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Clinical Trial Evaluating Technosphere® Insulin Versus Insulin Aspart in Subjects With Type 1 Diabetes Mellitus Over a 24-week Treatment Period

Primary Purpose

Type 1 Diabetes Mellitus

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Technosphere® Insulin with MedTone C Inhaler
Technosphere ®Insulin with Gen2 Inhaler
Insulin Aspart in combination with a basal insulin
Sponsored by
Mannkind Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes Mellitus

Eligibility Criteria

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

Inclusion Criteria:

  • Men and women = 18 years of age
  • Clinical diagnosis of type 1 diabetes mellitus for at least 12 months
  • Body mass index (BMI) = 38 kg/m2
  • Stable dose of basal/bolus insulin therapy for at least 3 months with an FPG consistently < 220 mg/dL:
  • HbA1c = 7.5% and = 10.0%
  • Fasting C-peptide = 0.30 pmol/mL
  • Subject willingness to not use CGM during the entire course of the trial
  • Nonsmoking (includes cigarettes, cigars, pipes, and chewing tobacco) for the preceding 6 months
  • Negative urine cotinine test, defined as = 100 ng/mL
  • Lung function tests: • Forced expiratory volume in 1 second (FEV1) = 70% Third National Health and Nutrition Examination Survey (NHANES III) predicted
  • Written informed consent

Exclusion Criteria:

  • Total daily insulin dose = 2 IU/kg/day. History of insulin pump use within 3 months of Screening or use of continuous glucose monitoring within 6 weeks of Screening
  • History of inhaled insulin use in the previous 6 months
  • Two or more unexplained severe hypoglycemic episodes within 3 months of Screening or an episode of severe hypoglycemia between Visit 1 and Visit 2. Unexplained refers to episodes of severe hypoglycemia that are not related to a dosing error, lack of or a change in meal size, or related to additional/unanticipated exercise
  • Any hospitalization or emergency room visit due to poor diabetic control within 6 months of Screening, or hospitalization or emergency room visit due to poor diabetic control between Visit 1 and Visit 2
  • Allergy or known hypersensitivity to insulin or to any of the drugs to be used in the study, or a history of hypersensitivity to TI Inhalation Powder or to drugs with a similar chemical structure
  • History of recent blood transfusions (within previous 3 months), hemoglobinopathies, or any other conditions that affect HbA1c measurements.
  • History of COPD, asthma, or any other clinically important pulmonary disease (eg, pulmonary fibrosis), or use of any medications for these conditions
  • Any clinically significant radiological findings on screening chest x-ray
  • Active respiratory infection within 30 days before Screening (subject may return after 30 days from resolution for rescreening)
  • Major organ system diseases, including: ? Seizure disorder; systemic autoimmune or collagen vascular disease requiring previous or current treatment with systemic corticosteroids, cytotoxic drugs, or penicillamine; cancer (other than excised cutaneous basal cell carcinoma) or any history of lung neoplasms
  • Current or previous chemotherapy or radiation therapy that may result in pulmonary toxicity; use of medications for weight loss (eg, sibutramine, orlistat) within 12 weeks of Screening; treatment with amiodarone within 12 weeks of Screening
  • Clinically significant abnormalities on screening laboratory evaluation or chest x-ray
  • Severe complications of diabetes, in the opinion of the PI, including symptomatic autonomic neuropathy; disabling peripheral neuropathy; active proliferative retinopathy; nephropathy with renal failure, renal transplant, or dialysis; nontraumatic amputations due to gangrene; or vascular claudication
  • Women who are pregnant, lactating, or planning to become pregnant during the clinical study period; women of childbearing potential (defined as premenopausal and not surgically sterilized or postmenopausal for fewer than 2 years) not practicing adequate birth control. Adequate birth control is defined as using oral, percutaneous, or transdermal contraceptives; condoms and diaphragms (double barrier) with a spermicide; or intrauterine devices. Postmenopausal for this study includes amenorrhea f
  • Current drug or alcohol abuse or a history of drug or alcohol abuse that, in the opinion of the PI, would make the subject an unsuitable candidate for participation in the study
  • Exposure to any investigational medications or devices within the previous 30 days before study entry
  • Unable to read or write, or unlikely to comprehend and follow the study protocol procedures; lack of compliance with medication or procedures that, in the PI's opinion, may affect the study data or subject safety and that precludes the subject from participation in the study; or any other concurrent medical or major psychiatric condition that, in the opinion of the PI, makes the subject unsuitable for the clinical study or could limit the validity of the informed consent or impair the subject'

