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Comparison of SAR341402 to NovoLog/NovoRapid in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine (GEMELLI1)

Primary Purpose

Type 1 Diabetes Mellitus-Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Insulin aspart
NovoLog/NovoRapid
Insulin glargine (HOE901)
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes Mellitus-Type 2 Diabetes Mellitus

Eligibility Criteria

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

Inclusion criteria :

  • Participants with T1DM or T2DM (T2DM US only) diagnosed for at least 12 months, who have been treated with a multiple daily injection regimen with
  • NovoLog/NovoRapid or insulin lispro (100 U/mL) in the last 6 months prior to screening visit AND
  • insulin glargine (100 U/mL) in the last 6 months prior to screening visit OR insulin detemir (Levemir®) in the last 12 months prior to screening visit.

Exclusion criteria:

  • At screening visit, age under legal age of adulthood.
  • HbA1c <7.0% or greater than (>) 10% at screening.
  • Less than 1 year on continuous insulin treatment.
  • Use of insulin pump in the last 3 months before screening visit.
  • Participants with incomplete baseline 7-point SMPG profile, defined as participants who do not have 7-point profiles with at least 5 points on at least 2 days in the week before randomization Visit 3.
  • Participants with T1DM: Use of glucose lowering agents other than insulin including use of non-insulin injectable peptides in the last 3 months prior to screening.
  • Participants with T2DM:

    • Use of glucagon-like peptide-1 (GLP-1) receptor agonists in the last 3 months before screening visit.
    • Use of oral antidiabetic drugs (OADs) not on stable dose in the last 3 months before screening visit (sulfonylureas was discontinued at baseline).
  • At screening visit, body mass index (BMI) greater than or equal to (>=) 35 kilogram per meter square (kg/m^2) in participants with T1DM and >=40 kg/m^2 in participants with T2DM.
  • Use of insulin other than:

    • insulin glargine 100 U/mL and NovoLog/NovoRapid or insulin lispro 100 U/mL as part of a multiple injection regimen in the last 6 months before screening visit, OR
    • insulin detemir 100 U/mL in the 12 months before screening visit and NovoLog/NovoRapid or insulin lispro 100 U/mL in the last 6 months before screening visit as part of a multiple injection regimen.
  • Status post pancreatectomy.
  • Status post pancreas and/or islet cell transplantation.
  • Hospitalization for recurrent diabetic ketoacidosis in the last 3 months before screening visit.
  • History of severe hypoglycemia requiring Emergency Room admission or hospitalization in the last 3 months before screening visit.
  • Unstable proliferative diabetic retinopathy or any other rapidly progressive diabetic retinopathy or macular edema likely to require treatment (eg, laser, surgical treatment or injectable drugs) during the study period.
  • Pregnant or breastfeeding women.
  • Women of childbearing potential not protected by highly effective method(s) of birth control.

