Effect of Nesiritide Infusion on Insulin Sensitivity in Healthy Obese Insulin Resistant Subjects (BNP3)
Primary Purpose
Diabetes
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Continous IV infusion of Nesiritide
Hyperinsulinemic euglycemic clamp
Placebo
Sponsored by
About this trial
This is an interventional basic science trial for Diabetes focused on measuring human B-type natriuretic peptide
Eligibility Criteria
Inclusion Criteria:
- Age 40-65 years inclusive
- Men and women
- Able to provide written, informed consent
- Weight stable (± 3 kg) during the 3 months prior to enrollment
- BMI ≥ 30 kg/m2; body weight ≤ 106 kg
- Resting blood pressure ≥ 110/60 mmHg and ≤ 150/100 mmHg
Exclusion Criteria:
- Known coronary artery disease, angina or heart failure
- Type 1 or Type 2 Diabetes (A1c ≥ 6.5% and/or fasting plasma glucose >125mg/dL)
- Bleeding disorders
- Hemoglobin level < 12.5 g/dL for women; < 13.0 g/dL for men
- Acute or chronic infections
- Hepatitis and/or cirrhosis (AST or Alanine Aminotransferase 2.5 times upper limit of normal)
- Severe asthma or chronic obstructive pulmonary disease
- Renal insufficiency (creatinine > 1.6 mg/dL)
- Prior bariatric surgery
- Inflammatory bowel disease or malabsorption
- Cancer within the last 3 years (except non-melanoma skin cancer or treated cervical carcinoma in situ)
- Psychiatric or eating disorders
- Untreated or inadequately controlled thyroid (abnormal TSH) or other endocrine disorders
- Active rheumatoid arthritis or other inflammatory rheumatic disorder
- Pregnant or nursing women
- Presence of clinically significant abnormalities on electrocardiogram
- Smoking (within the last 3 months)
- Known hypersensitivity to nesiritide or any of its excipients
- Poor intravenous access
- Use of medications: a) nitrates, b) beta-blockers, c) digoxin, d) anti-diabetic agents, e) oral, injected or chronic topical steroids (inhaled steroids for mild asthma are acceptable), f) chronic use of aspirin or other non-steroidal anti-inflammatory drugs, including cyclooxygenase-2 inhibitors, g) other drugs known to affect immune or metabolic function and h) orlistat, phenteramine or other weight loss or anorectic agents.
Sites / Locations
- Translational Research Institute for Metabolism and Diabetes
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Obese nondiabetic insulin resistant subjects- Panel A
Obese nondiabetic insulin resistant subjects- Panel B
Arm Description
IV nesiritide 3 pmol/kg/min or placebo for nesiritide
IV nesiritide 2 pmol/kg/min or placebo for nesiritide
Outcomes
Primary Outcome Measures
IV infusion of nesiritide at a 3pmol/kg rate
Average changes in glucose disposal rates (GDR) and endogenous glucose production (EGP) from baseline corrected for body weight at steady state of the clamp during the high- and low-dose portions.
Secondary Outcome Measures
Full Information
NCT ID
NCT03234751
First Posted
July 18, 2017
Last Updated
March 9, 2020
Sponsor
AdventHealth Translational Research Institute
1. Study Identification
Unique Protocol Identification Number
NCT03234751
Brief Title
Effect of Nesiritide Infusion on Insulin Sensitivity in Healthy Obese Insulin Resistant Subjects
Acronym
BNP3
Official Title
Effect of Nesiritide Infusion on Insulin Sensitivity in Healthy Obese Insulin Resistant Subjects
Study Type
Interventional
2. Study Status
Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
July 13, 2017 (Actual)
Primary Completion Date
September 24, 2018 (Actual)
Study Completion Date
February 19, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AdventHealth Translational Research Institute
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of the study is to compare the effects of nesiritide to placebo administered by a continuous IV infusion over 48 hours for the treatment of insulin resistance in healthy, obese, insulin resistant individuals.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes
Keywords
human B-type natriuretic peptide
7. Study Design
Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Model Description
This study is prospective randomized, double masked, 2-period cross over design, proof of concept study of the effects of intravenously administered rhBNP (nesiritide) on insulin sensitivity in otherwise healthy obese nondiabetic insulin resistant subjects.