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Experimental

Arm Label

Technosphere® Insulin with MedTone C Inhaler

Aspart Group

Technosphere ® Insulin-Gen2 Group

Arm Description

Subjects will receive TI with the MedToneC inhaler and remain on the basal insulin they were taking prior to study entry

Subjects will receive insulin aspart and remain on the basal insulin they were taking prior to study entry

Subject will receive Technosphere Insulin with Gen2 Inhaler and remain on the basal insulin they were taking prior to study entry

Outcomes

Primary Outcome Measures

Change From Baseline to Week 24 in HbA1c
Effect of treatment as measured by change from baseline in glycated hemoglobin (HbA1c). Primary treatment difference is TI-Gen2 vs. Insulin Aspart at Week 24

Secondary Outcome Measures

FEV1 Change From Baseline to Week 24
Forced Expiratory Volume in 1 second - change from baseline to week 24
FPG Change From Baseline to Week 24
Comparison of mean change from Baseline to Week 24 visit in fasting plasma glucose (FPG) levels (central laboratory results)
Mean 7-point Glucose Baseline Values
Mean 7-point glucose at baseline
Mean 7-point Glucose Week 24 Values
Change in Body Weight From Baseline to Week 24
Change in body weight from Baseline to Week 24
Proportion of Responders Achieving HbA1c <= 7.0%
Efficacy as measured in proportion of subjects achieving HbA1c < or = to 7.0%

Full Information

First Posted
September 30, 2011
Last Updated
October 20, 2014
Sponsor
Mannkind Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01445951
Brief Title
Clinical Trial Evaluating Technosphere® Insulin Versus Insulin Aspart in Subjects With Type 1 Diabetes Mellitus Over a 24-week Treatment Period
Official Title
A Phase 3, Multicenter, Open-label, Randomized, Forced-titration Clinical Trial Evaluating the Efficacy and Safety of Technosphere® Insulin Inhalation Powder in Combination With a Basal Insulin Versus Insulin Aspart in Combination With a Basal Insulin in Subjects With Type 1 Diabetes Mellitus Over a 24-week Treatment Period
Study Type
Interventional

