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| Name | Class |
|---|---|
| Integrium | INDUSTRY |
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This study is a Phase 2 randomized, crossover study comparing ORMD-0801 given QD versus TID in subjects with T1D. Subjects with T1D will have a screening visit (Visit 1) during which they will be required to review and sign the informed consent form. Medical history and demographics will be collected. Vital signs will be measured, physical exam will be performed, and blood and urine samples will be collected for hematology/chemistry/urinalysis
Placebo capsules will be given QD at bedtime during placebo run-in period 10 days prior to randomization.
This study is a Phase 2 randomized, crossover study comparing ORMD-0801 given QD versus TID in subjects with T1D. Subjects with T1D will have a screening visit (Visit 1) during which they will be required to review and sign the informed consent form. Medical history and demographics will be collected. Vital signs will be measured, physical exam will be performed, and blood and urine samples will be collected for hematology/chemistry/urinalysis. Eligible subjects will be scheduled to return to the clinic in 1 week (Visit 2). Subjects fulfilling all inclusion/exclusion criteria will have a CGM placed, provided with a diary, dispensed Placebo capsules and asked to return to the clinic in 10 Days (Visit 3, Day 1) for randomization. At Visit 3, data from CGM will be downloaded and diaries will be collected. Blood samples will be collected in fasting for chemistry and HbA1c. Subjects will be randomized to receive either ORMD-0801 24 mg given once daily at bedtime, or ORMD-0801 8 mg given three times a day, 45-90 minutes before meals.
Subjects will be instructed to continue their normal diet, and to adjust their basal and bolus insulin in the normal fashion. Subjects will be instructed to return to the clinic 10 days before Visit 5 (Visit 4, Day 18). At Visit 4, compliance will be assessed, IMP and diary dispensed and the CGM will be placed. Subjects will be instructed to return to the clinic in 10 days for Visit 5 (Day 28). At Visit 5 a fasting blood sample for chemistry panel and HbA1C will be drawn and after the diary has been collected and the CGM monitor removed, they will be crossed over to the alternate treatment regimen. IMP will be dispensed, and the subject will be asked to return 10 days before Visit 7 for Visit 6 (Day 46). At Visit 6, compliance will be checked, IMP and diary will be dispensed and the CGM will be placed. Subjects will be instructed to return in 10 days for Visit 7 (Day 56). At Visit 7 the CGM will be removed, compliance checked, the diary will be collected, and a blood sample will be drawn for a chemistry panel and HbA1C. A physical examination will be performed, and the subject will exit the study. Subjects will be provided with diaries at Visits 2, 4 and 6, and will be asked to capture the amount of basal and bolus exogenous insulin administered each day and calculate their carbohydrate count for all meals and snacks over the 10-day CGM monitoring period. Diaries will be collected at Visits 3, 5 and 7.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo then Treatment A then Treatment B | Experimental | Treatment administered in the following order:
|
|
| Placebo then Treatment B then Treatment A | Experimental | Treatment administered in the following order:
Treatment B: 8 mg ORMD-0801; one 8 mg capsule three times a day (TID) 45-90 minutes before meals |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ORMD-0801 Treatment A | Drug | Treatment A: 24 mg (16 mg capsule + 8 mg capsule) Once Daily (QD) at bedtime |
|
| Measure | Description | Time Frame |
|---|---|---|
| Average Exogenous Basal Insulin Compared to Baseline (Placebo) | The least squares means difference of basal exogenous insulin between treatment A and placebo and treatment B and placebo, utilized over the final ten (10) days of each treatment period | Combined Final ten days of each treatment period. Period1 (days -8 to 1)Period 2 (days 19 to 28) ,and Period 3 (days 47 to 56) |
| Average Exogenous Bolus Insulin Compared to Baseline (Placebo) | The amount of exogenous bolus insulin utilized over the final ten (10) days of each treatment period measured in mg/dL | Combined Final ten days of treatment per treatment period (Days -8 to 1, Days 19 to 28, and Days 47 to 56) |
| Average Exogenous Total Insulin Compared to Baseline | The Least Squares Mean Difeerence ( (mg/dL) of total exogenous insulin (the sum of basal + bolus exogenous insulin) over the final ten (10) days of treatment. | Combined Final ten days of treatment , day -8 to 1 (Period 1) Days 19 to 28 (Period 2), Days 47 to 56 (Period 3) |
| Measure | Description | Time Frame |
|---|---|---|
| Daytime Average Mean Glucose Compared to Baseline | Least Squares Mean Difference from Baseline of Daytime Average Mean Glucose over the final ten (10) days of each treatment and each treatment period as measured by CGM. | Combined Study days -8 to 1 (Period 1) Days 19 to 28 (Period 2), and days 47 to 56 (Period 3) |
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Inclusion Criteria:
Male and female subjects aged 18 and older.
