- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03490942
Glucagon Infusion in T1D Patients With Recurrent Severe Hypoglycemia: Effects on Counter-Regulatory Responses
February 2, 2021 updated by: Xeris Pharmaceuticals
Fixed Rate Continuous Subcutaneous Glucagon Infusion (CSGI) vs Placebo in Type 1 Diabetes Mellitus Patients With Recurrent Severe Hypoglycemia: Effects on Counter-Regulatory Responses to Insulin-Induced Hypoglycemia
This is a prospective, randomized, controlled, double-blind, parallel 4-group trial with the primary analysis after 4 weeks of treatment with continuous subcutaneous glucagon infusion (CSGI) or placebo.
After a 1-week qualification on continuous glucose monitoring (CGM), subjects will have their baseline hypoglycemia counter-regulatory response hormones quantified using a step-wise hypoglycemia induction procedure.
Subjects meeting eligibility requirements will be randomized to 1 of 4 treatment groups, 2 glucagon, 2 placebo.
Subjects will receive blinded study drug for 4 weeks, and they will be followed for an additional 26 weeks post-treatment.
Subjects' counter-regulatory hormone response will be measured at baseline, the end of treatment (4 weeks), and 13 and 26 weeks after treatment ends.
Study Overview
Status
Terminated
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
49
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Alabama
-
Birmingham, Alabama, United States, 35294
- University of Alabama, Birmingham
-
-
California
-
San Diego, California, United States, 92037
- University of California, San Diego
-
-
Georgia
-
Atlanta, Georgia, United States, 30303
- Emory University - Grady Memorial Hospital
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Atlanta, Georgia, United States, 30318
- Atlanta Diabetes Associates
-
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
21 years to 64 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Males or females diagnosed with type 1 diabetes mellitus for at least 24 months.
- Random serum C-peptide concentration < 0.5 ng/ml at Screening.
- Current use of multiple daily dosing insulin treatment < 1 U/(kg*day) total daily dose either administered with subcutaneous injections or continuous subcutaneous insulin infusion (CSII).
- Recurrent severe hypoglycemia as defined by minimally two events during the last year and at least one the last six months requiring not merely receiving third party intervention and either confirmation with a measured glucose < 50 mg/dl, or prompt recovery from impaired consciousness. Events must be documented in patient chart prior to study entry. Events induced as a part of clinical diagnostics or experimentation do not qualify.
- Performs monitoring of glucose minimally 3 times a day. Patients using continuous glucose monitoring for monitoring should continue to do so during the course of the study.
- Age 21-64 years, inclusive, at screening.
- Willingness to provide informed consent and follow all study procedures, including using the Medtronic smart phone application "iPRO2mylog" for diabetes data logging and attending all scheduled visits.
Exclusion Criteria:
- Subjects using CSII, who do not use a Medtronic pump.
- Hemoglobin A1c ≥9.0% at Screening.
- Chronic kidney disease stage 4 or 5.
- Hepatic disease, including serum alanine transaminase (ALT) or aspartate transaminase (AST) greater than or equal to 3 times the upper limit of normal; hepatic synthetic insufficiency as defined as serum albumin < 3.0 g/dL; or serum bilirubin > 2.0.
- Hematocrit of less than or equal to 30% at Screening.
- Blood pressure (BP) reading at Screening where systolic BP <90 or >150 mm Hg, or diastolic BP <50 or >100 mm Hg.
- Clinically significant echocardiogram (ECG) abnormalities at Screening.
- Congestive heart failure, New York Heart Association (NYHA) class II, III or IV,
- History of myocardial infarction, unstable angina or revascularization within the past 6 months.
- History of a cerebrovascular accident.
- Current seizure disorder.
- History of pheochromocytoma or disorder with increased risk of pheochromocytoma (multiple endocrine neoplasia type 2, neurofibromatosis, or Von Hippel-Lindau disease).
