- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02375828
Glibentek in Patients With Neonatal Diabetes Secondary to Mutations in K+-ATP Channels (NEOGLI)
Tolerance and Acceptability of Glibentek in Patients With Neonatale Diabetes Secondary to Mutations in K+-ATP Channels
Study Overview
Status
Intervention / Treatment
Detailed Description
Neonatal diabetes mellitus (NDM), characterized by hyperglycaemia requiring exogenous insulin therapy, is a rare condition that appears during the first months of life with an estimated incidence of 1 in 12000 newborns. We recently published that in our large cohort, the origin of the disease is an heterozygous activating mutation of the coding sequence of KCNJ11 or ABCC8 genes in 42% of patients. These genes encode for the Kir 6.2 subunit (KCNJ11 gene) and for the SUR1 subunit (ABCC8 gene) of the ATP-sensitive K+ channel (KATP) whom function in the beta cell is to induce a membrane depolarization triggering the exocytosis of insulin-containing granules. The understanding of the molecular substrate of the disease has deeply changed the therapy, allowing the switch from insulin injections to an oral medication with sulfonylureas. Indeed, these drugs specifically bind to SUR1 subunit increasing the closing ability of the KATP by an ATP-independent mechanisms stimulating insulin secretion. Together with others we demonstrated that these drugs were efficient in replacement of subcutaneous injected insulin in children or adults with a Kir6.2 or a SUR1 activating mutation allowing an excellent metabolic control of the disease without the side effects of insulin (hypoglycemia).
Anyway, in most countries, glibenclamide has not been approved for use in children by heath authorities in france and its use is then only temporary tolerated in this specific indication.
Furthermore its galenic form (pills) is not suitable for children and especially for infants. The dosage is too high for most infants and young children or children wih neurologic defects (frequently associated to this kind of neonatal diabetes) can't swallow pills. Chewing the pill can't be an alternative as sulfamides are known induce alterations of tooth enamel color.
Most patients parents have to crush the pills and dilute the powder in water before administrating it to their child. Such process doesn't follow recommendations of administration of and medicine contradiction. It can also alter the drug cinetic.as glibenclamide is not completely soluble in water.
After our successful clinical trial, we decided then to be a part in the development of a galenice form suitable for children. The AMMtek company has created a new galenic dedicated to pediatric patients. This new oral solution has been demonstrated to be safe and effective in a phase 1 study. Its pediatric investigation plan has been validated in july 2013 by the European medicine agency. The French drug and food agency (ANSM) has asked for a tolerance and acceptability study before giving its approval for use in children and infants with neonatal diabetes.
The aim of this study is then to determine the tolerance and acceptability of an oral solution of glibenclamide (Glinbentek) developed and dedicated to pediatric patients with neonatal diabetes secondary to mutation in potassium channels.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Paris, France, 7501
- Hôpital Universitaire Necker Enfants Malades
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age below 18 years
- Neonatal diabetes secondary to documented mutation in one of the 2 sub units of potassium channels
- Patients already treated by glibenclamide pills
- Signed consent
Exclusion Criteria:
- Families unable to fill in the questionnaries
- Patients unable to answer to the visual hedonic squale
- Patients unable to take the oral solution
- Known allergy to sulfonylureas or to other antidiabetic or antibiotic sulfamides
- Insulin therapy associated to glibenclamide
- Miconazole therapy
- Porphyria
- Breast feeding
- Severe renal failure (creatinine clearance below 30 ml/mn)
- Liver failure (prothombine time below 70)
- Not affiliated to the health care system
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patients with neonatal diabetes
|
Glibenclamide pills will be administrated during one month at the previously used dosage.
During the first month of the study we wwil record pharmacokinetic data, number of hypoglycaemia and the administration problems associated to this galenic form.
At the end of the first month of enrolment, patients will be given oral solution of glibenclamide for the 4 remaining months.
Pharmacocinetic data, number of hypoglycaemia and parents and children feeling about pratictability of administration will be then recorded.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Acceptability of an oral solution of glibenclamide (Hedonic visual scale)
Time Frame: 2 months after the change from pills to oral solution.
|
Hedonic visual scale
|
2 months after the change from pills to oral solution.
|
Acceptability of an oral solution of glibenclamide (Hedonic visual scale)
Time Frame: 3 months after the change from pills to oral solution.
|
Hedonic visual scale
|
3 months after the change from pills to oral solution.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Tolerance of an oral solution of glibenclamide (Self administrated questionnaries)
Time Frame: 2 months after the change from pills to oral solution.
