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| Name | Class |
|---|---|
| SGS S.A. | INDUSTRY |
| Integrated Medical Development | INDUSTRY |
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This is a non-inferiority, 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 Lilly 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 hypoglycemia through IV administration of regular insulin diluted in normal saline. After a hypoglycemic state with plasma glucose < 50 mg/dL is verified, the subject is administered a dose of G-Pen or Lilly Glucagon via subcutaneous injection. Plasma glucose levels are monitored for up to 180 minutes post-dosing, with a value of >70.0 mg/dL 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 procedure 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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| G-Pen followed by Lilly Glucagon | Other | 1 mg G-Pen at the first treatment visit followed by 1 mg Lilly Glucagon at the second treatment visit |
|
| Lilly Glucagon followed by G-Pen | Other | 1 mg Lilly Glucagon at the first treatment visit followed by 1 mg G-Pen at the second treatment visit |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| G-Pen | Drug | 1 mg subcutaneous injection of G-Pen (glucagon injection) administered via auto-injector |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects With a Positive Glucose Response | Increase in plasma glucose concentration from below 50.0 mg/dL to greater than 70.0 mg/dL within 30 minutes after receiving glucagon | 0 to 30 minutes post dose |
| Measure | Description | Time Frame |
|---|---|---|
| Time for Positive Glucose Response | Time from administration of glucagon for plasma glucose to rise from below 50.0 mg/dL to above 70.0 mg/dL | 0 to 180 minutes post dose |
| Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Positive Glucose Increase |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ProSciento, Inc. | Chula Vista | California | 91911 | United States | ||
| Diablo Clinical Research, Inc. |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34620618 | Derived | Christiansen MP, Cummins M, Prestrelski S, Close NC, Nguyen A, Junaidi K. Comparison of a ready-to-use liquid glucagon injection administered by autoinjector to glucagon emergency kit for the symptomatic relief of severe hypoglycemia: two randomized crossover non-inferiority studies. BMJ Open Diabetes Res Care. 2021 Oct;9(1):e002137. doi: 10.1136/bmjdrc-2021-002137. |
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A total of 81 eligible subjects were randomized to treatment. However, two subjects withdrew consent prior to dosing, so the number of subjects exposed to study treatment was 79.
The recruitment period began 08 Jan 2018 and ran through 02 Apr 2018. Subjects were screened for study eligibility at one of the six clinical sites up to 30 days prior to randomization.
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| ID | Title | Description |
|---|---|---|
| FG000 | G-Pen Followed by Lilly Glucagon | 1 mg G-Pen at the first treatment visit followed by 1 mg Lilly Glucagon at the second treatment visit G-Pen: 1 mg subcutaneous injection of G-Pen (glucagon injection) administered via auto-injector Lilly Glucagon: 1 mg subcutaneous injection of Lilly Glucagon (glucagon injection [RNDA Origin]) |
| FG001 | Lilly Glucagon Followed by G-Pen | 1 mg Lilly Glucagon at the first treatment visit followed by 1 mg G-Pen at the second treatment visit G-Pen: 1 mg subcutaneous injection of G-Pen (glucagon injection) administered via auto-injector Lilly Glucagon: 1 mg subcutaneous injection of Lilly Glucagon (glucagon injection [RNDA Origin]) |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
All randomized subjects
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| ID | Title | Description |
|---|---|---|
| BG000 | All Randomized Subjects | A total of 81 subjects met eligibility requirements and were randomized to study treatment. |
| 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 | Number of Subjects With a Positive Glucose Response | Increase in plasma glucose concentration from below 50.0 mg/dL to greater than 70.0 mg/dL within 30 minutes after receiving glucagon | Intent to treat analysis population | Posted | Count of Participants | Participants | 0 to 30 minutes post dose |
|
Adverse events were collected for up to 9 weeks, from the time of consent through the follow-up visit.
Treatment-Emergent Adverse Events
Note: Some subjects experienced multiple adverse events. Consequently, the sum of the number of subjects experiencing each individual adverse events is greater than the number of unique subjects experiencing at least one adverse event.
