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Single Doses of ZP4207 Adm. sc to Hypoglycemic TD1 pt. to Describe the PK and PD of ZP4207 as Comp. to Marketed Glucagon

Primary Purpose

Hypoglycemia

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
ZP4207
GlucaGen
Sponsored by
Zealand Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypoglycemia

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Informed consent obtained before any trial-related activities (trial-related activities are any procedure that would not have been performed during normal management of the patient).
  2. Male and female patients with T1D for at least one year, as defined by the American Diabetes Association.
  3. Having been treated with insulin for T1D for at least 1 year.
  4. Stable disease with HbA1c < 8.5%.
  5. Expected stable insulin treatment during participation in trial and 3 month prior to the screening visit.
  6. Age between 18 and 50 years, both inclusive.
  7. Body weight between 60 and 90 kg, both inclusive.
  8. Patients in good health according to age (medical history, physical examination, vital signs, ECG, lab assessments), as judged by the Investigator.

    -

Exclusion Criteria:

  1. Previously treated with ZP4207.
  2. Known or suspected allergy to trial product(s) or related products.
  3. Previous participation (randomization) in this trial.
  4. Receipt of any investigational drug within 3 months prior to screening.
  5. A history or presence of cancer, or any clinically significant cardiovascular, respiratory, metabolic, renal, hepatic, gastrointestinal, endocrinological, hematological, dermatological, venereal, neurological, psychiatric diseases, or other major diseases.
  6. Clinically significant illness within 4 weeks before screening, as judged by the Investigator.
  7. History of, or positive results to the screening test for Hepatitis B surface antigen (HBsAg) or Hepatitis C antibodies
  8. Positive result of test for HIV antibodies.
  9. Any clinically significant abnormal hematology, biochemistry or urinalysis screening tests, as judged by the Investigator.
  10. Clinically significant abnormal ECG at screening as evaluated by the Investigator.
  11. Donation of blood or plasma in the past month, or in excess of 500 mL within 12 weeks prior to screening.
  12. A significant history of alcoholism or drug/chemical abuse, or who has a positive result in the urine drug screen, or who consumes more than 14 units of alcohol per week (one unit of alcohol equals about 250 mL of beer, 1 glass of wine, or 20 mL of spirits).
  13. Habitual smoking, i.e., daily smoking or more than 7 cigarettes/week within the last 3 months prior to screening. Patients have to accept refraining from smoking while at the clinical site.
  14. Patients with mental incapacity or language barriers which preclude adequate understanding or cooperation, who are unwilling to participate in the trial, or who in the opinion of the Investigator should not participate in the trial.
  15. Surgery or trauma with significant blood loss within the last 2 months prior to screening.
  16. Any condition interfering with trial participation or evaluation or that could be hazardous to the patient.
  17. Severe hypoglycaemic events within one year prior to screening, as judged by the Investigator.
  18. Significant changes in basal insulin within 3 weeks before screening, as judged by the Investigator.
  19. Clinically relevant diabetic complications (macrovascular disease with symptoms or signs of coronary artery disease or peripheral vascular disease, microvascular disease with symptoms or signs of neuropathy, gastroparesis, retinopathy, nephropathy, or poor blood glucose control with polyuria, polydipsia, or weight loss), as judged by the Investigator.
  20. Females of childbearing potential who are pregnant, breast-feeding or intend to become pregnant or are not using highly effective contraceptive methods (highly effective contraceptive methods are considered those with a failure rate less than 1% undesired pregnancies per year including surgical sterilisation, hormonal intrauterine devices (coil), oral hormonal contraceptives, sexual abstinence or a surgically sterilised partner) or postmenopausal women being amenorrheic for less than 1 year with serum FSH level <= 40 IU/L and not using highly effective contraceptive methods during the trial and until one month after completion of the trial.
  21. Male who is sexually active and not surgically sterilized who or whose partner(s) is not using highly effective contraceptive methods (highly effective contraceptive measures include surgical sterilisation, hormonal intrauterine devices [coil], oral hormonal contraceptives, each in combination with spermicide-coated condoms), or who is not willing to refrain from sexual intercourse from the first dosing until one month after last dosing in the trial.

