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Single-dose Study to Evaluate Safety, Tolerability, and Pharmacodynamics of REMD-477 in Subjects With Type 1 Diabetes Mellitus

Primary Purpose

Type 1 Diabetes Mellitus, Diabetes

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
REMD-477
Placebo Comparator
Sponsored by
REMD Biotherapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes Mellitus

Eligibility Criteria

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

Inclusion Criteria:

  • Men and women between the ages of 18 and 60 years old, inclusive, at the time of screening;
  • Females of non-child bearing potential must be ≥1 year post-menopausal (confirmed by a serum follicle-stimulating hormone (FSH) levels ≥ 40 IU/mL) or documented as being surgically sterile. Females of child bearing potential must agree to use two methods of contraception;
  • Male subjects must be willing to use clinically acceptable method of contraception during the entire study;
  • Body mass index between 18.5 and 26.9 kg/m2, inclusive, at screening;
  • Diagnosed with Type 1 diabetes for greater than 2 years, based on clinical history or as defined by the current American Diabetes Association (ADA) criteria;
  • HbA1c ≥6.0 % but <9.0 % at screening;
  • Fasting C-peptide <0.2 ng/mL;
  • Current use of insulin pump and willing to use continuous glucose monitoring (CGM) system (e.g. DexCom) throughout the entire study;
  • ALT and/or AST within <1.5x ULN at screening;
  • Serum amylase and lipase within normal limits at screening;
  • Able to provide written informed consent approved by an Institutional Review Board (IRB).

Exclusion Criteria:

  • History or evidence of clinically-significant disorder or condition that, in the opinion of the Investigator, would pose a risk to subject safety or interfere with the study evaluation, procedures, or completion;
  • Significant organ system dysfunction (e.g., clinically significant pulmonary or cardiovascular disease, anemia [Hemoglobin <10.0 g/dL], and renal dysfunction [eGFR <90 ml/1.73M2/min]);
  • Any severe symptomatic hypoglycemic event associated with a seizure or requiring help from other people or medical facility in the past 6 months;
  • Current or recent (within 1 month of screening) use of diabetes medications other than insulin;
  • Use of steroids and/or other prescribed or over-the-counter medications that are known to affect the outcome measures in this study or known to influence glucose metabolism;
  • Smokes tobacco;
  • Known sensitivity to mammalian-derived drug preparations, recombinant protein-based drugs or to humanized or human antibodies;
  • History of illegal drug use or alcohol abuse within the last 6 months or a positive drug urine test result at screening;
  • History of pancreatitis, pancreatic neuroendocrine tumors or multiple endocrine neoplasia;
  • History of pheochromocytoma, or family history of familial pheochromocytoma;
  • Known or suspected susceptibility to infectious disease (eg, taking immunosuppressive agents or has a documented inherited or acquired immunodeficiency);
  • Positive for human immunodeficiency virus (HIV) antibodies, hepatitis B surface antigen (HbsAg), or hepatitis C antibodies (HepC Ab);
  • Participation in an investigational drug or device trial within 30 days of screening or within 5 times the half-life of the investigational agent in the other clinical study, if known, whichever period is longer;
  • Blood donor or blood loss >500 mL within 30 days of Day 1;
  • Women who are pregnant or lactating/breastfeeding;
  • Regular exercise >120 min/week within 14 days of Day 1;
  • Unable or unwilling to follow the study protocol or who are non-compliant with screening appointments or study visits;
  • Family history of multiple endocrine neoplasia.

Other inclusion and exclusion criteria may apply.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

REMD-477 Treatment A

Matching placebo

Arm Description

Administered as a single SC dose in subjects with Type 1 Diabetes

Administered as a single SC dose in subjects with Type 1 Diabetes

Outcomes

Primary Outcome Measures

Number of treatment emergent adverse events per subject, including changes in vital signs, physical and neurological examinations, laboratory safety tests and ECGs
Changes from baseline in 24-hour insulin requirements on Day 1 relative to the two 24 hour periods post-treatment on Days 3 and 4, between the REMD-477 and placebo treated subjects, needed to maintain targeted glycemic control.

