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Trial · Interventional

CompletedPhase 3Results postedRegistry data

G-Pen™ Compared to Lilly Glucagon for Hypoglycemia Rescue in Adults With Type 1 Diabetes

Overview

Status
Completed
Phase
Phase 3
Enrollment
81 participants (actual)
Sponsor
Xeris Pharmaceuticals · Industry
Design
Randomized · Single masking
Countries
2 countries

United States, Canada

Start
23 Jan 2018
Primary completion
18 Apr 2018
Completion
3 May 2018
First posted
20 Feb 2018
Last update posted
17 Feb 2020
Conditions
Insulin Hypoglycemia · Type 1 Diabetes Mellitus · Severe Hypoglycemia

Timeline

1 trial · 1 completed · 1 with posted results

  • Completed
  • Ongoing
  • Not yet recruiting
  • Stopped
  • Estimated dates (est.)
  • Results posted
20182019
  1. Ph 3

    G-Pen™ Compared to Lilly Glucagon for Hypoglycemia Rescue in Adults With Type 1 Diabetes

    NCT03439072

    23 Jan 2018 to 3 May 2018

Registry summary

Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.

This is a non-inferiority, multi-center, randomized, controlled, single-blind, two-way crossover efficacy and safety study in subjects with Type 1 diabetes mellitus. The study involves two daytime clinical research center (CRC) visits with random assignment to receive G-Pen™ glucagon 1 mg during one period and Lilly Glucagon 1 mg during the other. Each daytime visit is preceded by an overnight stay in the CRC. In the morning of the inpatient study visit, the subject is brought into a state of hypoglycemia through IV administration of regular insulin diluted in normal saline. After a hypoglycemic state with plasma glucose \< 50 mg/dL is verified, the subject is administered a dose of G-Pen or Lilly Glucagon via subcutaneous injection. Plasma glucose levels are monitored for up to 180 minutes post-dosing, with a value of \>70.0 mg/dL within 30 minutes of glucagon administration indicating a positive response. After 3 hours, the subject is given a meal and discharged when medically stable. After a wash-out period of 7 to 28 days, subjects return to the CRC, and the procedure are repeated with each subject crossed over to the other treatment. A follow-up visit as a safety check is conducted 2-7 days following administration of the final dose of study drug.

Interventions

  • G-PenDrug
  • Lilly GlucagonDrug

Arms2

  • Other

    G-Pen followed by Lilly Glucagon

    1 mg G-Pen at the first treatment visit followed by 1 mg Lilly Glucagon at the second treatment visit

  • Other

    Lilly Glucagon followed by G-Pen

    1 mg Lilly Glucagon at the first treatment visit followed by 1 mg G-Pen at the second treatment visit

Primary outcomes1

Outcomes the sponsor listed as primary.

  1. Number of Subjects With a Positive Glucose Response

    Time frame · 0 to 30 minutes post dose

    Registry description

    Increase in plasma glucose concentration from below 50.0 mg/dL to greater than 70.0 mg/dL within 30 minutes after receiving glucagon

Secondary outcomes(13)
  1. Time for Positive Glucose Response

    Time frame · 0 to 180 minutes post dose

    Registry description

    Time from administration of glucagon for plasma glucose to rise from below 50.0 mg/dL to above 70.0 mg/dL

  2. Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Positive Glucose Increase

    Time frame · 0 to 30 minutes post dose

    Registry description

    A positive response for this endpoint is a return of plasma glucose to \> 70 mg/dL or an increase in plasma glucose by ≥20 mg/dL within 30 minutes after receiving glucagon

  3. Number of Subjects With a Positive Glucose Increase

    Time frame · 0 to 30 minutes post dose

    Registry description

    Increase in plasma glucose by ≥ 20.0 mg/dL within 30 minutes after receiving glucagon

  4. Time for Positive Glucose Increase

    Time frame · 0 to 180 minutes post dose

    Registry description

    Time from administration of glucagon for plasma glucose to increase by ≥20 mg/dL from baseline

  5. Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Relief of Neuroglycopenic Symptoms

    Time frame · 0 to 30 minutes post dose

    Registry description

    A positive response for this endpoint is a return of plasma glucose to \> 70 mg/dL or clearance of all neuroglycopenic symptoms of hypoglycemia within 30 minutes after receiving glucagon. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness.

