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A Study of Continuous Subcutaneous Insulin Infusion (CSII) Pump Function in Subjects With Type 1 Diabetes With Recombinant Human Hyaluronidase (rHuPH20) (HALO-117-406)

Primary Purpose

Type 1 Diabetes Mellitus

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Rapid Acting insulin with pre-treatment of rHuPH20
Sham injection
Sponsored by
Halozyme Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes Mellitus focused on measuring Diabetes, Type 1 Diabetes Mellitus, Type 1 Diabetes, T1DM, Continuous Subcutaneous Insulin Infusion (CSII), CSII, Insulin pump, Insulin, rHuPH20, Hylenex, recombinant human hyaluronidase (rHuPH20), Recombinant hyaluronidase

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female participants between the ages 18 and 65 years, inclusive.
  2. Females of child-bearing potential must agree to use a standard and effective means of birth control for the duration of the study. Adequate contraceptive measures include oral or injectable contraceptives, sterilization, intra-uterine device (IUD), barrier methods, or abstinence.
  3. Participants with type 1 diabetes mellitus treated with insulin (multiple daily injections or continuous subcutaneous insulin infusion [CSII]) diagnosed ≥ 12 months prior to enrollment
  4. Body mass index (BMI) 18.0 to 32.0 kilograms per meters squared (kg/m^2)
  5. HbA1c (glycated hemoglobin A1c) ≤ 10% based on local laboratory results
  6. Fasting C-peptide < 0.6 nanograms per milliliter (ng/mL)
  7. Current treatment with insulin <1.2 Units per kg per day (U/kg/day)
  8. Participant should be in good general health based on medical history and physical examination, without medical conditions that might prevent the completion of study drug injections and assessments required in this protocol

Exclusion Criteria:

  1. Inability to comply with study requirements as judged by the Investigator
  2. Known or suspected allergy to any component of any of the study drugs in this trial
  3. A participant who has proliferative retinopathy or maculopathy, severe gastroparesis, and/or severe neuropathy, in particular autonomic neuropathy, as judged by the Investigator
  4. As judged by the Investigator, clinically significant active disease of the gastrointestinal, cardiovascular (including a history of arrhythmia or conduction delays on electrocardiogram), hepatic, neurological, renal, genitourinary, or hematological systems
  5. As judged by the Investigator, uncontrolled hypertension (diastolic blood pressure ≥ 100 millimeters of mercury [mmHg] and/or systolic blood pressure ≥ 160 mmHg after 5 minutes in the supine position)
  6. History of any illness or disease that in the opinion of the Investigator might confound the results of the trial or pose additional risk in administering the study drugs to the participant
  7. As judged by the Investigator, clinically significant findings in routine laboratory data. Anemia with hemoglobin less than lower limits of normal at screening is specifically exclusionary
  8. Use of drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia, or drugs not permitted according to Hylenex recombinant package insert
  9. Recurrent major hypoglycemia or hypoglycemic unawareness, as judged by the Investigator
  10. Current addiction to alcohol or substances of abuse as determined by the Investigator
  11. Blood donation (> 500 mL) within the previous 8 weeks (56 days) prior to Day -1 of Treatment Period 1
  12. Pregnancy, breast-feeding, the intention of becoming pregnant, or not using adequate contraceptive measures (adequate contraceptive measures consist of sterilization, IUD, oral or injectable contraceptives, or barrier methods)
  13. Mental incapacity, unwillingness, or language barriers precluding adequate understanding or cooperation in this study
  14. Participation in any other clinical trial and receipt of any investigational drug within 4 weeks of Day -1 of Treatment Period 1
  15. Any condition (intrinsic or extrinsic) that in the judgment of the Investigator will interfere with trial participation or evaluation of data
  16. Positive for human immunodeficiency virus (HIV), Hepatitis C or Hepatitis B
  17. Tobacco and nicotine use within 3 months prior to Day 1 of Treatment Period 1 or use during the study

Sites / Locations

  • Profil Institute for Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

Hylenex recombinant

Sham Injection

Arm Description

Comparing the preadministration of Hylenex recombinant in the setting of continuous subcutaneous insulin infusion (CSII).

