A Clinical Study to Investigate if SAR425899 Binds to the Liver and Pancreas in Overweight to Obese Type 2 Diabetes Mellitus Patients
Primary Purpose
Type 2 Diabetes Mellitus
Status
Completed
Phase
Phase 1
Locations
Sweden
Study Type
Interventional
Intervention
SAR425899
[68Ga] Ga-DO3A-VS-Cys40-Tuna-2 (glucagon receptor tracer)
[68Ga] Ga-DO3A-VS-Cys40-Exendin-4 (GLP-1 receptor tracer)
Sponsored by

About this trial
This is an interventional basic science trial for Type 2 Diabetes Mellitus
Eligibility Criteria
Inclusion criteria :
- Male and female patients, between 18 and 75 years of age, inclusive.
- Body weight between 60.0 and 120.0 kg, inclusive, body mass index between 28.0 and 38.0 kg/m2, inclusive.
- Diagnosis of type 2 diabetes mellitus for at least 1 year at the time of inclusion with stable metformin treatment prior to inclusion, with or without comorbidities related to type 2 diabetes mellitus.
- Fasting plasma glucose ≥ 90 mg/dL at screening.
- Glycosylated hemoglobin (HbA1c) ≥6.5% and ≤9 % at screening.
Exclusion criteria:
- Any history or presence of clinically relevant cardiovascular, pulmonary, gastrointestinal, hepatic, renal, metabolic, hematological, neurological, osteomuscular, articular, psychiatric, systemic, ocular, gynecologic (if female), urologic or infectious disease, hormonal active tumors (e.g. pheochromocytoma or insulinoma), or signs of acute illness that is not related to the metabolic status of the patient.
- Presence or history of drug hypersensitivity (including known allergic reactions associated with glucagon like peptide-1 (GLP-1) agonist treatment [exenatide, liraglutide, lixisenatide]), or allergic disease diagnosed and treated by a physician.
- Any intake of menopausal hormone replacement therapy, systemic corticosteroids, growth hormones, weight-loss drugs, antihyperlipidemic treatment, antihyperglycemic treatment [e.g., GLP-1 agonists, insulin, thiazolidinediones, dipeptidylpeptidase (DPP-IV) inhibitors, sodium/glucose cotransporter-2 (SGLT-2) inhibitors etc.]) during the treatment period and within 21 days before first dosing or within 5 times the elimination half-life or pharmacodynamic half-life of the medication (if known), with the exception of metformin, sulphonylureas (SU), standard antihypertensive treatment, statins and acetyl salicylic acid.
- Any condition possibly affecting gastric emptying or absorption from gastro-intestinal tract (e.g., gastric surgery, gastrectomy, bariatric surgery, malabsorption syndromes, gastroparesis, abdominal surgery other than appendectomy, hysterectomy, cholecystectomy and herniaplasty).
- Surgically treated obesity, bariatric surgery.
- Severe dyslipidemia with fasting triglycerides >450 mg/dL at screening.
- Severe hypoglycemia resulting in seizure/unconsciousness/coma or hospitalization for diabetic ketoacidosis in the last 3 months before screening.
- Persistent hyperglycemia not adequately controlled by metformin, SUs and/or diet/exercise.
- Diagnosed diabetic neuropathy, retinopathy, nephropathy or renal impairment (GFR <60 mL/min; estimate after Cockcroft-Gault) at screening.
- Unstable hypo- or hyperthyroidism (as assessed by TSH) at screening.
- History of pancreatitis or pancreatectomy.
- Amylase and/or lipase > 2 upper limit of normal (ULN) at screening.
- Personal history or family history of medullary thyroid cancer or a genetic condition that predisposes to medullary thyroid cancer.
- Elevated basal calcitonin (≥20 pg/mL / 5.9 pmol/L) at screening.
- Known past or present diseases or disorders of any target organ (liver, pancreas, spleen).