  6. Number of Subjects With Relief of Neuroglycopenic Symptoms

    Time frame · 0 to 30 minutes post dose

    Registry description

    Clearance of all neuroglycopenic symptoms of hypoglycemia within 30 minutes after receiving glucagon. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness.

  7. Time to Resolution of Autonomic Symptoms

    Time frame · 0 to 180 minutes post dose

    Registry description

    Time from administration of glucagon to complete resolution of 4 autonomic symptoms of hypoglycemia. Symptoms included: sweating, tremor, palpitations and feeling of nervousness.

  8. Time to Resolution of Neuroglycopenic Symptoms

    Time frame · 0 to 180 minutes post dose

    Registry description

    Time from administration of glucagon to complete resolution of 4 neuroglycopenic symptoms of hypoglycemia. Four symptoms were assessed: dizziness, blurred vision, difficulty in thinking and faintness.

  9. Time to Resolution of the Feeling of Hypoglycemia

    Time frame · 0 to 180 minutes post dose

    Registry description

    Time from administration of glucagon to resolution of the overall sensation of hypoglycemia. Subjects were asked to answer yes/no to the question, "Do you feel hypoglycemic?" The time point as which the subject first answered "no" was considered the time of resolution.

  10. Glucose AUC

    Time frame · 0 to 180 minutes post dose - Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose.

    Registry description

    Area under the curve for plasma glucose.

  11. Glucose Cmax

    Time frame · 0 to 180 minutes post dose - Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose.

    Registry description

    Maximum concentration of plasma glucose.

  12. Glucose Tmax

    Time frame · 0 to 180 minutes post dose

    Registry description

    Time to maximum concentration of plasma glucose. Blood samples for assessment of blood glucose concentration were collected every 5 minutes post-dose to 90 minutes, and then at 120, 150 and 180 minutes post dose.

  13. Glucagon Preparation and Administration Time

    Time frame · 0 to 5 minutes pre-dose

    Registry description

    Time required to prepare and inject glucagon as measured between a "decision to dose" and completion of the injection

Posted results

Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.

Primary outcome results

Primary outcomeCount of participants· 0 to 30 minutes post dose

Number of Subjects With a Positive Glucose Response

GroupValue (Participants)
G-Pen76
Lilly Glucagon78
Secondary and other outcome results(7)
Secondary outcomeMean· 0 to 180 minutes post dose

Time for Positive Glucose Response

GroupValue (minutes)Spread
G-Pen12.173.604
Lilly Glucagon8.582.026
Secondary outcomeCount of participants· 0 to 30 minutes post dose

Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Positive Glucose Increase

GroupValue (Participants)
G-Pen76
Lilly Glucagon78
Secondary outcomeCount of participants· 0 to 30 minutes post dose

Number of Subjects With a Positive Glucose Increase

GroupValue (Participants)
G-Pen76
Lilly Glucagon78
Secondary outcomeMean· 0 to 180 minutes post dose

Time for Positive Glucose Increase

GroupValue (minutes)Spread
G-Pen11.363.345
Lilly Glucagon8.021.856
Secondary outcomeCount of participants· 0 to 30 minutes post dose

Number of Subjects With a Positive Response for the Combination Endpoint: Positive Glucose Response/Relief of Neuroglycopenic Symptoms

GroupValue (Participants)
G-Pen76
Lilly Glucagon78
Secondary outcomeCount of participants· 0 to 30 minutes post dose

Number of Subjects With Relief of Neuroglycopenic Symptoms

GroupValue (Participants)
G-Pen74
Lilly Glucagon77
Secondary outcomeMean· 0 to 180 minutes post dose

Time to Resolution of Autonomic Symptoms

GroupValue (minutes)Spread
G-Pen13.810.89
Lilly Glucagon12.07.44

Adverse events, as posted

Adverse events as posted: participants affected out of participants at risk, by group
GroupDeathsSerious eventsOther events
G-PenG-Pen: 1 mg subcutaneous injection of G-Pen (glucagon injection) administered via auto-injector. Between the 2 arms, a total of 76 subjects received a dose of G-Pen in the study.0 / 760 / 7646 / 76
Lilly GlucagonLilly Glucagon: 1 mg subcutaneous injection of Lilly Glucagon (glucagon injection \[RNDA Origin\]). Between the 2 arms, a total of 78 subjects received a dose of Lilly Glucagon in the study.0 / 780 / 7834 / 78

Each cell reads participants affected / participants at risk, as the registry posted them.