The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

Sites / Locations

  • Investigational Site Number 8400040
  • Investigational Site Number 8400012
  • Investigational Site Number 8400002
  • Investigational Site Number 8400030
  • Investigational Site Number 8400004
  • Investigational Site Number 8400014
  • Investigational Site Number 8400043
  • Investigational Site Number 8400036
  • Investigational Site Number 8400011
  • Investigational Site Number 8400013
  • Investigational Site Number 8400037
  • Investigational Site Number 8400018
  • Investigational Site Number 8400031
  • Investigational Site Number 8400027
  • Investigational Site Number 8400007
  • Investigational Site Number 8400022
  • Investigational Site Number 8400032
  • Investigational Site Number 8400038
  • Investigational Site Number 8400005
  • Investigational Site Number 8400041
  • Investigational Site Number 8400015
  • Investigational Site Number 8400042
  • Investigational Site Number 8400019
  • Investigational Site Number 8400003
  • Investigational Site Number 8400024
  • Investigational Site Number 8400028
  • Investigational Site Number 8400025
  • Investigational Site Number 8400010
  • Investigational Site Number 8400023
  • Investigational Site Number 8400029
  • Investigational Site Number 8400033
  • Investigational Site Number 8400044
  • Investigational Site Number 8400009
  • Investigational Site Number 8400035
  • Investigational Site Number 8400021
  • Investigational Site Number 8400017
  • Investigational Site Number 8400001
  • Investigational Site Number 8400020
  • Investigational Site Number 8400016
  • Investigational Site Number 8400034
  • Investigational Site Number 8400008
  • Investigational Site Number 8400039
  • Investigational Site Number 2460006
  • Investigational Site Number 2460002
  • Investigational Site Number 2460004
  • Investigational Site Number 2460003
  • Investigational Site Number 2760001
  • Investigational Site Number 2760006
  • Investigational Site Number 2760004
  • Investigational Site Number 2760005
  • Investigational Site Number 2760002
  • Investigational Site Number 3480012
  • Investigational Site Number 3480011
  • Investigational Site Number 3480008
  • Investigational Site Number 3480001
  • Investigational Site Number 3480005
  • Investigational Site Number 3480004
  • Investigational Site Number 3480007
  • Investigational Site Number 3480003
  • Investigational Site Number 3480010
  • Investigational Site Number 3480009
  • Investigational Site Number 3920009
  • Investigational Site Number 3920008
  • Investigational Site Number 3920007
  • Investigational Site Number 3920001
  • Investigational Site Number 3920005
  • Investigational Site Number 3920003
  • Investigational Site Number 3920010
  • Investigational Site Number 3920002
  • Investigational Site Number 3920004
  • Investigational Site Number 3920006
  • Investigational Site Number 6160004
  • Investigational Site Number 6160003
  • Investigational Site Number 6160005
  • Investigational Site Number 6160007
  • Investigational Site Number 6160006
  • Investigational Site Number 6160001
  • Investigational Site Number 6160002
  • Investigational Site Number 6430002
  • Investigational Site Number 6430003
  • Investigational Site Number 6430001
  • Investigational Site Number 6430004

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

SAR341402

NovoLog/NovoRapid

Arm Description

SAR341402 subcutaneous (SC), before meals intake on top of once daily (QD) Insulin Glargine, up to Week 52.

NovoLog/NovoRapid SC, before meals intake on top of QD Insulin Glargine, up to Week 52.

Outcomes

Primary Outcome Measures

Change in Glycated Hemoglobin A1c (HbA1c) From Baseline to Week 26
All values up to Week 26 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 26 value. Missing changes at Week 26 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted least square (LS) means and standard errors (SE) were obtained using an analysis of covariance (ANCOVA) model on data obtained from the multiple imputations (results were combined using Rubin's formulae).

Secondary Outcome Measures

Change in HbA1c From Baseline to Week 52
All values up to Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 52 value. Missing changes at Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Percentage of Participants With HbA1c <7% at Week 26 and Week 52
Participants who had no available assessment at Week 26 and Week 52 were considered as non-responders.
Change in Fasting Plasma Glucose (FPG) From Baseline to Week 26 and Week 52
All values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in FPG at Week 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Change in the Mean 24-hour Plasma Glucose Concentration From Baseline to Week 26 and Week 52
Mean 24-hour plasma glucose concentration was calculated based on 7-point self-measured plasma glucose (SMPG) profiles with plasma glucose measurements before and 2-hours after each main meal and at bedtime. Mean 24-hour plasma glucose concentration was calculated for each profile and then averaged across profiles performed in the week before a visit. All calculated values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in mean 24-hour plasma glucose concentration at Weeks 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a return-to-baseline multiple imputation method (values imputed as participant baseline plus an error). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Change in Postprandial Plasma Glucose (PPG) Excursion From Baseline to Week 26 and Week 52
Plasma glucose excursions were calculated at breakfast, lunch and dinner for each 7-point SMPG profile, as 2-hour PPG minus plasma glucose value obtained 30 minutes prior to start of the meal. Values of plasma glucose excursions at each visit were then calculated as the average across profiles performed in the week before the visit. All calculated values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in PPG excursions at Weeks 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a return-to-baseline multiple imputation method (values imputed as participant baseline plus an error). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Change in 7-Point SMPG Profiles From Baseline to Week 26 and Week 52 Per Time Point
7-point SMPG profiles were measured at the following 7 points at each visit (Baseline, Week 26, and Week 52): before breakfast, 2 hours after breakfast, before lunch, 2 hours after lunch, before dinner, 2 hours after dinner, and bedtime. For each time point, the value at each visit was calculated as the average of values obtained for the same time point across profiles performed in the week before the visit.
Number of Participants With at Least One Hypoglycemic Event
Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of <=3.9 mmol/L (<=70 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Number of Hypoglycemia Events Per Participant-Year
Number of hypoglycemia events (any, severe and documented [both thresholds]) per participant-year of exposure were reported. Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of <=3.9 mmol/L (<=70 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Percentage of Participants With Hypersensitivity Reactions and Injection Site Reactions
Participants with at least one treatment-emergent adverse event linked to hypersensitivity reaction and injection site reaction regardless of relationship to IMP during the main 6-month and the 12-month on-treatment periods was assessed and reported.
Percentage of Participants With at Least One Positive Anti-Insulin Aspart Antibodies (AIA) Sample
Participants with at least one positive AIA sample at baseline or at any time during the on-treatment period (Prevalence).
Percentage of Participants With Treatment-Induced, Treatment-Boosted and Treatment-Emergent Anti-insulin Aspart Antibodies (AIAs)
AIA incidence were categorized as: treatment-induced, treatment-boosted AIAs, and treatment-emergent AIA. 1) Participants with treatment-induced AIAs were those who developed AIA following IMP administration (participants with at least one positive AIA sample at any time during on-treatment period, in those participants without pre-existing AIA or with missing baseline sample). 2) Participants with treatment-boosted AIAs were those with pre-existing AIAs that were boosted to a significant higher titer following IMP administration (participants with at least one AIA sample with at least a 4-fold increase in titers compared to baseline value at any time during on-treatment period). 3) Participants with treatment-emergent AIA were defined as participants with treatment-induced, or treatment-boosted AIAs.

