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Multiple Ascending Dose Study in Healthy Male Subjects and Overweight to Obese Male and Female Type 2 Diabetes Mellitus (T2DM) Patients

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
SAR425899
placebo
metformin
Sponsored by
Sanofi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Type 2 Diabetes Mellitus

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion criteria:

Healthy subjects:

  • Males, between 18 and 55 years of age, inclusive.
  • Body mass index (BMI) between 20.0 and 30.0 kg/m^2, inclusive; body weight between 50.0 and 120.0 kg, inclusive.
  • Certified as healthy by comprehensive clinical assessment (detailed medical history, complete physical examination). Comorbidities of higher weight (eg, mild impaired glucose tolerance, mild hypertension, mild hyperlipidemia) are permitted unless, per investigator, these conditions hamper participation.
  • Normal vital signs after 10 minutes resting supine:
  • 95 mmHg <systolic blood pressure (SBP) <150 mmHg.
  • 45 mmHg <diastolic blood pressure (DBP) <100 mmHg.
  • 50 bpm <heart rate (HR) <100 bpm.
  • Standard 12-lead electrocardiogram (ECG) parameters after 10 minutes resting in supine position within; 120 ms <PR <220 ms, QRS <120 ms, QTc ≤430 ms, normal ECG.
  • Normal 24-hour Holter electrocardiography at screening.
  • Laboratory parameters within normal range; however serum creatinine, alkaline phosphatase, hepatic enzymes (aspartate aminotransferase, alanine aminotransferase), and total bilirubin (unless subject has Gilbert syndrome) should not exceed upper laboratory norm (ULN).

T2DM patients:

  • Males and females, 18-70 years of age.
  • Body weight 50.0-150.0 kg, BMI 28.0 - 42.0 kg/m^2.
  • Diagnosis of T2DM for at least 1 year with stable metformin prior to inclusion; comorbidities related to T2DM but otherwise healthy.
  • Normal vital signs supine:
  • 95 mmHg < SBP <160 mmHg
  • 45 mmHg < DBP <100 mmHg
  • 50 bpm < HR <100 bpm
  • Normal standard 12-lead ECG in supine position unless abnormality is clinically irrelevant.
  • Laboratory parameters in normal range unless abnormality is clinically irrelevant or strongly associated with T2DM; total bilirubin not to exceed ULN.
  • Fasting plasma glucose ≥90 mg/dL.
  • HbA1c ≥6.5% and ≤8.5%.
  • Females: Sterilization at least 3 months before inclusion or postmenopausal.

Both:

  • Signed written informed consent.
  • Not supervised/confined for legal or administrative reasons.
  • Male subject with partner of childbearing potential (including lactating women) must use double contraception method.
  • Male subject with pregnant partner must use a condom up to 2 months after last dosing.
  • Male subject agreed not to donate sperm up to 2 months after last dosing.
  • Not undergoing physical training program/planning changes in activity; not vegetarian or following special diet.

Exclusion criteria:

Healthy subjects:

  • History of clinically relevant disease/signs of acute illness.
  • History of drug hypersensitivity/allergic disease.
  • Smoking more than 5 cigarettes/day.
  • Any medication within 14 days before inclusion or within 5 times elimination/pharmacodynamic half-life of the medication and during study; vaccination within last 28 days, biologics given within 4 months before inclusion.

T2DM patients:

  • History/presence of clinically relevant disease/signs of acute illness not related to patient's metabolic status.
  • History/presence of drug hypersensitivity or allergic disease.
  • Smoking more than 5 cigarettes per day.
  • If female, pregnancy/breast-feeding.
  • Any intake of medication during treatment period and within 21 days before first dosing or within 5 times half-life of the medication, except: metformin, standard antihypertensive treatment, statins, acetyl salicylic acid.
  • Thyroid hormone replacement is allowed if dose was stable for 3 months prior to screening.
  • Individual background therapy, considered necessary for the patient's welfare, that could not be discontinued for the duration of the study, may be given at the discretion of the Investigator, with a stable dose (when possible) and only if its intake is unlikely to interfere with the investigational product.
  • Treated with sulphonyl-ureas up to 3 months, proton pump inhibitors up to 1 week prior to dosing.
  • Vaccination within last 28 days, any biologics within 4 months before inclusion.
  • Severe hypoglycemia resulting in seizure/unconsciousness/coma/hospitalization for diabetic ketoacidosis in last 3 months before screening.
  • Persistent hyperglycemia not controlled by metformin/diet/exercise.
  • Diabetic neuropathy, retinopathy, nephropathy or renal impairment.
  • Hepatic impairment.
  • Unstable hypo- or hyperthyroidism.

