This is a blinded, randomized crossover study to compare the safety and efficacy of G-Pen (glucagon injection) to Lilly Glucagon (glucagon for injection \[rDNA origin\]) for hypoglycemia rescue of adult patients with type 1 diabetes.
This is a blinded, randomized, Phase 3 comparative efficacy and safety study in adults with type 1 diabetes. Patients will complete screening procedures up to 60 days before randomization to determine eligibility before enrollment to the treatment phase. The procedure for evaluating the efficacy of the G-Pen (glucagon injection) consists of inducing hypoglycemia by intravenous administration of regular insulin diluted in normal saline. Each participant will undergo two episodes of insulin-induced hypoglycemia, and in random order will receive 1 mg G-Pen (glucagon injection) during one episode and 1 mg Lilly Glucagon during the other episode. There will be wash out period of 7-28 days between treatment visits. Blood glucose levels will be monitored post-dosing, with a return of plasma glucose to a concentration \> 70 mg/dL within 30 minutes signifying successful hypoglycemia rescue. As a confirmation of efficacy, subjects will complete a questionnaire concerning changes in symptoms of hypoglycemia following treatment with glucagon. Subjects will return for a follow-up safety visit 3-14 days following administration of the final dose of glucagon.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
80
1 mg of pre-mixed liquid Xeris glucagon delivered via auto-injector
1 mg of Lilly glucagon reconstituted from lyophilized powder
University of Alabama at Birmingham
Birmingham, Alabama, United States
ProSciento, Inc.
Chula Vista, California, United States
AMCR Institute
Escondido, California, United States
Diablo Clinical Research
Walnut Creek, California, United States
Hypoglycemia Rescue: Intent-to-Treat Population
Number of subjects with an increase in plasma glucose concentration from below 50 mg/dL to greater than 70 mg/dL within 30 minutes after administration of glucagon
Time frame: At 30 minutes following administration of study drug
Hypoglycemia Rescue: Per Protocol Population
Number of subjects with an increase in plasma glucose concentration from below 50 mg/dL to greater than 70 mg/dL within 30 minutes after administration of glucagon
Time frame: At 30 minutes following administration of study drug
Hypoglycemia Rescue: Alternate Glucose Response Definition
Number of subjects with either an increase in plasma glucose concentration from below 50 mg/dL to greater than 70 mg/dL or an increase in from baseline in plasma glucose concentration of at least 20 mg/dL within 30 minutes after administration of glucagon
Time frame: At 30 minutes following administration of study drug
Plasma Glucose Area Under the Curve (AUC)
Pharmacodynamic endpoint of plasma glucose AUC from baseline to 90 minutes following administration of glucagon
Time frame: At -5, 0, 10, 20, 30, 45, 60, and 90 minutes following administration of glucagon
Plasma Glucose Maximum Concentration (Cmax)
Pharmacodynamic endpoint of plasma glucose Cmax from baseline to 4 hours following administration of glucagon
Time frame: At -5, 0, 10, 20, 30, 45, 60, 90, 120, 180 and 240 minutes following administration of glucagon
Plasma Glucose Time to Maximum Concentration (Tmax)
Pharmacodynamic endpoint of plasma glucose Tmax from baseline to 4 hours following administration of glucagon
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Clinical Trials of Texas, Inc.
San Antonio, Texas, United States
Rainier Research
Renton, Washington, United States
LMC Diabetes & Endocrinology
Toronto, Ontario, Canada
Time frame: At -5, 0, 10, 20, 30, 45, 60, 90, 120, 180 and 240 minutes following administration of glucagon
Plasma Glucose Time to Concentration > 70 mg/dL
Pharmacodynamic endpoint of time to achieve a plasma glucose concentration \> 70 mg/dL following administration of glucagon
Time frame: At -5, 0, 10, 20, 30, 45, 60, 90, 120, 180 and 240 minutes following administration of glucagon
Time to Resolution of Hypoglycemia Symptoms
Time to resolution of mean autonomic, mean neuroglycopenic and mean total hypoglycemia symptom scores from baseline through 90 minutes following administration of glucagon.
Time frame: At 0, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85 and 90 minutes following administration of glucagon
Global Assessment of Hypoglycemia
Time to resolution of the overall sensation of hypoglycemia following administration of glucagon
Time frame: At 0, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85 and 90 minutes following administration of glucagon