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This is a randomized, placebo-controlled, double-blind study to evaluate safety, tolerability and pharmacodynamics of REMD-477 in subjects who have Type 1 diabetes and are currently receiving insulin treatment. This proof of concept study will determine whether glucagon receptor blockade using a single dose REMD-477 can improve short-term glucose homeostasis in people with Type 1 diabetes.
The study will be conducted at two sites in the United States, and approximately 20 subjects with type 1 diabetes will be enrolled. Eligible subjects will be admitted to the clinical research unit, to carefully monitor blood glucose; and establish the baseline insulin requirement for maintaining targeted normoglycemia (postabsorptive: 90-120 mg/dL; and postprandial: <180 mg/dL).
The patients will then be subjected to a hyperglycemic period (250-300 mg/dL) by a stepwise reduction in insulin infusion. After receiving a single SC dose of REMD-477 or matching placebo in a double-blinded fashion, all subjects will be assessed for the post-treatment 24-hour insulin requirement needed to maintain targeted normoglycemia (postabsorptive: 90-120 mg/dL; and postprandial: <180 mg/dL); and to be monitored closely for safety, tolerability and targeted glycemic control, for a 48-hr period. After the in-patient residency period, subjects will return to the clinic for weekly out-patient safety follow-up visits for 8 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| REMD-477 Treatment A | Experimental | Administered as a single SC dose in subjects with Type 1 Diabetes |
|
| Matching placebo | Placebo Comparator | Administered as a single SC dose in subjects with Type 1 Diabetes |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| REMD-477 | Biological |
| ||
| Placebo Comparator |
| Measure | Description | Time Frame |
|---|---|---|
| Number of treatment emergent adverse events per subject, including changes in vital signs, physical and neurological examinations, laboratory safety tests and ECGs | Baseline and 57 days | |
| Changes from baseline in 24-hour insulin requirements on Day 1 relative to the two 24 hour periods post-treatment on Days 3 and 4, between the REMD-477 and placebo treated subjects, needed to maintain targeted glycemic control. | Baseline (24 hour period on Day 1) and Days 3 and 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Immunogenicity: Incidence of REMD-477 neutralizing and non-neutralizing antibodies | Baseline and 57 days | |
| Changes from baseline over time of AST. | Incidence of elevated serum aspartate transaminase (AST) values > 3x the upper limit of normal (ULN). |
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Inclusion Criteria:
Exclusion Criteria:
Other inclusion and exclusion criteria may apply.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| San Diego | California | United States | ||||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29283470 | Derived | Pettus J, Reeds D, Cavaiola TS, Boeder S, Levin M, Tobin G, Cava E, Thai D, Shi J, Yan H, Bautista E, McMillan J, Unger R, Henry RR, Klein S. Effect of a glucagon receptor antibody (REMD-477) in type 1 diabetes: A randomized controlled trial. Diabetes Obes Metab. 2018 May;20(5):1302-1305. doi: 10.1111/dom.13202. Epub 2018 Jan 22. |
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|
| Baseline and 57 days |
| Changes from baseline over time of ALT. | Incidence of elevated serum alanine transaminase (ALT) values >3x the upper limit of normal (ULN). | Baseline and 57 days |
| Changes from baseline over time of ALP. | Incidence of elevated serum alkaline phosphatase (ALP) >2x upper limit of normal (ULN) | Baseline and 57 days |
| Changes from baseline over time of total bilirubin. | Incidence of elevated serum total bilirubin >2x upper limit of normal (ULN). | Baseline and 57 days |
| Changes from baseline over time of amylase | Incidence of elevated serum amylase values at >2.5x ULN | Baseline and 57 days |
| Changes from baseline over time of lipase | Incidence of elevated serum lipase values at >2.5x ULN | Baseline and 57 days |
| St Louis |
| Missouri |
| United States |
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| 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 |
|---|---|
| C000629677 | volagidemab |
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