Comparing the preadministration of a sham injection in the setting of CSII.

Outcomes

Primary Outcome Measures

Part 1: Area Under the Curve (AUC) of Glucose Infusion Rate (GIR) From 0-6 Hours
Part 2: Time to Reduction in Plasma Glucose by 80 Milligrams Per Deciliter (mg/dL) Following CSII Bolus
Time to reduction is reported as the maximum time it took for any participant receiving each treatment sequence to achieve a reduction in plasma glucose by 80 mg/dL. During the course of the study, it became difficult to establish a stable hyperglycemic plateau with a target glucose level of 220 mg/dL, even after adjusting several operational parameters. The study was stopped early, prior to enrolling the planned 24 participants for Part 2. Thus, analysis for this endpoint was not conducted. Raw data (as a maximum) are reported.
Part 3: Time to Achieve Plasma Glucose >90 mg/dL After Release of Hypoglycemic CSII Clamp

Secondary Outcome Measures

Part 1: Time-action Profile, Assessed by GIR in Euglycemic Participants
Part 1: Mean Maximum Concentration (Cmax)
Part 1: Time to Achieve Maximum Concentration (Tmax)
Part 1: Early Time to 50% Maximum Serum Insulin Concentration (t50%) Max
Part 1: Time to 50% of Total AUC (AUC0-last)
Part 1: Fractional and Absolute AUC0-1hr
Part 1: Fractional and Absolute AUC2hr-end
Part 1: Area Under the Curve From Time Zero to the Last Measureable Concentration (AUC0-last)
Part 1: Mean Residence Time (MRT)
Part 2: Plasma Glucose Concentration Over Time
Plasma glucose concentration over time is reported as the maximum concentration for any participant receiving each treatment sequence. During the course of the study, it became difficult to establish a stable hyperglycemic plateau with a target glucose level of 220 mg/dL, even after adjusting several operational parameters. The study was stopped early, prior to enrolling the planned 24 participants for Part 2. Thus, analysis for this endpoint was not conducted. Raw data (as a maximum) are reported.
Part 2: Insulin Analog Serum Concentration as a Function of Time Following Bolus Insulin Infusion
Insulin analog serum concentration is reported as the maximum concentration for any participant receiving each treatment sequence. During the course of the study, it became difficult to establish a stable hyperglycemic plateau with a target glucose level of 220 mg/dL, even after adjusting several operational parameters. The study was stopped early, prior to enrolling the planned 24 participants for Part 2. Thus, analysis for this endpoint was not conducted. Raw data (as a maximum) are reported.
Part 3: Plasma Glucose Concentration Over Time
Part 3: Insulin Analog Serum Concentration as a Function of Time Following Termination of Insulin Infusion

Full Information

First Posted
August 13, 2018
Last Updated
January 30, 2019
Sponsor
Halozyme Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT03662334
Brief Title
A Study of Continuous Subcutaneous Insulin Infusion (CSII) Pump Function in Subjects With Type 1 Diabetes With Recombinant Human Hyaluronidase (rHuPH20)
Acronym
HALO-117-406
Official Title
A Phase 4, Double Blind, Single Center, Randomized, Cross-Over Study of Continuous Subcutaneous Insulin Infusion (CSII) Pump Functionality in Subjects With Type 1 Diabetes Comparing Pretreatment vs. No Pretreatment With Recombinant Human Hyaluronidase (rHuPH20)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
October 3, 2013 (Actual)
Primary Completion Date
February 27, 2014 (Actual)
Study Completion Date
February 27, 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Halozyme Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this study is to determine if Hylenex recombinant leads to changes in the insulin time-action profiles and glucose responses when preadministered in the setting of continuous subcutaneous insulin infusion (CSII) compared to CSII without Hylenex recombinant (sham injection).
Detailed Description
There is a recognized need for more rapid insulin action than is available from current rapid-acting analog products. In addition, current products have inconstant absorption and action profiles over the course of infusion set life. Previous human studies of prandial insulin preparations have used co-mixtures of rHuPH20 (study drug) with insulin delivered to study participants by subcutaneous injection and have demonstrated acceleration of insulin absorption and action. CSII has been used clinically for the treatment of diabetes over the last three decades, and a previous study using a co-mixture of rHuPH20 during CSII showed that the combination resulted in a more consistent and ultrafast profile of insulin absorption and action across infusion set use as compared to rapid analog insulin alone.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus
Keywords
Diabetes, Type 1 Diabetes Mellitus, Type 1 Diabetes, T1DM, Continuous Subcutaneous Insulin Infusion (CSII), CSII, Insulin pump, Insulin, rHuPH20, Hylenex, recombinant human hyaluronidase (rHuPH20), Recombinant hyaluronidase

