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With REMD's glucagon receptor antagonist, the study team propose to provide a comprehensive examination of the effect of elevated plasma glucagon concentrations in Type 2 Diabetes Mellitus (T2D) patients on:
(i) glucose tolerance; (ii) insulin sensitivity in liver, muscle, and adipocytes; (iii) beta cell function; (iv) adipocyte inflammation.
Subjects with T2DM inadequately controlled on current medications will participate in a glucose tolerance test, euglycemic insulin clamp combined with 3-3H-glucose and 14-C glycerol infusion, adipose tissue biopsy, before and 12 weeks after treatment with REMD 477 or placebo.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Glucagon Receptor Agonist (GRA) REMD-477 group | Experimental | Participants are assigned to a 12 week treatment of REMD-477 |
|
| Placebo group | Placebo Comparator | Participants are assigned to a 12 week course of placebo for REMD-477 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| REMD-477 | Drug | A biologic glucagon receptor agonist to which randomized subjects are assigned 2:1 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Glycated Hemoglobin (HbA1c) | Change in HbA1c measured at baseline and after intervention administration | Baseline to 13 weeks |
| Fasting Plasma glucose (FPG) | Change in fasting plasma glucose measured at baseline and after intervention administration | Baseline to 13 weeks |
| Plasma glucose (PG) | Change in plasma PG measured at baseline and after intervention administration using an oral glucose tolerance test (OGTT) | Baseline to 13 weeks |
| Hepatic insulin sensitivity | Change in hepatic glucose production (HGP) | Baseline to 13 weeks |
| Whole body glucose disposal | Change in whole body glucose disposal measured in mg/kg/min | Baseline to 13 weeks |
| Plasma Free Fatty Acids (FFA) | Change in plasma free fatty acids | Baseline to 13 weeks |
| Muscle Insulin sensitivity | Change in muscle insulin sensitivity measured by insulin-stimulated glucose uptake during low dose high dose insulin clamp. | Baseline to 13 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ralph DeFronzo, MD | University of Texas Health San Antonio | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Texas Diabetes Institute | San Antonio | Texas | 78207 | United States |
Summary results will be published in ClinicalTrials.gov as required by law and research findings will be published in a peer reviewed scientific journal.
Once the study has completed enrollment and data analysis is complete, data will become available.
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A randomized 2-arm placebo controlled trial
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Participants will be blinded to the study drug or placebo randomization.
| Placebo Subcutaneous injection | Drug | Placebo for REMD-477 to which subjects will be randomized 1:2. |
|
|
| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D018149 | Glucose Intolerance |
| D007333 | Insulin Resistance |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D006943 | Hyperglycemia |
| D006946 | Hyperinsulinism |
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| ID | Term |
|---|---|
| C000629677 | volagidemab |
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