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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
AdventHealth Translational Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Diabetes focused on measuring human B-type natriuretic peptide

Eligibility Criteria

40 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Age 40-65 years inclusive
  2. Men and women
  3. Able to provide written, informed consent
  4. Weight stable (± 3 kg) during the 3 months prior to enrollment
  5. BMI ≥ 30 kg/m2; body weight ≤ 106 kg
  6. Resting blood pressure ≥ 110/60 mmHg and ≤ 150/100 mmHg

Exclusion Criteria:

  1. Known coronary artery disease, angina or heart failure
  2. Type 1 or Type 2 Diabetes (A1c ≥ 6.5% and/or fasting plasma glucose >125mg/dL)
  3. Bleeding disorders
  4. Hemoglobin level < 12.5 g/dL for women; < 13.0 g/dL for men
  5. Acute or chronic infections
  6. Hepatitis and/or cirrhosis (AST or Alanine Aminotransferase 2.5 times upper limit of normal)
  7. Severe asthma or chronic obstructive pulmonary disease
  8. Renal insufficiency (creatinine > 1.6 mg/dL)
  9. Prior bariatric surgery
  10. Inflammatory bowel disease or malabsorption
  11. Cancer within the last 3 years (except non-melanoma skin cancer or treated cervical carcinoma in situ)
  12. Psychiatric or eating disorders
  13. Untreated or inadequately controlled thyroid (abnormal TSH) or other endocrine disorders
  14. Active rheumatoid arthritis or other inflammatory rheumatic disorder
  15. Pregnant or nursing women
  16. Presence of clinically significant abnormalities on electrocardiogram
  17. Smoking (within the last 3 months)
  18. Known hypersensitivity to nesiritide or any of its excipients
  19. Poor intravenous access
  20. 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

First Posted
July 18, 2017
Last Updated
March 9, 2020
Sponsor
AdventHealth Translational Research Institute
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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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