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Obese nondiabetic insulin resistant subjects- Panel A
Arm Type
Active Comparator
Arm Description
IV nesiritide 3 pmol/kg/min or placebo for nesiritide
Arm Title
Obese nondiabetic insulin resistant subjects- Panel B
Arm Type
Active Comparator
Arm Description
IV nesiritide 2 pmol/kg/min or placebo for nesiritide
Intervention Type
Drug
Intervention Name(s)
Continous IV infusion of Nesiritide
Intervention Description
Nesiritide (fhBNP) administered by continuous IV infusion during 48 hours.
Intervention Type
Drug
Intervention Name(s)
Hyperinsulinemic euglycemic clamp
Intervention Description
48 hours IV infusion of nesiritide on insulin sensitivity (IS) measured by two-step hyperinsulinemic euglycemic clamp in obese nondiabetic insulin resistant subjects.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
48 hours of placebo.
Primary Outcome Measure Information:
Title
IV infusion of nesiritide at a 3pmol/kg rate
Description
Average changes in glucose disposal rates (GDR) and endogenous glucose production (EGP) from baseline corrected for body weight at steady state of the clamp during the high- and low-dose portions.
Time Frame
48 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Age 40-65 years inclusive
Men and women
Able to provide written, informed consent
Weight stable (± 3 kg) during the 3 months prior to enrollment
BMI ≥ 30 kg/m2; body weight ≤ 106 kg
Resting blood pressure ≥ 110/60 mmHg and ≤ 150/100 mmHg
Exclusion Criteria:
Known coronary artery disease, angina or heart failure
Type 1 or Type 2 Diabetes (A1c ≥ 6.5% and/or fasting plasma glucose >125mg/dL)
Bleeding disorders
Hemoglobin level < 12.5 g/dL for women; < 13.0 g/dL for men
Acute or chronic infections
Hepatitis and/or cirrhosis (AST or Alanine Aminotransferase 2.5 times upper limit of normal)
Severe asthma or chronic obstructive pulmonary disease
Renal insufficiency (creatinine > 1.6 mg/dL)
Prior bariatric surgery
Inflammatory bowel disease or malabsorption
Cancer within the last 3 years (except non-melanoma skin cancer or treated cervical carcinoma in situ)
Psychiatric or eating disorders
Untreated or inadequately controlled thyroid (abnormal TSH) or other endocrine disorders
Active rheumatoid arthritis or other inflammatory rheumatic disorder
Pregnant or nursing women
Presence of clinically significant abnormalities on electrocardiogram
Smoking (within the last 3 months)
Known hypersensitivity to nesiritide or any of its excipients
Poor intravenous access
Use of medications: a) nitrates, b) beta-blockers, c) digoxin, d) anti-diabetic agents, e) oral, injected or chronic topical steroids (inhaled steroids for mild asthma are acceptable), f) chronic use of aspirin or other non-steroidal anti-inflammatory drugs, including cyclooxygenase-2 inhibitors, g) other drugs known to affect immune or metabolic function and h) orlistat, phenteramine or other weight loss or anorectic agents.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Pratley, MD
Organizational Affiliation
Translational Reseach institute for Metabolism and Diabetes
Official's Role
Principal Investigator
Facility Information:
Facility Name
Translational Research Institute for Metabolism and Diabetes
City
Orlando
State/Province
Florida
ZIP/Postal Code
32804
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Effect of Nesiritide Infusion on Insulin Sensitivity in Healthy Obese Insulin Resistant Subjects
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