|
Self administrated questionnaries, liver and renal biology
|
2 months after the change from pills to oral solution.
|
Tolerance of an oral solution of glibenclamide (Self administrated questionnaries)
Time Frame: 3 months after the change from pills to oral solution.
|
Self administrated questionnaries, liver and renal biology
|
3 months after the change from pills to oral solution.
|
Recording pharmaceutical data on pills and oral solution of glibenclamide (Blood drug dosage)
Time Frame: At inclusion
|
Blood drug dosage
|
At inclusion
|
Recording pharmaceutical data on pills and oral solution of glibenclamide (Blood drug dosage)
Time Frame: 2 months after the switch from pills to oral solution
|
Blood drug dosage
|
2 months after the switch from pills to oral solution
|
No alteration in metabolic control of the disease
Time Frame: During the first month of administration
|
HbA1C at month 3, fructosamine at month 2 and 3, self record of hypoglycaemia during month 1, 2 and 3, glycemia before and after meals during 2 consecutive days at introduction of oral solution and during 2 meals at month 2 and month 3
|
During the first month of administration
|
No alteration in metabolic control of the disease
Time Frame: 2 months after the change from pills to oral solution
|
HbA1C at month 3, fructosamine at month 2 and 3, self record of hypoglycaemia during month 1, 2 and 3, glycemia before and after meals during 2 consecutive days at introduction of oral solution and during 2 meals at month 2 and month 3
|
2 months after the change from pills to oral solution
|
No alteration in metabolic control of the disease
Time Frame: 3 months after the change from pills to oral solution
|
HbA1C at month 3, fructosamine at month 2 and 3, self record of hypoglycaemia during month 1, 2 and 3, glycemia before and after meals during 2 consecutive days at introduction of oral solution and during 2 meals at month 2 and month 3
|
3 months after the change from pills to oral solution
|
Collaborators and Investigators
Investigators
- Study Director: Michel Polak, MD, PhD, Hopital Universitaire Necker Enfants Malades, Assistance publique - hôpitaux de Paris, Faculté de medicine Paris Descartes, Université Sorbonne Paris cité
Publications and helpful links
General Publications
- Busiah K, Drunat S, Vaivre-Douret L, Bonnefond A, Simon A, Flechtner I, Gerard B, Pouvreau N, Elie C, Nimri R, De Vries L, Tubiana-Rufi N, Metz C, Bertrand AM, Nivot-Adamiak S, de Kerdanet M, Stuckens C, Jennane F, Souchon PF, Le Tallec C, Desiree C, Pereira S, Dechaume A, Robert JJ, Phillip M, Scharfmann R, Czernichow P, Froguel P, Vaxillaire M, Polak M, Cave H; French NDM study group. Neuropsychological dysfunction and developmental defects associated with genetic changes in infants with neonatal diabetes mellitus: a prospective cohort study [corrected]. Lancet Diabetes Endocrinol. 2013 Nov;1(3):199-207. doi: 10.1016/S2213-8587(13)70059-7. Epub 2013 Sep 6. Erratum In: Lancet Diabetes Endocrinol. 2013 Nov;1(3):e14.
- Pearson ER, Flechtner I, Njolstad PR, Malecki MT, Flanagan SE, Larkin B, Ashcroft FM, Klimes I, Codner E, Iotova V, Slingerland AS, Shield J, Robert JJ, Holst JJ, Clark PM, Ellard S, Sovik O, Polak M, Hattersley AT; Neonatal Diabetes International Collaborative Group. Switching from insulin to oral sulfonylureas in patients with diabetes due to Kir6.2 mutations. N Engl J Med. 2006 Aug 3;355(5):467-77. doi: 10.1056/NEJMoa061759.
- Babenko AP, Polak M, Cave H, Busiah K, Czernichow P, Scharfmann R, Bryan J, Aguilar-Bryan L, Vaxillaire M, Froguel P. Activating mutations in the ABCC8 gene in neonatal diabetes mellitus. N Engl J Med. 2006 Aug 3;355(5):456-66. doi: 10.1056/NEJMoa055068.