Body mass index (BMI) of 19-30 kg/m2 at Screening and stable weight, with no more than 5 kg gain or loss in the 3 months prior to Screening.
T1D subjects must have:
Females of childbearing potential must have a negative serum pregnancy test result at Screening.
Females who are not of childbearing potential are defined as:
Subjects who are of childbearing potential must:
a. agree to remain abstinent from heterosexual activity† or agree to use (or have their partner use) acceptable contraception to prevent pregnancy within the projected duration of the trial and for 14 days after the last dose of blinded investigational product. Two methods of contraception will be used to avoid pregnancy. Acceptable combinations of methods include: i. Use of one of the following double-barrier methods: diaphragm with spermicide and a condom; cervical cap and a condom; or a contraceptive sponge and condom ii. Use of hormonal contraception (any registered and marketed contraceptive agent that contains an estrogen and/or a progestational agent [including oral, subcutaneous, intrauterine and intramuscular agents, and cutaneous patch]) with one of the following: diaphragm with spermicide; cervical cap; contraceptive sponge; condom; vasectomy; or IUD. iii. Use of an IUD with one of the following: condom; diaphragm with spermicide; contraceptive sponge; vasectomy; or hormonal contraception (see above).
iv. Vasectomy with one of the following: diaphragm with spermicide; cervical cap; contraceptive sponge; condom; IUD; or hormonal contraception (see above).
†Abstinence can be used as the sole method of contraception if it is in line with the subject's preferred and usual lifestyle and if considered acceptable by local regulatory agencies and ethics committees. Periodic abstinence (e.g., calendar, ovulation, sympto-thermal, post-ovulation methods, etc.) and withdrawal are not acceptable methods of contraception.
Exclusion Criteria:
Clinical diagnosis of type 2 diabetes;
Evidence of unawareness of hypoglycemia unawareness, a documented plasma glucose ≤50 mg/dL in the absence of symptoms of hypoglycemia at Screening.
FPG >300 mg/dL at Screening; a single repeat test is allowable.
Use of the following medications:
Laboratory abnormalities at Screening including:
Subject has a Screening systolic blood pressure ≥165 mmHg or diastolic blood pressure ≥100 mmHg. Subjects will be allowed to take a BP rescue medication.
Any clinically significant ECG abnormality at Screening or cardiovascular disease. Clinically significant cardiovascular disease will include:
a. History of stroke, transient ischemic attack, or myocardial infarction within 6 months prior to Screening,
History of or currently have New York Heart Associate Class II-IV heart failure prior to Screening.
Presence of any clinically significant endocrine disease according to the Investigator (euthyroid subjects on replacement therapy will be included if the dosage of thyroxine is stable for at least six weeks prior to Screening).
Presence of any clinically significant condition (in the opinion of the Investigator) that might interfere with the evaluation of study medication, such as significant renal, hepatic, gastrointestinal (GI), cardiovascular (CV), immune disease, blood dyscrasias or any disorders causing hemolysis or unstable red blood cells, or clinically important hematological disorders (i.e. aplastic anemia, myeloproliferative or myelodysplastic syndromes, thrombocytopenia) at Screening.
History of gastrointestinal disorders (e.g. hypochlorhydria) with the potential to interfere with drug absorption.
Presence or history of cancer within the past 5 years of Screening, with the exception of adequately-treated localized basal cell skin cancer or in situ uterine cervical cancer.
Positive history of active liver disease (other than non-alcoholic hepatic steatosis), including chronic hepatitis B or C, primary biliary cirrhosis, or active symptomatic gallbladder disease.
Positive history of HIV.
Known allergy to soy.
Subject is on a weight loss program and is not in the maintenance phase, or subject has started weight loss medication (e.g., orlistat or liraglutide), within 8 weeks prior to Screening. Subjects who have had bariatric surgery are also excluded.
S ubject is pregnant or breast-feeding.
Subject is a user of recreational or illicit drugs or has had a recent history (within 1 year of Screening) of drug or alcohol abuse or dependence. (Note: Alcohol abuse includes heavy alcohol intake as defined by >3 drinks per day or >14 drinks per week, or binge drinking) at Screening.
At the Principal Investigator's discretion, any condition or other factor that is deemed unsuitable for subject enrollment into the study.
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| Name | Affiliation | Role |
|---|---|---|
| Miriam Kidron, PhD | Oramed Pharmaceuticals, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Orange County Research Center | Tustin | California | 92780 | United States |
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This is a crossover study with one crossover point.
There are three periods in this study:
Period 1: all patients consented receive placebo (run-in period). Period 2: all patients are randomized to receive either Treatment A or Treatment B.
Period 3: Crossover point. Patients receiving Treatment A in period 2 now receive Treatment B in period 3, and patients receiving Treatment B in period 2 now receive Treatment A in period 3.