Full Information

First Posted
July 6, 2017
Last Updated
March 15, 2022
Sponsor
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT03211858
Brief Title
Comparison of SAR341402 to NovoLog/NovoRapid in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine
Acronym
GEMELLI1
Official Title
Six-month, Randomized, Open-label, Parallel-group Comparison of SAR341402 to NovoLog®/NovoRapid® in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine, With a 6-month Safety Extension Period
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
August 2, 2017 (Actual)
Primary Completion Date
July 16, 2018 (Actual)
Study Completion Date
January 12, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sanofi

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary Objective: To demonstrate non-inferiority of SAR341402 versus NovoLog/NovoRapid in glycated hemoglobin A1c (HbA1c) change from baseline to Week 26 in participants with type 1 or type 2 diabetes mellitus (T1DM or T2DM) also using Lantus®. Secondary Objectives: To assess the immunogenicity of SAR341402 and NovoLog/NovoRapid in terms of positive/negative status and anti-insulin antibody (AIA) titers during the course of the study. To assess the relationship of AIAs with efficacy and safety. To assess the efficacy of SAR341402 and NovoLog/NovoRapid in terms of proportion of participants reaching HbA1c lesser than (<) 7.0% and change in HbA1c, fasting plasma glucose (FPG), and self-measured plasma glucose (SMPG) profiles from baseline to Week 26 and Week 52 (only Week 52 for HbA1c). To assess safety of SAR341402 and NovoLog/NovoRapid.
Detailed Description
The study consisted of a 2-week screening period, a 26-week treatment period, a 26-week comparative safety extension period, and a 1-day follow-up period. The maximum study duration was 54 weeks per participant and a 1 day safety follow-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus-Type 2 Diabetes Mellitus

