A Randomized, Single-Blind, Two-Way Crossover, Placebo-Controlled Phase I Study to Compare the 24-hour Glucose Profile and Safety of Pramlintide and Insulin, Co-Administered in a Fixed-Dose Ratio, Versus Placebo and Insulin in Patients With Type 1 Diabetes Mellitus With Inadequate Glycemic Control
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 发起方
- AstraZeneca
- 入组人数
- 34
- 试验地点
- 1
- 主要终点
- Efficacy of Pramlintide by Measurement of 24-hour Tissue Mean Weighted Glucose (MWG) Obtained With Continuous Glucose Monitoring (CGM)
研究概览
简要总结
This study is designed to investigate the clinical efficacy and safety of pramlintide co-administered as a fixed-dose ratio with basal-bolus SC insulin, delivered simultaneously via 2 separate pumps, in subjects with type 1 diabetes who are failing to achieve the desired level of glycemic control using insulin therapy.
详细描述
Potentially eligible subjects with Type 1 diabetes mellitus who are treated with with a basal-bolus insulin regimen through multiple daily injections or insulin pump at a total daily insulin dose ≤60 U, will be eligible. Visit 1 is approximately 3-6 weeks prior to randomization. Given some variability in HbA1c and C-peptide assays, re-testing for HbA1c and C-peptide can be performed within 18 days from the initial visit. Visit 2 is approximately 2-5 weeks prior to randomization. Subjects are on lispro insulin throughout study except during Visit 4 and Visit 5, the domicile 24 hr treatment period, when they are switched to regular insulin U-100.
Screen failed patients may be re-screened for inclusion in the study, as long as re-screening takes place at least 3 months after the original screening visit. If a subject is re-screened, he/she must continue to meet all inclusion/exclusion criteria. All study procedures of initial Visit 1 must be repeated at the re-screening visit.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Provision of informed consent prior to any study-specific procedures
- •Female and/or male aged between 18 and 70 years
- •Must have a prior diagnosis of T1DM
- •Body mass index (BMI) <30 kg/m2
- •Subjects are not on current treatment with pramlintide (Symlin) and have not received pramlintide during the 6-month period prior to enrollment
- •Subjects should be willing to consume all of the components of the standardized meals administered during the study
- •Negative serum pregnancy test for female subjects of childbearing potential
- •Female subjects of childbearing potential must be 1 year postmenopausal, surgically sterile, or using an acceptable method of contraception for the duration of the study
- •Male subjects must be surgically sterile or using an acceptable method of contraception for the duration of the study
排除标准
- •Recurrent severe hypoglycemia requiring assistance within 6 months before screening
- •A history of hypoglycemia unawareness
- •A confirmed diagnosis of gastroparesis
- •Has been treated, is currently being treated, or is expected to require or undergo treatment with the following medications:
- •Any oral antihyperglycemic agent or any other injectable antihyperglycemic agent that is not insulin
- •Drugs that directly affect GI motility (eg, anticholinergic agents such as atropine)
- •Drugs that slow the intestinal absorption of nutrients (eg, α-glucosidase inhibitors
- •A history of gastric surgery (such as gastric banding, Roux- and Y bypass)
- •Is expected to require or undergo treatment with acetaminophen after enrollment and at any point during the study
- •Has experienced diabetic ketoacidosis within the last 24 weeks
- •History of hospitalization within the last 6 months for glycemic control (for both hyperglycemia or hypoglycemia)
- •Subject has any significant disease or disorder, which, in the opinion of the investigator, may either put the subject at risk because of participation in the study, or may influence the results of the study, or the subject's ability to participate in the study
- •Any clinically relevant abnormal findings, which, in the opinion of the investigator, may put the subject at risk because of his/her participation in the study.
- •Pregnancy confirmed by a positive pregnancy test, or otherwise verified.