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo Followed by Treatment A Followed by Treatment B | Treatment administered in the following order:
|
| FG001 | Placebo Followed by Treatment B Followed by Treatment A | Treatment administered in the following order:
|
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Period 1- Placebo run-in (All Patients) |
| |||||||||||||
| Period 2- Either Treatment A or B |
| |||||||||||||
| Period 3 Crossover-Treatment B or A |
|
All patients are first administered a placebo, or is the standard of care.
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo Followed by Treatment A Followed by Treatment B | Treatment administerd in the following order:
|
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | This is a crossover study. All patients were administered placebo at baseline. |
| 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 | Average Exogenous Basal Insulin Compared to Baseline (Placebo) | The least squares means difference of basal exogenous insulin between treatment A and placebo and treatment B and placebo, utilized over the final ten (10) days of each treatment period | Information collected at the day 28 visits (Day 28 and Day 56) will be analyzed using an Analysis of Covariance model with subject as a random effect. | Posted | Least Squares Mean | Standard Error | mg/dL | Combined Final ten days of each treatment period. Period1 (days -8 to 1)Period 2 (days 19 to 28) ,and Period 3 (days 47 to 56) |
|
Sixty-six (66) days
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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 | Placebo | Placebo - Fish Oil | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharangitis | Infections and infestations | MedDRA (21.0) | Systematic Assessment | mild |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Miriam Kidron, PhD | Oramed, Ltd. | +972-2-566-0001 | miriam@oramed.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 | Aug 29, 2019 | Oct 18, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Mar 9, 2020 | Oct 18, 2021 | SAP_001.pdf |
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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 |
|---|---|
| D007328 | Insulin |
| ID | Term |
|---|---|
| D011384 | Proinsulin |
| D061385 | Insulins |
| D010187 | Pancreatic Hormones |
| D036361 | Peptide Hormones |
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This is an open-label crossover study in which all subjects will receive placebo run-in during Period 1 followed by Period 2, where subjects will be randomly assigned to either daily Treatment A (taken at Bedtime) and Treatment B (taken daily before each of three daily meals). At visit 5, the start of Period 3, subjects will stop their treatment (either A or B) and be CROSSED OVER to the other treatment (patients on treatment A during Period 2 will be crossed over to Treatment B and patients who were on Treatment B during Period 2 will be crossed over to Treatment A in Period 3).
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Open-Label
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|
| ORMD-0801 Treatment B | Drug | Treatment B: 8 mg (8 mg capsule) three times a day (TID) 45-90 minutes before meals |
|
|
| Placebo | Other | Fish oil capsule |
|
| Daytime Glucose Coefficient of Variation Compared to Baseline |
Least Squares Mean Continuous Glucose Monitor (CGM) Glucose Coefficient of Variation measured over daytime hours, compared to Baseline |
| Study Days -8 to 1 (Period 1), Days 19-28 (Period 2), and Days 47-56 (Period 3) |
| Daytime Low Blood Glucose Index (LBGI) Compared to Baseline | Least Squares Mean Daytime Low Blood Glucose Index (LBGI) measured over the last ten (10) days of the treatment period, compared to Baseline LBGI is a clinical scale that indicates the probability for hypoglycemia. Blood Glucose Variability is an important measure because it provides additional clarification for HbA1c value. The risk of hypglycemic events and the LBGI scale is defined as follows: Minimal Risk ( LBGI < 1.1) Low Risk ( 1.1 < LBGI < 2.5) Moderate Risk (2.5 < LBGI < 5), HIgh Risk ( LBGI > 5) | Combined Study Days -8 to 1 (Period 1), Days 19-28 (Period 2), and Days 47-56 (Period 3) |
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| NOT COMPLETED |
|
|
| BG001 | Placebo Followed by Treatment B Followed by Treatment A | Treatment administerd in the following order:
|
| BG002 | Total | Total of all reporting groups |
| Mean |
| Standard Deviation |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Pre-dose Hb1Ac(%) | Hb1Ac is a measurement from a blood sample of the glycated form of hemoglobin to obtain the two to three-month average of blood sugar. the inclusion criterion for Hb1Ac is 6.5% ≤ HbA1c ≤10% | Mean | Standard Deviation | percent |
|
Treatment A is 24 mg (16 mg + 8 mg capsules) Once Daily (QD) at Bedtime of ORMD-0801
ORMD-0801: Oral Insulin Capsules
| OG002 | Treatment B | Treatment B is 8 mg (8 mg capsule) three times a day (TID) 45-90 minutes before meals ORMD-0801: Oral Insulin Capsules |
|
|
|