Sites / Locations

  • Profil Institut für Stoffwechselforschung GmbH

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

ZP4207

GlucaGen

Arm Description

ZP4207 (peptide analogue of human glucagon) Planned doses: 0.1, 0.3, 0.6, 1.0 mg s.c.

GlucaGen (native glucagon) Planned doses: 0.5, 1.0 mg s.c.

Outcomes

Primary Outcome Measures

PD endpoint: Plasma glucose profiles 0-360 min above baseline (Area under the effect curve 0-360 min)
At visit 2 and 3
PD endpoint: Time to peak plasma glucose concentration (tmax)
At visit 2 and 3
PK endpoint: Plasma ZP4207 and glucagon profiles 0-360 min
At visit 2 and 3
PK endpoint: Peak plasma concentration (Cmax)
At visit 2 and 3
PK endpoint: Time to peak plasma concentration (tCmax)
At visit 2 and 3

Secondary Outcome Measures

PD endpoints: Percentage of patients achieving a plasma glucose concentration ≥70 mg/dL within 30 minutes after treatment
At visit 2 and 3
PD endpoints: Time to plasma glucose concentration of ≥70 mg/dL
At visit 2 and 3
PD endpoints: Percentage of patients achieving a plasma glucose increase of ≥20 mg/dL within 30 minutes after treatment
At visit 2 and 3,
PD endpoints: Time to plasma glucose increase of ≥20 mg/dL
At visit 2 and 3,
PK endpoints: Baseline adjusted glucagon profiles 0-360 min
At visit 2 and 3,
PK endpoints: AUC0-inf for plasma ZP4207 concentration
At visit 2 and 3, Area under the plasma curve from 0 to infinity
Exploratory endpoint: Insulin concentrations
At visit 2 and 3, insulin concentrations in serum
Exploratory endpoint: Changes in hypoglycaemic symptom scores from 0-30 minutes
At visit 2 and 3
Safety and Tolerability: Number of participants with adverse events
Number of participants with adverse events
Safety and Tolerability: Changes or findings from baseline in physical examination
An examination of the following body systems will be performed: Head, ears, eyes, nose, throat (HEENT), incl. thyroid gland Heart, lung, chest Abdomen Skin and mucosae Musculoskeletal system Nervous system Lymph node Other findings
Safety and Tolerability: Changes or findings from baseline (normal ranges) in clinical safety laboratory parameters
Haematology biochemistry, and urinalysis
Safety and Tolerability: Changes or findings from baseline in vital signs
systolic/diastolic blood pressure (mmHg) and heart rate (beats per minute), body temperature (°C), respiratory frequency (RF/min)
Safety and Tolerability: Changes or findings from baseline in ECG
Heart rate, PQ, QRS, QT, QTcB
Safety and Tolerability: Local tolerability of injection site
Findings in local tolerability by means of the following assessments. spontaneous pain pain on palpation itching redness oedema induration/infiltration other
Safety and Tolerability: Immunogenicity (Ant-Drug Antibody sampling)
Antidrug antibodies incidences

Full Information

First Posted
January 6, 2016
Last Updated
June 14, 2016
Sponsor
Zealand Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT02660008
Brief Title
Single Doses of ZP4207 Adm. sc to Hypoglycemic TD1 pt. to Describe the PK and PD of ZP4207 as Comp. to Marketed Glucagon
Official Title
A Randomized, Double-blind Trial of Single Doses of ZP4207 Administered s.c. to Hypoglycemic Type 1 Diabetic Patients to Describe the Pharmacokinetics and Pharmacodynamics of ZP4207 as Compared to Marketed Glucagon
Study Type
Interventional