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SAR341402
Arm Type
Experimental
Arm Description
SAR341402 subcutaneous (SC), before meals intake on top of once daily (QD) Insulin Glargine, up to Week 52.
Arm Title
NovoLog/NovoRapid
Arm Type
Active Comparator
Arm Description
NovoLog/NovoRapid SC, before meals intake on top of QD Insulin Glargine, up to Week 52.
Intervention Type
Drug
Intervention Name(s)
Insulin aspart
Intervention Description
SAR341402 100 units per milliliters (U/mL) (dose range of 1 unit to 80 units) self-administered by SC injection, immediately (within 5-10 minutes) before meal intake. Dose adjusted to achieve a 2-hour postprandial plasma glucose (PPG <10 millimoles/liter [mmol/L] [<180 milligram/deciliter {mg/dL}]) while avoiding hypoglycemia.
Intervention Type
Drug
Intervention Name(s)
NovoLog/NovoRapid
Other Intervention Name(s)
Insulin aspart
Intervention Description
NovoLog/NovoRapid 100 U/mL (dose range of 1 unit to 60 units) self-administered by SC injection, immediately (within 5-10 minutes) before meal intake. Dose adjusted to achieve a 2-hour postprandial plasma glucose (PPG <10 mmol/L [<180 mg/dL]) while avoiding hypoglycemia.
Intervention Type
Drug
Intervention Name(s)
Insulin glargine (HOE901)
Other Intervention Name(s)
Lantus
Intervention Description
Insulin glargine 100 U/mL injected QD subcutaneously consistent with the local label. Doses adjusted to achieve glycemic target for fasting, preprandial plasma glucose between 4.4 to 7.2 mmol/L (80 to 130 mg/dL) without hypoglycemia.
Primary Outcome Measure Information:
Title
Change in Glycated Hemoglobin A1c (HbA1c) From Baseline to Week 26
Description
All values up to Week 26 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 26 value. Missing changes at Week 26 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted least square (LS) means and standard errors (SE) were obtained using an analysis of covariance (ANCOVA) model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Time Frame
Baseline, Week 26
Secondary Outcome Measure Information:
Title
Change in HbA1c From Baseline to Week 52
Description
All values up to Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 52 value. Missing changes at Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Time Frame
Baseline, Week 52
Title
Percentage of Participants With HbA1c <7% at Week 26 and Week 52
Description
Participants who had no available assessment at Week 26 and Week 52 were considered as non-responders.
Time Frame
Week 26 and Week 52
Title
Change in Fasting Plasma Glucose (FPG) From Baseline to Week 26 and Week 52
Description
All values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in FPG at Week 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Time Frame
Baseline, Week 26, and Week 52
Title
Change in the Mean 24-hour Plasma Glucose Concentration From Baseline to Week 26 and Week 52
Description
Mean 24-hour plasma glucose concentration was calculated based on 7-point self-measured plasma glucose (SMPG) profiles with plasma glucose measurements before and 2-hours after each main meal and at bedtime. Mean 24-hour plasma glucose concentration was calculated for each profile and then averaged across profiles performed in the week before a visit. All calculated values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in mean 24-hour plasma glucose concentration at Weeks 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a return-to-baseline multiple imputation method (values imputed as participant baseline plus an error). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Time Frame
Baseline, Week 26, and Week 52
Title
Change in Postprandial Plasma Glucose (PPG) Excursion From Baseline to Week 26 and Week 52
Description
Plasma glucose excursions were calculated at breakfast, lunch and dinner for each 7-point SMPG profile, as 2-hour PPG minus plasma glucose value obtained 30 minutes prior to start of the meal. Values of plasma glucose excursions at each visit were then calculated as the average across profiles performed in the week before the visit. All calculated values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in PPG excursions at Weeks 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a return-to-baseline multiple imputation method (values imputed as participant baseline plus an error). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Time Frame
Baseline, Week 26, and Week 52
Title
Change in 7-Point SMPG Profiles From Baseline to Week 26 and Week 52 Per Time Point
Description
7-point SMPG profiles were measured at the following 7 points at each visit (Baseline, Week 26, and Week 52): before breakfast, 2 hours after breakfast, before lunch, 2 hours after lunch, before dinner, 2 hours after dinner, and bedtime. For each time point, the value at each visit was calculated as the average of values obtained for the same time point across profiles performed in the week before the visit.
Time Frame
Baseline, Week 26, and Week 52
Title
Number of Participants With at Least One Hypoglycemic Event
Description
Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of <=3.9 mmol/L (<=70 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Time Frame
From first injection of investigational medicinal product (IMP) up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Number of Hypoglycemia Events Per Participant-Year
Description
Number of hypoglycemia events (any, severe and documented [both thresholds]) per participant-year of exposure were reported. Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of <=3.9 mmol/L (<=70 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Time Frame