- Medical positron emitting tomography (PET), single photon emission computer tomography (SPECT), abdominal or thoracic computer tomography (CT) examination during the previous 12 months' time period.
- Claustrophobia.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Sites / Locations
- Investigational Site Number 7520001
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
SAR425899 high dose
SAR425899 low dose
Arm Description
Repeated once daily subcutaneous (SC) doses of SAR425899 administered over 20 days
Repeated once daily SC doses of SAR425899 administered over 20 days
Outcomes
Primary Outcome Measures
Glucagon receptor occupancy
Change of glucagon receptor tracer binding in the liver with SAR425899 between Day 1 and Day 20
Secondary Outcome Measures
GLP-1 receptor occupancy
Change of GLP-1 receptor tracer binding in the pancreas with SAR425899 between Day 1 and Day 17
Adverse events
Number of adverse events in patients under treatment with SAR425899
Pharmacokinetics
Assessment of SAR425899 maximum plasma concentration (Cmax)
Change in fasting plasma glucose (FPG)
Absolute change in FPG from baseline to Day 20
Change in ketone bodies
Absolute change in ketone bodies from baseline to Day 20
Change lipid biomarkers
Absolute change cholesterol from baseline to Day 20
Change in volume of distribution (Vt) in the liver
Change of glucagon receptor tracer Vt in the liver with SAR425899 between Day 1 and Day 20
Change in Vt in the pancreas
Change of GLP-1 receptor tracer Vt in the pancreas with SAR425899 between Day 1 and Day 17
Average standard uptake values (SUVs) of PET tracers in the liver and pancreas
Average SUVs for glucagon and GLP-1 tracer in liver and pancreas
Pharmacokinetics
Assessment of SAR425899 time to reach Cmax ( tmax)
Pharmacokinetics
Assessment of SAR425899 area under the concentration versus time curve (AUC)
Pharmacokinetics
Assessment of SAR425899 terminal elimination half-life ( t1/2)
Pharmacokinetics
Assessment of SAR425899 total body clearance from the plasma (CL)
Change lipid biomarkers
Absolute change in free fatty acids from baseline to Day 20
Change lipid biomarkers
Absolute change in triglycerides from baseline to Day 20
Full Information
NCT ID
NCT03350191
First Posted
November 16, 2017
Last Updated
April 21, 2022
Sponsor
Sanofi
Collaborators
Antaros Medical
1. Study Identification
Unique Protocol Identification Number
NCT03350191
Brief Title
A Clinical Study to Investigate if SAR425899 Binds to the Liver and Pancreas in Overweight to Obese Type 2 Diabetes Mellitus Patients
Official Title
A PET/CT Study to Assess the Receptor Occupancy by SAR425899 After Repeat Dosing Using Radiolabelled Tracers for the Glucagon and GLP-1 Receptor in Overweight to Obese T2DM Patients
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
December 20, 2017 (Actual)
Primary Completion Date
June 7, 2018 (Actual)
Study Completion Date
June 7, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi
Collaborators
Antaros Medical
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Primary Objectives:
To assess in overweight to obese T2DM patients:
The glucagon receptor occupancy of SAR425899 at two dose levels in the human liver with positron-emission tomography (PET) imaging using [68Ga]Ga-DO3A-VS-Cys40-Tuna-2 as a tracer compound.
The GLP-1 receptor occupancy of SAR425899 at two dose levels in the human pancreas with PET imaging using [68Ga]Ga-DO3A-VS-Cys40-Exendin-4 as a tracer compound.
Pharmacodynamic effects on fasting plasma glucose and biomarkers of lipid metabolism.
Pharmacokinetic parameters for SAR425899 after repeated subcutaneous (SC) doses in plasma.
Safety and tolerability of SAR425899.