Secondary Outcome Measures

Immunogenicity: Incidence of REMD-477 neutralizing and non-neutralizing antibodies
Changes from baseline over time of AST.
Incidence of elevated serum aspartate transaminase (AST) values > 3x the upper limit of normal (ULN).
Changes from baseline over time of ALT.
Incidence of elevated serum alanine transaminase (ALT) values >3x the upper limit of normal (ULN).
Changes from baseline over time of ALP.
Incidence of elevated serum alkaline phosphatase (ALP) >2x upper limit of normal (ULN)
Changes from baseline over time of total bilirubin.
Incidence of elevated serum total bilirubin >2x upper limit of normal (ULN).
Changes from baseline over time of amylase
Incidence of elevated serum amylase values at >2.5x ULN
Changes from baseline over time of lipase
Incidence of elevated serum lipase values at >2.5x ULN

Full Information

First Posted
February 29, 2016
Last Updated
February 6, 2017
Sponsor
REMD Biotherapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02715193
Brief Title
Single-dose Study to Evaluate Safety, Tolerability, and Pharmacodynamics of REMD-477 in Subjects With Type 1 Diabetes Mellitus
Official Title
A Randomized, Placebo-controlled, Double-blind, In-patient Study to Evaluate Safety, Tolerability, and Pharmacodynamics of REMD-477 Following a Single Dose in Subjects With Type 1 Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
March 2016 (Actual)
Primary Completion Date
January 2017 (Actual)
Study Completion Date
January 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
REMD Biotherapeutics, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a randomized, placebo-controlled, double-blind study to evaluate safety, tolerability and pharmacodynamics of REMD-477 in subjects who have Type 1 diabetes and are currently receiving insulin treatment. This proof of concept study will determine whether glucagon receptor blockade using a single dose REMD-477 can improve short-term glucose homeostasis in people with Type 1 diabetes.
Detailed Description
The study will be conducted at two sites in the United States, and approximately 20 subjects with type 1 diabetes will be enrolled. Eligible subjects will be admitted to the clinical research unit, to carefully monitor blood glucose; and establish the baseline insulin requirement for maintaining targeted normoglycemia (postabsorptive: 90-120 mg/dL; and postprandial: <180 mg/dL). The patients will then be subjected to a hyperglycemic period (250-300 mg/dL) by a stepwise reduction in insulin infusion. After receiving a single SC dose of REMD-477 or matching placebo in a double-blinded fashion, all subjects will be assessed for the post-treatment 24-hour insulin requirement needed to maintain targeted normoglycemia (postabsorptive: 90-120 mg/dL; and postprandial: <180 mg/dL); and to be monitored closely for safety, tolerability and targeted glycemic control, for a 48-hr period. After the in-patient residency period, subjects will return to the clinic for weekly out-patient safety follow-up visits for 8 weeks.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Arm Title
REMD-477 Treatment A
Arm Type
Experimental
Arm Description
Administered as a single SC dose in subjects with Type 1 Diabetes
Arm Title
Matching placebo
Arm Type
Placebo Comparator
Arm Description
Administered as a single SC dose in subjects with Type 1 Diabetes
Intervention Type
Biological
Intervention Name(s)
REMD-477
Intervention Type
Biological
Intervention Name(s)
Placebo Comparator
Primary Outcome Measure Information:
Title
Number of treatment emergent adverse events per subject, including changes in vital signs, physical and neurological examinations, laboratory safety tests and ECGs
Time Frame
Baseline and 57 days
Title
Changes from baseline in 24-hour insulin requirements on Day 1 relative to the two 24 hour periods post-treatment on Days 3 and 4, between the REMD-477 and placebo treated subjects, needed to maintain targeted glycemic control.
Time Frame
Baseline (24 hour period on Day 1) and Days 3 and 4
Secondary Outcome Measure Information:
Title
Immunogenicity: Incidence of REMD-477 neutralizing and non-neutralizing antibodies
Time Frame
Baseline and 57 days
Title
Changes from baseline over time of AST.
Description
Incidence of elevated serum aspartate transaminase (AST) values > 3x the upper limit of normal (ULN).
Time Frame
Baseline and 57 days
Title
Changes from baseline over time of ALT.
Description
Incidence of elevated serum alanine transaminase (ALT) values >3x the upper limit of normal (ULN).
Time Frame
Baseline and 57 days
Title
Changes from baseline over time of ALP.
Description
Incidence of elevated serum alkaline phosphatase (ALP) >2x upper limit of normal (ULN)
Time Frame
Baseline and 57 days
Title
Changes from baseline over time of total bilirubin.
Description
Incidence of elevated serum total bilirubin >2x upper limit of normal (ULN).
Time Frame
Baseline and 57 days
Title
Changes from baseline over time of amylase
Description
Incidence of elevated serum amylase values at >2.5x ULN
Time Frame
Baseline and 57 days
Title
Changes from baseline over time of lipase
Description
Incidence of elevated serum lipase values at >2.5x ULN
Time Frame
Baseline and 57 days

