1 to Day 7 (+/- 1 day)
    Title
    Time to reach a smoothed blood glucose of 90 mg/dL after initial administration of investigational medicinal product
    Time Frame
    Day 1

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion criteria : Male or female patients, between 18 and 60 years of age, inclusive, with T1DM for at least one year, as defined by the American Diabetes Association (ADA). Total (basal+short acting) daily insulin dose of <1.2 U/kg/day. Body weight between 50.0 and 110 kg, inclusive, the body mass index (BMI) between 18.5 and 30.0 kg/m^2, inclusive. Fasting serum C-peptide <0.3 nmol/L. Glycohemoglobin (HbA1c) ≤75 mmol/mol (≤9%). Stable insulin regimen for at least 2 months prior to study and self-monitoring of blood glucose before screening visit. Certified as otherwise healthy for T1DM by assessment of medical history and physical examination (cardiovascular system, chest and lungs, thyroid, abdomen, nervous system, skin and mucosae, and musculoskeletal system), unless the Investigator considers any abnormality to be clinically irrelevant and not interfering with the conduct of the study. Female subject must use a double contraception method, including a highly effective method of birth control, except if she has undergone sterilization defined as tubal occlusion, hysterectomy, bilateral salpingectomy, bilateral oophorectomy, and bilateral tubal ligation at least 3 months earlier or is postmenopausal. The accepted double contraception methods include the use of intrauterine device or hormonal contraception started at least 30 days prior to the screening start and continued for at least 3 months after IMP dosing in addition to one of the following contraceptive options: (1) condom plus spermicide; (2) diaphragm plus spermicide or cervical/vault cap plus spermicide. Menopause is defined as being amenorrheic for at least 2 years with plasma follicle-stimulating hormone (FSH) level >30 UI/L in women older than 40 years of age. Having given written informed consent prior to undertaking any study-related procedure. Not under any administrative or legal supervision. Male subject, whose partners are of childbearing potential (including lactating women), must accept to use, during sexual intercourse, a double contraception method according to the following algorithm: (condom, diaphragm or cervical cap, plus spermicide) plus (intra-uterine device or hormonal contraceptive) from the inclusion up to 3 months after the last dosing (except if sterilized). Male subject whose partners are pregnant must use during sexual intercourse a condom from the inclusion up to 3 months after the last dosing. Male subject has agreed not to donate sperm from the inclusion up to 3 months after the last dosing. Exclusion criteria: Any history or presence of clinically relevant cardiovascular (includes ischemia, atrioventricular (AV) block; arrhythmias), pulmonary, gastrointestinal, hepatic, renal, metabolic (apart from T1DM), hematological, neurological, osteomuscular, articular, psychiatric, systemic, ocular, gynecologic (if female), or infectious disease, or signs of acute illness. Severe hypoglycemia resulting in coma/seizures or requiring assistance of another person, and/or hospitalization for diabetic ketoacidosis in the last 6 months before screening visit. Frequent severe headaches and/or migraine, recurrent nausea and/or vomiting (more than twice a month). Blood loss (>300 mL) within 3 months before inclusion. Symptomatic postural hypotension, irrespective of the decrease in blood pressure (BP), or asymptomatic postural hypotension defined as a decrease in systolic BP ≥20 mmHg within 3 minutes when changing from supine to standing position. Presence or history of drug hypersensitivity, or allergic disease diagnosed and treated by a physician. Likelihood of requiring treatment during the study period with drugs not permitted by the clinical study protocol. If female, pregnancy (defined as positive beta-human chorionic gonadotropin [β-HCG] blood test), breast-feeding at screening and before any treatment periods (defined as positive β-HCG urine test). Any patient who, in the judgment of the Investigator, is likely to be noncompliant during the study, or unable to cooperate because of a language problem or poor mental development. Positive result on any of the following tests: hepatitis B surface antigen (HBs Ag), anti-hepatitis C virus (HCV) Abs, anti-human immunodeficiency virus 1 (HIV1) and anti-HIV2 Abs, and HIV1 Ag. Positive result on urine drug screen (amphetamines/methamphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, opiates). Positive alcohol breath test. Known hypersensitivity to glucagon, lactose or any other constituent in GlucaGen^® HypoKit and SAR438544 or Novolin^®R and their excipients. Any contraindication from the use of glucagon: Pheochromocytoma Insulinoma and glucagonoma 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 Sciences & Operations
    Organizational Affiliation
    Sanofi
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    A Study to Evaluate Safety, Pharmacokinetics, and Pharmacodynamics of a Single Dose of SAR438544 in Comparison to Glucagon in Type 1 Diabetes Mellitus Patients Under Induced Hypoglycemia

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