From first injection of investigational medicinal product (IMP) up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Percentage of Participants With Hypersensitivity Reactions and Injection Site Reactions
Description
Participants with at least one treatment-emergent adverse event linked to hypersensitivity reaction and injection site reaction regardless of relationship to IMP during the main 6-month and the 12-month on-treatment periods was assessed and reported.
Time Frame
From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Percentage of Participants With at Least One Positive Anti-Insulin Aspart Antibodies (AIA) Sample
Description
Participants with at least one positive AIA sample at baseline or at any time during the on-treatment period (Prevalence).
Time Frame
From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Percentage of Participants With Treatment-Induced, Treatment-Boosted and Treatment-Emergent Anti-insulin Aspart Antibodies (AIAs)
Description
AIA incidence were categorized as: treatment-induced, treatment-boosted AIAs, and treatment-emergent AIA. 1) Participants with treatment-induced AIAs were those who developed AIA following IMP administration (participants with at least one positive AIA sample at any time during on-treatment period, in those participants without pre-existing AIA or with missing baseline sample). 2) Participants with treatment-boosted AIAs were those with pre-existing AIAs that were boosted to a significant higher titer following IMP administration (participants with at least one AIA sample with at least a 4-fold increase in titers compared to baseline value at any time during on-treatment period). 3) Participants with treatment-emergent AIA were defined as participants with treatment-induced, or treatment-boosted AIAs.
Time Frame
From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Other Pre-specified Outcome Measures:
Title
Change in Glycated Hemoglobin A1c From Baseline to Week 26 and Week 52: Subgroup Analysis by Prior Use of NovoLog/NovoRapid or Humalog/Liprolog
Description
All values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c at Week 26 and Week 52 was calculated by subtracting baseline value from Week 26 and Week 52 value, respectively. Missing changes at Week 26 and Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Time Frame
Baseline, Week 26 and Week 52
Title
Number of Participants With at Least One Hypoglycemic Event: Subgroup Analysis by Prior Use of NovoLog/NovoRapid or Humalog/Liprolog
Description
Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of <=3.9 mmol/L (<=70 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Time Frame
From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Number of Participants With Adverse Events: Subgroup Analysis by Prior Use of NovoLog/NovoRapid or Humalog/Liprolog
Description
Any untoward medical occurrence in a participant who received IMP was considered an AE without regard to possibility of causal relationship with this treatment. Treatment-emergent adverse events (TEAEs) were defined as AEs that developed or worsened or became serious during the main 6-month or 12-month on-treatment periods.
Time Frame
From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Percentage of Participants With Treatment-Induced, Treatment-Boosted and Treatment-Emergent Anti-insulin Aspart Antibodies (AIAs): Subgroup Analysis by Prior Use of NovoLog/NovoRapid or Humalog/Liprolog
Description
AIA incidence were categorized as: treatment-induced, treatment-boosted AIAs, and treatment-emergent AIA. 1) Participants with treatment-induced AIAs were those who developed AIA following IMP administration (participants with at least one positive AIA sample at any time during on-treatment period, in those participants without pre-existing AIA or with missing baseline sample. 2) Participants with treatment-boosted AIAs were those with pre-existing AIAs that were boosted to a significant higher titer following IMP administration (participants with at least one AIA sample with at least a 4-fold increase in titers compared to baseline value at any time during on-treatment period). 3) Participants with treatment-emergent AIA were defined as participants with treatment-induced, or treatment-boosted AIAs. Data was summarized separately for each treatment arm in each subgroup (based on the prior use of NovoLog/NovoRapid or Humalog/Liprolog).
Time Frame
From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Title
Change in Daily Insulin Dose From Baseline to Day 1, Week 26 and Week 52
Description
Change in daily insulin dose (basal, mealtime and total) was calculated by subtracting baseline value from Day1, Week 26 and Week 52 values respectively. Baseline was defined as the median of daily doses available in the week prior to the first injection of IMP (corresponding to doses of the pre-study insulin), value at Day 1 as the median of daily doses available in the week after the first injection of IMP (first doses of IMP), and value at Week 26 and Week 52 as the median of daily doses available in the week prior to each visit.
Time Frame
