Safety, Tolerability, Pharmacokinetic (PK) and Pharmacodynamic (PD) Study of G-Pen(TM) (Glucagon Injection) to Treat Severe Hypoglycemia

A RANDOMIZED, PHASE 2, DOUBLE-BLIND, 3-WAY CROSSOVER STUDY WITH G-PEN™ (GLUCAGON INJECTION) TO EVALUATE SAFETY, TOLERABILITY AND COMPARATIVE PHARMACOKINETICS AND PHARMACODYNAMICS TO LILLY GLUCAGON™ (GLUCAGON FOR INJECTION [rDNA ORIGIN]) IN HEALTHY VOLUNTEERS

The purpose of this study is to demonstrate that G-Pen(TM) glucagon is comparable to Lilly Glucagon(TM) in terms of safety and efficacy, as a treatment for severe hypoglycemia, a complication of diabetes.

Study Overview

• Status: Completed
• Conditions: Hypoglycemia
• Intervention / Treatment: Drug: G-Pen(TM) 1 mg; Drug: Lilly Glucagon(TM) 1 mg; Drug: G-Pen(TM) 0.5 mg

Detailed Description

Primary objective: To Evaluate the Safety and Tolerability of G-Pen™ (Glucagon Injection) 1 mg

Secondary objective (1): To Evaluate the pharmacodynamics (Efficacy) of G-Pen™ (Glucagon Injection) 1 mg

Secondary objective (2):To compare the pharmacokinetics of G-Pen™ (glucagon injection) 1mg [test] administered as 0.5 mg and 1 mg injections, versus Lilly Glucagon™ (glucagon for injection [rDNA origin]) 1 mg (reference)

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Texas
    • San Antonio, Texas, United States, 78207
      • Texas Diabetes Institute, University Health System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Healthy male or female subjects between the ages of 18 and 60 years of age, inclusive, at Screening.

2. Women must be of non-childbearing potential as defined by one of the following:

   • Females who are >45 and < 60 years of age at Screening and amenorrheic for at least 2 years
   • Females who have had a documented hysterectomy and/or bilateral oophorectomy.

3. Females of childbearing potential with a negative pregnancy test at Screening and Treatment visits, using one of the following forms of contraception for the duration of participation in the study (i.e., until Follow-up 7-14 days post last dose):

   • Oral contraceptive
   • Injectable progesterone
   • Subdermal implant
   • Spermicidal foam/gel/film/cream/suppository
   • Diaphragm with spermicide
   • Copper or hormonal containing intrauterine device (IUD)
   • Sterile male partner vasectomized > 6 month pre-dosing.
4. Male subjects are required to use a condom and one of the methods of contraception in 2. or 3. above starting at Randomization and for the duration of the study.
5. Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
6. Subjects must be willing and able to comply with scheduled visits, treatment, laboratory tests and study procedures.

Exclusion Criteria:

1. Recent (i.e., within three (3) months prior to Screening) evidence or medical history of unstable concurrent disease such as: documented evidence or history of clinically significant hematological, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, immunological, or clinically significant neurological disease.
2. Mean of triplicate set of seated BP readings at Screening, confirmed by 1 set of triplicate at Screening, if deemed necessary where systolic blood pressure (SBP) <90 or >140 mm Hg, and diastolic blood pressure (DBP) <50 or >90 mm Hg.
3. Cardiovascular event within 6 months prior to screening such as unstable angina, acute coronary syndrome, myocardial infarction, therapeutic coronary procedure (e.g., stent placement, Percutaneous Transluminal Coronary Angioplasty (PTCA), Coronary Artery By-pass Grafting (CABG)), stroke or transient ischemic attack.
4. Clinically significant ECG abnormalities.
5. Study participants who are pregnant at Screening are not eligible for this study.
6. Breast feeding must be discontinued if a subject wishes to participate in this study.
7. Positive test for hepatitis B, hepatitis C, or HIV found at Screening.
8. Positive urine drug test for illicit drugs at Screening.
9. Allergies to glucagon, glucagon-like products or to any of the excipients in the investigational formulation.
10. Recent (i.e., within three (3) months prior to Screening) administration of glucagon.
11. Any prior cerebrovascular accident or major permanent neurological damage such as aphasia, hemiparesis, or dementia.
12. Peripheral artery disease with uncontrolled claudication
13. Current diagnosis or current clinical evidence of any New York Heart Association classification of heart failure.