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: Men and women between the ages of 18 and 60 years old, inclusive, at the time of screening; Females of non-child bearing potential must be ≥1 year post-menopausal (confirmed by a serum follicle-stimulating hormone (FSH) levels ≥ 40 IU/mL) or documented as being surgically sterile. Females of child bearing potential must agree to use two methods of contraception; Male subjects must be willing to use clinically acceptable method of contraception during the entire study; Body mass index between 18.5 and 26.9 kg/m2, inclusive, at screening; Diagnosed with Type 1 diabetes for greater than 2 years, based on clinical history or as defined by the current American Diabetes Association (ADA) criteria; HbA1c ≥6.0 % but <9.0 % at screening; Fasting C-peptide <0.2 ng/mL; Current use of insulin pump and willing to use continuous glucose monitoring (CGM) system (e.g. DexCom) throughout the entire study; ALT and/or AST within <1.5x ULN at screening; Serum amylase and lipase within normal limits at screening; Able to provide written informed consent approved by an Institutional Review Board (IRB). Exclusion Criteria: History or evidence of clinically-significant disorder or condition that, in the opinion of the Investigator, would pose a risk to subject safety or interfere with the study evaluation, procedures, or completion; Significant organ system dysfunction (e.g., clinically significant pulmonary or cardiovascular disease, anemia [Hemoglobin <10.0 g/dL], and renal dysfunction [eGFR <90 ml/1.73M2/min]); Any severe symptomatic hypoglycemic event associated with a seizure or requiring help from other people or medical facility in the past 6 months; Current or recent (within 1 month of screening) use of diabetes medications other than insulin; Use of steroids and/or other prescribed or over-the-counter medications that are known to affect the outcome measures in this study or known to influence glucose metabolism; Smokes tobacco; Known sensitivity to mammalian-derived drug preparations, recombinant protein-based drugs or to humanized or human antibodies; History of illegal drug use or alcohol abuse within the last 6 months or a positive drug urine test result at screening; History of pancreatitis, pancreatic neuroendocrine tumors or multiple endocrine neoplasia; History of pheochromocytoma, or family history of familial pheochromocytoma; Known or suspected susceptibility to infectious disease (eg, taking immunosuppressive agents or has a documented inherited or acquired immunodeficiency); Positive for human immunodeficiency virus (HIV) antibodies, hepatitis B surface antigen (HbsAg), or hepatitis C antibodies (HepC Ab); Participation in an investigational drug or device trial within 30 days of screening or within 5 times the half-life of the investigational agent in the other clinical study, if known, whichever period is longer; Blood donor or blood loss >500 mL within 30 days of Day 1; Women who are pregnant or lactating/breastfeeding; Regular exercise >120 min/week within 14 days of Day 1; Unable or unwilling to follow the study protocol or who are non-compliant with screening appointments or study visits; Family history of multiple endocrine neoplasia. Other inclusion and exclusion criteria may apply.
Facility Information:
City
San Diego
State/Province
California
Country
United States
City
St. Louis
State/Province
Missouri
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29283470
Citation
Pettus J, Reeds D, Cavaiola TS, Boeder S, Levin M, Tobin G, Cava E, Thai D, Shi J, Yan H, Bautista E, McMillan J, Unger R, Henry RR, Klein S. Effect of a glucagon receptor antibody (REMD-477) in type 1 diabetes: A randomized controlled trial. Diabetes Obes Metab. 2018 May;20(5):1302-1305. doi: 10.1111/dom.13202. Epub 2018 Jan 22.
Results Reference
derived

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Single-dose Study to Evaluate Safety, Tolerability, and Pharmacodynamics of REMD-477 in Subjects With Type 1 Diabetes Mellitus

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