Baseline, Day 1, Week 26 and Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria : Participants with T1DM or T2DM (T2DM US only) diagnosed for at least 12 months, who have been treated with a multiple daily injection regimen with NovoLog/NovoRapid or insulin lispro (100 U/mL) in the last 6 months prior to screening visit AND insulin glargine (100 U/mL) in the last 6 months prior to screening visit OR insulin detemir (Levemir®) in the last 12 months prior to screening visit. Exclusion criteria: At screening visit, age under legal age of adulthood. HbA1c <7.0% or greater than (>) 10% at screening. Less than 1 year on continuous insulin treatment. Use of insulin pump in the last 3 months before screening visit. Participants with incomplete baseline 7-point SMPG profile, defined as participants who do not have 7-point profiles with at least 5 points on at least 2 days in the week before randomization Visit 3. Participants with T1DM: Use of glucose lowering agents other than insulin including use of non-insulin injectable peptides in the last 3 months prior to screening. Participants with T2DM: Use of glucagon-like peptide-1 (GLP-1) receptor agonists in the last 3 months before screening visit. Use of oral antidiabetic drugs (OADs) not on stable dose in the last 3 months before screening visit (sulfonylureas was discontinued at baseline). At screening visit, body mass index (BMI) greater than or equal to (>=) 35 kilogram per meter square (kg/m^2) in participants with T1DM and >=40 kg/m^2 in participants with T2DM. Use of insulin other than: insulin glargine 100 U/mL and NovoLog/NovoRapid or insulin lispro 100 U/mL as part of a multiple injection regimen in the last 6 months before screening visit, OR insulin detemir 100 U/mL in the 12 months before screening visit and NovoLog/NovoRapid or insulin lispro 100 U/mL in the last 6 months before screening visit as part of a multiple injection regimen. Status post pancreatectomy. Status post pancreas and/or islet cell transplantation. Hospitalization for recurrent diabetic ketoacidosis in the last 3 months before screening visit. History of severe hypoglycemia requiring Emergency Room admission or hospitalization in the last 3 months before screening visit. Unstable proliferative diabetic retinopathy or any other rapidly progressive diabetic retinopathy or macular edema likely to require treatment (eg, laser, surgical treatment or injectable drugs) during the study period. Pregnant or breastfeeding women. Women of childbearing potential not protected by highly effective method(s) of birth control. The above information is not intended to contain all considerations relevant to a participant'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 8400040
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72211
Country
United States
Facility Name
Investigational Site Number 8400012
City
Concord
State/Province
California
ZIP/Postal Code
94520
Country
United States
Facility Name
Investigational Site Number 8400002
City
Escondido
State/Province
California
ZIP/Postal Code
92025
Country
United States
Facility Name
Investigational Site Number 8400030
City
Fresno
State/Province
California
ZIP/Postal Code
93720
Country
United States
Facility Name
Investigational Site Number 8400004
City
Greenbrae
State/Province
California
ZIP/Postal Code
94904
Country
United States
Facility Name
Investigational Site Number 8400014
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
Facility Name
Investigational Site Number 8400043
City
Los Angeles
State/Province
California
ZIP/Postal Code
90057
Country
United States
Facility Name
Investigational Site Number 8400036
City
Pomona
State/Province
California
ZIP/Postal Code
91766
Country
United States
Facility Name
Investigational Site Number 8400011
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93105
Country
United States
Facility Name
Investigational Site Number 8400013
City
Ventura
State/Province
California
ZIP/Postal Code
93003
Country
United States
Facility Name
Investigational Site Number 8400037
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Investigational Site Number 8400018
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
Facility Name
Investigational Site Number 8400031
City
New Port Richey
State/Province
Florida
ZIP/Postal Code
34652
Country
United States
Facility Name
Investigational Site Number 8400027
City
Ocoee
State/Province
Florida
ZIP/Postal Code
34761
Country
United States
Facility Name
Investigational Site Number 8400007
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Facility Name
Investigational Site Number 8400022
City
Columbus
State/Province
Georgia
ZIP/Postal Code
31904
Country
United States
Facility Name
Investigational Site Number 8400032
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
Facility Name
Investigational Site Number 8400038
City
Arlington Heights
State/Province
Illinois
ZIP/Postal Code
60005
Country
United States
Facility Name
Investigational Site Number 8400005
City
Des Moines
State/Province
Iowa
ZIP/Postal Code
50314
Country
United States
Facility Name
Investigational Site Number 8400041
City
Metairie
State/Province
Louisiana
ZIP/Postal Code
70006
Country
United States
Facility Name
Investigational Site Number 8400015
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20852-4267
Country
United States
Facility Name
Investigational Site Number 8400042
City
Waltham
State/Province
Massachusetts
ZIP/Postal Code
02453
Country
United States
Facility Name
Investigational Site Number 8400019
City
Flint
State/Province
Michigan
ZIP/Postal Code
48532-3447
Country
United States
Facility Name
Investigational Site Number 8400003
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68131
Country
United States
Facility Name
Investigational Site Number 8400024
City
Henderson
State/Province
Nevada
ZIP/Postal Code
89052
Country
United States
Facility Name
Investigational Site Number 8400028
City
New York
State/Province
New York
ZIP/Postal Code
10001
Country
United States
Facility Name
Investigational Site Number 8400025
City
Morehead City
State/Province
North Carolina
ZIP/Postal Code
28557
Country
United States
Facility Name
Investigational Site Number 8400010
City
Wilmington