2. Study Status

Record Verification Date
October 2014
Overall Recruitment Status
Completed
Study Start Date
September 2011 (undefined)
Primary Completion Date
May 2013 (Actual)
Study Completion Date
June 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mannkind Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Open-label, randomized, forced-titration clinical trial evaluating the efficacy and safety of TI Inhalation Power in combination with a basal insulin versus insulin aspart in combination with a basal insulin
Detailed Description
Phase 3 clinical trial designed to examine the efficacy and safety of inhaled prandial TI Inhalation Power in combination with basal insulin versus insulin aspart in combination with basal insulin in subjects with type 1 diabetes who are suboptimally controlled with their current insulin regimens. This trial will employ a variety of methods to intensively manage these subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
518 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Technosphere® Insulin with MedTone C Inhaler
Arm Type
Experimental
Arm Description
Subjects will receive TI with the MedToneC inhaler and remain on the basal insulin they were taking prior to study entry
Arm Title
Aspart Group
Arm Type
Active Comparator
Arm Description
Subjects will receive insulin aspart and remain on the basal insulin they were taking prior to study entry
Arm Title
Technosphere ® Insulin-Gen2 Group
Arm Type
Experimental
Arm Description
Subject will receive Technosphere Insulin with Gen2 Inhaler and remain on the basal insulin they were taking prior to study entry
Intervention Type
Drug
Intervention Name(s)
Technosphere® Insulin with MedTone C Inhaler
Intervention Description
Inhalation Powder and injectable insulin
Intervention Type
Drug
Intervention Name(s)
Technosphere ®Insulin with Gen2 Inhaler
Intervention Description
Inhalation Powder and injectable insulin
Intervention Type
Drug
Intervention Name(s)
Insulin Aspart in combination with a basal insulin
Intervention Description
Injectable insulin
Primary Outcome Measure Information:
Title
Change From Baseline to Week 24 in HbA1c
Description
Effect of treatment as measured by change from baseline in glycated hemoglobin (HbA1c). Primary treatment difference is TI-Gen2 vs. Insulin Aspart at Week 24
Time Frame
Baseline to Week 24
Secondary Outcome Measure Information:
Title
FEV1 Change From Baseline to Week 24
Description
Forced Expiratory Volume in 1 second - change from baseline to week 24
Time Frame
Baseline to Week 24
Title
FPG Change From Baseline to Week 24
Description
Comparison of mean change from Baseline to Week 24 visit in fasting plasma glucose (FPG) levels (central laboratory results)
Time Frame
Baseline to Week 24
Title
Mean 7-point Glucose Baseline Values
Description
Mean 7-point glucose at baseline
Time Frame
Baseline
Title
Mean 7-point Glucose Week 24 Values
Time Frame
Week 24
Title
Change in Body Weight From Baseline to Week 24
Description
Change in body weight from Baseline to Week 24
Time Frame
Baseline to Week 24
Title
Proportion of Responders Achieving HbA1c <= 7.0%
Description
Efficacy as measured in proportion of subjects achieving HbA1c < or = to 7.0%
Time Frame
Week 24
Other Pre-specified Outcome Measures:
Title
Incidence of Total Hypoglycemia
Description
Hypoglycemia, defined as blood glucose <= 70 mg/dL or in absence of blood glucose, symptoms that are resolved by the administration of carbohydrates.
Time Frame
Baseline to Week 24
Title
Incidence of Severe Hypoglycemia
Description
Severe Hypoglycemia defined as: Requiring 3rd party assistance.
Time Frame
Baseline to Week 24
Title
Total Hypoglycemia Event Rate
Description
Number of Hypoglycemic Events/Total Subject Exposure Time (in months)
Time Frame
Baseline to Week 24
Title
Severe Hypoglycemia Event Rate
Description
Number of Severe Hypoglycemic Events/Total Subject Exposure Time (in months)
Time Frame
Baseline to Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women = 18 years of age Clinical diagnosis of type 1 diabetes mellitus for at least 12 months Body mass index (BMI) = 38 kg/m2 Stable dose of basal/bolus insulin therapy for at least 3 months with an FPG consistently < 220 mg/dL: HbA1c = 7.5% and = 10.0% Fasting C-peptide = 0.30 pmol/mL Subject willingness to not use CGM during the entire course of the trial Nonsmoking (includes cigarettes, cigars, pipes, and chewing tobacco) for the preceding 6 months Negative urine cotinine test, defined as = 100 ng/mL Lung function tests: • Forced expiratory volume in 1 second (FEV1) = 70% Third National Health and Nutrition Examination Survey (NHANES III) predicted Written informed consent Exclusion Criteria: Total daily insulin dose = 2 IU/kg/day. History of insulin pump use within 3 months of Screening or use of continuous glucose monitoring within 6 weeks of Screening History of inhaled insulin use in the previous 6 months Two or more unexplained severe hypoglycemic episodes within 3 months of Screening or an episode of severe hypoglycemia between Visit 1 and Visit 2. Unexplained refers to episodes of severe hypoglycemia that are not related to a dosing error, lack of or a change in meal size, or related to additional/unanticipated