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The primary goal of the study is to investigate the safety and tolerability of the investigational drug lisofylline, when administered under the skin or in the vein, in people with type 1 diabetes. A second aim is to determine how much drug is available in the blood after injection under the skin, compared to injection in the vein.
This is an open-label, randomized, crossover study in subjects with type 1 diabetes. There are two treatment periods separated by approximately one week. One treatment will consist of a 10 hour subcutaneous infusion of lisofylline, and the other treatment will consist of a 10 hour intravenous infusion of lisofylline.
Eligible subjects will be admitted to the Infusion Center the morning of dosing (Day 1, Day 7) during each treatment period, receive their assigned dose of study drug on Day 1 and Day 7, and will remain confined to the Infusion Center until approximately 3 hours following the start of study drug administration for the remaining blood draws. The subjects will then be escorted to the Sleep Center of Eastern Virginia Medical School for an overnight stay during which time their heart rate and oxygen saturation will be monitored by pulse oximetry. The next morning the subjects will return to the Infusion Center for a final blood draw and physical examination. The Infusion Center and the Sleep Disorders Center are both within Sentara Norfolk General Hospital.
All subjects will be assigned to a treatment sequence according to a randomization schedule.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lisofylline subcutaneous | Experimental | Lisofylline 12mg/kg as a continuous subcutaneous infusion over a 10 hours period |
|
| Lisofylline intravenous | Experimental | Lisofylline 9 mg/kg as a continuous intravenous infusion over a 10 hours period |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lisofylline | Drug | Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability of Study Drug | Subjects will be monitored for adverse events both during and after the study drug infusion and will undergo physical examinations, electrocardiograms and clinical safety laboratory tests. Study staff will contact subjects within 5 days after each dosing period and approximately 30 days after the 2nd dosing period, to review laboratory results and to ask the subject about any changes in health that they have experienced. Should the subject require an in-person evaluation, this will be arranged with the principal or sub-investigator promptly. | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Study Drug Bioavailability After Subcutaneous and Intravenous Infusion | Blood will be collected for determination of lisofylline concentrations at various predetermined time points during the infusions, and 10 and 24 hours following infusion completion. This will help to determine if subcutaneous infusion over 10 hours results in similar lisofylline plasma concentrations as with intravenous infusion. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David C Lieb, MD | Eastern Virginia Medical School | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Eastern Virginia Medical School Strelitz Diabetes Center | Norfolk | Virginia | 23510 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Lisofylline Subcutaneous First, Then Lisofylline Intravenous | Lisofylline 12mg/kg as a continuous subcutaneous infusion over a 10 hours period Lisofylline: Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. |
| FG001 | Lisofylline Intravenous First, Then Lisofylline Subcutaneous | Lisofylline 9 mg/kg as a continuous intravenous infusion over a 10 hours period Lisofylline: Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Intervention, 10 Hours |
| |||||||||||||
| Second Intervention, 10 Hours |
|
All subjects enrolled into the study were included in the baseline analysis.
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| ID | Title | Description |
|---|---|---|
| BG000 | All Study Participants | Lisofylline: Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Safety and Tolerability of Study Drug | Subjects will be monitored for adverse events both during and after the study drug infusion and will undergo physical examinations, electrocardiograms and clinical safety laboratory tests. Study staff will contact subjects within 5 days after each dosing period and approximately 30 days after the 2nd dosing period, to review laboratory results and to ask the subject about any changes in health that they have experienced. Should the subject require an in-person evaluation, this will be arranged with the principal or sub-investigator promptly. | Posted | 1 month |
|
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Adverse events were assessed for through investigator assessment during the treatment period, and planned phone calls with patient following treatment periods.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Lisofylline Subcutaneous | Lisofylline 12mg/kg as a continuous subcutaneous infusion over a 10 hours period Lisofylline: Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Syncope | General disorders | Systematic Assessment | Syncope may have been related to lisofylline, though was also taking an ACE-inhibitor, and in retrospect this medication should have been held during the study period. The patient responded immediately to a change in positioning/fluid hydration. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Dizziness | General disorders | Systematic Assessment | Subject reported a brief period of dizziness one day after subcutaneous infusion of lisofylline. |
Early termination due to difficulty recruiting subjects.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. David Lieb, Principal Investigator | Eastern Virginia Medical School | 7574465910 | liebdc@evms.edu |
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| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| C025189 | lisofylline |
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| 24 hours |
| Evaluation of Early Efficacy of Study Drug | Blood draws will be performed at predetermined time points during and after the infusions in order to measure serum cytokine and chemokine concentrations, as well as to measure plasma STAT 4 and phosphorylated STAT 4 (markers of lisofylline efficacy). | 24 hours |
| NOT COMPLETED |
|
|
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 | Lisofylline Intravenous | Lisofylline 9 mg/kg as a continuous intravenous infusion over a 10 hours period Lisofylline: Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. |
|
| Secondary | Study Drug Bioavailability After Subcutaneous and Intravenous Infusion | Blood will be collected for determination of lisofylline concentrations at various predetermined time points during the infusions, and 10 and 24 hours following infusion completion. This will help to determine if subcutaneous infusion over 10 hours results in similar lisofylline plasma concentrations as with intravenous infusion. | Posted | 24 hours |
|
|
| Secondary | Evaluation of Early Efficacy of Study Drug | Blood draws will be performed at predetermined time points during and after the infusions in order to measure serum cytokine and chemokine concentrations, as well as to measure plasma STAT 4 and phosphorylated STAT 4 (markers of lisofylline efficacy). | Posted | 24 hours |
|
|
| 0 |
| 1 |
| 1 |
| 1 |
| EG001 | Lisofylline Intravenous | Lisofylline 9 mg/kg as a continuous intravenous infusion over a 10 hours period Lisofylline: Lisofylline single dose of 9 mg/kg continuous intravenous infusion over a 10 hour period, and lisofylline single dose of 12 mg/kg continuous subcutaneous infusion over a 10 hour period during the alternate period 1 week apart. | 1 | 1 | 0 | 1 |
|
| Hypotension | General disorders | Systematic Assessment | Hypotension may have been related to lisofylline, though was also taking an ACE-inhibitor, and in retrospect this medication should have been held during the study period. The patient responded immediately to a change in positioning/fluid hydration. |
|
|
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| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |