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The purpose of Part I of this study is to evaluate the safety and tolerability of intravenous (IV) doses of MK-2640 in healthy participants and to obtain preliminary plasma pharmacokinetic profiles of MK-2640. The purpose of Parts II and III of this study is to evaluate the safety and tolerability of IV doses of MK-2640 and regular human insulin (RHI), and to evaluate the pharmacokinetic and pharmacodynamic profile of MK-2640 and RHI in participants with type 1 diabetes mellitus (T1DM). Part II will be initiated only if Part I general safety, tolerability and other observed data are supportive of progression to Part II. Part III will be initiated only if Parts I and II general safety, tolerability and other observed data are supportive of progression to Part III.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Part I: MK-2640 (Panel A) | Experimental | Part I: Lowest dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
|
| Part I: MK-2640 (Panel B) | Experimental | Part I: Low dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
|
| Part I: MK-2640 (Panel C) | Experimental | Part I: Medium-low dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
|
| Part I: MK-2640 (Panel D) | Experimental | Part I: Medium dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
|
| Part I: MK-2640 (Panel E) | Experimental | Part I: Medium-high dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MK-2640 | Drug | MK-2640 intravenous infusion administered to participant in a fasted state |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants who experienced an adverse event | Up to 30 days following last dose | |
| Pharmacokinetic parameter: steady state plasma concentration (Css) | Part I: final 30 minutes of each infusion rate; Parts II and III: final 30 minutes of each interval | |
| Pharmacokinetic parameter: area under the plasma concentration curve from time 0 to infinity (AUC [0 to infinity]) | Part I: 18 time points between predose and 600 minutes (min.); Part II: 19 time points between predose and 535 min.; Part III: 18 time points between predose and 415 min. following start of infusion | |
| Pharmacokinetic parameter: clearance (CL) | Part I: final 30 minutes of each infusion rate; Parts II and III: final 30 minutes of each interval | |
| Pharmacokinetic parameter: volume of distribution (Vd) | Part I: final 30 minutes of each infusion rate; Parts II and III: final 30 minutes of each interval | |
| Pharmacokinetic parameter: plasma apparent terminal half-life | Part II: following 9 hour infusion; Part III: following 7 hour infusion | |
| Pharmacodynamic parameter: steady-state glucose infusion-rate (GIR) in Part II | Part II: during the final 60 minutes of the infusion | |
| Number of participants who discontinued study drug due to an adverse event | Part I: 1 day; Parts II and III: 9 days |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with anti-drug antibody (ADA) formation | Up to 30 days following last dose |
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Inclusion Criteria (Part I):
Inclusion Criteria (Parts II and III):
Exclusion Criteria:
Exclusion Criteria (Parts II and III):
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| Name | Affiliation | Role |
|---|---|---|
| Medical Director | Merck Sharp & Dohme LLC | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30125349 | Result | Krug AW, Visser SAG, Tsai K, Kandala B, Fancourt C, Thornton B, Morrow L, Kaarsholm NC, Bernstein HS, Stoch SA, Crutchlow M, Kelley DE, Iwamoto M. Clinical Evaluation of MK-2640: An Insulin Analog With Glucose-Responsive Properties. Clin Pharmacol Ther. 2019 Feb;105(2):417-425. doi: 10.1002/cpt.1215. Epub 2018 Sep 30. |
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|
| Part I: MK-2640 (Panel F) | Experimental | Part I: High dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
|
| Part I: MK-2640 (Panel G) | Experimental | Part 1: Highest dose of MK-2640 infusion (3 approximately three-hour infusions at escalating rates) and dextrose infusion for 9 hours. |
|
| Part II: MK-2640 followed by RHI | Experimental | Part II: MK-2640 infusion and dextrose infusion for 9 hours during Period 1 of Part II followed by a 7-day wash-out period followed by RHI infusion and dextrose infusion for 9 hours during Period 2 of Part II. Insulin aspart administered approximately 10 hours before Periods 1 and 2 of Part II. |
|
| Part II: RHI followed by MK-2640 | Experimental | Part II: RHI infusion and dextrose infusion for 9 hours during Period 1 of Part II followed by a 7-day wash-out period followed by MK-2640 infusion and dextrose infusion for 9 hours during Period 2 of Part II. Insulin aspart administered approximately 10 hours before Periods 1 and 2 of Part II. |
|
| Part III: MK-2640 followed by RHI | Experimental | Part III: MK-2640 infusion and dextrose infusion for 7 hours during Period 1 of Part III followed by a 7-day wash-out period followed by RHI infusion and dextrose infusion for 7 hours during Period 2 of Part III. Insulin aspart administered approximately 10 hours before Periods 1 and 2 of Part III. |
|
| Part III: RHI followed by MK-2640 | Experimental | Part III: RHI infusion and dextrose infusion for 7 hours during Period 1 of Part III followed by a 7-day wash-out period followed by MK-2640 infusion and dextrose infusion for 7 hours during Period 2 of Part III. Insulin aspart administered approximately 10 hours before Periods 1 and 2 of Part III. |
|
| Regular Human Insulin (RHI) | Biological | RHI 100 units/mL intravenous infusion to maintain target glycemic level |
|
| Dextrose | Drug | Dextrose 20% or 50% intravenous infusion for approximately 9 or 7 hours, as appropriate to attain a target glycemic level |
|
| Insulin aspart | Biological | Insulin aspart subcutaneous injection or intravenous infusion the evening before each period in Parts II and III to achieve/maintain glycemic target. |
|
| Rescue medication | Drug | Rescue medication may be administered for hypotension or mild to moderate infusion reaction. Rescue medication may include epinephrine, antihistamines, steroids, or acetaminophen/paracetamol. |
|
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C000628736 | MK-2640 |
| D007328 | Insulin |
| D005947 | Glucose |
| D061267 | Insulin Aspart |
| ID | Term |
|---|---|
| D011384 | Proinsulin |
| D061385 | Insulins |
| D010187 | Pancreatic Hormones |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D006601 | Hexoses |
| D009005 | Monosaccharides |
| D000073893 | Sugars |
| D002241 | Carbohydrates |
| D061266 | Insulin, Short-Acting |
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