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Bioavailability of Technosphere® Insulin Versus Subcutaneous Regular Human Insulin in Type 2 Diabetes

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Technosphere Insulin
Actrapid
Sponsored by
Mannkind Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes Mellitus

Eligibility Criteria

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

Inclusion Criteria:

  • Clinical Diagnosis of type 2 diabetes mellitus
  • Current regimen of intensified insulin therapy (defined as separate injections of basal and prandial insulin with at least three injections per day) for at least six months prior to the study, including the use of long-lasting insulin analogue glargine (Lantus)
  • Patients must have been willing to withhold insulin glargine for 24 hours prior to study drug dosing
  • 18 to 65 years old
  • Body Mass Index <35kg/m2
  • HbA1c<9%
  • Non-smoker for at least 2 years
  • If medications (other than oral anti-diabetic agents) in addition to insulin were taken at screening, the patient had to be on a stable regimen as defined by continued use of the same dose of each medication for a period of at least 3 months immediately prior to study enrollment
  • FVC, FEV1, and VC all >80% of expected normal
  • Written informed consent

Exclusion Criteria:

  • Diabetes mellitus type 1
  • Current treatment (within the last 30 days) with oral anti-diabetic agents
  • Regular pre-prandial doses of regular subcutaneous insulin for more than 30 IU per meal
  • Intake of any drug or herbal preparation that, in the evaluation of the investigator, may interfere with the interpretation of clinical trials results or that is known to cause clinically relevant interference with insulin action, glucose utilization or recovery from hypoglycemia (eg, systematic steroid)
  • HIstory of hypersensitivity to the drug or to drugs with similar chemical structures
  • Treatment with any investigation drug within 3 months prior to enrollment or during this study
  • Progressive fatal disease
  • History of malignancy within 5 years of study entry (other than basal cell carcinoma)
  • History of drug or alcohol abuse
  • Evidence of severe secondary complications of diabetes (neuropathy, nephropathy as evidenced by creatinine >1.5 mg/dL for females or >1.8 mg/dL for males, grade III or IV retinopathy, or severe peripheral vascular disease)
  • Evidence of gastroparesis, orthostatic hypotension or hypoglycemia unawareness (autonomic neuropathy)
  • Myocardial infraction or stroke within the preceding six months
  • Positive hepatitis B (hepatitis B surface antigen) and /or hepatitis C (hepatitis C antibody) serology and /or positive HIV serology
  • History of presence of clinically significant cardiovascular, hepatic (as evidenced by ALT or AST >3 times the normal reference range), gastrointestinal, neurological, or infectious disorders capable of altering the absorption, metabolism or elimination of drugs, or constituting a significant risk factor when taking the study medications
  • Anemia (hemoglobin concentrations <11 g/dL for females of <g/dL for males)
  • Ongoing respiratory tract infection
  • Pregnancy, lactation, or intention to become pregnant
  • Women of child-bearing potential practicing inadequate birth control (adequate birth control was defined as using oral contraceptives, condoms, or diaphragms with spermicide, intrauterine devices, or surgical sterilization)
  • Regular alcohol intake greater than 14 units*/week, or patients unwilling to stop alcohol during the duration of the study (*1 unit=8 g ethanol, 1/4 liter of beer or 1 glass of wine or 1 measure of spirits)
  • Investigator or site personnel directly affiliated with this study and their immediate families. Immediate family was defined as a spouse, parent, child or sibling, whether biological or legally adopted

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Technosphere Insulin

    Actrapid

    Arm Description

    Technosphere Insulin Inhalation Powder

    Subcutaneous regular human insulin

    Outcomes

    Primary Outcome Measures

    Dose-corrected area-under-the serum insulin concentration vs. time curve (AUC0-540 min) for inhaled Technosphere® Insulin compared to that of subcutaneous regular human insulin
    Area under the glucose infusion rate (GIR AUC0-540 min) for Technosphere® Insulin compared to regular human insulin
    Intra-patient and inter-patient comparison of CV % between treatments was based on a t-test.for bioavailability (ie, SI AUC0-540 min) & bioeffect (ie, GIR AUC0-540 min)

    Secondary Outcome Measures

    Safety variables included adverse events, HbA1c, pulmonary function tests, and diabetes-specific signs (ie, hypoglycemia and hyperglycemia)
    Safety variables included adverse events (AEs), clinical laboratory tests, HbA1c, pulmonary function tests, electrocardiograms, vital signs, physical examinations, and diabetes-specific signs

    Full Information

    First Posted
    August 3, 2007
    Last Updated
    June 28, 2011
    Sponsor
    Mannkind Corporation
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00511719
    Brief Title
    Bioavailability of Technosphere® Insulin Versus Subcutaneous Regular Human Insulin in Type 2 Diabetes
    Official Title
    A Prospective, Controlled, Single-Center, Open-Label,Randomized, Replicated, Crossover Isoglycemic Glucose Clamp Study Evaluating Intrapatient Variability in Bioavailability of Technosphere® Insulin Compared With Subcutaneous Regular Human Insulin in Patients With Type 2 Diabetes
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2011
    Overall Recruitment Status
    Completed
    Study Start Date
    February 2004 (undefined)
    Primary Completion Date
    April 2004 (Actual)
    Study Completion Date
    March 2005 (Actual)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Mannkind Corporation

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this study is to compare the kinetics and biodynamics of inhaled Technosphere Insulin with those of subcutaneous (SC) regular human insulin.

    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
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Crossover Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    13 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Technosphere Insulin
    Arm Type
    Experimental
    Arm Description
    Technosphere Insulin Inhalation Powder
    Arm Title
    Actrapid
    Arm Type
    Active Comparator
    Arm Description
    Subcutaneous regular human insulin
    Intervention Type
    Drug
    Intervention Name(s)
    Technosphere Insulin
    Intervention Description
    48U
    Intervention Type
    Drug
    Intervention Name(s)
    Actrapid
    Intervention Description
    24IU
    Primary Outcome Measure Information:
    Title
    Dose-corrected area-under-the serum insulin concentration vs. time curve (AUC0-540 min) for inhaled Technosphere® Insulin compared to that of subcutaneous regular human insulin
    Time Frame
    crossover approx every 2 weeks for up to 10 weeks
    Title
    Area under the glucose infusion rate (GIR AUC0-540 min) for Technosphere® Insulin compared to regular human insulin
    Time Frame
    crossover approx every 2 weeks for up to 10 weeks
    Title
    Intra-patient and inter-patient comparison of CV % between treatments was based on a t-test.for bioavailability (ie, SI AUC0-540 min) & bioeffect (ie, GIR AUC0-540 min)
    Time Frame
    crossover approx every 2 weeks for up to 10 weeks
    Secondary Outcome Measure Information:
    Title
    Safety variables included adverse events, HbA1c, pulmonary function tests, and diabetes-specific signs (ie, hypoglycemia and hyperglycemia)
    Time Frame
    crossover approx every 2 weeks for up to 10 weeks
    Title
    Safety variables included adverse events (AEs), clinical laboratory tests, HbA1c, pulmonary function tests, electrocardiograms, vital signs, physical examinations, and diabetes-specific signs
    Time Frame
    crossover approx every 2 weeks for up to 10 weeks

    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: Clinical Diagnosis of type 2 diabetes mellitus Current regimen of intensified insulin therapy (defined as separate injections of basal and prandial insulin with at least three injections per day) for at least six months prior to the study, including the use of long-lasting insulin analogue glargine (Lantus) Patients must have been willing to withhold insulin glargine for 24 hours prior to study drug dosing 18 to 65 years old Body Mass Index <35kg/m2 HbA1c<9% Non-smoker for at least 2 years If medications (other than oral anti-diabetic agents) in addition to insulin were taken at screening, the patient had to be on a stable regimen as defined by continued use of the same dose of each medication for a period of at least 3 months immediately prior to study enrollment FVC, FEV1, and VC all >80% of expected normal Written informed consent Exclusion Criteria: Diabetes mellitus type 1 Current treatment (within the last 30 days) with oral anti-diabetic agents Regular pre-prandial doses of regular subcutaneous insulin for more than 30 IU per meal Intake of any drug or herbal preparation that, in the evaluation of the investigator, may interfere with the interpretation of clinical trials results or that is known to cause clinically relevant interference with insulin action, glucose utilization or recovery from hypoglycemia (eg, systematic steroid) HIstory of hypersensitivity to the drug or to drugs with similar chemical structures Treatment with any investigation drug within 3 months prior to enrollment or during this study Progressive fatal disease History of malignancy within 5 years of study entry (other than basal cell carcinoma) History of drug or alcohol abuse Evidence of severe secondary complications of diabetes (neuropathy, nephropathy as evidenced by creatinine >1.5 mg/dL for females or >1.8 mg/dL for males, grade III or IV retinopathy, or severe peripheral vascular disease) Evidence of gastroparesis, orthostatic hypotension or hypoglycemia unawareness (autonomic neuropathy) Myocardial infraction or stroke within the preceding six months Positive hepatitis B (hepatitis B surface antigen) and /or hepatitis C (hepatitis C antibody) serology and /or positive HIV serology History of presence of clinically significant cardiovascular, hepatic (as evidenced by ALT or AST >3 times the normal reference range), gastrointestinal, neurological, or infectious disorders capable of altering the absorption, metabolism or elimination of drugs, or constituting a significant risk factor when taking the study medications Anemia (hemoglobin concentrations <11 g/dL for females of <g/dL for males) Ongoing respiratory tract infection Pregnancy, lactation, or intention to become pregnant Women of child-bearing potential practicing inadequate birth control (adequate birth control was defined as using oral contraceptives, condoms, or diaphragms with spermicide, intrauterine devices, or surgical sterilization) Regular alcohol intake greater than 14 units*/week, or patients unwilling to stop alcohol during the duration of the study (*1 unit=8 g ethanol, 1/4 liter of beer or 1 glass of wine or 1 measure of spirits) Investigator or site personnel directly affiliated with this study and their immediate families. Immediate family was defined as a spouse, parent, child or sibling, whether biological or legally adopted

    12. IPD Sharing Statement

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    Bioavailability of Technosphere® Insulin Versus Subcutaneous Regular Human Insulin in Type 2 Diabetes

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