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Immunosafety Study of Recombinant Human Insulins in Type 1 Diabetics

Primary Purpose

Type I Diabetes

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Wosulin (N or 70/30 with R)
Novolin® (N or 70/30 with R)
Sponsored by
Wockhardt
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type I Diabetes

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects who understand the nature of the study and are willing to provide written informed consent.
  2. Subjects who have been pre-diagnosed as cases of type-1 diabetes (fasting C-peptide < 0.5 nmol/L) and have been on an insulin regimen for at least 12 months prior to inclusion in the trial.
  3. Subjects who have been on a stable regimen of recombinant human insulin or analogs for at least 3 months prior to randomization. (A stable regimen is defined as the dose within +/- 10%).
  4. Male or female subjects ≥ 18 and < 55 years of age.
  5. Subjects with body mass index (BMI) of ≥18.0 to < 35.0 kg/m2
  6. Subjects with glycosylated hemoglobin (HbA1c) levels between ≥6.5 and < 9.5%
  7. Subjects who are cooperative, reliable, and agree to have regular injections of insulin and are willing to comply with protocol procedures.
  8. Female subjects who are not pregnant and non-lactating with adequate protection from conception and fulfilling one of the following criteria are also eligible if within ≥ 18 and < 55 years age limits:

    1. Women of childbearing potential on an acceptable method of birth control (including but not limited to barrier-method, contraceptives, or intrauterine device)
    2. Women with history of bilateral tubal ligation,
    3. Women who have undergone total hysterectomy
    4. Women who are two years post-menopausal
  9. Subjects who are able to use the self glucose-monitoring device and to self inject insulin.

Exclusion Criteria:

  1. Female subjects who are pregnant (as confirmed by a positive urine and serum β-HCG) or are currently breast-feeding.
  2. Compromised hepatic or renal function, as shown by but not limited to:

    i.Baseline AST or ALT >3 times the upper limit of normal range, and/or ii.Serum Creatinine >2.0 mg/dl and/or iii.BUN >30 mg/dl Abnormal laboratory findings will be discussed with the medical monitor prior to the subject's entry.

  3. Employee of Investigator or have direct involvement with trial or other trials under the direction of Investigator.
  4. Those treated with other investigational agents or devices within previous 30 days, from screening, have planned use of an investigational drug or device, or have been previously randomized in this trial.
  5. History or evidence of allergy to insulin preparations.
  6. History or evidence of severe hypoglycemia (severe hypoglycemic episode defined as the subject required glucose, glucagon, orange juice etc administered by a second person)
  7. Requirement for total daily dose of insulin is >1.4 units/kg
  8. Who have received Wockhardt's (Wosulin) or Novo Nordisk's Insulin (Novolin® R, Novolin® N, Novolin® 70/30, in US and Actrapid® Insulatard®, and Mixtard® in India) during the previous one year.
  9. Serum AIA level > 20 microU/ml.
  10. Receipt of any insulin of an animal origin during the last 3 years.
  11. Currently receiving or have received within the last year any immunomodulators medications, including corticosteroids that would possibly modify antibody generation either at the enrollment or during the course of the study. (Topical/ ophthalmic/intra-articular/nasal spray corticosteroids will be allowed).
  12. Hepatitis B or Hepatitis C or HIV positive.
  13. Oral hypoglycaemic agent within 4 weeks prior to signing the consent form.
  14. Who have undergone pancreatectomy or pancreas/islet cell transplant.
  15. Unlikely to comply with the study protocol e.g. unable to return periodically for subsequent visits.
  16. History or evidence of active severe proliferative retinopathy, nephropathy and/or neuropathy significant cardiovascular disease, anemia or hemoglobinopathy, uncontrolled hypothyroidism or uncontrolled hyperthyroidism, alcohol or drug abuse or any other medical condition that in the opinion of Investigator can interfere with the study.
  17. Judged by the investigator as inappropriate to participate in the study for any reason other than those mentioned above.