Both:

  • Headaches/migraine.
  • Recurrent nausea/vomiting.
  • Blood donation within 1 month before inclusion.
  • Symptomatic postural hypotension, irrespective of decrease in BP, or asymptomatic postural hypotension defined as decrease in SBP ≥20 mmHg within 3 minutes when changing from supine to standing.
  • History/presence of drug or alcohol abuse.
  • Positive result: hepatitis B surface antigen, anti-hepatitis C virus antibodies, anti-human immunodeficiency virus 1 and 2 antibodies.
  • Any condition affecting gastric emptying or absorption from GI tract.
  • Surgically treated obesity, bariatric surgery.
  • Severe dyslipidemia with fasting triglycerides >450 mg/dL.
  • History of pancreatitis or pancreatectomy.
  • Amylase/lipase >3 ULN.
  • History of thyroid cancer or a genetic condition that predisposes to thyroid cancer.
  • Elevated basal calcitonin.

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

Sites / Locations

  • Investigational Site Number 276001

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Arm Label

SAR425899 (healthy subjects)

Placebo (healthy subjects)

SAR425899 (T2DM Patients)

Placebo (T2DM Patients)

Arm Description

Once daily SC doses of SAR425899

Once daily SC doses of placebo

Once daily SC doses of SAR425899 and two up titration steps in each dose cohort with metformin as background therapy

Once daily SC doses of placebo and two up titration steps in each dose cohort with metformin as background therapy

Outcomes

Primary Outcome Measures

Number of adverse events

Secondary Outcome Measures

Changes in vital signs
Changes in physical examination
Changes in ECG
Changes in clinical laboratory parameters (hematology)
Changes in clinical laboratory parameters (biochemistry)
Changes in body temperature
Change from baseline in biomarkers (FGF21)
Change from baseline in biomarkers (lipid biomarker)
Change from baseline in biomarkers (incretins)
Assessment of pharmacokinetic parameters in blood (AUC)
Assessment of pharmacokinetic parameters in blood (Cmax)
Assessment of pharmacokinetic parameters in blood (t1/2)
Assessment of pharmacokinetic parameters in urine (Ae0-24)
Assessment of pharmacokinetic parameters in urine (fe0-24)
Change from baseline in Body weight
Change from baseline in Fasting Blood Glucose
Change from baseline in Postprandial Blood Glucose
Change from baseline in postprandial Insulin
Change from baseline in postprandial C-peptide profiles
Change from baseline in HbA1c

Full Information

First Posted
March 24, 2015
Last Updated
June 14, 2018
Sponsor
Sanofi
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1. Study Identification

Unique Protocol Identification Number
NCT02411825
Brief Title
Multiple Ascending Dose Study in Healthy Male Subjects and Overweight to Obese Male and Female Type 2 Diabetes Mellitus (T2DM) Patients
Official Title
A Randomized, Double-blind, Placebo-controlled Study to Assess the Safety and Tolerability, Pharmacokinetics and Pharmacodynamics of Repeated Subcutaneous Doses of SAR425899 in Healthy Male Subjects and Overweight to Obese Patients With Type 2 Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
June 2018
Overall Recruitment Status
Completed
Study Start Date
March 2015 (undefined)
Primary Completion Date
January 2016 (Actual)
Study Completion Date
January 2016 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Primary Objective: To assess in healthy adult male subjects: The tolerability and safety of 21-day repeated subcutaneous (SC) doses of SAR425899 including two up titration steps. Pharmacokinetic (PK) parameters of SAR425899 after ascending repeated SC doses in plasma. Pharmacodynamic (PD) effects on fasting and postprandial plasma glucose, insulin, biomarkers of lipid metabolism and fibroblast growth factor 21 (FGF21). To assess in overweight to obese T2DM mellitus patients: The tolerability and safety after 28-day repeated SC doses of SAR425899 including 2 up titration steps. PK parameters of SAR425899 after ascending repeated SC doses in plasma and urine. PD effects on fasting and postprandial plasma glucose, insulin, C-peptide, incretin panel (total and active ghrelin, total peptide YY [PYY], total and active glucagon-like peptide -1 [GLP-1], glucagon and total gastric inhibitory polypeptide-1 [GIP]), body weight, FGF21, biomarkers of lipid metabolism and HbA1c.
Detailed Description
The total study duration is approximately 10-15 weeks.

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
Basic Science
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
76 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SAR425899 (healthy subjects)
Arm Type
Experimental
Arm Description
Once daily SC doses of SAR425899
Arm Title
Placebo (healthy subjects)
Arm Type
Placebo Comparator
Arm Description
Once daily SC doses of placebo
Arm Title
SAR425899 (T2DM Patients)
Arm Type
Experimental
Arm Description
Once daily SC doses of SAR425899 and two up titration steps in each dose cohort with metformin as background therapy
Arm Title
Placebo (T2DM Patients)
Arm Type
Placebo Comparator
Arm Description
Once daily SC doses of placebo and two up titration steps in each dose cohort with metformin as background therapy
Intervention Type
Drug
Intervention Name(s)
SAR425899
Intervention Description
Pharmaceutical form: solution for injection Route of administration: subcutaneous
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Pharmaceutical form: solution for injection Route of administration: subcutaneous
Intervention Type
Drug
Intervention Name(s)
metformin
Intervention Description
Pharmaceutical form: tablet Route of administration: oral
Primary Outcome Measure Information:
Title
Number of adverse events
Time Frame
28 to 35 days
Secondary Outcome Measure Information:
Title
Changes in vital signs
Time Frame
28 to 35 days
Title
Changes in physical examination
Time Frame
28 to 35 days
Title
Changes in ECG
Time Frame
28 to 35 days
Title
Changes in clinical laboratory parameters (hematology)
Time Frame
28 to 35 days
Title
Changes in clinical laboratory parameters (biochemistry)
Time Frame
28 to 35 days
Title
Changes in body temperature
Time Frame
28 to 35 days
Title
Change from baseline in biomarkers (FGF21)
Time Frame
28 to 35 days
Title
Change from baseline in biomarkers (lipid biomarker)
Time Frame
28 to 35 days
Title
Change from baseline in biomarkers (incretins)
Time Frame
28 to 35 days
Title
Assessment of pharmacokinetic parameters in blood (AUC)
Time Frame
28 to 35 days
Title
Assessment of pharmacokinetic parameters in blood (Cmax)
Time Frame
28 to 35 days
Title
Assessment of pharmacokinetic parameters in blood (t1/2)
Time Frame
28 to 35 days
Title
Assessment of pharmacokinetic parameters in urine (Ae0-24)
Time Frame
28 to 35 days
Title
Assessment of pharmacokinetic parameters in urine (fe0-24)
Time Frame
28 to 35 days
Title
Change from baseline in Body weight
Time Frame
28 to 35 days
Title
Change from baseline in Fasting Blood Glucose
Time Frame
28 to 35 days
Title
Change from baseline in Postprandial Blood Glucose
Time Frame
28 to 35 days
Title
Change from baseline in postprandial Insulin
Time Frame
28 to 35 days
Title
Change from baseline in postprandial C-peptide profiles
Time Frame
28 to 35 days
Title
Change from baseline in HbA1c
Time Frame
28 to 35 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion criteria: Healthy subjects: Males, between 18 and 55 years of age, inclusive. Body mass index (BMI) between 20.0 and 30.0 kg/m^2, inclusive; body weight between 50.0 and 120.0 kg, inclusive. Certified as healthy by comprehensive clinical assessment (detailed medical history, complete physical examination). Comorbidities of higher weight (eg, mild impaired glucose tolerance, mild hypertension, mild hyperlipidemia) are permitted unless, per investigator, these conditions hamper participation. Normal vital signs after 10 minutes resting supine: 95 mmHg <systolic blood pressure (SBP) <150 mmHg. 45 mmHg <diastolic blood pressure (DBP) <100 mmHg. 50 bpm <heart rate (HR) <100 bpm. Standard 12-lead electrocardiogram (ECG) parameters after 10 minutes resting in supine position within; 120 ms <PR <220 ms, QRS <120 ms, QTc ≤430 ms, normal ECG. Normal 24-hour Holter electrocardiography at screening. Laboratory parameters within normal range; however serum creatinine, alkaline phosphatase, hepatic enzymes (aspartate aminotransferase, alanine aminotransferase), and total bilirubin (unless subject has Gilbert syndrome) should not exceed upper laboratory norm (ULN). T2DM patients: Males and females, 18-70 years of age. Body weight 50.0-150.0 kg, BMI 28.0 - 42.0 kg/m^2. Diagnosis of T2DM for at least 1 year with stable metformin prior to inclusion; comorbidities related to T2DM but otherwise healthy. Normal vital signs supine: 95 mmHg < SBP <160 mmHg 45 mmHg < DBP <100 mmHg 50 bpm < HR <100 bpm Normal standard 12-lead ECG in supine position unless abnormality is clinically irrelevant. Laboratory parameters in normal range unless abnormality is clinically