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18-Week, Randomized, Double-blind, Placebo Controlled, Forced Titration Study of Patients With Type 2 Diabetes

Phase 2
Completed
Conditions
Type 2 Diabetes Mellitus
Interventions
Drug: Technosphere Insulin
Drug: Technosphere Placebo
Registration Number
NCT00511732
Lead Sponsor
Mannkind Corporation
Brief Summary

Designed to evaluate dose response of force-titrated prandial administration of TI as compared to placebo (TP) in subjects with Type 2 diabetes who were suboptimally controlled

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
227
Inclusion Criteria
  • Male and females patients from 18 to <80 years of age
  • Clinical diagnosis of type 2 diabetes mellitus
  • Duration of diabetes of >3 years and <20 years
  • Glycemic control at upper end of acceptable level or sub-optimal in control (HbA1c between 7.0% and 12?0%)
  • Confirmation of diagnosis of diabetes such as a history of 2 hour postprandial blood glucose >11.1 mmol/L (200 mg/dL) or following a glucose tolerance test
  • A minimum of 2 months of treatment with a stable dose of one or more of the following anti-hyperglycemic agents: sulphonylureas, alpha glucosidase inhibitors, metformin, meglitinides, thiazolidinediones and/or Lantus basal insulin therapy
  • FBG:>6 mmol/L (108 mg/dL)
  • C-peptide: >0.5 nmol/L
  • BMI <38 kg/m2
  • Baseline DLco, FVC, FEV1 >75% of predicted normal
  • Subjects who, in the opinion of the Investigator, will be able to complete this study
  • Written informed consent
Exclusion Criteria
  • Severe complications of diabetes including history of: blindness from or grade III or IV diabetic retinopathy, renal failure requiring dialysis or transplantation, amputation of limbs or digits related to diabetic vasculopathy or foot ulcers
  • Treatment with another investigational drug within 3 months prior to study entry and for the duration of the study
  • History of drug or alcohol dependency
  • Significant hepatic disease (as evidenced by ALT or AST >3 times the normal upper reference range or bilirubin >1.5 times the normal upper reference range)
  • Significant renal disease (as evidenced by creatinine >1.5 mg/dL for males or >1.3 mg/dL for females) or proteinuria >1,000 mg/24 hours
  • History of chronic obstructive pulmonary disease, or history of other known chronic pulmonary diseases, such as reactive airway disease, chronic bronchitis, emphysema, or asthma
  • Heart disease graded as class III or class IV according to New York Heart Association criteria
  • Prior treatment with , or participation in a clinical study involving an inhaled insulin product
  • Smokers
  • Current use of preprandial or prandially administered fast-acting or rapid acting insulin or insulin analogs
  • Previous participation in a TI or TP clinical trial
  • Allergy to insulin or to any drugs to be used as part of the clinical trial
  • History of malignancy within 5 years of study entry (other than basal cell carcinoma)
  • Anemia (hemoglobin level less than 11 g/dL for females or 12 g/dL for males at study entry)
  • Diagnosis of Acquired Immunodeficiency Syndrome (AIDS) and Aids Related Complex A major psychiatric disorder that will preclude satisfactory participation in this study
  • Subjects who have had a myocardial infarction or stroke within the preceding 6 months
  • Prior diagnosis of systemic autoimmune or collagen vascular disease requiring previous or current treatment with systemic corticosteroids, cytotoxic drugs, or penicillamine
  • History of severe or multiple allergies
  • Progressive fatal disease
  • Recent loss (within the past 2 months) of >5% of body weight
  • Evidence of "moderate" or greater ketones in urine or history of ketoacidosis
  • Use of medications known to modify glucose metabolism or the ability to recover from hypoglycemia such as oral, parenteral and inhaled steroids, or greater than 25 mg hydrochlorothiazide daily
  • Women who are pregnant or lactating
  • Women of childbearing potential practicing inadequate birth control (adequate birth control is defined as using oral contraceptives, condoms or diaphragms with spermicide, intrauterine devices, or surgical sterilization).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Technosphere InsulinTechnosphere Insulin-
Technosphere Inhalation PowderTechnosphere Placebo-
Primary Outcome Measures
NameTimeMethod
HbA1c change from baseline (week 6) to end of treatment (week 17)measured from week 6 (baseline) to week 17
Area under the plasma glucose concentration versus time (AUCglucose) compared to week 6 (baseline.at weeks 4, 6, 11 and 17

Timepoints: 0 minutes (before meal) and at 15, 30, 60, 90, 120, 180, 240, and 300 minutes after TI administration

Area under the plasma glucose concentration versus time (AUCglucose) compared to week 6 (baseline)at weeks 4, 6, 11 and 17

Timepoints: 0 minutes (before meal) and at 15, 30, 60, 90, 120, 180, 240, and 300 minutes after Technosphere Placebo administration

Secondary Outcome Measures
NameTimeMethod
Fasting blood glucose concentration compared to week 6 (baseline)at weeks 4, 6, 11 and 17
Safety variables included adverse events (AEs), clinical laboratory tests, vital signs and physical examinations18 weeks
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