A Phase 3 interventional study of Nasal Glucagon (NG) and Glucagon IM in Drug-specific Antibodies and Diabetes Mellitus, sponsored by Eli Lilly and Company. Completed at 1 site in Canada. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2019-09-06.
Sponsored by Eli Lilly and Company · Phase 3, Interventional, and Other
This study provides information on immunogenicity of Nasal Glucagon (AMG504-1) with regards to the potential development of treatment-emergent anti-glucagon antibodies.
This study is a single center, randomized, laboratory-blinded, three periods, parallel design study.
The main objective of this study is to evaluate the immunogenicity of repeated single doses of glucagon following nasal and intramuscular (IM) administration in adults with Type 1 or Type 2 diabetes (T1D or T2D). The secondary objective is to evaluate the safety and tolerability of glucagon following NG and IM administration in adults with T1D or T2D.
A single dose of glucagon was administered in the morning after a 10-hour overnight fast, either by intranasal or intramuscular route, on 3 occasions. Each drug administration was separated by at least seven calendar days. Patients were randomized in a 2:1 ratio (NG:IMG) to receive NG or IMG at each of the 3 periods.
Blood samples were collected for measurement of anti-glucagon antibodies at screening visit, prior to dosing at Period 3, and at the post-study visit (approximately 4 weeks after the last glucagon administration).
10,925 studies on the registry are indexed under Diabetes Mellitus; 1,318 are open to participants now.
This study's enrollment of 75 is close to the median of 80 across 8,367 interventional studies indexed under Diabetes Mellitus.
Browse Diabetes Mellitus studies →Eli Lilly and Company is the lead sponsor of 2,048 studies on the registry; 140 are open to participants now.
Of its 521 completed or terminated interventional studies of FDA-regulated products, 341 (65%) have results posted.
Counted across the registry records on this site, refreshed daily.
A female volunteer must meet one of the following criteria:
Participant is of childbearing potential and agrees to use one of the accepted contraceptive regimens throughout the entire duration of the study (from the screening visit until study completion). Additionally, if the participant is using systemic contraceptives, she must use an additional form of acceptable contraception. An acceptable method of contraception includes one of the following:
or
The informed consent form must be signed by all volunteers, prior to their participation in the study.
Exclusion Criteria:
No participants will be allowed to enroll in this study more than once (i.e. if the study is conducted with more than 1 group).
Glucagon dose of 1 milligram (mg) administered intramuscularly (IM).
Drug: Glucagon IM
Nasal Glucagon (NG) doses of 3 mg administered intra-nasally.
Drug: Nasal Glucagon (NG)
Also known as: Nasal Glucagon, AMG504-1 Dry-Mist Intranasal Glucagon, LY900018
Also known as: GlucaGen® HypoKit
Percentage of Participants With Treatment-emergent Anti-Drug Antibody (ADA)
Glucagon anti-drug antibodies (ADA) were assessed at baseline through study completion. Percentage of participants (Pts) with ADA=(number of Pts with treatment-emergent ADA/number of Pts assessed)\*100. Treatment-Emergent ADA includes treatment-induced ADA and treatment boosted ADA. Treatment-induced is defined as participants with 'Not Detected' ADA at baseline (drug-naive) and at least one post-baseline ADA 'Detected' sample with a corresponding titer that is one 2-fold dilution higher than the MRD (minimal required dilution) of the assay. For the nasal glucagon Tier 1-3 ADA screening assay, the MRD is 1:20. Treatment-boosted is defined as Patient with ADA 'Detected' at baseline (drug-naive) and at least one post-baseline ADA 'Detected' sample with a corresponding titer that is at least (\>or=) 4-fold higher than the baseline titer.
Time frame: Baseline through study completion (up to 10 weeks)
Percentage of Participants With Neutralizing Antibodies
Time frame: Baseline through study completion (up to 10 weeks)
Number of Participants With At Least One Adverse Event
Safety parameters assessed included the occurrence of adverse events, the measurement of clinical laboratory parameters; vital signs, ECGs, physical examination, blood glucose, and examination of the injection site (following the IM administration). An AE was defined as any untoward medical occurrence in a clinical investigation subject administered the investigational product and which did not necessarily have a causal relationship with this treatment A summary of other nonserious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.