Sites / Locations

  • University Clinical Investigators, Inc. dba Diabetes Research Center
  • International Research Associates
  • The Center for Diabetes and Endocrine Care
  • Baptist Diabetes Associates, PA
  • Suncoast Clinical Research
  • Ormond Medical Arts Pharmaceutical Research Center
  • Suncoast Clinical Research
  • International Clinical Research - US, LLC
  • Cotton-O'Neil Clinical Research Center, Diabetes & Endocrinology
  • Kentucky Diabetes Endocrinology Center
  • Endocrine & Metabolic Consultants
  • ActivMed Practices and Research
  • Alzohaili Medical Consultants
  • ActivMed Practices and Research
  • University Diabetes & Endocrine Association
  • Sergio Rovner, MD
  • Optimum Clinical Research, Inc.
  • Dr Rakesh Sahay
  • Dia Care - A Complete Diabetes Care Centre
  • Dr Sanjay Kalra
  • Dr Mala Dharmalingam
  • Bangalore Diabetes Hospital
  • Dr Sharad Pendsey
  • Diabetes Thyroid &Endocrine Centre
  • Bhandari's Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Wosulin (N or 70/30 with R)

Novolin® (N or 70/30 with R)

Arm Description

Basal bolus conventional Insulin viz. Wosulin (N or 70/30 with R) to be injected subcutaneously.

Basal bolus conventional Insulin viz. Novolin® (N or 70/30 with R) to be injected subcutaneously.

Outcomes

Primary Outcome Measures

Change in HbAlc from baseline to 6 months of treatment between Wosulin arm and Novolin arm(as surrogate indicator of change in insulin antibodies titers between the two treatment arms).

Secondary Outcome Measures

Correlation between change in HbA1c and change in anti insulin and insulin neutralizing antibodies.
Insulin dose will be used as a covariate
To compare the change from baseline in the level of serum anti insulin antibodies and insulin neutralizing antibodies between the two arms
Compare the change in Insulin dose between the two arms
Glycated hemoglobin levels and the number of hypoglycemic episodes will be the covariants for this analysis
Correlation of the immunogenicity with hypoglycemia, local allergic reactions and systemic allergic reactions will be evaluated.
Immunogenicity is measured as percentage change in serum antiinsulin antibodies and insulin neutralizing antibodies.

Full Information

First Posted
February 9, 2011
Last Updated
June 22, 2023
Sponsor
Wockhardt
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1. Study Identification

Unique Protocol Identification Number
NCT01308437
Brief Title
Immunosafety Study of Recombinant Human Insulins in Type 1 Diabetics
Official Title
An Open Label,Randomized,Comparison of the Immunogenicity and Safety of Wockhardt's Human Insulin Basal Bolus Regimen With the Novo Nordisk's Yeast Based Human Insulin Basal Bolus Regimens, Marketed in United States, in Type 1 Diabetics.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Terminated
Why Stopped
Business reasons
Study Start Date
March 2011 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
April 2013 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open label, randomized, parallel group comparison of the immunogenicity safety of Wockhardt's human insulin and isophane insulin compared with the Novo Nordisk's yeast based human insulin products (marketed in USA) in type 1 diabetics. There are two phases of the study, which are as follows: Phase 1 is a comparative phase in which there will be 2 arms (which are described in the section below). Phase 2 is a follow up phase only applicable to Wosulin Arm. The study will last for 54 weeks for the patients enrolled in Wosulin arm and approximately 28 weeks for the patients enrolled in the comparator arm. Two hundred and forty two patients will be enrolled considering an estimated dropout rate of 15% for a sample size of approximately 105 evaluable patients per arm. The total planned enrollment period for this study is approximately 3 months (90 days).