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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 | G-Pen | G-Pen: 1 mg subcutaneous injection of G-Pen (glucagon injection) administered via auto-injector. Between the 2 arms, a total of 76 subjects received a dose of G-Pen in the study. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | MedDRA 20.0 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Martin J. Cummins | Xeris Pharmaceuticals, Inc. | 312-736-1624 | mcummins@xerispharma.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 29, 2018 | May 9, 2019 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | May 3, 2018 | May 9, 2019 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| D007003 | Hypoglycemia |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D005934 | Glucagon |
| ID | Term |
|---|---|
| D052336 | Proglucagon |
| D010187 | Pancreatic Hormones |
| D036361 | Peptide Hormones |
| D006728 | Hormones |
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|
| Lilly Glucagon | Drug | 1 mg subcutaneous injection of Lilly Glucagon (glucagon injection [RNDA Origin]) |
|
|
A positive response for this endpoint is a return of plasma glucose to > 70 mg/dL or an increase in plasma glucose by ≥20 mg/dL within 30 minutes after receiving glucagon |
| 0 to 30 minutes post dose |
| Number of Subjects With a Positive Glucose Increase | Increase in plasma glucose by ≥ 20.0 mg/dL within 30 minutes after receiving glucagon | 0 to 30 minutes post dose |
| Time for Positive Glucose Increase | Time from administration of glucagon for plasma glucose to increase by ≥20 mg/dL from baseline | 0 to 180 minutes post dose |
| Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Relief of Neuroglycopenic Symptoms | A positive response for this endpoint is a return of plasma glucose to > 70 mg/dL or clearance of all neuroglycopenic symptoms of hypoglycemia within 30 minutes after receiving glucagon. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness. | 0 to 30 minutes post dose |
| Number of Subjects With Relief of Neuroglycopenic Symptoms | Clearance of all neuroglycopenic symptoms of hypoglycemia within 30 minutes after receiving glucagon. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness. | 0 to 30 minutes post dose |
| Time to Resolution of Autonomic Symptoms | Time from administration of glucagon to complete resolution of 4 autonomic symptoms of hypoglycemia. Symptoms included: sweating, tremor, palpitations and feeling of nervousness. | 0 to 180 minutes post dose |
| Time to Resolution of Neuroglycopenic Symptoms | Time from administration of glucagon to complete resolution of 4 neuroglycopenic symptoms of hypoglycemia. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness. | 0 to 180 minutes post dose |
| Time to Resolution of the Feeling of Hypoglycemia | Time from administration of glucagon to resolution of the overall sensation of hypoglycemia. Subjects were asked to answer yes/no to the question, "Do you feel hypoglycemic?" The time point as which the subject first answered "no" was considered the time of resolution. | 0 to 180 minutes post dose |
| Glucose AUC | Area under the curve for plasma glucose. | 0 to 180 minutes post dose - Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose. |
| Glucose Cmax | Maximum concentration of plasma glucose. | 0 to 180 minutes post dose - Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose. |
| Glucose Tmax | Time to maximum concentration of plasma glucose. Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose. | 0 to 180 minutes post dose |
| Glucagon Preparation and Administration Time | Time required to prepare and inject glucagon as measured between a "decision to dose" and completion of the injection | 0 to 5 minutes pre-dose |
| Walnut Creek |
| California |
| 94598 |
| United States |
| Atlanta Diabetes Associates | Atlanta | Georgia | 30318 | United States |
| Rainier Clinical Research Center, Inc. | Renton | Washington | 98057 | United States |
| LMC ESD, Inc. | Toronto | Ontario | M4G 3E8 | Canada |
| Altasciences Algorithme Pharma | Montreal | Quebec | H3P 3P1 | Canada |
| 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 |
|
| Units | Counts |
|---|---|
| Participants |
|
|
| Secondary | Time for Positive Glucose Response | Time from administration of glucagon for plasma glucose to rise from below 50.0 mg/dL to above 70.0 mg/dL | Intent-to treat analysis population | Posted | Mean | Standard Deviation | minutes | 0 to 180 minutes post dose |
|
|
|