Detailed Description
Study duration is approximately 7 weeks with a 20 days treatment period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes Mellitus
7. Study Design
Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
13 (Actual)
8. Arms, Groups, and Interventions
Arm Title
SAR425899 high dose
Arm Type
Experimental
Arm Description
Repeated once daily subcutaneous (SC) doses of SAR425899 administered over 20 days
Arm Title
SAR425899 low dose
Arm Type
Experimental
Arm Description
Repeated once daily SC doses of SAR425899 administered over 20 days
Intervention Type
Drug
Intervention Name(s)
SAR425899
Intervention Description
Pharmaceutical form: Solution for injection
Route of administration: Subcutaneous
Intervention Type
Drug
Intervention Name(s)
[68Ga] Ga-DO3A-VS-Cys40-Tuna-2 (glucagon receptor tracer)
Intervention Description
Pharmaceutical form: Solution for injection
Route of administration: Subcutaneous
Intervention Type
Drug
Intervention Name(s)
[68Ga] Ga-DO3A-VS-Cys40-Exendin-4 (GLP-1 receptor tracer)
Intervention Description
Pharmaceutical form: Solution for injection
Route of administration: Subcutaneous
Primary Outcome Measure Information:
Title
Glucagon receptor occupancy
Description
Change of glucagon receptor tracer binding in the liver with SAR425899 between Day 1 and Day 20
Time Frame
Day 1 and Day 20
Secondary Outcome Measure Information:
Title
GLP-1 receptor occupancy
Description
Change of GLP-1 receptor tracer binding in the pancreas with SAR425899 between Day 1 and Day 17
Time Frame
Day 1 and Day 17
Title
Adverse events
Description
Number of adverse events in patients under treatment with SAR425899
Time Frame
Up to 27 days
Title
Pharmacokinetics
Description
Assessment of SAR425899 maximum plasma concentration (Cmax)
Time Frame
Day 20
Title
Change in fasting plasma glucose (FPG)
Description
Absolute change in FPG from baseline to Day 20
Time Frame
Day 1 to Day 20
Title
Change in ketone bodies
Description
Absolute change in ketone bodies from baseline to Day 20
Time Frame
Day 1 to Day 20
Title
Change lipid biomarkers
Description
Absolute change cholesterol from baseline to Day 20
Time Frame
Day 1 to Day 20
Title
Change in volume of distribution (Vt) in the liver
Description
Change of glucagon receptor tracer Vt in the liver with SAR425899 between Day 1 and Day 20
Time Frame
Day 1 and Day 20
Title
Change in Vt in the pancreas
Description
Change of GLP-1 receptor tracer Vt in the pancreas with SAR425899 between Day 1 and Day 17
Time Frame
Day 1 and Day 17
Title
Average standard uptake values (SUVs) of PET tracers in the liver and pancreas
Description
Average SUVs for glucagon and GLP-1 tracer in liver and pancreas
Time Frame
Day 1, Day 17 and Day 20
Title
Pharmacokinetics
Description
Assessment of SAR425899 time to reach Cmax ( tmax)
Time Frame
Day 20
Title
Pharmacokinetics
Description
Assessment of SAR425899 area under the concentration versus time curve (AUC)
Time Frame
Day 20
Title
Pharmacokinetics
Description
Assessment of SAR425899 terminal elimination half-life ( t1/2)
Time Frame
Day 20
Title
Pharmacokinetics
Description
Assessment of SAR425899 total body clearance from the plasma (CL)
Time Frame
Day 20
Title
Change lipid biomarkers
Description
Absolute change in free fatty acids from baseline to Day 20
Time Frame
Day 1 to Day 20
Title
Change lipid biomarkers
Description
Absolute change in triglycerides from baseline to Day 20
Time Frame
Day 1 to Day 20
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria :
Male and female patients, between 18 and 75 years of age, inclusive.
Body weight between 60.0 and 120.0 kg, inclusive, body mass index between 28.0 and 38.0 kg/m2, inclusive.