14. Subjects with any of the following abnormalities in clinical laboratory tests at Screening, confirmed by a single repeat, if necessary:

    • Total bilirubin > 1.5x upper limit of normal (ULN)
    • aspartate aminotransferase (AST/SGOT) or alanine aminotransferase (ALT/SGPT) ≥ 2.5x ULN.
    • Creatinine > 2.5x ULN.
15. History of regular alcohol consumption as defined by alcohol intake in a quantity exceeding 7 drinks per week for females or 14 drinks per week for males, where 1 drink = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of hard liquor.
16. Participation in other studies involving administration of an investigational drug or device within 30 days or 5 half-lives, whichever is longer, before screening for the current study and during participation in the current study.
17. Blood donation of approximately 1 pint (500 mL) within 8 weeks prior to Screening.
18. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: G-Pen(TM) 1 mg; G-Pen(TM) (glucagon injection), single 1 mg subcutaneous (SC) injection	Drug: G-Pen(TM) 1 mg; Drug: Lilly Glucagon(TM) 1 mg; Drug: G-Pen(TM) 0.5 mg
Experimental: G-Pen(TM) 0.5 mg; G-Pen(TM) (glucagon injection), single 0.5 mg SC injection	Drug: G-Pen(TM) 1 mg; Drug: Lilly Glucagon(TM) 1 mg; Drug: G-Pen(TM) 0.5 mg
Active Comparator: Lilly Glucagon(TM) 1 mg; Lilly Glucagon(TM) [glucagon for injection (rDNA origin)], single 1 mg SC injection	Drug: G-Pen(TM) 1 mg; Drug: Lilly Glucagon(TM) 1 mg; Drug: G-Pen(TM) 0.5 mg

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Serious Adverse Events	Number of serious adverse events (SAEs) per treatment group	From first dose until completion of the post-treatment follow-up visit, up to 6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Glucose Area Under the Curve (AUC)	Pharmacodynamic parameter: Glucose area under the curve from baseline to 240 minutes post-treatment	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucose Cmax	Pharmacodynamic parameter: Maximum concentration of glucose	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucose Tmax	Pharmacodynamic parameter: Time to Maximum Glucose Concentration	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucose AUCex	Pharmacodynamic parameter: Area Under the Glucose Excursion Curve	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucose MAE	Pharmacodynamic parameter: Maximum absolute glucose excursion from baseline	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucose Tex	Pharmacodynamic parameter: Earliest reported time of MAE, based on within-subject changes from baseline	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucagon AUC	Pharmacokinetic parameter: Glucagon area under the curve from baseline to 240 minutes post-treatment	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucagon Cmax	Pharmacokinetic parameter: Maximum concentration of glucagon	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection
Glucagon Tmax	Pharmacokinetic parameter: Time to maximum concentration of glucagon	Approximately 15 minutes before each injection and at 5, 10, 15, 20, 30, 45, 60, 120 and 240 minutes post-injection

Collaborators and Investigators

• Sponsor: Xeris Pharmaceuticals
• Collaborators: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Emissary International LLC
• Investigators: Principal Investigator: Ralph A DeFronzo, MD, Texas Diabetes Institute, University Health System

Study record dates

Study Major Dates

• Study Start: October 1, 2013
• Primary Completion (Actual): February 1, 2014
• Study Completion (Actual): February 1, 2014

Study Registration Dates

• First Submitted: October 18, 2013
• First Submitted That Met QC Criteria: October 23, 2013
• First Posted (Estimate): October 30, 2013

Study Record Updates

• Last Update Posted (Estimate): February 3, 2016
• Last Update Submitted That Met QC Criteria: January 4, 2016
• Last Verified: January 1, 2016

More Information

Terms related to this study

• Keywords: Hypoglycemia; Glucagon
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Hypoglycemia; Physiological Effects of Drugs; Gastrointestinal Agents; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Glucagon
• Other Study ID Numbers: XSGP-201; 2R44DK085809-02 (U.S. NIH Grant/Contract)