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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
21
Unnamed facility
San Diego, California, United States
Unnamed facility
St Louis, Missouri, United States
Number of treatment emergent adverse events per subject, including changes in vital signs, physical and neurological examinations, laboratory safety tests and ECGs
Time frame: 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.
Time frame: Baseline (24 hour period on Day 1) and Days 3 and 4
Immunogenicity: Incidence of REMD-477 neutralizing and non-neutralizing antibodies
Time frame: 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).
Time frame: 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).
Time frame: Baseline and 57 days
Changes from baseline over time of ALP.
Incidence of elevated serum alkaline phosphatase (ALP) \>2x upper limit of normal (ULN)
Time frame: Baseline and 57 days
Changes from baseline over time of total bilirubin.
Incidence of elevated serum total bilirubin \>2x upper limit of normal (ULN).
Time frame: Baseline and 57 days
Changes from baseline over time of amylase
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Incidence of elevated serum amylase values at \>2.5x ULN
Time frame: Baseline and 57 days
Changes from baseline over time of lipase
Incidence of elevated serum lipase values at \>2.5x ULN
Time frame: Baseline and 57 days