- Beltrand J, Baptiste A, Busiah K, Bouazza N, Godot C, Boucheron A, Djerada Z, Gozalo C, Berdugo M, Treluyer JM, Elie C, Polak M; GLID-KIR study group. Glibenclamide oral suspension: Suitable and effective in patients with neonatal diabetes. Pediatr Diabetes. 2019 May;20(3):246-254. doi: 10.1111/pedi.12823. Epub 2019 Feb 21.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2014-003436-39
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Neonatal Diabetes Secondary to Mutation in the Potassium Channel
-
University of the West of ScotlandSwansea UniversityCompletedTo Assess the Impact of the HIT Intervention on Physiological Responses | To Assess the Role of a Secondary High School as a Setting for Promoting Healthy Eating and PA Behaviours | To Determine the Associations Between CVD Risk Factors at Baseline in 15 - 18 Year Old YouthUnited Kingdom
-
University Hospital, CaenNot yet recruitingthe Aim of This Study is to Describe Genomic Epidemiology of MSSA in Neonatal ICU
-
King Edward Medical UniversityCompletedTo Assess the Glycemic Control of Insulin Glargine in Combination With Regular Insulin in Type 1 Diabetes in ChildrenPakistan
-
Regeneron PharmaceuticalsRecruitingCongenital Hearing Loss Secondary to Biallelic Mutations in the Otoferlin Gene (OTOF) | Biallelic Mutations in the Gap Junction Beta 2 (GJB2) Gene | Digenic Mutations in GJB2/Gap Junction Beta 6 (GJB6) GenesUnited States
-
Universitaire Ziekenhuizen KU LeuvenNot yet recruitingTo Evaluate the Added Value of the Use of Artificial Intelligence in the Diagnosis of Referable Diabetic Retinopathy in a Teaching Hospital Setting
-
Second Affiliated Hospital of Nanchang UniversityUnknownTo Assess the Level of Control of Blood Glucose, Blood Pressure, and Blood Lipids Among Patients With Type 2 Diabetes in Jiangxi ProvinceChina
-
Lotus PharmaceuticalUnknownThe Objectives of the Study is to Evaluate the Efficacy and Safety of Acarmet (Metformin HCl 500 mg | Plus Acarbose 50 mg Tablets) Thrice Daily Versus Acarbose 50 mg Thrice Daily Over 16 Weeks in | Subjects With Type 2 Diabetes Mellitus.Taiwan
-
Mei-fang HuangUnknownTo Investigate the Effectiveness of Health Management of Glycemic Control and Physical Activity in Type 2 Diabetes Mellitus Using Smartphone ApplicationTaiwan
-
University of WashingtonActive, not recruitingBRCA1 Gene Mutation | BRCA2 Gene Mutation | Castration-Resistant Prostate Carcinoma | Homologous Recombination Deficiency | PSA Progression | Stage IV Prostate Adenocarcinoma AJCC v7 | Castration Levels of Testosterone | ATM Gene Mutation | Prostate Carcinoma Metastatic in the Bone | PSA Level Greater...United States
-
Wuhan UniversityPeking University; PfizerUnknownThe Primary Evaluation is the Change From Baseline at End of Study for CDSS Total Scores. | The Secondary Efficacy Evaluations Include: MADRS, PANSS Total Scores and Subscales and Responder Rate; CGI-S and CGI-I Scales. | Safety Evaluations Include: Laboratory Test Abnormalities; BARS... and other conditions
Clinical Trials on Glibenclamide
-
BiogenTerminatedStroke, Acute | Brain EdemaUnited States, Spain, China, Italy, United Kingdom, Germany, Australia, Hungary, Taiwan, Israel, Canada, Portugal, Korea, Republic of, Czechia, Brazil, Switzerland, France, Belgium, Japan, Lithuania, Croatia, Denmark, Finland, Russian...
-
University of GiessenMerck Sharp & Dohme LLCCompletedType 2 Diabetes
-
King's College Hospital NHS TrustUnknownType 1 Diabetes MellitusUnited Kingdom
-
University of Campinas, BrazilFundação de Amparo à Pesquisa do Estado de São PauloCompletedHypertension | Obesity | Diabetes Mellitus, Type 2 | Blood Pressure | Vascular Stiffness | Cardiac Hypertrophy | MicroalbuminuriaBrazil
-
Beijing Tiantan HospitalBeijing Tongren HospitalRecruiting
-
University of EdinburghChief Scientist Office of the Scottish GovernmentCompletedPregnancy | Gestational DiabetesUnited Kingdom
-
Assistance Publique - Hôpitaux de ParisCompletedDiabetes MellitusFrance
-
AstraZenecaTerminatedType 2 DiabetesItaly, Poland, South Africa, Norway, Belgium, Hungary, Slovakia, Taiwan, Philippines, Thailand, Mexico, Hong Kong, Malaysia
-
Genuine Research Center, EgyptMedochemie LTD CyprusCompleted
-
University of Sao Paulo General HospitalUnknownSubarachnoid Hemorrhage, AneurysmalBrazil