exercise Any hospitalization or emergency room visit due to poor diabetic control within 6 months of Screening, or hospitalization or emergency room visit due to poor diabetic control between Visit 1 and Visit 2 Allergy or known hypersensitivity to insulin or to any of the drugs to be used in the study, or a history of hypersensitivity to TI Inhalation Powder or to drugs with a similar chemical structure History of recent blood transfusions (within previous 3 months), hemoglobinopathies, or any other conditions that affect HbA1c measurements. History of COPD, asthma, or any other clinically important pulmonary disease (eg, pulmonary fibrosis), or use of any medications for these conditions Any clinically significant radiological findings on screening chest x-ray Active respiratory infection within 30 days before Screening (subject may return after 30 days from resolution for rescreening) Major organ system diseases, including: ? Seizure disorder; systemic autoimmune or collagen vascular disease requiring previous or current treatment with systemic corticosteroids, cytotoxic drugs, or penicillamine; cancer (other than excised cutaneous basal cell carcinoma) or any history of lung neoplasms Current or previous chemotherapy or radiation therapy that may result in pulmonary toxicity; use of medications for weight loss (eg, sibutramine, orlistat) within 12 weeks of Screening; treatment with amiodarone within 12 weeks of Screening Clinically significant abnormalities on screening laboratory evaluation or chest x-ray Severe complications of diabetes, in the opinion of the PI, including symptomatic autonomic neuropathy; disabling peripheral neuropathy; active proliferative retinopathy; nephropathy with renal failure, renal transplant, or dialysis; nontraumatic amputations due to gangrene; or vascular claudication Women who are pregnant, lactating, or planning to become pregnant during the clinical study period; women of childbearing potential (defined as premenopausal and not surgically sterilized or postmenopausal for fewer than 2 years) not practicing adequate birth control. Adequate birth control is defined as using oral, percutaneous, or transdermal contraceptives; condoms and diaphragms (double barrier) with a spermicide; or intrauterine devices. Postmenopausal for this study includes amenorrhea f Current drug or alcohol abuse or a history of drug or alcohol abuse that, in the opinion of the PI, would make the subject an unsuitable candidate for participation in the study Exposure to any investigational medications or devices within the previous 30 days before study entry Unable to read or write, or unlikely to comprehend and follow the study protocol procedures; lack of compliance with medication or procedures that, in the PI's opinion, may affect the study data or subject safety and that precludes the subject from participation in the study; or any other concurrent medical or major psychiatric condition that, in the opinion of the PI, makes the subject unsuitable for the clinical study or could limit the validity of the informed consent or impair the subject'
Facility Information:
City
Burlingame
State/Province
California
ZIP/Postal Code
94010
Country
United States
City
Escondido
State/Province
California
ZIP/Postal Code
92026
Country
United States
City
Huntington Beach
State/Province
California
ZIP/Postal Code
92648
Country
United States
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
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La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90017
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90036
Country
United States
City
Los Gatos
State/Province
California
ZIP/Postal Code
95032
Country
United States
City
San Mateo
State/Province
California
ZIP/Postal Code
94401
Country
United States
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93105
Country
United States
City
Tustin
State/Province
California
ZIP/Postal Code
92780
Country
United States
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33012
Country
United States
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33021
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33156
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33173
Country
United States
City
New Port Richey
State/Province
Florida
ZIP/Postal Code
34652
Country
United States
City
Palm Harbor
State/Province
Florida
ZIP/Postal Code
34652
Country
United States
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33401
Country
United States
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
City
Dunwoody
State/Province
Georgia
ZIP/Postal Code
30338
Country
United States
City
Lawrenceville
State/Province
Georgia
ZIP/Postal Code
30045
Country
United States
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60602
Country
United States
City
Vincennes
State/Province
Indiana
ZIP/Postal Code
47591
Country
United States
City
Des Moines
State/Province
Iowa
ZIP/Postal Code
50314
Country
United States
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70808
Country
United States
City
Metairie
State/Province
Louisiana
ZIP/Postal Code
70006
Country
United States
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
City
Edina
State/Province