State/Province
North Carolina
ZIP/Postal Code
28401
Country
United States
Facility Name
Investigational Site Number 8400023
City
Fargo
State/Province
North Dakota
ZIP/Postal Code
58104
Country
United States
Facility Name
Investigational Site Number 8400029
City
Bend
State/Province
Oregon
ZIP/Postal Code
97701
Country
United States
Facility Name
Investigational Site Number 8400033
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
Investigational Site Number 8400044
City
Austin
State/Province
Texas
ZIP/Postal Code
78731
Country
United States
Facility Name
Investigational Site Number 8400009
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
Investigational Site Number 8400035
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
Investigational Site Number 8400021
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
Investigational Site Number 8400017
City
Houston
State/Province
Texas
ZIP/Postal Code
77043
Country
United States
Facility Name
Investigational Site Number 8400001
City
Houston
State/Province
Texas
ZIP/Postal Code
77079
Country
United States
Facility Name
Investigational Site Number 8400020
City
Houston
State/Province
Texas
ZIP/Postal Code
77089
Country
United States
Facility Name
Investigational Site Number 8400016
City
Mesquite
State/Province
Texas
ZIP/Postal Code
75149
Country
United States
Facility Name
Investigational Site Number 8400034
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84102
Country
United States
Facility Name
Investigational Site Number 8400008
City
Renton
State/Province
Washington
ZIP/Postal Code
98057
Country
United States
Facility Name
Investigational Site Number 8400039
City
Bridgeport
State/Province
West Virginia
ZIP/Postal Code
26330
Country
United States
Facility Name
Investigational Site Number 2460006
City
Jyväskylä
ZIP/Postal Code
40100
Country
Finland
Facility Name
Investigational Site Number 2460002
City
Kuopio
ZIP/Postal Code
70100
Country
Finland
Facility Name
Investigational Site Number 2460004
City
Pori
ZIP/Postal Code
28500
Country
Finland
Facility Name
Investigational Site Number 2460003
City
Seinäjoki
ZIP/Postal Code
60100
Country
Finland
Facility Name
Investigational Site Number 2760001
City
Berlin
ZIP/Postal Code
10115
Country
Germany
Facility Name
Investigational Site Number 2760006
City
Essen
ZIP/Postal Code
45136
Country
Germany
Facility Name
Investigational Site Number 2760004
City
Heidelberg
ZIP/Postal Code
69115
Country
Germany
Facility Name
Investigational Site Number 2760005
City
Oldenburg In Holstein
ZIP/Postal Code
23758
Country
Germany
Facility Name
Investigational Site Number 2760002
City
Pirna
ZIP/Postal Code
01796
Country
Germany
Facility Name
Investigational Site Number 3480012
City
Balatonfüred
ZIP/Postal Code
8230
Country
Hungary
Facility Name
Investigational Site Number 3480011
City
Budapest
ZIP/Postal Code
1036
Country
Hungary
Facility Name
Investigational Site Number 3480008
City
Budapest
ZIP/Postal Code
1042
Country
Hungary
Facility Name
Investigational Site Number 3480001
City
Budapest
ZIP/Postal Code
1062
Country
Hungary
Facility Name
Investigational Site Number 3480005
City
Budapest
ZIP/Postal Code
1062
Country
Hungary
Facility Name
Investigational Site Number 3480004
City
Budapest
ZIP/Postal Code
1139
Country
Hungary
Facility Name
Investigational Site Number 3480007
City
Debrecen
ZIP/Postal Code
4031
Country
Hungary
Facility Name
Investigational Site Number 3480003
City
Nagykanizsa
ZIP/Postal Code
8800
Country
Hungary
Facility Name
Investigational Site Number 3480010
City
Nyíregyháza
ZIP/Postal Code
4400
Country
Hungary
Facility Name
Investigational Site Number 3480009
City
Szentendre
ZIP/Postal Code
2000
Country
Hungary
Facility Name
Investigational Site Number 3920009
City
Fukuyama-Shi
Country
Japan
Facility Name
Investigational Site Number 3920008
City
Higashiosaka-Shi
Country
Japan
Facility Name
Investigational Site Number 3920007
City
Kashiwara-Shi
Country
Japan
Facility Name
Investigational Site Number 3920001
City
Koriyama-Shi
Country
Japan
Facility Name
Investigational Site Number 3920005
City
Kumamoto-Shi
Country
Japan
Facility Name
Investigational Site Number 3920003
City
Mito-Shi
Country
Japan
Facility Name
Investigational Site Number 3920010
City
Osaka-Shi
Country
Japan
Facility Name
Investigational Site Number 3920002
City
Sagamihara-Shi
Country
Japan
Facility Name
Investigational Site Number 3920004
City
Shinjuku-Ku
Country
Japan
Facility Name
Investigational Site Number 3920006
City
Ushiku-Shi
Country
Japan
Facility Name
Investigational Site Number 6160004
City
Bialystok
ZIP/Postal Code
15-435
Country
Poland
Facility Name
Investigational Site Number 6160003
City
Krakow
ZIP/Postal Code
31-501
Country
Poland
Facility Name
Investigational Site Number 6160005
City
Krakow
ZIP/Postal Code
31-548
Country
Poland
Facility Name
Investigational Site Number 6160007
City
Lublin
ZIP/Postal Code
20-538
Country
Poland
Facility Name
Investigational Site Number 6160006
City
Nowy Sacz
ZIP/Postal Code
33-300
Country
Poland
Facility Name
Investigational Site Number 6160001
City
Poznan
ZIP/Postal Code
60-834
Country
Poland
Facility Name
Investigational Site Number 6160002
City
Warszawa
ZIP/Postal Code
02-507
Country
Poland
Facility Name
Investigational Site Number 6430002
City
Samara
ZIP/Postal Code
443041
Country
Russian Federation
Facility Name
Investigational Site Number 6430003
City
Saratov
ZIP/Postal Code
410030
Country
Russian Federation
Facility Name
Investigational Site Number 6430001
City
St. Petersburg
ZIP/Postal Code
194358
Country
Russian Federation
Facility Name
Investigational Site Number 6430004
City
Tomsk
ZIP/Postal Code
634050
Country
Russian Federation

