Comparative Bioequivalence Study of Wockhardt's Insulin Analogue Mixture Listro Mix 75/25® and Humalog Mix75/25 ® in Healthy Subjects

The aim of this study is to assess the bioequivalence of two insulin analog mixtures: Listro Mix75/25® and Humalog Mix75/25® in healthy subjects based on the pharmacokinetic parameter (PK) and the pharmacodynamic parameter (PD).

Study Overview

• Status: Withdrawn
• Conditions: Bioequivalence in Healthy Subjects
• Intervention / Treatment: Biological: Insulin Lispro

Detailed Description

The aim of this study is to assess the bioequivalence of two insulin analog mixtures: Listro Mix75/25® and Humalog Mix75/25® in healthy subjects based on the pharmacokinetic parameter (PK)AUC (INS-LIS 0-20h) and the pharmacodynamic parameter (PD)AUC (GIR 0-20h) and also assess the safety and local tolerability of the two insulin preparations.

• Study Type: Interventional
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • California
    • San Diego, California, United States, 91911
      • Profil Institute for Clinical Research, Inc.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 48 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Healthy male or female subjects.
2. Age ≥18 and ≤50 years.
3. Considered generally healthy upon completion of medical history, physical examination and biochemical investigations as judged by the Investigator.
4. Body Mass Index (BMI) between 18.0 and 27.0 kg/m2, inclusive.
5. Non-smoker, defined as no nicotine consumption for at least one year.
6. Signed and dated 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 subject.)

Exclusion Criteria:

1. Previous participation in this trial or other clinical trials within the last 30 days.
2. Pregnant, breast-feeding or the intention of becoming pregnant or not using adequate contraceptive measures (e.g. intrauterine device (IUD) that has been in place for at least 3 months, or sterilization, or the oral contraceptive pill, which should have been taken without difficulty for at least 3 months, or an approved hormonal implant or double barrier method including male condoms used plus spermicide , diaphragm with spermicide plus male condom cap with spermicide plus male condom are acceptable options).
3. Clinically significant abnormal hematology or biochemistry screening tests, as judged by the Investigator. In particular, subjects with elevated liver enzymes (AST or ALT >2 times the upper limit of normal) or impaired renal function (elevated serum creatinine values above the upper limit of normal) or elevated blood glucose at screening as measured by YSI (> 5.5 mmol/L / 100 mg/dL) will not be allowed to enter the trial. Subjects with abnormal TSH may be required to have additional testing of thyroid hormones for further clarification. Subjects with abnormal TSH judged by the Investigator as clinically significant will be excluded from the study.
4. Any serious systemic infectious disease during the four weeks prior to the first dose of test drug, as judged by the Investigator.
5. History of any illness that, in the opinion of the Investigator, might confound the results of the trial or pose risk in administering the trial drug to the subject. In particular, subjects with significant cardiovascular disease, anemia (hemoglobin below the lower limit of normal) or hemoglobinopathy will not be allowed to enter the trial.
6. Cardiac problems defined as decompensated heart failure (New York Heart Association (NYHA) class III and IV) at any time and/or angina pectoris within the last 12 months and/or acute myocardial infarction at any time.
7. Clinically significant abnormal ECG at screening, as judged by the Investigator.
8. History of alcohol or drug abuse in the past five years.
9. Any positive screen for drugs of abuse.
10. Hepatitis B or C or HIV positive.
11. Use of prescription drugs within 3 weeks preceding the first dosing of insulin, except for oral contraceptives/hormonal implants.
12. Use of non-prescription drugs, except routine vitamins or herbal products, within 3 weeks prior to the first dose of the test drug.
13. Occasional use of acetaminophen is permitted. Acetaminophen is not allowed on the dosing day until 4 hours postdosing.
14. Use of systemic corticosteroids, monoamine oxidase (MAO) inhibitors, prostaglandin blockers, systemic non-selective beta-blockers, growth hormones
15. Thyroid hormones are not allowed unless stable during the past 3 months.
16. Any use of non-steroid anti-inflammatory drugs (NSAIDs) except for low-dose Aspirin is not allowed within 7 days prior to dosing and on the dosing day.
17. Mental incapacity, unwillingness or language barriers precluding adequate understanding or co-operation.
18. Blood donation of more than 500 ml within the last 12 weeks.
19. History of multiple and/or severe allergies to drugs or foods or a history of severe anaphylactic reaction.
20. Known or suspected allergy to trial product or related products.
21. History of deep leg vein thrombosis or a frequent appearance of deep leg vein thrombosis in 1st degree relatives (parents, siblings or children) as judged by the Investigator.
22. Any disease or condition that, in the opinion of the Investigator, would represent an unacceptable risk for the subject's safety.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Listro Mix75/25®; Insulin Lispro/ insulin Lispro protamine (Listro Mix75/25®; 100 U/mL), DispoPen 3.0 mL.	Biological: Insulin Lispro; Dosage form- Subcutaneous Injection; Other Names: Listro Mix75/25® ,Humalog Mix75/25®
Active Comparator: Humalog Mix75/25®; Insulin Lispro/ insulin Lispro protamine (Humalog® Mix75/25TM; 100 U/mL), Humalog Mix 75/25® Kwik PenTM 3.0 mL.	Biological: Insulin Lispro; Dosage form- Subcutaneous Injection; Other Names: Listro Mix75/25® ,Humalog Mix75/25®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bioequivalence based on Pharmacokinetic parameter: AUC (INS-LIS 0-20h)	Glucose clamp will be terminated 22 hours post dose and the primary pharmacokinetic bioequivalance will be calculated based on the Area under the curve (AUC) between 0 - 20 hours postdose of the study medication.	20 hrs post dose
Bioequivalence based on Pharmacodynamic parameter: AUC (GIR 0-20h)	Glucose clamp will be terminated 22 hours post dose and the primary pharmacodymanic bioequivalance will be calculated based on the Area under the curve (AUC) for the glucose infusion rate (GIR) between 0 - 20 hours postdose of the study medication	20 hrs post dose

