"FEXIS": (Feasibility of an Extended Wear CSII Set in Participants With T1DM) (FEXIS)

Feasibility of an Investigational Extended Wear Infusion Set for Continuous Subcutaneous Insulin Infusion (CSII) in Type 1 Diabetes Mellitus (T1DM) Participants

Over 1 million patients globally currently manage their Type 1 Diabetes mellitus using continuous subcutaneous insulin infusion with an infusion set that needs to be changed every 3 days. This study will assess the feasibility and device performance of the study device, the Achilles infusion set over three periods during routine insulin infusion.

This study will include 20 participants and has 3 periods:

Period 1 (up to 7 days): Trial run with study device with saline infusion. Period 2 (up to 7 days): participants will manage their blood glucose solely with their insulin pump and the Achilles infusion set. Blood glucose will be closely monitored with a continuous glucose monitoring (CGM) device.

Period 3 (up to 7 days): Participants will return to study center to receive a fresh Achilles infusion set and continue blood glucose management at home until infusion set failure or 7 days.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus, Type 1; Type 1 Diabetes; Type 1 Diabetes Mellitus; Diabetes Mellitus, Insulin-Dependent, 1
• Intervention / Treatment: Device: coil-reinforced soft polymer indwelling cannula

Detailed Description

This is a prospective, non-randomized, home-use feasibility study of device performance, usability, tolerability, and safety of the Capillary Biomedical, Inc. (CapBio) Achilles infusion set for continuous subcutaneous insulin infusion (CSII or insulin pump therapy) in up to 20 participants diagnosed with type 1 diabetes mellitus (T1DM).

The CapBio Achilles infusion set is a sterile single use device designed to be used with commercially available infusion pumps (e.g., Medtronic MiniMed). The investigational Achilles infusion set contains a coil reinforced soft polymer indwelling cannula with one distal and three proximal holes.

The primary objective of this study is to determine feasibility and device performance of the CapBio Achilles infusion set over 2 extended home use wear periods of up to 7 days each during routine therapeutic insulin infusion. Feasibility is evidenced by the absence of uncontrolled hyperglycemia and/or suspected infusion set cannula occlusion.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Australia
  • Melbourne, Australia
    • St Vincent's Hospital (Melbourne) Ltd - Fitzroy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Participant is 18 - 70 years of age inclusive
2. Participant is in generally good health, as determined by the investigator
3. Participant is willing and able to individually complete written informed consent and agrees to comply with all study related testing and examinations
4. Participant must be geographically stable (e.g., expects to be available and capable of returning for all study specified test and examinations) during the study period
5. Participant has been diagnosed with T1DM for at least 12 months
6. C-peptide less than 0.6 nmol per L at screening
7. Subject can provide a minimum of 14 days of insulin pump data to demonstrate pump use compliance
8. Participant is willing to perform serum ketone measurements whenever the blood glucose is determined to be greater than 250 mg per dL (14 mmol per L) using a ketone meter and strips provided by the sponsor
9. Participant has BMI in the range 20 - 35 kg per square metre inclusive
10. Participant has experience infusing a rapid-acting insulin analog for at least 6 months
11. Participant has been using an insulin pump with commercially available infusion sets for at least 6 months (this includes Automated Insulin Delivery systems)
12. Participant has previous experience using a continuous glucose monitor (CGM) and is willing to use a CGM for the duration of the study and perform necessary calibration fingerstick glucose readings
13. Participant has ability to understand and comply with protocol procedures and to provide informed consent
14. AST and ALT less than or equal to 120 U per L
15. Creatinine less than 1.8 mg per dL

Exclusion Criteria:

1. Participants whose average total daily insulin dose exceeds 85 units per day (i.e. typically change insulin reservoirs more often than every 3.5 days on average)
2. Participants who routinely change their commercial insulin infusion sets twice weekly or less often (wear time greater than 3.5 days)
3. Female participant is pregnant or nursing (Documented negative pregnancy test results for female participants required unless participant is menopausal without any spontaneous menstrual cycles for >12 months or key organs have been removed.)
4. Participant has abnormal skin at intended device infusion sites (existing infection, inflammation, burns, or other extensive scarring)
5. Participant has HbA1C greater than 8.5 percent at screening
6. Participant has documented history in last 6 months of severe hypoglycemia associated with cognitive dysfunction sufficiently severe to require third party intervention or a history of impaired awareness of hypoglycemia.
7. Participant has a history of diabetic ketoacidosis in the last 6 months
8. Participant has known cardiovascular disease considered to be clinically relevant by the investigator
9. Participant has known arrhythmias considered to be clinically relevant by the investigator

10. Participant has known history of:

    1. Cushing's Disease,
    2. pancreatic islet cell tumor, or
    3. insulinoma

11. Participant has:

    1. Lipodystrophy,
    2. extensive lipohypertrophy, as assessed by the investigator

12. Participant is undergoing current treatment with:

    1. Systemic oral or intravenous corticosteroids,
    2. monoamine oxidase (MAO) inhibitors,
    3. non-selective beta-blockers,
    4. growth hormone,
    5. thyroid hormones, unless use has been stable during the past 3 months

13. Subject has significant history of any of the following, that in the opinion of the investigator would compromise the subject's safety or successful study participation:

    1. Alcoholism,
    2. drug abuse
14. Significant acute or chronic illness, that in the investigator's opinion, might interfere with subject safety or integrity of study results
15. Planned operation, MRI or CT which require removal of infusion set or CGM sensor during wear periods
16. Current participation in another clinical drug or device study
17. AST and ALT greater than 120 U per L
18. Creatinine equal to or greater than 1.8 mg per dL -

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Device Feasibility
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Achilles Infusion Set; Coil-reinforced soft polymer indwelling cannula	Device: coil-reinforced soft polymer indwelling cannula; This is a prospective, non-randomized, home-use feasibility study of device performance, usability, tolerability, and safety of the Capillary Biomedical, Inc. (CapBio) Achilles infusion set for continuous subcutaneous insulin infusion (CSII or insulin pump therapy) in up to 20 participants diagnosed with type 1 diabetes mellitus (T1DM).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of Infusion Set Survival at End of Day 7	The composite primary objective of this study is to evaluate feasibility and device performance of the Achilles infusion set over three extended home use wear periods of up to 7 days each during routine therapeutic insulin infusion.	7 days during weeks 2 and 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
BG control	Evaluation of, Standard glucose control measures obtained from Continuous Glucose Monitoring (CGM), including observed hyper- and hypoglycemic episodes. This outcome will be assessed by means of CGM readings and participant diary.	Week 2 and week 3
Tolerability: VAS (Visual Analog Scale)	Evaluation of, Subject tolerability (subject comfort) during wear period. This outcome will be assessed by means of a Participant diary, which includes a Visual Pain Scale (VAS), to be filled daily with the participant's feedback and pain level of wearing the device. Furthest left means no pain; furthest right means extreme pain as perceived by the participant. The line is a continuum from none to an extreme amount of pain	Week 1, Week 2 and Week 3

Collaborators and Investigators

• Sponsor: Capillary Biomedical, Inc.
• Investigators: Principal Investigator: David O'Neal, M.D., St Vincent's Hospital Department of Medicine

Study record dates

Study Major Dates

• Study Start (Actual): November 13, 2019
• Primary Completion (Actual): November 11, 2020
• Study Completion (Actual): November 11, 2020

Study Registration Dates

• First Submitted: July 9, 2020
• First Submitted That Met QC Criteria: August 5, 2020
• First Posted (Actual): August 7, 2020

Study Record Updates

• Last Update Posted (Estimate): March 7, 2023
• Last Update Submitted That Met QC Criteria: May 27, 2022
• Last Verified: May 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Immune System Diseases; Autoimmune Diseases; Endocrine System Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 1
• Other Study ID Numbers: 150-1072-00; ACTRN12620000021976 (Registry Identifier: ANZCTR (Australian New Zealand Clinical Trials Registry)

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: No
• Studies a U.S. FDA-regulated device product: Yes