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A Study of the Effect of ZT-01 on Night-time Hypoglycemia in Type 1 Diabetes

Phase 2
Recruiting
Conditions
Type 1 Diabetes Mellitus with Hypoglycemia
Interventions
Drug: Placebo
Drug: ZT-01, 7 mg
Drug: ZT-01, 22 mg
Drug: ZT-01, 15 mg
Registration Number
NCT05762107
Lead Sponsor
Zucara Therapeutics Inc.
Brief Summary

The goal of this clinical trial is to learn about the effect of the study drug (ZT-01) on low blood sugar (hypoglycemia) in adults with type 1 diabetes (T1D) who have been having low blood sugars ("hypos") at night. ZT-01 increases the amount of a hormone called glucagon during low blood sugar, and this may help prevent the occurrence of hypos. The main questions this trial aims to answer are whether ZT-01 lowers the number of hypos happening at night, and what its effects are on blood sugar levels. The safety of ZT-01 will also be measured.

Participants will be asked to wear a study-provided continuous glucose monitor (CGM) during two 4-week periods when they will self-inject the study drug before bed. They will get ZT-01 at one of three dose levels during one period, and placebo (which looks like the study drug but doesn't contain the active ingredient) during the other. Neither the participant nor the study site will know what they are receiving during each treatment period or see data from the CGM. The participant will continue to use their usual methods of measuring blood sugar (including their personal CGM) and giving insulin during the study. The participant will be asked to complete a short diary each evening, and will be asked to upload the CGM data to a study phone every day.

If a participant uses their own CGM and is willing to share information on how often they have low blood sugar with the study site at the first visit to see if they meet study entry requirements, they will have 6 study visits, 2 study phone calls, and be in the study for about 16 weeks. If they don't use CGM or don't want to share their information, then they will be asked to wear a study CGM for an extra 4 weeks to find out how many low blood sugars they have, and will have an extra visit.

Study participants will be asked to give blood and urine for testing to see whether they meet the requirements to enter the study, and at the start and end of each treatment period to see if the study treatment has any effects. They will also have their blood pressure and temperature taken at each study visit, and have an ECG at 4 visits to measure the electrical activity of their heart.

Some participants will be asked to also take part in a sub-study where their blood level of ZT-01 and glucagon is measured, after the first and last dose. They will be asked to stay at the study site overnight for each set of measurements (4 in total).

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
186
Inclusion Criteria
  • Has type 1 diabetes for at least 5 years
  • is at risk of nocturnal hypoglycemia (if using personal CGM, time below 54 mg/dL at least 1% over previous 4 weeks at screening; if not using personal CGM then recent history suggestive of nocturnal hypoglycemia at screening and time below 54 mg/dL at least 1% over 4 weeks using blinded study CGM during additional screening)
  • HbA1c at screening </= 10.0%
  • Body mass index (BMI) at screening >/=18.5 to <33 kg/m2
Exclusion Criteria
  • Has been hospitalized for diabetic ketoacidosis (DKA) more than once within previous 6 months
  • Has experienced >/= 1 severe hypoglycemia (requiring assistance) during previous 4 weeks or >2 in previous 3 months
  • Diagnosis of type 2 diabetes, pheochromocytoma, insulinoma, glucagonoma, acromegaly, Cushing's disease, glycogen storage disease, adrenal insufficiency
  • Clinically significant kidney disease
  • Abnormal liver function

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
ZT-01 7 mgPlaceboParticipants receive placebo and ZT-01 7 mg each by subcutaneous injection daily for 28 days, randomized to order
ZT-01 7 mgZT-01, 7 mgParticipants receive placebo and ZT-01 7 mg each by subcutaneous injection daily for 28 days, randomized to order
ZT-01 22 mgZT-01, 22 mgParticipants receive placebo and ZT-01 22 mg by subcutaneous injection daily for 28 days, randomized to order
ZT-01 15 mgPlaceboParticipants receive placebo and ZT-01 15 mg by subcutaneous injection daily for 28 days, randomized to order
ZT-01 15 mgZT-01, 15 mgParticipants receive placebo and ZT-01 15 mg by subcutaneous injection daily for 28 days, randomized to order
ZT-01 22 mgPlaceboParticipants receive placebo and ZT-01 22 mg by subcutaneous injection daily for 28 days, randomized to order
Primary Outcome Measures
NameTimeMethod
Incidence of nocturnal hypoglycemiaDuring each 28 day treatment period

Rate of nocturnal (midnight to 06:00 AM) hypoglycemic events (glucose \<54 mg/dL) lasting at least 15 minutes, compared to placebo

Secondary Outcome Measures
NameTimeMethod
Incidence and severity of adverse events (AEs)During each 28 day treatment period and 2-week followup

Number of patients experiencing AEs compared to placebo

Incidence of hypoglycemiaDuring each 28 day treatment period

Number of hypoglycemic events (glucose \<70 mg/dL for at least 15 minutes, compared to placebo

Glucose time below rangeDuring each 28 day treatment period

Glucose time below 54 mg/dL (as %) compared to placebo

Trial Locations

Locations (25)

Headlands Research

🇺🇸

Escondido, California, United States

USC Keck Medicine Eastside Center for Diabetes

🇺🇸

Los Angeles, California, United States

LCGK Research

🇺🇸

San Carlos, California, United States

East Coast Institute for Research LLC

🇺🇸

Jacksonville, Florida, United States

Suncoast Clinical Research

🇺🇸

New Port Richey, Florida, United States

Hanson Diabetes Center

🇺🇸

Port Charlotte, Florida, United States

Metabolic Research Institute

🇺🇸

West Palm Beach, Florida, United States

East Coast Institute for Research

🇺🇸

Macon, Georgia, United States

IU Health University Hospital

🇺🇸

Indianapolis, Indiana, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

MedStar Good Samaritan Hospital

🇺🇸

Baltimore, Maryland, United States

Palm Research Center, Inc.

🇺🇸

Las Vegas, Nevada, United States

Albany Medical Center

🇺🇸

Albany, New York, United States

Lucas Research Inc.

🇺🇸

Morehead City, North Carolina, United States

University Diabetes & Endocrine Consultants

🇺🇸

Chattanooga, Tennessee, United States

Texas Diabetes & Endocrinology, PA

🇺🇸

Austin, Texas, United States

Southern Endocrinology Associates

🇺🇸

Mesquite, Texas, United States

Diabetes & Glandular Disease Clinic

🇺🇸

San Antonio, Texas, United States

Centricity Research Calgary Endocrinology

🇨🇦

Calgary, Alberta, Canada

BC Diabetes

🇨🇦

Vancouver, British Columbia, Canada

Centricity Research Barrie Endocrinology

🇨🇦

Barrie, Ontario, Canada

Centricity Research Vaughan Endocrinology

🇨🇦

Concord, Ontario, Canada

Centricity Research Etobicoke Endocrinology

🇨🇦

Etobicoke, Ontario, Canada

Centricity Research Toronto

🇨🇦

Toronto, Ontario, Canada

Mount Sinai Hospital: Leadership Sinai Centre for Diabetes

🇨🇦

Toronto, Ontario, Canada

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