Registry data comes from ClinicalTrials.gov. Study results come from studies, not from the registry. How PepBank works

Studies1

Studies that cite this trial.

Studies with results

1 study on this page

Indexing hint: Randomized controlled trial · 2021

5 results

Comparison of a ready-to-use liquid glucagon injection administered by autoinjector to glucagon emergency kit for the symptomatic relief of severe hypoglycemia: two randomized crossover non-inferiority studies.

Christiansen et al. 2021BMJ open diabetes research & carecited by 19

PMID 34620618PMC8499286DOI 10.1136/bmjdrc-2021-002137PUB-34620618

Free to read · publisher termsCC BY-NC5 results

Eligibility

Who could join, as posted.

Sex
All
Age
from 18 Years up to 75 Years
Healthy volunteers
Not accepted
Inclusion and exclusion criteria, as posted
Inclusion Criteria: 1. Males and females diagnosed with type 1 diabetes mellitus for at least 24 months. 2. Current usage of daily insulin treatment that includes having an assigned "correction factor" for managing hyperglycemia. 3. Age 18-75 years, inclusive. 4. Random serum C-peptide concentration \< 0.5 ng/mL. 5. Willingness to follow all study procedures, including attending all clinic visits. 6. Subject has provided informed consent as evidenced by a signed/dated informed consent form completed before any trial-related activities occur. Exclusion Criteria: 1. Pregnancy: For women of childbearing potential, there is a requirement for a negative urine pregnancy test and for agreement to use contraception throughout the study and for 7 days after the last dose of study glucagon. Acceptable contraception includes birth control pill / patch / vaginal ring, Depo-Provera, Norplant, an IUD, the double barrier method (the woman uses a diaphragm and spermicide and the man uses a condom), or abstinence. 2. Breastfeeding: Nursing mothers will be allowed into the study. However, breast feeding during the during inpatient study visits and for 48 hours after each dose of study drug is not allowed. 3. HbA1c \>9.0% at Screening. 4. BMI \> 40 kg/m2. 5. Renal insufficiency (serum creatinine greater than 3.0 mg/dL) or end-stage renal disease. requiring renal replacement therapy. 6. Serum ALT or AST equal to or greater than 3 times the upper limit of normal. 7. Hepatic synthetic insufficiency as defined as a serum albumin of less than 3.0 g/dL. 8. Hematocrit of less than or equal to 30%. 9. BP readings at Screening where SBP \<90 or \>150 mm Hg, and DBP \<50 or \>100 mm Hg. 10. Clinically significant ECG abnormalities. 11. Use of \> 2.0 U/kg total insulin dose per day. 12. Inadequate venous access. 13. Congestive heart failure, NYHA class III or IV. 14. History of myocardial infarction, unstable angina, or revascularization within the past 6 months. 15. History of a cerebrovascular accident in past 6 months or with major neurological deficits. 16. Active malignancy within 5 years from Screening, except basal cell or squamous cell skin cancers. History of breast cancer or malignant melanoma will be exclusionary. 17. Major surgical operation within 30 days prior to Screening. 18. Current seizure disorder (other than with suspect or documented hypoglycemia). 19. Current bleeding disorder, treatment with warfarin, or platelet count below 50 x 10e9 per liter. 20. History of pheochromocytoma or disorder with increased risk of pheochromocytoma (MEN 2, neurofibromatosis, or Von Hippel-Lindau disease). 21. History of insulinoma. 22. History of allergies to glucagon or glucagon-like products, or any history of significant hypersensitivity to glucagon or any related products or to any of the excipients (DMSO \& trehalose) in the investigational formulation. 23. History of glycogen storage disease. 24. Subject tests positive for HIV, HCV or HBV infection (HBsAg+) at Screening. 25. Active substance or alcohol abuse (more than 21 drinks/wk. for males or 14 drinks/wk. for females). Subjects reporting active marijuana use or testing positive for tetrahydrocannabinol (THC) via rapid urine test will be allowed to participate in the study at the discretion of the Investigator. 26. Administration of glucagon within 28 days of Screening. 27. Participation in other studies involving administration of an investigational drug or device within 30 days or 5 half-lives, whichever is longer, before Screening for the current study and during participation in the current study. 28. Any reason the Investigator deems exclusionary.

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