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Wosulin (N or 70/30 with R)
Arm Type
Experimental
Arm Description
Basal bolus conventional Insulin viz. Wosulin (N or 70/30 with R) to be injected subcutaneously.
Arm Title
Novolin® (N or 70/30 with R)
Arm Type
Active Comparator
Arm Description
Basal bolus conventional Insulin viz. Novolin® (N or 70/30 with R) to be injected subcutaneously.
Intervention Type
Biological
Intervention Name(s)
Wosulin (N or 70/30 with R)
Other Intervention Name(s)
Wosulin R,, Wosulin N,, Wosulin 70/30
Intervention Description
Basal bolus conventional Insulin viz. Wosulin (N or 70/30 with R) to be injected subcutaneously.
Intervention Type
Biological
Intervention Name(s)
Novolin® (N or 70/30 with R)
Other Intervention Name(s)
Novolin® R,, Novolin® N,, Novolin® 70/30
Intervention Description
Basal bolus conventional Insulin viz. Novolin® (N or 70/30 with R) to be injected subcutaneously.
Primary Outcome Measure Information:
Title
Change in HbAlc from baseline to 6 months of treatment between Wosulin arm and Novolin arm(as surrogate indicator of change in insulin antibodies titers between the two treatment arms).
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Correlation between change in HbA1c and change in anti insulin and insulin neutralizing antibodies.
Description
Insulin dose will be used as a covariate
Time Frame
6 months and 12 months
Title
To compare the change from baseline in the level of serum anti insulin antibodies and insulin neutralizing antibodies between the two arms
Time Frame
6 months
Title
Compare the change in Insulin dose between the two arms
Description
Glycated hemoglobin levels and the number of hypoglycemic episodes will be the covariants for this analysis
Time Frame
3 and 6 months
Title
Correlation of the immunogenicity with hypoglycemia, local allergic reactions and systemic allergic reactions will be evaluated.
Description
Immunogenicity is measured as percentage change in serum antiinsulin antibodies and insulin neutralizing antibodies.
Time Frame
6 and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who understand the nature of the study and are willing to provide written informed consent. Subjects who have been pre-diagnosed as cases of type-1 diabetes (fasting C-peptide < 0.5 nmol/L) and have been on an insulin regimen for at least 12 months prior to inclusion in the trial. Subjects who have been on a stable regimen of recombinant human insulin or analogs for at least 3 months prior to randomization. (A stable regimen is defined as the dose within +/- 10%). Male or female subjects ≥ 18 and < 55 years of age. Subjects with body mass index (BMI) of ≥18.0 to < 35.0 kg/m2 Subjects with glycosylated hemoglobin (HbA1c) levels between ≥6.5 and < 9.5% Subjects who are cooperative, reliable, and agree to have regular injections of insulin and are willing to comply with protocol procedures. Female subjects who are not pregnant and non-lactating with adequate protection from conception and fulfilling one of the following criteria are also eligible if within ≥ 18 and < 55 years age limits: Women of childbearing potential on an acceptable method of birth control (including but not limited to barrier-method, contraceptives, or intrauterine device) Women with history of bilateral tubal ligation, Women who have undergone total hysterectomy Women who are two years post-menopausal Subjects who are able to use the self glucose-monitoring device and to self inject insulin. Exclusion Criteria: Female subjects who are pregnant (as confirmed by a positive urine and serum β-HCG) or are currently breast-feeding. Compromised hepatic or renal function, as shown by but not limited to: i.Baseline AST or ALT >3 times the upper limit of normal range, and/or ii.Serum Creatinine >2.0 mg/dl and/or iii.BUN >30 mg/dl Abnormal laboratory findings will be discussed with the medical monitor prior to the subject's entry. Employee of Investigator or have direct involvement with trial or other trials under the direction of Investigator. Those treated with other investigational agents or devices within previous 30 days, from screening, have planned use of an investigational drug or device, or have been previously randomized in this trial. History or evidence of allergy to insulin preparations. History or evidence of severe hypoglycemia (severe hypoglycemic episode defined as the subject required glucose, glucagon, orange juice etc administered by a second person) Requirement for total daily dose of insulin is >1.4 units/kg Who have received Wockhardt's (Wosulin) or Novo Nordisk's Insulin (Novolin® R, Novolin® N, Novolin® 70/30, in US and Actrapid® Insulatard®, and Mixtard® in India) during the