Diagnosis of type 2 diabetes mellitus for at least 1 year at the time of inclusion with stable metformin treatment prior to inclusion, with or without comorbidities related to type 2 diabetes mellitus.
Fasting plasma glucose ≥ 90 mg/dL at screening.
Glycosylated hemoglobin (HbA1c) ≥6.5% and ≤9 % at screening.
Exclusion criteria:
Any history or presence of clinically relevant cardiovascular, pulmonary, gastrointestinal, hepatic, renal, metabolic, hematological, neurological, osteomuscular, articular, psychiatric, systemic, ocular, gynecologic (if female), urologic or infectious disease, hormonal active tumors (e.g. pheochromocytoma or insulinoma), or signs of acute illness that is not related to the metabolic status of the patient.
Presence or history of drug hypersensitivity (including known allergic reactions associated with glucagon like peptide-1 (GLP-1) agonist treatment [exenatide, liraglutide, lixisenatide]), or allergic disease diagnosed and treated by a physician.
Any intake of menopausal hormone replacement therapy, systemic corticosteroids, growth hormones, weight-loss drugs, antihyperlipidemic treatment, antihyperglycemic treatment [e.g., GLP-1 agonists, insulin, thiazolidinediones, dipeptidylpeptidase (DPP-IV) inhibitors, sodium/glucose cotransporter-2 (SGLT-2) inhibitors etc.]) during the treatment period and within 21 days before first dosing or within 5 times the elimination half-life or pharmacodynamic half-life of the medication (if known), with the exception of metformin, sulphonylureas (SU), standard antihypertensive treatment, statins and acetyl salicylic acid.
Any condition possibly affecting gastric emptying or absorption from gastro-intestinal tract (e.g., gastric surgery, gastrectomy, bariatric surgery, malabsorption syndromes, gastroparesis, abdominal surgery other than appendectomy, hysterectomy, cholecystectomy and herniaplasty).
Surgically treated obesity, bariatric surgery.
Severe dyslipidemia with fasting triglycerides >450 mg/dL at screening.
Severe hypoglycemia resulting in seizure/unconsciousness/coma or hospitalization for diabetic ketoacidosis in the last 3 months before screening.
Persistent hyperglycemia not adequately controlled by metformin, SUs and/or diet/exercise.
Diagnosed diabetic neuropathy, retinopathy, nephropathy or renal impairment (GFR <60 mL/min; estimate after Cockcroft-Gault) at screening.
Unstable hypo- or hyperthyroidism (as assessed by TSH) at screening.
History of pancreatitis or pancreatectomy.
Amylase and/or lipase > 2 upper limit of normal (ULN) at screening.
Personal history or family history of medullary thyroid cancer or a genetic condition that predisposes to medullary thyroid cancer.
Elevated basal calcitonin (≥20 pg/mL / 5.9 pmol/L) at screening.
Known past or present diseases or disorders of any target organ (liver, pancreas, spleen).
Medical positron emitting tomography (PET), single photon emission computer tomography (SPECT), abdominal or thoracic computer tomography (CT) examination during the previous 12 months' time period.
Claustrophobia.
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
Facility Information:
Facility Name
Investigational Site Number 7520001
City
Uppsala
ZIP/Postal Code
75237
Country
Sweden
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
Citations:
PubMed Identifier
34503957
Citation
Eriksson O, Velikyan I, Haack T, Bossart M, Laitinen I, Larsen PJ, Berglund JE, Antoni G, Johansson L, Pierrou S, Tillner J, Wagner M. Glucagonlike Peptide-1 Receptor Imaging in Individuals with Type 2 Diabetes. J Nucl Med. 2022 May;63(5):794-800. doi: 10.2967/jnumed.121.262506. Epub 2021 Sep 9.
Results Reference
derived
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A Clinical Study to Investigate if SAR425899 Binds to the Liver and Pancreas in Overweight to Obese Type 2 Diabetes Mellitus Patients
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