- •Breast feeding
- •Positive hepatitis C virus antibody (HCV Ab), hepatitis B virus surface antigen (HBsAg), hepatitis B virus core antibody (anti-Hbc), or human immunodeficiency virus 1/2 antibody (HIV-1/2 Ab) at Screening
- •History of, or current alcohol or drug abuse
- •Has donated blood within 2 months of Visit 1 (Screening) or is planning to donate blood during the study
- •Has had a major surgery or a blood transfusion within 2 months before Visit 1 (screening)
- •Participation in any clinical study with an investigational drug or new formulation of a marketed drug during the last 1 month prior to Visit 1
研究组 & 干预措施
Pramlintide acetate & regular insulin
Pramlintide will be adiministered by sc infusion at a concentration of 1000ug/mL
干预措施: Pramlintide acetate (Drug)
Pramlintide acetate & regular insulin
Pramlintide will be adiministered by sc infusion at a concentration of 1000ug/mL
干预措施: Lispro insulin U-100 (Drug)
Pramlintide acetate & regular insulin
Pramlintide will be adiministered by sc infusion at a concentration of 1000ug/mL
干预措施: Regular insulin U-100 (Drug)
Placebo and regular insulin
Placebo is similar sterile solution without pramlintide.
干预措施: Placebo (Drug)
Placebo and regular insulin
Placebo is similar sterile solution without pramlintide.
干预措施: Lispro insulin U-100 (Drug)
Placebo and regular insulin
Placebo is similar sterile solution without pramlintide.
干预措施: Regular insulin U-100 (Drug)
结局指标
主要结局
Efficacy of Pramlintide by Measurement of 24-hour Tissue Mean Weighted Glucose (MWG) Obtained With Continuous Glucose Monitoring (CGM)
时间窗: 24 h
24-hour MWG mg/dL, defined as total area under the 24-hour tissue glucose curve obtained with CGM, divided by actual time span in the 24-hour period.
次要结局
- Efficacy of Pramlintide by Measurement of Absolute Plasma Glucose Area Under the Plasma Concentration-time Curve (AUC) Following Lunch(3 hours)
- Efficacy of Pramlintide by Measurement of Absolute Plasma Glucose Area Under the Plasma Concentration-time Curve (AUC) Following Dinner(2 hours)
- Efficacy of Pramlintide by Measurement of Absolute Plasma Glucose Area Under the Plasma Concentration-time Curve (AUC) Following Breakfast(2 hours)
- Efficacy of Pramlintide by Measurement of Incremental 24-hour Tissue Glucose Area Under the Plasma Concentration-time Curve (AUC) Obtained With Continuous Glucose Monitoring (CGM)(24 h)
- Efficacy of Pramlintide by Measurement of Absolute 24-hour Plasma Glucose Area Under the Plasma Concentration-time Curve (AUC)(24 h)
- Efficacy of Pramlintide by Measurement of Incremental 24-hour Plasma Glucose Area Under the Plasma Concentration-time Curve (AUC)(24 hours)
- Efficacy of Pramlintide Measured by Percent Time Spent in the Range of >70 mg/dL to <180 mg/dL Tissue Glucose Obtained With Continuous Glucose Monitoring (CGM)(24 h)
- Efficacy of Pramlintide by Measurement of Absolute 24-hour Plasma Glucagon Area Under the Plasma Concentration-time Curve (AUC)(24 h)
- Efficacy of Pramlintide by Measurement of Incremental 24-hour Plasma Glucagon Area Under the Plasma Concentration-time Curve (AUC)(24 h)
- Fasting Plasma Glucose Concentration(12 hours after dinner meal)
- Pharmacokinetics of Insulin as Demonstrated by 24-hour Plasma Insulin Area Under the Plasma Concentration-time Curve (AUC)(24 hours)
- Pharmacokinetics of Insulin as Demonstrated by 24-hour Average Plasma Insulin Concentration.(24 hours)
- Pharmacokinetics of Insulin as Demonstrated by Maximum Plasma Insulin Concentration(24 hours)
- Pharmacokinetics of Insulin as Demonstrated by the Time to the Maximum Plasma Insulin Concentration(24 hours)