| Primary | Average Exogenous Bolus Insulin Compared to Baseline (Placebo) | The amount of exogenous bolus insulin utilized over the final ten (10) days of each treatment period measured in mg/dL | Safety Population | Posted | Least Squares Mean | Standard Error | mg/dL | Combined Final ten days of treatment per treatment period (Days -8 to 1, Days 19 to 28, and Days 47 to 56) |
|
|
|
|
| Primary | Average Exogenous Total Insulin Compared to Baseline | The Least Squares Mean Difeerence ( (mg/dL) of total exogenous insulin (the sum of basal + bolus exogenous insulin) over the final ten (10) days of treatment. | Safety Population The number of participants anylized is based on the the number of participants that completed at least 80% of the Continuous Glucose Montioring measurements. Participants that did not meet this criterion are not inclued in this analysis. | Posted | Least Squares Mean | Standard Error | mg/dL | Combined Final ten days of treatment , day -8 to 1 (Period 1) Days 19 to 28 (Period 2), Days 47 to 56 (Period 3) |
|
|
|
|
| Secondary | Daytime Average Mean Glucose Compared to Baseline | Least Squares Mean Difference from Baseline of Daytime Average Mean Glucose over the final ten (10) days of each treatment and each treatment period as measured by CGM. | Safety Population. The number of participants anylized is based on the the number of participants that completed at least 80% of the Continuous Glucose Montioring measurements. Participants that did not meet this criterion are not inclued in this analysis. | Posted | Least Squares Mean | Standard Error | mg/dL | Combined Study days -8 to 1 (Period 1) Days 19 to 28 (Period 2), and days 47 to 56 (Period 3) |
|
|
|
|
| Secondary | Daytime Glucose Coefficient of Variation Compared to Baseline | Least Squares Mean Continuous Glucose Monitor (CGM) Glucose Coefficient of Variation measured over daytime hours, compared to Baseline | Safety Population. The number of participants anylized is based on the the number of participants that completed at least 80% of the Continuous Glucose Montioring measurements. Participants that did not meet this criterion are not inclued in this analysis. | Posted | Least Squares Mean | Standard Error | percent (%) | Study Days -8 to 1 (Period 1), Days 19-28 (Period 2), and Days 47-56 (Period 3) |
|
|
|
|
| Secondary | Daytime Low Blood Glucose Index (LBGI) Compared to Baseline | Least Squares Mean Daytime Low Blood Glucose Index (LBGI) measured over the last ten (10) days of the treatment period, compared to Baseline LBGI is a clinical scale that indicates the probability for hypoglycemia. Blood Glucose Variability is an important measure because it provides additional clarification for HbA1c value. The risk of hypglycemic events and the LBGI scale is defined as follows: Minimal Risk ( LBGI < 1.1) Low Risk ( 1.1 < LBGI < 2.5) Moderate Risk (2.5 < LBGI < 5), HIgh Risk ( LBGI > 5) | Safety Population. The number of participants anylized is based on the the number of participants that completed at least 80% of the Continuous Glucose Montioring measurements. Participants that did not meet this criterion are not inclued in this analysis | Posted | Least Squares Mean | Standard Error | units on a scale | Combined Study Days -8 to 1 (Period 1), Days 19-28 (Period 2), and Days 47-56 (Period 3) |
|
|
|
|
| 30 |
| 0 |
| 30 |
| 0 |
| 30 |
| EG001 | Treatment A ORMD-0801 | Treatment A is 24 mg (16 mg + 8 mg capsules) Once Daily (QD) at Bedtime of ORMD-0801 ORMD-0801 Treatment A: Treatment A: 24 mg (16 mg capsule + 8 mg capsule) Once Daily (QD) at bedtime | 0 | 30 | 0 | 30 | 9 | 30 |
| EG002 | Treatment B ORMD-0801 | Treatment B is 8 mg (8 mg capsule) three times a day (TID) 45-90 minutes before meals ORMD-0801 Treatment B: Treatment B: 8 mg (8 mg capsule) three times a day (TID) 45-90 minutes before meals | 0 | 30 | 0 | 30 | 6 | 30 |
| OTITIS EXTERNA | Infections and infestations | MedDRA (21.0) | Systematic Assessment | mild |
|
| Sinusitis | Immune system disorders | MedDRA (21.0) | Systematic Assessment | mild |
|
| UPPER RESPIRATORY TRACT INFECTION | Infections and infestations | MedDRA (21.0) | Systematic Assessment | mild |
|
| Urinary Tract Infection | Infections and infestations | MedDRA (21.0) | Systematic Assessment | mild |
|
| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment | mild |
|
| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment | moderate |
|
| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (21.0) | Systematic Assessment | severe |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment | mild |
|
| Abdominal discomfort | Gastrointestinal disorders | MedDRA (21.0) | Systematic Assessment | mild |
|
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| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D006728 |
| Hormones |
| D006730 | Hormones, Hormone Substitutes, and Hormone Antagonists |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
|
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| Least Squares Mean Difference between Treatment A and Placebo, Treatment B and Placebo. |
|