Time frame: First dose of study drug through the post-study completion (up to 10 weeks)
| Milestone | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Started | 26 | 49 |
| Completed | 26 | 49 |
| Not completed | 0 | 0 |
| Milestone | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Started | 26 | 49 |
| Completed | 25 | 49 |
| Not completed | 1 | 0 |
| Withdrew: Adverse event | 1 | 0 |
| Milestone | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Started | 25 | 49 |
| Completed | 25 | 48 |
| Not completed | 0 | 1 |
| Withdrew: Adverse event | 0 | 1 |
Glucagon anti-drug antibodies (ADA) were assessed at baseline through study completion. Percentage of participants (Pts) with ADA=(number of Pts with treatment-emergent ADA/number of Pts assessed)\*100. Treatment-Emergent ADA includes treatment-induced ADA and treatment boosted ADA. Treatment-induced is defined as participants with 'Not Detected' ADA at baseline (drug-naive) and at least one post-baseline ADA 'Detected' sample with a corresponding titer that is one 2-fold dilution higher than the MRD (minimal required dilution) of the assay. For the nasal glucagon Tier 1-3 ADA screening assay, the MRD is 1:20. Treatment-boosted is defined as Patient with ADA 'Detected' at baseline (drug-naive) and at least one post-baseline ADA 'Detected' sample with a corresponding titer that is at least (\>or=) 4-fold higher than the baseline titer.
| percentage of participants | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Percentage of Participants With Treatment-emergent Anti-Drug Antibody (ADA) | 0 | 2.0 |
| percentage of participants | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Percentage of Participants With Neutralizing Antibodies | 0 | 0 |
Safety parameters assessed included the occurrence of adverse events, the measurement of clinical laboratory parameters; vital signs, ECGs, physical examination, blood glucose, and examination of the injection site (following the IM administration). An AE was defined as any untoward medical occurrence in a clinical investigation subject administered the investigational product and which did not necessarily have a causal relationship with this treatment A summary of other nonserious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.
| Participants | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Number of Participants With At Least One Adverse Event | 21 | 49 |
Collected over The period of observation of adverse events extended from time of the first dose of study drug until the post-study completion (up to 10 weeks).. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Glucagon IM | — | 0/26 (0%) | 21/26 (80.8%) |
| Nasal Glucagon (NG) | — | 0/49 (0%) | 49/49 (100%) |
| Event | Glucagon IM | Nasal Glucagon (NG) |
|---|---|---|
| Lacrimation increasedEye disorders | 0/26 | 48/49 |
| HeadacheNervous system disorders | 3/26 | 25/49 |
| Ocular hyperaemiaEye disorders | 1/26 | 21/49 |
| RhinorrhoeaRespiratory, thoracic and mediastinal disorders | 0/26 | 21/49 |
| Nasal discomfortRespiratory, thoracic and mediastinal disorders | 0/26 | 20/49 |
| Nasal congestionRespiratory, thoracic and mediastinal disorders | 0/26 | 20/49 |
| Nasal pruritusRespiratory, thoracic and mediastinal disorders | 0/26 | 17/49 |
| Eye pruritusEye disorders | 0/26 | 15/49 |
| NauseaGastrointestinal disorders | 3/26 | 13/49 |
| SneezingRespiratory, thoracic and mediastinal disorders | 0/26 | 12/49 |
All enrolled participants.
| Age, Continuous(years) | Glucagon IM | Nasal Glucagon (NG) | Total |
|---|---|---|---|
| Mean | 42 ± 12 | 43 ± 15 | 43 ± 14 |
| Sex: Female, Male(Participants) | Glucagon IM | Nasal Glucagon (NG) | Total |
|---|---|---|---|
| Female | 6 | 13 | 19 |
| Male | 20 | 36 | 56 |
| Race (NIH/OMB)(Participants) | Glucagon IM | Nasal Glucagon (NG) | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 2 | 2 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 2 | 1 | 3 |
| White | 24 | 44 | 68 |
| More than one race | 0 | 2 | 2 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Region of Enrollment(Participants) | Glucagon IM | Nasal Glucagon (NG) | Total |
|---|---|---|---|
| Canada | 26 | 49 | 75 |
| BMI (Body Mass Index)(kilogram per square metre (kg/m2)) | Glucagon IM | Nasal Glucagon (NG) | Total |
|---|---|---|---|
| Mean | 27.08 ± 4.28 | 27.18 ± 3.93 | 27.15 ± 4.03 |
Plan to share: Yes — Lilly provides access to the individual patient data from studies on approved medicines and indications as defined by the sponsor specific information on ClinicalStudyDataRequest.com. This access is provided in a timely fashion after the primary publication is accepted. Researchers need to have an approved research proposal submitted through ClinicalStudyDataRequest.com. Access to the data will be provided in a secure data sharing environment after signing a data sharing agreement.
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