2. Study Status

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

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zealand Pharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The trial is a single-centre, randomized, double-blind, parallel trial in Group 1 and cross-over trial in Groups 2-4 with single doses of ZP4207 administered s.c. to hypoglycemic Type 1 diabetic patients to evaluate the pharmacokinetics and pharmacodynamics of ZP4207 as compared to marketed glucagon.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypoglycemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
81 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ZP4207
Arm Type
Experimental
Arm Description
ZP4207 (peptide analogue of human glucagon) Planned doses: 0.1, 0.3, 0.6, 1.0 mg s.c.
Arm Title
GlucaGen
Arm Type
Active Comparator
Arm Description
GlucaGen (native glucagon) Planned doses: 0.5, 1.0 mg s.c.
Intervention Type
Drug
Intervention Name(s)
ZP4207
Other Intervention Name(s)
analogue af human glucagon
Intervention Description
Parallel trial in Group 1 and cross-over trial in Groups 2-4 with single doses of ZP4207 administered s.c. to hypoglycemic Type 1 diabetic patients
Intervention Type
Drug
Intervention Name(s)
GlucaGen
Other Intervention Name(s)
glucagon
Intervention Description
Parallel trial in Group 1 and cross-over trial in Groups 2-4 with single doses of GlucaGen administered s.c. to hypoglycemic Type 1 diabetic patients
Primary Outcome Measure Information:
Title
PD endpoint: Plasma glucose profiles 0-360 min above baseline (Area under the effect curve 0-360 min)
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-360min)
Title
PD endpoint: Time to peak plasma glucose concentration (tmax)
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-360min)
Title
PK endpoint: Plasma ZP4207 and glucagon profiles 0-360 min
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-360min)
Title
PK endpoint: Peak plasma concentration (Cmax)
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-360min)
Title
PK endpoint: Time to peak plasma concentration (tCmax)
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-360min)
Secondary Outcome Measure Information:
Title
PD endpoints: Percentage of patients achieving a plasma glucose concentration ≥70 mg/dL within 30 minutes after treatment
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-30min)
Title
PD endpoints: Time to plasma glucose concentration of ≥70 mg/dL
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-360min)
Title
PD endpoints: Percentage of patients achieving a plasma glucose increase of ≥20 mg/dL within 30 minutes after treatment
Description
At visit 2 and 3,
Time Frame
During visit 2 and 3 (0-30min)
Title
PD endpoints: Time to plasma glucose increase of ≥20 mg/dL
Description
At visit 2 and 3,
Time Frame
During visit 2 and 3 (0-360min)
Title
PK endpoints: Baseline adjusted glucagon profiles 0-360 min
Description
At visit 2 and 3,
Time Frame
During visit 2 and 3 (0-360min)
Title
PK endpoints: AUC0-inf for plasma ZP4207 concentration
Description
At visit 2 and 3, Area under the plasma curve from 0 to infinity
Time Frame
During visit 2 and 3 (0-360min)
Title
Exploratory endpoint: Insulin concentrations
Description
At visit 2 and 3, insulin concentrations in serum
Time Frame
During visit 2 and 3 (0-360min)
Title
Exploratory endpoint: Changes in hypoglycaemic symptom scores from 0-30 minutes
Description
At visit 2 and 3
Time Frame
During visit 2 and 3 (0-30min)
Title
Safety and Tolerability: Number of participants with adverse events
Description
Number of participants with adverse events
Time Frame
Through study completion (up to 63 days)
Title
Safety and Tolerability: Changes or findings from baseline in physical examination
Description
An examination of the following body systems will be performed: Head, ears, eyes, nose, throat (HEENT), incl. thyroid gland Heart, lung, chest Abdomen Skin and mucosae Musculoskeletal system Nervous system Lymph node Other findings
Time Frame
Through study completion (up to 63 days)
Title
Safety and Tolerability: Changes or findings from baseline (normal ranges) in clinical safety laboratory parameters
Description
Haematology biochemistry, and urinalysis
Time Frame
Through study completion (up to 63 days)
Title
Safety and Tolerability: Changes or findings from baseline in vital signs
Description
systolic/diastolic blood pressure (mmHg) and heart rate (beats per minute), body temperature (°C), respiratory frequency (RF/min)
Time Frame
Through study completion (up to 63 days)
Title
Safety and Tolerability: Changes or findings from baseline in ECG
Description
Heart rate, PQ, QRS, QT, QTcB
Time Frame
Through study completion (up to 63 days)
Title
Safety and Tolerability: Local tolerability of injection site
Description
Findings in local tolerability by means of the following assessments. spontaneous pain pain on palpation itching redness oedema induration/infiltration other
Time Frame
Through study completion (up to 63 days)
Title
Safety and Tolerability: Immunogenicity (Ant-Drug Antibody sampling)
Description
Antidrug antibodies incidences
Time Frame