irrelevant or strongly associated with T2DM; total bilirubin not to exceed ULN. Fasting plasma glucose ≥90 mg/dL. HbA1c ≥6.5% and ≤8.5%. Females: Sterilization at least 3 months before inclusion or postmenopausal. Both: Signed written informed consent. Not supervised/confined for legal or administrative reasons. Male subject with partner of childbearing potential (including lactating women) must use double contraception method. Male subject with pregnant partner must use a condom up to 2 months after last dosing. Male subject agreed not to donate sperm up to 2 months after last dosing. Not undergoing physical training program/planning changes in activity; not vegetarian or following special diet. Exclusion criteria: Healthy subjects: History of clinically relevant disease/signs of acute illness. History of drug hypersensitivity/allergic disease. Smoking more than 5 cigarettes/day. Any medication within 14 days before inclusion or within 5 times elimination/pharmacodynamic half-life of the medication and during study; vaccination within last 28 days, biologics given within 4 months before inclusion. T2DM patients: History/presence of clinically relevant disease/signs of acute illness not related to patient's metabolic status. History/presence of drug hypersensitivity or allergic disease. Smoking more than 5 cigarettes per day. If female, pregnancy/breast-feeding. Any intake of medication during treatment period and within 21 days before first dosing or within 5 times half-life of the medication, except: metformin, standard antihypertensive treatment, statins, acetyl salicylic acid. Thyroid hormone replacement is allowed if dose was stable for 3 months prior to screening. Individual background therapy, considered necessary for the patient's welfare, that could not be discontinued for the duration of the study, may be given at the discretion of the Investigator, with a stable dose (when possible) and only if its intake is unlikely to interfere with the investigational product. Treated with sulphonyl-ureas up to 3 months, proton pump inhibitors up to 1 week prior to dosing. Vaccination within last 28 days, any biologics within 4 months before inclusion. Severe hypoglycemia resulting in seizure/unconsciousness/coma/hospitalization for diabetic ketoacidosis in last 3 months before screening. Persistent hyperglycemia not controlled by metformin/diet/exercise. Diabetic neuropathy, retinopathy, nephropathy or renal impairment. Hepatic impairment. Unstable hypo- or hyperthyroidism. Both: Headaches/migraine. Recurrent nausea/vomiting. Blood donation within 1 month before inclusion. Symptomatic postural hypotension, irrespective of decrease in BP, or asymptomatic postural hypotension defined as decrease in SBP ≥20 mmHg within 3 minutes when changing from supine to standing. History/presence of drug or alcohol abuse. Positive result: hepatitis B surface antigen, anti-hepatitis C virus antibodies, anti-human immunodeficiency virus 1 and 2 antibodies. Any condition affecting gastric emptying or absorption from GI tract. Surgically treated obesity, bariatric surgery. Severe dyslipidemia with fasting triglycerides >450 mg/dL. History of pancreatitis or pancreatectomy. Amylase/lipase >3 ULN. History of thyroid cancer or a genetic condition that predisposes to thyroid cancer. Elevated basal calcitonin. The above information is not intended to contain all considerations relevant to a patient'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 276001
City
Berlin
ZIP/Postal Code
10117
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
31808298
Citation
Visentin R, Schiavon M, Gobel B, Riz M, Cobelli C, Klabunde T, Dalla Man C. Dual glucagon-like peptide-1 receptor/glucagon receptor agonist SAR425899 improves beta-cell function in type 2 diabetes. Diabetes Obes Metab. 2020 Apr;22(4):640-647. doi: 10.1111/dom.13939. Epub 2019 Dec 22.
Results Reference
derived
PubMed Identifier
30091218
Citation
Tillner J, Posch MG, Wagner F, Teichert L, Hijazi Y, Einig C, Keil S, Haack T, Wagner M, Bossart M, Larsen PJ. A novel dual glucagon-like peptide and glucagon receptor agonist SAR425899: Results of randomized, placebo-controlled first-in-human and first-in-patient trials. Diabetes Obes Metab. 2019 Jan;21(1):120-128. doi: 10.1111/dom.13494. Epub 2018 Sep 16.
Results Reference
derived

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Multiple Ascending Dose Study in Healthy Male Subjects and Overweight to Obese Male and Female Type 2 Diabetes Mellitus (T2DM) Patients

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