G-Pen Compared to Glucagen Hypokit for Severe Hypoglycemia Rescue in Adults With Type 1 Diabetes

Last updated: May 12, 2020
Sponsor: Xeris Pharmaceuticals
Overall Status: Completed

Phase

3

Condition

Diabetes (Pediatric)

Diabetes Mellitus, Type 1

Hormone Deficiencies

Treatment

N/A

Clinical Study ID

NCT03738865
XSGP-304
  • Ages 18-75
  • All Genders

Study Summary

This is a multi-center, randomized, controlled, single-blind, two-way crossover efficacy and safety study in subjects with Type 1 diabetes mellitus. The study involves two daytime clinical research center (CRC) visits with random assignment to receive G-Pen glucagon 1 mg during one period and Novo Glucagon 1 mg during the other. Each daytime visit is preceded by an overnight stay in the CRC. In the morning of the inpatient study visit, the subject is brought into a state of severe hypoglycemia through IV administration of regular insulin diluted in normal saline. After a hypoglycemic state with plasma glucose < 54 mg/dL (3 mmol/L) is verified, the subject is administered a dose of G-Pen or Novo Glucagon via subcutaneous injection. Plasma glucose levels are monitored for up to 180 minutes post-dosing, with a value of >70.0 mg/dL (3.89 mmol/L) or an increase of > 20 mg/dL (>1.11 mmol/L) within 30 minutes of glucagon administration indicating a positive response. After 3 hours, the subject is given a meal and discharged when medically stable. After a wash-out period of 7 to 28 days, subjects return to the CRC, and the procedures are repeated with each subject crossed over to the other treatment. A follow-up visit as a safety check is conducted 2-7 days following administration of the final dose of study drug.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Males and non-pregnant females diagnosed with type 1 diabetes (T1D) for at least 24months.

  2. Current usage of daily insulin treatment that includes having an assigned "correctionfactor" for managing hyperglycemia.

  3. Age 18 to 75 years, inclusive.

  4. Random serum C-peptide concentration < 0.6 ng/mL.

  5. Willingness to follow all study procedures, including attending all clinic visits.

  6. Subject has provided informed consent as evidenced by a signed and dated informedconsent form (ICF) completed before any trial-related activities occur.

Exclusion

Exclusion Criteria:

  1. Pregnancy

  2. Glycated hemoglobin (HbA1c) > 10% at Screening.

  3. Body mass index (BMI) > 40 kg/m2.

  4. Renal insufficiency (serum creatinine greater than 3.0 mg/dL) or end-stage renaldisease requiring renal replacement therapy.

  5. Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) equal to orgreater than 3 times the upper limit of normal.

  6. Hepatic synthetic insufficiency as defined as a serum albumin of less than 3.0 g/dL.

  7. Hematocrit < 30%.

  8. Blood pressure (BP) readings at Screening where systolic blood pressure (SBP) < 90 or > 150 mm Hg, and diastolic blood pressure (DBP) < 50 or > 100 mm Hg.

  9. Clinically significant electrocardiogram (ECG) abnormalities.

  10. Use of total insulin dose per day > 2 U/kg.

  11. Inadequate venous access.

  12. Congestive heart failure, New York Heart Association (NYHA) class III or IV.

  13. History of myocardial infarction, unstable angina, or revascularization within thepast 6 months.

  14. History of a cerebrovascular accident in the past 6 months or with major neurologicaldeficits.

  15. Active malignancy within 5 years from Screening, except basal cell or squamous cellskin cancers. Any history of breast cancer or malignant melanoma will be exclusionary.

  16. Major surgical operation within 30 days prior to Screening.

  17. Current seizure disorder (other than with suspect or documented hypoglycemia).

  18. Current bleeding disorder, treatment with warfarin, or platelet count below 50 × 109per liter.

  19. History of pheochromocytoma or disorder with increased risk of pheochromocytoma (multiple endocrine neoplasia type 2 (MEN 2), neurofibromatosis, or Von Hippel-Lindaudisease).

  20. History of insulinoma.

  21. History of allergies to glucagon or glucagon-like products, or any history ofsignificant hypersensitivity to glucagon or any related products or to any of theexcipients (DMSO and trehalose) in the investigational formulation.

  22. History of glycogen storage disease.

  23. Subject tests positive for human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV) infection (hepatitis B surface antigen positive [HBsAg+]) at Screening.

  24. Active substance other than tetrahydrocannabinol (THC) or alcohol abuse (more than 21drinks per week for male subjects or 14 drinks per week for female subject).

  25. Administration of glucagon within 7 days of Screening.

  26. Participation in other studies involving administration of an investigational drug ordevice within 30 days or 5 half-lives, whichever is longer, before Screening for thecurrent study and during participation in the current study.

  27. Any other reason the Investigator deems exclusionary.

Study Design

Total Participants: 132
Study Start date:
September 27, 2018
Estimated Completion Date:
April 02, 2019

Connect with a study center

  • Medizinische Universität Graz-Center for Medical Research

    Graz, 8010
    Austria

    Site Not Available

  • LMC Diabetes & Endocrinology

    Toronto, Ontario M4G 3E8
    Canada

    Site Not Available

  • AltaSciences

    Montréal, Quebec H3P 3P1
    Canada

    Site Not Available

  • Profil Institut für Stoffwechselforschung GmbH

    Neuss, 41460
    Germany

    Site Not Available

  • Institut für Diabetes-Technologie

    Ulm, 89081
    Germany

    Site Not Available

  • Diablo Clinical Research

    Walnut Creek, California 94598
    United States

    Site Not Available

  • Atlanta Diabetes Associates

    Atlanta, Georgia 30318
    United States

    Site Not Available

  • PPD-Las Vegas Clinical Research Unit

    Las Vegas, Nevada 89113
    United States

    Site Not Available

  • Rainier Research Center

    Renton, Washington 98057
    United States

    Site Not Available

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