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pharmacokinetic parameter: Area under curve from 0-22 hrs	AUC (INS-LIS 0-6h), AUC (INS-LIS 6-12h), AUC (INS-LIS 0-12h), AUC (INS-LIS 6-20h), AUC (INS-LIS 0-22h), AUC (INS-LIS 0-∞)	Over 22 hrs post dose
Pharmacodynamic parameters: Area under curve glucose infusion rate from 0-22hrs	AUC (GIR 0-6h), AUC (GIR 0-12h), AUC (GIR 6-12h), AUC (GIR 6-20h), AUC (GIR 0-22h)	Over 22 hrs post dose
Safety endpoints	Number of AE's, SAE's, Hypoglycemic events and local tolerability	Over 22 hrs post dose
Pharmacokinetic parameters:Maximum concentration (Cmax)		Over 22 hrs postdose
Pharmacokinetic Parameters: tmax and t1/2		Over 22 hrs postdose
Pharmacodynamic parameter: GIR max and tGIR max		Over 22 hrs postdose

Collaborators and Investigators

• Sponsor: Wockhardt

Study record dates

Study Major Dates

• Study Start: November 1, 2011
• Primary Completion (Anticipated): May 1, 2012
• Study Completion (Anticipated): June 1, 2012

Study Registration Dates

• First Submitted: July 20, 2011
• First Submitted That Met QC Criteria: July 20, 2011
• First Posted (Estimate): July 22, 2011

Study Record Updates

• Last Update Posted (Estimate): January 25, 2013
• Last Update Submitted That Met QC Criteria: January 24, 2013
• Last Verified: January 1, 2013

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Hypoglycemic Agents; Physiological Effects of Drugs; Insulin Lispro
• Other Study ID Numbers: Listro Mix75/25/PK-PD/FDA/2011