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Hylenex recombinant
Arm Type
Experimental
Arm Description
Comparing the preadministration of Hylenex recombinant in the setting of continuous subcutaneous insulin infusion (CSII).
Arm Title
Sham Injection
Arm Type
Sham Comparator
Arm Description
Comparing the preadministration of a sham injection in the setting of CSII.
Intervention Type
Drug
Intervention Name(s)
Rapid Acting insulin with pre-treatment of rHuPH20
Other Intervention Name(s)
Humalog, Hylenex
Intervention Description
Hylenex recombinant will be administered via infusion sets and insulin pumps. These will be compatible with component tubing system attached to the insulin infusion site and will be placed in the lower abdominal area.
Intervention Type
Device
Intervention Name(s)
Sham injection
Other Intervention Name(s)
placebo
Intervention Description
A sham injection will be administered via infusion sets and insulin pumps. These will be compatible with component tubing system attached to the insulin infusion site and will be placed in the lower abdominal area.
Primary Outcome Measure Information:
Title
Part 1: Area Under the Curve (AUC) of Glucose Infusion Rate (GIR) From 0-6 Hours
Time Frame
0-6 hours
Title
Part 2: Time to Reduction in Plasma Glucose by 80 Milligrams Per Deciliter (mg/dL) Following CSII Bolus
Description
Time to reduction is reported as the maximum time it took for any participant receiving each treatment sequence to achieve a reduction in plasma glucose by 80 mg/dL. During the course of the study, it became difficult to establish a stable hyperglycemic plateau with a target glucose level of 220 mg/dL, even after adjusting several operational parameters. The study was stopped early, prior to enrolling the planned 24 participants for Part 2. Thus, analysis for this endpoint was not conducted. Raw data (as a maximum) are reported.
Time Frame
0-10 hours
Title
Part 3: Time to Achieve Plasma Glucose >90 mg/dL After Release of Hypoglycemic CSII Clamp
Time Frame
0-12 hours
Secondary Outcome Measure Information:
Title
Part 1: Time-action Profile, Assessed by GIR in Euglycemic Participants
Time Frame
up to approximately 10 hours
Title
Part 1: Mean Maximum Concentration (Cmax)
Time Frame
up to approximately 22 hours
Title
Part 1: Time to Achieve Maximum Concentration (Tmax)
Time Frame
up to approximately 22 hours
Title
Part 1: Early Time to 50% Maximum Serum Insulin Concentration (t50%) Max
Time Frame
up to approximately 22 hours
Title
Part 1: Time to 50% of Total AUC (AUC0-last)
Time Frame
up to approximately 22 hours
Title
Part 1: Fractional and Absolute AUC0-1hr
Time Frame
0 to 1 hour
Title
Part 1: Fractional and Absolute AUC2hr-end
Time Frame
2 to approximately 22 hours
Title
Part 1: Area Under the Curve From Time Zero to the Last Measureable Concentration (AUC0-last)
Time Frame
up to approximately 22 hours
Title
Part 1: Mean Residence Time (MRT)
Time Frame
up to approximately 22 hours
Title
Part 2: Plasma Glucose Concentration Over Time
Description
Plasma glucose concentration over time is reported as the maximum concentration for any participant receiving each treatment sequence. During the course of the study, it became difficult to establish a stable hyperglycemic plateau with a target glucose level of 220 mg/dL, even after adjusting several operational parameters. The study was stopped early, prior to enrolling the planned 24 participants for Part 2. Thus, analysis for this endpoint was not conducted. Raw data (as a maximum) are reported.
Time Frame
up to approximately 10 hours
Title
Part 2: Insulin Analog Serum Concentration as a Function of Time Following Bolus Insulin Infusion
Description
Insulin analog serum concentration is reported as the maximum concentration for any participant receiving each treatment sequence. During the course of the study, it became difficult to establish a stable hyperglycemic plateau with a target glucose level of 220 mg/dL, even after adjusting several operational parameters. The study was stopped early, prior to enrolling the planned 24 participants for Part 2. Thus, analysis for this endpoint was not conducted. Raw data (as a maximum) are reported.
Time Frame
up to approximately 10 hours