| Secondary | Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Positive Glucose Increase | A positive response for this endpoint is a return of plasma glucose to > 70 mg/dL or an increase in plasma glucose by ≥20 mg/dL within 30 minutes after receiving glucagon | Intent to treat analysis population | Posted | Count of Participants | Participants | 0 to 30 minutes post dose |
|
|
|
| Secondary | Number of Subjects With a Positive Glucose Increase | Increase in plasma glucose by ≥ 20.0 mg/dL within 30 minutes after receiving glucagon | Intent to treat analysis population | Posted | Count of Participants | Participants | 0 to 30 minutes post dose |
|
|
|
| Secondary | Time for Positive Glucose Increase | Time from administration of glucagon for plasma glucose to increase by ≥20 mg/dL from baseline | Intent to treat analysis population | Posted | Mean | Standard Deviation | minutes | 0 to 180 minutes post dose |
|
|
|
| Secondary | Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Relief of Neuroglycopenic Symptoms | A positive response for this endpoint is a return of plasma glucose to > 70 mg/dL or clearance of all neuroglycopenic symptoms of hypoglycemia within 30 minutes after receiving glucagon. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness. | Intent to treat analysis population | Posted | Count of Participants | Participants | 0 to 30 minutes post dose |
|
|
|
| Secondary | Number of Subjects With Relief of Neuroglycopenic Symptoms | Clearance of all neuroglycopenic symptoms of hypoglycemia within 30 minutes after receiving glucagon. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness. | Intent to treat analysis population | Posted | Count of Participants | Participants | 0 to 30 minutes post dose |
|
|
|
| Secondary | Time to Resolution of Autonomic Symptoms | Time from administration of glucagon to complete resolution of 4 autonomic symptoms of hypoglycemia. Symptoms included: sweating, tremor, palpitations and feeling of nervousness. | Intent to treat analysis population | Posted | Mean | Standard Deviation | minutes | 0 to 180 minutes post dose |
|
|
|
| Secondary | Time to Resolution of Neuroglycopenic Symptoms | Time from administration of glucagon to complete resolution of 4 neuroglycopenic symptoms of hypoglycemia. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness. | Intent to treat analysis population | Posted | Mean | Standard Deviation | minutes | 0 to 180 minutes post dose |
|
|
|
| Secondary | Time to Resolution of the Feeling of Hypoglycemia | Time from administration of glucagon to resolution of the overall sensation of hypoglycemia. Subjects were asked to answer yes/no to the question, "Do you feel hypoglycemic?" The time point as which the subject first answered "no" was considered the time of resolution. | Intent to treat analysis population | Posted | Mean | Standard Deviation | minutes | 0 to 180 minutes post dose |
|
|
|
| Secondary | Glucose AUC | Area under the curve for plasma glucose. | Intent to treat analysis population. Due to missing data AUC was only evaluable in 67 subjects per arm. | Posted | Mean | Standard Deviation | mg∙min/dL | 0 to 180 minutes post dose - Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose. |
|
|
|
| Secondary | Glucose Cmax | Maximum concentration of plasma glucose. | Intent to treat analysis population | Posted | Mean | Standard Deviation | mg/dL | 0 to 180 minutes post dose - Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose. |
|
|
|
| Secondary | Glucose Tmax | Time to maximum concentration of plasma glucose. Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose. | Intent to treat analysis population | Posted | Mean | Standard Deviation | minutes | 0 to 180 minutes post dose |
|
|
|
| Secondary | Glucagon Preparation and Administration Time | Time required to prepare and inject glucagon as measured between a "decision to dose" and completion of the injection | Intent to treat analysis population | Posted | Mean | Standard Deviation | seconds | 0 to 5 minutes pre-dose |
|
|
|
| 0 |
| 76 |
| 0 |
| 76 |
| 46 |
| 76 |
| EG001 | Lilly Glucagon | Lilly Glucagon: 1 mg subcutaneous injection of Lilly Glucagon (glucagon injection [RNDA Origin]). Between the 2 arms, a total of 78 subjects received a dose of Lilly Glucagon in the study. | 0 | 78 | 0 | 78 | 34 | 78 |
| Nausea | Gastrointestinal disorders | MedDRA 20.0 | Non-systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA 20.0 | Non-systematic Assessment |
|
Neither the Institution nor the principal investigator may submit for publication or presentation, the results of this trial without prior written consent of the sponsor.
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D006730 |
| Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |