Trial Outcomes & Findings for A Study To Compare the Effects of Insulin Peglispro and Glargine on Insulin Sensitivity and Meal Time Insulin Requirements in Type 2 Diabetics (NCT NCT02197520)

NCT ID: NCT02197520

Last Updated: 2018-11-01

Results Overview

During the euglycemic 2-step hyperinsulinemic clamp, both low and high insulin was infused sequentially during the same procedure. The 2-step clamp procedure allowed insulin sensitivity to be measured in participants and uses a lower dose of insulin of which the effect is largely on the liver and a high dose of insulin at which the effect has reached 100% on liver and effects are largely on glucose uptake in peripheral tissues. Measurements for average glucose infusion rate are collected for both steps (low and high) of the clamp procedure.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

24 participants

Primary outcome timeframe

Day 33, last 30 minutes (final step) of euglycemic 2-step hyperinsulinemic clamp

Results posted on

2018-11-01

Participant Flow

Participant milestones

Participant milestones
Measure
Sequence AB
A: Insulin peglispro, administered SC for 33 days B. Insulin glargine, administered SC for 33 days
Sequence BA
B. Insulin glargine, administered SC for 33 days A: Insulin peglispro, administered SC for 33 days
Period 1
STARTED
12
12
Period 1
COMPLETED
11
12
Period 1
NOT COMPLETED
1
0
Period 2
STARTED
11
12
Period 2
COMPLETED
10
10
Period 2
NOT COMPLETED
1
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Sequence AB
A: Insulin peglispro, administered SC for 33 days B. Insulin glargine, administered SC for 33 days
Sequence BA
B. Insulin glargine, administered SC for 33 days A: Insulin peglispro, administered SC for 33 days
Period 1
Withdrawal by Subject
1
0
Period 2
Adverse Event
0
2
Period 2
Withdrawal by Subject
1
0

Baseline Characteristics

A Study To Compare the Effects of Insulin Peglispro and Glargine on Insulin Sensitivity and Meal Time Insulin Requirements in Type 2 Diabetics

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Participants
n=24 Participants
All participants who received Insulin peglispro, administered SC for 33 days then Insulin glargine, administered SC for 33 days or Insulin glargine, administered SC for 33 days then Insulin peglispro, administered SC for 33 days
Age, Continuous
51.3 years
STANDARD_DEVIATION 9.1 • n=5 Participants
Sex: Female, Male
Female
9 Participants
n=5 Participants
Sex: Female, Male
Male
15 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
24 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
Race (NIH/OMB)
White
20 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
24 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Day 33, last 30 minutes (final step) of euglycemic 2-step hyperinsulinemic clamp

Population: All participants who received at least 1 dose of study drug and had evaluable PD parameters.

During the euglycemic 2-step hyperinsulinemic clamp, both low and high insulin was infused sequentially during the same procedure. The 2-step clamp procedure allowed insulin sensitivity to be measured in participants and uses a lower dose of insulin of which the effect is largely on the liver and a high dose of insulin at which the effect has reached 100% on liver and effects are largely on glucose uptake in peripheral tissues. Measurements for average glucose infusion rate are collected for both steps (low and high) of the clamp procedure.

Outcome measures

Outcome measures
Measure
Insulin Peglispro
n=21 Participants
Insulin peglispro, a once daily SC
Insulin Glargine
n=22 Participants
Insulin glargine, a once daily SC
Pharmacodynamics (PD): Average Glucose Infusion Rate From Euglycemic 2-step Hyperinsulinemic Clamp (M-value)
High Dose Insulin
59.09 milligram*hour per deciliter
Standard Deviation 10.48
55.52 milligram*hour per deciliter
Standard Deviation 16.50
Pharmacodynamics (PD): Average Glucose Infusion Rate From Euglycemic 2-step Hyperinsulinemic Clamp (M-value)
Low Dose Insulin
17.22 milligram*hour per deciliter
Standard Deviation 6.24
19.67 milligram*hour per deciliter
Standard Deviation 7.61

SECONDARY outcome

Timeframe: Days 30 through 32:Pre-dose, 10, 20, 30, 40, 50, 60, 90, 120, 150, 180, 210, 240, 270, 300 minutes post-breakfast

Population: All participants who received at least 1 dose of study drug and had evaluable PD parameters.

Outcome measures

Outcome measures
Measure
Insulin Peglispro
n=23 Participants
Insulin peglispro, a once daily SC
Insulin Glargine
n=22 Participants
Insulin glargine, a once daily SC
Pharmacodynamics (PD): Plasma Glucose Area Under the Concentration Curve Zero Through 5 Hours (AUC 0-5h), Above Pre Meal Baseline for Insulin Lispro
10% Insulin Lispro Dose
437.78 milligram*hour per deciliter
Standard Deviation 147.47
398.26 milligram*hour per deciliter
Standard Deviation 159.89
Pharmacodynamics (PD): Plasma Glucose Area Under the Concentration Curve Zero Through 5 Hours (AUC 0-5h), Above Pre Meal Baseline for Insulin Lispro
20% Insulin Lispro Dose
334.23 milligram*hour per deciliter
Standard Deviation 165.96
343.54 milligram*hour per deciliter
Standard Deviation 182.13
Pharmacodynamics (PD): Plasma Glucose Area Under the Concentration Curve Zero Through 5 Hours (AUC 0-5h), Above Pre Meal Baseline for Insulin Lispro
30% Insulin Lispro Dose
244.68 milligram*hour per deciliter
Standard Deviation 136.01
239.83 milligram*hour per deciliter
Standard Deviation 175.54

SECONDARY outcome

Timeframe: Days 30 through 32:Pre-dose, 10, 20, 30, 40, 50, 60, 90, 120, 150, 180, 210, 240, 270, 300 minutes post-breakfast

Population: All participants who received at least 1 dose of study drug and had evaluable PK parameters.

Outcome measures

Outcome measures
Measure
Insulin Peglispro
n=21 Participants
Insulin peglispro, a once daily SC
Insulin Glargine
n=21 Participants
Insulin glargine, a once daily SC
Pharmacokinetics (PK): Area Under the Concentration Curve Concentration Curve Zero Through 5 Hours (AUC 0-5h) for Prandial Insulin Lispro
839 picomol*hour per liter
Standard Deviation 47
835 picomol*hour per liter
Standard Deviation 64

SECONDARY outcome

Timeframe: Day 29:Pre-dose, 10, 20, 30, 40, 50, 60, 90, 120, 150, 180, 210, 240, 270, 300 minutes post-breakfast

Population: All participants who received at least 1 dose of study drug and had evaluable PK data.

Outcome measures

Outcome measures
Measure
Insulin Peglispro
n=23 Participants
Insulin peglispro, a once daily SC
Insulin Glargine
n=22 Participants
Insulin glargine, a once daily SC
Pharmacokinetics (PK): Area Under the Concentration Curve Zero Through 5 Hours (AUC 0-5h) for Acetaminophen
33700 nanograms*hour per milliliter
Geometric Coefficient of Variation 28
35700 nanograms*hour per milliliter
Geometric Coefficient of Variation 31

SECONDARY outcome

Timeframe: Day 29:Upon waking, pre-breakfast, 1 hour (hr), 2 hr, 3 hr, 4 hr and 5 hr post breakfast

Population: All participants who received at least 1 dose of study drug and had a VAS score.

VAS was scored from 0 - 100 millimeters (mm) as a perception of appetite and satiety (Flint et al. 2000), 0 being not hungry at all or nothing at all and 100 being extremely hungry and extremely large amount. The questions are abbreviated in table from: How hungry do you feel right now? to Hunger and How much food do you think you could eat right now? to Food amount. Scores were averaged and will be presented and calculated by a sum of the scores dividing by the total by the number of scores reported for timepoints.

Outcome measures

Outcome measures
Measure
Insulin Peglispro
n=21 Participants
Insulin peglispro, a once daily SC
Insulin Glargine
n=21 Participants
Insulin glargine, a once daily SC
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: Waking
30.2 millimeters
Standard Deviation 23.9
34.4 millimeters
Standard Deviation 25.6
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger: Pre-breakfast
41.5 millimeters
Standard Deviation 30.1
51.4 millimeters
Standard Deviation 32.8
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: Pre-breakfast
43.9 millimeters
Standard Deviation 27.7
51.5 millimeters
Standard Deviation 30.2
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger:3 hour Post-breakfast
34.8 millimeters
Standard Deviation 26.5
29.2 millimeters
Standard Deviation 20.8
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger: Waking
25.7 millimeters
Standard Deviation 23.2
38.6 millimeters
Standard Deviation 31.3
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger: 1 hour Post-breakfast
7.8 millimeters
Standard Deviation 12.8
6.2 millimeters
Standard Deviation 16.4
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: 1 hour Post-breakfast
8.7 millimeters
Standard Deviation 12.2
6.0 millimeters
Standard Deviation 11.6
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger: 2 hour Post-breakfast
19.7 millimeters
Standard Deviation 23.5
14.9 millimeters
Standard Deviation 19.4
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: 2 hour Post-breakfast
20.7 millimeters
Standard Deviation 24.2
16.3 millimeters
Standard Deviation 17.4
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: 3 hour Post-breakfast
35.6 millimeters
Standard Deviation 27.3
31.1 millimeters
Standard Deviation 20.6
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger: 4 hour Post-breakfast
46.6 millimeters
Standard Deviation 27.8
48.0 millimeters
Standard Deviation 28.3
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: 4 hour Post-breakfast
48.2 millimeters
Standard Deviation 27.5
48.5 millimeters
Standard Deviation 28.2
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Hunger: 5 hour Post-breakfast
56.8 millimeters
Standard Deviation 28.6
55.5 millimeters
Standard Deviation 34.1
Appetite and Satiety Ratings, as Measured Using Visual Analog Scale (VAS) on Day 29
Food amount: 5 hour Post-breakfast
57.5 millimeters
Standard Deviation 27.2
53.4 millimeters
Standard Deviation 34.4

SECONDARY outcome

Timeframe: Day 33 during euglycemic 2-step hyperinsulinemic clamp

Population: No participant analyzed because Outcome Measure was incorrectly registered.

Outcome measures

Outcome data not reported

Adverse Events

Insulin Peglispro

Serious events: 0 serious events
Other events: 14 other events
Deaths: 0 deaths

Insulin Glargine

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Insulin Peglispro
n=24 participants at risk
Insulin peglispro, a once daily SC
Insulin Glargine
n=23 participants at risk
Insulin glargine, a once daily SC
Blood and lymphatic system disorders
Anaemia
8.3%
2/24 • Number of events 2
4.3%
1/23 • Number of events 1
Gastrointestinal disorders
Constipation
0.00%
0/24
13.0%
3/23 • Number of events 3
Gastrointestinal disorders
Nausea
4.2%
1/24 • Number of events 1
17.4%
4/23 • Number of events 5
General disorders
Catheter site haemorrhage
8.3%
2/24 • Number of events 2
4.3%
1/23 • Number of events 1
General disorders
Catheter site related reaction
12.5%
3/24 • Number of events 3
4.3%
1/23 • Number of events 1
General disorders
Injection site haemorrhage
4.2%
1/24 • Number of events 1
8.7%
2/23 • Number of events 3
General disorders
Vessel puncture site bruise
12.5%
3/24 • Number of events 3
4.3%
1/23 • Number of events 1
Infections and infestations
Upper respiratory tract infection
12.5%
3/24 • Number of events 3
21.7%
5/23 • Number of events 6
Infections and infestations
Urinary tract infection
12.5%
3/24 • Number of events 3
4.3%
1/23 • Number of events 1
Nervous system disorders
Headache
8.3%
2/24 • Number of events 2
13.0%
3/23 • Number of events 3
Skin and subcutaneous tissue disorders
Dermatitis contact
8.3%
2/24 • Number of events 2
0.00%
0/23

Additional Information

Chief Medical Officer

Eli Lilly and Company

Phone: 800-545-5979

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60