Title
Part 3: Plasma Glucose Concentration Over Time
Time Frame
up to approximately 12 hours
Title
Part 3: Insulin Analog Serum Concentration as a Function of Time Following Termination of Insulin Infusion
Time Frame
up to approximately 12 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants between the ages 18 and 65 years, inclusive. Females of child-bearing potential must agree to use a standard and effective means of birth control for the duration of the study. Adequate contraceptive measures include oral or injectable contraceptives, sterilization, intra-uterine device (IUD), barrier methods, or abstinence. Participants with type 1 diabetes mellitus treated with insulin (multiple daily injections or continuous subcutaneous insulin infusion [CSII]) diagnosed ≥ 12 months prior to enrollment Body mass index (BMI) 18.0 to 32.0 kilograms per meters squared (kg/m^2) HbA1c (glycated hemoglobin A1c) ≤ 10% based on local laboratory results Fasting C-peptide < 0.6 nanograms per milliliter (ng/mL) Current treatment with insulin <1.2 Units per kg per day (U/kg/day) Participant should be in good general health based on medical history and physical examination, without medical conditions that might prevent the completion of study drug injections and assessments required in this protocol Exclusion Criteria: Inability to comply with study requirements as judged by the Investigator Known or suspected allergy to any component of any of the study drugs in this trial A participant who has proliferative retinopathy or maculopathy, severe gastroparesis, and/or severe neuropathy, in particular autonomic neuropathy, as judged by the Investigator As judged by the Investigator, clinically significant active disease of the gastrointestinal, cardiovascular (including a history of arrhythmia or conduction delays on electrocardiogram), hepatic, neurological, renal, genitourinary, or hematological systems As judged by the Investigator, uncontrolled hypertension (diastolic blood pressure ≥ 100 millimeters of mercury [mmHg] and/or systolic blood pressure ≥ 160 mmHg after 5 minutes in the supine position) History of any illness or disease that in the opinion of the Investigator might confound the results of the trial or pose additional risk in administering the study drugs to the participant As judged by the Investigator, clinically significant findings in routine laboratory data. Anemia with hemoglobin less than lower limits of normal at screening is specifically exclusionary Use of drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia, or drugs not permitted according to Hylenex recombinant package insert Recurrent major hypoglycemia or hypoglycemic unawareness, as judged by the Investigator Current addiction to alcohol or substances of abuse as determined by the Investigator Blood donation (> 500 mL) within the previous 8 weeks (56 days) prior to Day -1 of Treatment Period 1 Pregnancy, breast-feeding, the intention of becoming pregnant, or not using adequate contraceptive measures (adequate contraceptive measures consist of sterilization, IUD, oral or injectable contraceptives, or barrier methods) Mental incapacity, unwillingness, or language barriers precluding adequate understanding or cooperation in this study Participation in any other clinical trial and receipt of any investigational drug within 4 weeks of Day -1 of Treatment Period 1 Any condition (intrinsic or extrinsic) that in the judgment of the Investigator will interfere with trial participation or evaluation of data Positive for human immunodeficiency virus (HIV), Hepatitis C or Hepatitis B Tobacco and nicotine use within 3 months prior to Day 1 of Treatment Period 1 or use during the study
Facility Information:
Facility Name
Profil Institute for Clinical Research
City
Chula Vista
State/Province
California
ZIP/Postal Code
91911
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.halozyme.com
Description
Halozyme Therapeutics

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A Study of Continuous Subcutaneous Insulin Infusion (CSII) Pump Function in Subjects With Type 1 Diabetes With Recombinant Human Hyaluronidase (rHuPH20)

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