Minnesota
ZIP/Postal Code
55435
Country
United States
City
Jefferson City
State/Province
Missouri
ZIP/Postal Code
65109
Country
United States
City
St Peters
State/Province
Missouri
ZIP/Postal Code
63376
Country
United States
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
City
Billings
State/Province
Montana
ZIP/Postal Code
59101
Country
United States
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68114
Country
United States
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68131
Country
United States
City
Paramus
State/Province
New Jersey
ZIP/Postal Code
07652
Country
United States
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87131
Country
United States
City
Flushing
State/Province
New York
ZIP/Postal Code
11365
Country
United States
City
New Hyde Park
State/Province
New York
ZIP/Postal Code
11042
Country
United States
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28803
Country
United States
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
City
Morehead City
State/Province
North Carolina
ZIP/Postal Code
28557
Country
United States
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
City
Greer
State/Province
South Carolina
ZIP/Postal Code
29651
Country
United States
City
Bartlett
State/Province
Tennessee
ZIP/Postal Code
38133
Country
United States
City
Arlington
State/Province
Texas
ZIP/Postal Code
76014
Country
United States
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77095
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
City
Murray
State/Province
Utah
ZIP/Postal Code
84123
Country
United States
City
Federal Way
State/Province
Washington
ZIP/Postal Code
98003
Country
United States
City
Renton
State/Province
Washington
ZIP/Postal Code
98057
Country
United States
City
Wenatchee
State/Province
Washington
ZIP/Postal Code
98801
Country
United States
City
Porto Alegre
State/Province
RS
ZIP/Postal Code
90035-170
Country
Brazil
City
Sao Paulo
State/Province
SP
ZIP/Postal Code
01244-030
Country
Brazil
City
St. Petersburg
State/Province
Russia
ZIP/Postal Code
191186
Country
Russian Federation
City
St. Petersburg
State/Province
Russia
ZIP/Postal Code
193312
Country
Russian Federation
City
Kemerovo
State/Province
RUS
ZIP/Postal Code
650066
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
105120
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
109240
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
117036
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
117593
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
119048
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
119435
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
125299
Country
Russian Federation
City
Moscow
State/Province
RUS
ZIP/Postal Code
125315
Country
Russian Federation
City
Petrozavodsk
State/Province
RUS
ZIP/Postal Code
185019
Country
Russian Federation
City
Smolensk
State/Province
RUS
ZIP/Postal Code
214018
Country
Russian Federation
City
St Petersburg
State/Province
RUS
ZIP/Postal Code
194291
Country
Russian Federation
City
St Petersburg
State/Province
RUS
ZIP/Postal Code
195257
Country
Russian Federation
City
St Petersburg
State/Province
RUS
ZIP/Postal Code
198013
Country
Russian Federation
City
St. Petersburg
State/Province
RUS
ZIP/Postal Code
192148
Country
Russian Federation
City
St. Petersburg
State/Province
RUS
ZIP/Postal Code
194044
Country
Russian Federation
City
St. Petersburg
State/Province
RUS
ZIP/Postal Code
194354
Country
Russian Federation
City
Yaroslavl
State/Province
RUS
ZIP/Postal Code
150003
Country
Russian Federation
City
Yaroslavl
State/Province
RUS
ZIP/Postal Code
150062
Country
Russian Federation
City
Dnipropetrovsk
State/Province
UKR
ZIP/Postal Code
49023
Country
Ukraine
City
Donetsk
State/Province
UKR
ZIP/Postal Code
83114
Country
Ukraine
City
Kharkiv
State/Province
UKR
ZIP/Postal Code
61070
Country
Ukraine
City
Kiev
State/Province
UKR
ZIP/Postal Code
04053
Country
Ukraine
City
Kiev
State/Province
UKR
ZIP/Postal Code
04114
Country
Ukraine
City
Kyiv
State/Province
UKR
ZIP/Postal Code
02175
Country
Ukraine
City
Odesa
State/Province
UKR
ZIP/Postal Code
65039
Country
Ukraine
City
Odesa
State/Province
UKR
ZIP/Postal Code
65114
Country
Ukraine
City
Vinnytsya
State/Province
UKR
ZIP/Postal Code
21010
Country
Ukraine

12. IPD Sharing Statement

Citations:
PubMed Identifier
31811662
Citation
Seaquist ER, Blonde L, McGill JB, Heller SR, Kendall DM, Bumpass JB, Pompilio FM, Grant ML. Hypoglycaemia is reduced with use of inhaled Technosphere(R) Insulin relative to insulin aspart in type 1 diabetes mellitus. Diabet Med. 2020 May;37(5):752-759. doi: 10.1111/dme.14202. Epub 2019 Dec 19.
Results Reference
derived
PubMed Identifier
26180109
Citation
Bode BW, McGill JB, Lorber DL, Gross JL, Chang PC, Bregman DB; Affinity 1 Study Group. Inhaled Technosphere Insulin Compared With Injected Prandial Insulin in Type 1 Diabetes: A Randomized 24-Week Trial. Diabetes Care. 2015 Dec;38(12):2266-73. doi: 10.2337/dc15-0075. Epub 2015 Jul 15.
Results Reference
derived

Learn more about this trial

Clinical Trial Evaluating Technosphere® Insulin Versus Insulin Aspart in Subjects With Type 1 Diabetes Mellitus Over a 24-week Treatment Period

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