previous one year. Serum AIA level > 20 microU/ml. Receipt of any insulin of an animal origin during the last 3 years. Currently receiving or have received within the last year any immunomodulators medications, including corticosteroids that would possibly modify antibody generation either at the enrollment or during the course of the study. (Topical/ ophthalmic/intra-articular/nasal spray corticosteroids will be allowed). Hepatitis B or Hepatitis C or HIV positive. Oral hypoglycaemic agent within 4 weeks prior to signing the consent form. Who have undergone pancreatectomy or pancreas/islet cell transplant. Unlikely to comply with the study protocol e.g. unable to return periodically for subsequent visits. History or evidence of active severe proliferative retinopathy, nephropathy and/or neuropathy significant cardiovascular disease, anemia or hemoglobinopathy, uncontrolled hypothyroidism or uncontrolled hyperthyroidism, alcohol or drug abuse or any other medical condition that in the opinion of Investigator can interfere with the study. Judged by the investigator as inappropriate to participate in the study for any reason other than those mentioned above.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ashima Bhatia, M.D.
Organizational Affiliation
Wockhardt
Official's Role
Study Director
Facility Information:
Facility Name
University Clinical Investigators, Inc. dba Diabetes Research Center
City
Tustin
State/Province
California
ZIP/Postal Code
92780
Country
United States
Facility Name
International Research Associates
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33012
Country
United States
Facility Name
The Center for Diabetes and Endocrine Care
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33021
Country
United States
Facility Name
Baptist Diabetes Associates, PA
City
Miami
State/Province
Florida
ZIP/Postal Code
33156
Country
United States
Facility Name
Suncoast Clinical Research
City
New Port Richey
State/Province
Florida
ZIP/Postal Code
34652
Country
United States
Facility Name
Ormond Medical Arts Pharmaceutical Research Center
City
Ormond Beach
State/Province
Florida
ZIP/Postal Code
32174
Country
United States
Facility Name
Suncoast Clinical Research
City
Palm Harbor
State/Province
Florida
ZIP/Postal Code
34684
Country
United States
Facility Name
International Clinical Research - US, LLC
City
Sanford
State/Province
Florida
ZIP/Postal Code
32771
Country
United States
Facility Name
Cotton-O'Neil Clinical Research Center, Diabetes & Endocrinology
City
Topeka
State/Province
Kansas
ZIP/Postal Code
66606
Country
United States
Facility Name
Kentucky Diabetes Endocrinology Center
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40503
Country
United States
Facility Name
Endocrine & Metabolic Consultants
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20852
Country
United States
Facility Name
ActivMed Practices and Research
City
Haverhill
State/Province
Massachusetts
ZIP/Postal Code
01830
Country
United States
Facility Name
Alzohaili Medical Consultants
City
Dearborn
State/Province
Michigan
ZIP/Postal Code
48124
Country
United States
Facility Name
ActivMed Practices and Research
City
Rochester
State/Province
New Hampshire
ZIP/Postal Code
03867
Country
United States
Facility Name
University Diabetes & Endocrine Association
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37411
Country
United States
Facility Name
Sergio Rovner, MD
City
El Paso
State/Province
Texas
ZIP/Postal Code
79925
Country
United States
Facility Name
Optimum Clinical Research, Inc.
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84102
Country
United States
Facility Name
Dr Rakesh Sahay
City
Hyderabad
State/Province
Andhra Pradesh
ZIP/Postal Code
500012
Country
India
Facility Name
Dia Care - A Complete Diabetes Care Centre
City
Ahmedabad
State/Province
Gujrat
ZIP/Postal Code
380015
Country
India
Facility Name
Dr Sanjay Kalra
City
Karnal
State/Province
Haryana
ZIP/Postal Code
132001
Country
India
Facility Name
Dr Mala Dharmalingam
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560003
Country
India
Facility Name
Bangalore Diabetes Hospital
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560052
Country
India
Facility Name
Dr Sharad Pendsey
City
Nagpur
State/Province
Maharashtra
ZIP/Postal Code
440012
Country
India
Facility Name
Diabetes Thyroid &Endocrine Centre
City
Jaipur
State/Province
Rajasthan
ZIP/Postal Code
302006
Country
India
Facility Name
Bhandari's Clinic
City
Jaipur
State/Province
Rajasthan
ZIP/Postal Code
302015
Country
India

12. IPD Sharing Statement

Learn more about this trial

Immunosafety Study of Recombinant Human Insulins in Type 1 Diabetics

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