Through study completion (up to 63 days)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Informed consent obtained before any trial-related activities (trial-related activities are any procedure that would not have been performed during normal management of the patient). Male and female patients with T1D for at least one year, as defined by the American Diabetes Association. Having been treated with insulin for T1D for at least 1 year. Stable disease with HbA1c < 8.5%. Expected stable insulin treatment during participation in trial and 3 month prior to the screening visit. Age between 18 and 50 years, both inclusive. Body weight between 60 and 90 kg, both inclusive. Patients in good health according to age (medical history, physical examination, vital signs, ECG, lab assessments), as judged by the Investigator. - Exclusion Criteria: Previously treated with ZP4207. Known or suspected allergy to trial product(s) or related products. Previous participation (randomization) in this trial. Receipt of any investigational drug within 3 months prior to screening. A history or presence of cancer, or any clinically significant cardiovascular, respiratory, metabolic, renal, hepatic, gastrointestinal, endocrinological, hematological, dermatological, venereal, neurological, psychiatric diseases, or other major diseases. Clinically significant illness within 4 weeks before screening, as judged by the Investigator. History of, or positive results to the screening test for Hepatitis B surface antigen (HBsAg) or Hepatitis C antibodies Positive result of test for HIV antibodies. Any clinically significant abnormal hematology, biochemistry or urinalysis screening tests, as judged by the Investigator. Clinically significant abnormal ECG at screening as evaluated by the Investigator. Donation of blood or plasma in the past month, or in excess of 500 mL within 12 weeks prior to screening. A significant history of alcoholism or drug/chemical abuse, or who has a positive result in the urine drug screen, or who consumes more than 14 units of alcohol per week (one unit of alcohol equals about 250 mL of beer, 1 glass of wine, or 20 mL of spirits). Habitual smoking, i.e., daily smoking or more than 7 cigarettes/week within the last 3 months prior to screening. Patients have to accept refraining from smoking while at the clinical site. Patients with mental incapacity or language barriers which preclude adequate understanding or cooperation, who are unwilling to participate in the trial, or who in the opinion of the Investigator should not participate in the trial. Surgery or trauma with significant blood loss within the last 2 months prior to screening. Any condition interfering with trial participation or evaluation or that could be hazardous to the patient. Severe hypoglycaemic events within one year prior to screening, as judged by the Investigator. Significant changes in basal insulin within 3 weeks before screening, as judged by the Investigator. Clinically relevant diabetic complications (macrovascular disease with symptoms or signs of coronary artery disease or peripheral vascular disease, microvascular disease with symptoms or signs of neuropathy, gastroparesis, retinopathy, nephropathy, or poor blood glucose control with polyuria, polydipsia, or weight loss), as judged by the Investigator. Females of childbearing potential who are pregnant, breast-feeding or intend to become pregnant or are not using highly effective contraceptive methods (highly effective contraceptive methods are considered those with a failure rate less than 1% undesired pregnancies per year including surgical sterilisation, hormonal intrauterine devices (coil), oral hormonal contraceptives, sexual abstinence or a surgically sterilised partner) or postmenopausal women being amenorrheic for less than 1 year with serum FSH level <= 40 IU/L and not using highly effective contraceptive methods during the trial and until one month after completion of the trial. Male who is sexually active and not surgically sterilized who or whose partner(s) is not using highly effective contraceptive methods (highly effective contraceptive measures include surgical sterilisation, hormonal intrauterine devices [coil], oral hormonal contraceptives, each in combination with spermicide-coated condoms), or who is not willing to refrain from sexual intercourse from the first dosing until one month after last dosing in the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ulrike Hövelmann, MD
Organizational Affiliation
Profil Institut für Stoffwechselforschung GmbH
Official's Role
Principal Investigator
Facility Information:
Facility Name
Profil Institut für Stoffwechselforschung GmbH
City
Neuss
ZIP/Postal Code
41460
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
29273578
Citation
Hovelmann U, Bysted BV, Mouritzen U, Macchi F, Lamers D, Kronshage B, Moller DV, Heise T. Pharmacokinetic and Pharmacodynamic Characteristics of Dasiglucagon, a Novel Soluble and Stable Glucagon Analog. Diabetes Care. 2018 Mar;41(3):531-537. doi: 10.2337/dc17-1402. Epub 2017 Dec 22.
Results Reference
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Single Doses of ZP4207 Adm. sc to Hypoglycemic TD1 pt. to Describe the PK and PD of ZP4207 as Comp. to Marketed Glucagon

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