- History of insulinoma.
- Active malignancy within 5 years from Screening, except basal cell or squamous cell skin cancers. History of breast cancer or malignant melanoma will be exclusionary.
- Major surgical operation within 30 days prior to Screening.
- Current bleeding disorder, treatment with warfarin, or platelet count below 50,000 at Screening.
- History of allergies to glucagon or glucagon-like products, or any history of significant hypersensitivity to glucagon or any related products or to any of the excipients in the investigational formulation.
- History of glycogen storage disease.
- Any concurrent illness, other than diabetes, that is not controlled by a stable therapeutic regimen.
- Whole blood donation of 1 pint (500 mL) within 8 weeks prior to Screening. Donations of plasma, packed red blood cells, platelets or quantities less than 500 mL are allowed at investigator discretion.
- Active substance or alcohol abuse (more than 21 drinks/wk. for males or 14 drinks/wk. for females). Subjects reporting active marijuana use and/or testing positive for tetrahydrocannabinol via rapid urine test will be allowed to participate in the study at the discretion of the investigator. Subjects positive for other drugs of abuse via rapid urine test who report use of a prescription or over-the-counter medication that would explain such a finding will be allowed to participate at the discretion of the investigator.
- Administration of glucagon within 14 days of Screening.
- Pregnant and/or Lactating. For subjects of childbearing potential, there is a requirement for a negative urine pregnancy test and for agreement to use contraception and to refrain from breast feeding during the study and for at least 1 month after participating in the study. Acceptable contraception includes birth control pill / patch / vaginal ring, Depo-Provera, Norplant, an intra-uterine device, the double barrier method (the female uses a diaphragm and spermicide and the male uses a condom), or abstinence.
- Inadequate venous access.
- Participation in other studies involving administration of an investigational drug or interventional device within 30 days or 5 half-lives, whichever is longer, before Screening for the current study and during the four weeks of study product administration in the current study.
- Any reason the principal investigator deems exclusionary.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: CSGI high infusion rate
Glucagon given as a continuous subcutaneous infusion for 28 days
|
CSI-Glucagon is a room temperature stable, non-aqueous, liquid formulation of glucagon.
Other Names:
|
Experimental: CSGI low infusion rate
Glucagon given as a continuous subcutaneous infusion for 28 days
|
CSI-Glucagon is a room temperature stable, non-aqueous, liquid formulation of glucagon.
Other Names:
|
Placebo Comparator: Placebo high infusion rate
Placebo given as a continuous subcutaneous infusion for 28 days
|
The placebo solution is a non-active formulation containing excipients only.
|
Placebo Comparator: Placebo low infusion rate
Placebo given as a continuous subcutaneous infusion for 28 days
|
The placebo solution is a non-active formulation containing excipients only.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma Epinephrine
Time Frame: 0-30 minutes
|
Plasma epinephrine concentration after 30 minutes of induced hypoglycemia.
Change from baseline to the end of treatment will be assessed.
|
0-30 minutes
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
March 15, 2018
Primary Completion (Actual)
November 4, 2019
Study Completion (Actual)
February 10, 2020
Study Registration Dates
First Submitted
March 25, 2018
First Submitted That Met QC Criteria
April 1, 2018
First Posted (Actual)
April 6, 2018
Study Record Updates
Last Update Posted (Actual)
February 21, 2021
Last Update Submitted That Met QC Criteria
February 2, 2021
Last Verified
May 1, 2020
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Glucose Metabolism Disorders
- Metabolic Diseases
- Immune System Diseases
- Autoimmune Diseases
- Endocrine System Diseases
- Diabetes Mellitus
- Diabetes Mellitus, Type 1
- Hypoglycemia
- Physiological Effects of Drugs
- Gastrointestinal Agents
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Incretins
- Glucagon
- Glucagon-Like Peptide 1
Other Study ID Numbers
- XSGO-AF01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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.
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