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
31804851
Citation
Garg SK, Wernicke-Panten K, Wardecki M, Kramer D, Delalande F, Franek E, Sadeharju K, Monchamp T, Mukherjee B, Shah VN. Efficacy and Safety of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Treated for 26 Weeks with Multiple Daily Injections in Combination with Insulin Glargine: A Randomized Open-Label Trial (GEMELLI 1). Diabetes Technol Ther. 2020 Feb;22(2):85-95. doi: 10.1089/dia.2019.0382.
Results Reference
background
PubMed Identifier
32068436
Citation
Garg SK, Wernicke-Panten K, Wardecki M, Kramer D, Delalande F, Franek E, Sadeharju K, Monchamp T, Miossec P, Mukherjee B, Shah VN. Safety, Immunogenicity, and Glycemic Control of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Also Using Insulin Glargine: 12-Month Results from the GEMELLI 1 Trial. Diabetes Technol Ther. 2020 Jul;22(7):516-526. doi: 10.1089/dia.2020.0008. Epub 2020 Mar 31.
Results Reference
background
PubMed Identifier
33432547
Citation
Shah VN, Franek E, Wernicke-Panten K, Pierre S, Mukherjee B, Sadeharju K. Efficacy, Safety, and Immunogenicity of Insulin Aspart Biosimilar SAR341402 Compared with Originator Insulin Aspart in Adults with Diabetes (GEMELLI 1): A Subgroup Analysis by Prior Type of Mealtime Insulin. Diabetes Ther. 2021 Feb;12(2):557-568. doi: 10.1007/s13300-020-00992-x. Epub 2021 Jan 11.
Results Reference
derived

Learn more about this trial

Comparison of SAR341402 to NovoLog/NovoRapid in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine

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