The trial's objective is to evaluate the immunogenicity of repeated single doses of dasiglucagon\* and GlucaGen following subcutaneous (SC) administration in patients with type 1 diabetes mellitus (T1DM) and further to evaluate the safety and tolerability of dasiglucagon and GlucaGen. \*dasiglucagon is the proposed International Nonproprietary Name (pINN) for ZP4207
Patients with T1DM were randomly assigned in a 1:1 ratio to receive 3 SC injections of either dasiglucagon (0.6 mg) or GlucaGen (1 mg), with 1 week between doses. Patients were followed for 15 weeks from the day of the first dose to assess the immune response. Patients with previous exogenic glucagon exposure were not excluded from the trial, but the information on previous glucagon administration was recorded to enable subgroup analyses. It was expected that 112 patients in total would be randomly assigned to treatment groups and treated. A total of 90 patients were expected to complete the trial (45 in each treatment arm). To qualify as completed, the patient had to be dosed according to the procedure described in the protocol and to have blood drawn for the antidrug antibody analyses as scheduled.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
112
Glucagon Analog
Native Glucagon
Compass Research
Orlando, Florida, United States
Advanced Clinical Research
Meridian, Idaho, United States
CRC - Clinical Research Center, Medizinische Universität Graz
Graz, Austria
LMC Manna Research
Barrie, Canada
Percentage of Patients With ADA
Percentage of the combined results of treatment-induced ADA-positive patients and treatment-boosted ADA-positive patients out of the total number of evaluable patients. ADA = antidrug antibodies.
Time frame: 104 days after the first dose
Percentage of Patients With Treatment-induced ADA
Percentage of the total number of evaluable patients that were ADA negative at baseline and ADA positive after drug administration out of the total number of evaluable patients. ADA = antidrug antibodies
Time frame: 104 days after the first dose
Percentage of Patients With Treatment-boosted ADA
Percentage of baseline ADA-positive patients with significant increases (≥5-fold) in ADA titre after drug administration out of the total number of evaluable patients. ADA = antidrug antibodies
Time frame: 104 days after the first dose
Characterization of ADA Response - Neutralizing Activity
Percentage of ADA positive patients with ADA neutralizing activity. ADA = antidrug antibodies.
Time frame: 104 days after the first dose
Characterization of ADA Response - Titer of Neutralizing Activity
Titre of neutralizing activity of ADA positive patients. ADA = antidrug antibodies.
Time frame: 104 days after the first dose
Characterization of ADA Response - Cross-reactivity
Percentage of ADA positive patients with cross-reactivity towards endogenous glucagon. ADA = antidrug antibodies.
Time frame: 104 days after the first dose
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LMC Calgary
Calgary, Canada
LMC Diabetes & Manna Research
Toronto, Canada
Diabeteszentrum Hamburg West, Gemeinschaftspraxis für Innere Medizin
Hamburg, Germany
Characterization of ADA Response - Timing
The timing of detected ADA response. ADA = antidrug antibodies.
Time frame: 104 days after the first dose
Characterization of ADA Response - Duration
The Duration of detected ADA response. ADA = antidrug antibodies.
Time frame: 104 days after the first dose
Pharmacokinetics - Area Under the Plasma Concentration Curve
Area under the plasma concentration curve (AUC) 0-30 minutes at visit 2 and 4 (days 0 and 14). Plasma PK concentrations were measured before dosing and at 5, 10 and 30 minutes after dosing.
Time frame: 0-30 minutes
Pharmacokinetics - Area Under the Plasma Concentration Curve
Area under the plasma concentration curve (AUC) 0-90 minutes at visit 2 and 4 (days 0 and 14). Plasma PK concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 0-90 minutes
Pharmacokinetics - Maximum Plasma Concentration
Maximum plasma concentration (Cmax) at visit 2 and 4 (days 0 and 14). Plasma PK concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 90 minutes
Pharmacokinetics - Time to Maximum Plasma Concentration
Time to maximum plasma concentration (Tmax) at visit 2 and 4 (days 0 and 14). Plasma PK concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 90 minutes
Pharmacodynamics - Area Under the Effect Curve
Plasma glucose profiles, area under the effect curve (AUE) 0-30 minutes at visit 2 and 4 (days 0 and 14). Plasma glucose concentrations were measured before dosing and at 5, 10 and 30 minutes after dosing.
Time frame: 0-30 minutes
Pharmacodynamics - Area Under the Effect Curve
Plasma glucose profiles, area under the effect curve (AUE) 0-90 minutes at visit 2 and 4 (days 0 and 14). Plasma glucose concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 0-90 minutes
Pharmacodynamics - Change From Baseline Plasma Glucose
Change from baseline plasma glucose to maximum plasma glucose (CEmax) at visit 2 and 4 (days 0 and 14). Plasma glucose concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 90 minutes
Pharmacodynamics - Time to Maximum Plasma Glucose Concentration
Time to maximum plasma glucose concentration (Tmax) at visit 2 and 4 (days 0 and 14). Plasma glucose concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 90 minutes
Pharmacodynamics - An Increase in the Plasma Glucose Concentration of ≥20 mg/dL Within 30 Minutes After Treatment
An increase in the plasma glucose concentration of ≥20 mg/dL within 30 minutes after treatment at visit 2 and visit 4. Plasma glucose concentrations were measured before dosing and at 5, 10, 30, 60 and 90 minutes after dosing.
Time frame: 30 minutes