Trial Outcomes & Findings for Feasibility Trial Testing the Bionic Pancreas With ZP4207 (NCT NCT02971228)

NCT ID: NCT02971228

Last Updated: 2021-03-23

Results Overview

Safety and tolerability of ZP4207 in the BP using either the iPhone or the iLet platform, as measured by adverse events (AEs), local tolerability of infusion site reactions, and clinical laboratory parameters. See adverse events section for results on AEs by system organ class and preferred term. Clinical laboratory parameters in terms of overall 'investigations' AEs and abnormal hematology parameters that did not resolve by the follow-up visit are presented below. LLN = lower limit of the normal range. Investigations and vital signs AEs by preferred term are presented in the AE section. Participants with infusion site pain and nausea measured by visual analog scales (VAS) are presented below; mean values are presented under secondary outcomes. For the VAS, individuals marked on a 10-cm line corresponding to the amount of pain or nausea being experienced, with low scores (cm) indicating no feelings of pain or nausea and high scores (cm) indicating high feelings of pain or nausea.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

13 participants

Primary outcome timeframe

Up to 50 days

Results posted on

2021-03-23

Participant Flow

In Part 1, it was planned to enrol 10 patients in two 1-day treatment arms in random order (iPhone-based bionic pancreas using ZP4207 or Lilly Glucagon) according to a pre-generated randomization scheme. The trial had a crossover design. In all, 19 patients were screened and 13 were randomized, but 1 patient withdrew before treatment. Thus, 12 patients were randomized and treated.

Part 2 was designed to enroll up to 10 new patients in two 1-day treatment arms in random order (iLet using ZP4207 or Lilly Glucagon). However, due to unavailability of the iLet, the sponsor decided to stop the trial upon completion of Part 1. Part 2 of the trial using the iLet was consequently not conducted.

Participant milestones

Participant milestones
Measure
Part 1 Lilly Glucagon or ZP4207
1 patient was enrolled but withdrew prior to treatment with either trial drug
Part 1, Lilly Glucagon Then ZP4207
7 patients received Lilly Glucagon then ZP4207 in this treatment sequence (2 withdrew before receiving ZP4207). Insulin Lispro was also administered in both treatment arms. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration. iPhone-based bionic pancreas: An experimental device.
Part 1, ZP4207 Then Lilly Glucagon
5 patients received ZP4207 then Lilly Glucagon in this treatment sequence. Insulin Lispro was also administered in both treatment arms. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration. iPhone-based bionic pancreas: An experimental device.
Part 2, ZP4207 Then Lilly Glucagon
Part 2 of the trial was not conducted - see above.
Part 2, Lilly Glucagon Then ZP4207
Part 2 of the trial was not conducted - see above.
Overall Study
STARTED
1
7
5
0
0
Overall Study
Randomized and Treated
0
7
5
0
0
Overall Study
COMPLETED
0
5
5
0
0
Overall Study
NOT COMPLETED
1
2
0
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Part 1 Lilly Glucagon or ZP4207
1 patient was enrolled but withdrew prior to treatment with either trial drug
Part 1, Lilly Glucagon Then ZP4207
7 patients received Lilly Glucagon then ZP4207 in this treatment sequence (2 withdrew before receiving ZP4207). Insulin Lispro was also administered in both treatment arms. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration. iPhone-based bionic pancreas: An experimental device.
Part 1, ZP4207 Then Lilly Glucagon
5 patients received ZP4207 then Lilly Glucagon in this treatment sequence. Insulin Lispro was also administered in both treatment arms. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration. iPhone-based bionic pancreas: An experimental device.
Part 2, ZP4207 Then Lilly Glucagon
Part 2 of the trial was not conducted - see above.
Part 2, Lilly Glucagon Then ZP4207
Part 2 of the trial was not conducted - see above.
Overall Study
Withdrawal by Subject
1
1
0
0
0
Overall Study
Logistical challenges
0
1
0
0
0

Baseline Characteristics

Feasibility Trial Testing the Bionic Pancreas With ZP4207

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Part 1, All Participants
n=12 Participants
In Part 1, 12 patients participated in 1-day treatment arms in random order (iPhone-based Bionic Pancreas using Lilly glucagon and iPhone-based Bionic Pancreas using ZP4207 (dasiglucagon) {experimental drug} with insulin lispro) according to pre-generated randomization scheme. Note: 13 patients were enrolled and 1 patient withdrew prior to treatment with either trial drug; thus, 12 patients were randomized and treated. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Age, Continuous
42.5 Years
STANDARD_DEVIATION 18.47 • n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
10 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 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
0 Participants
n=5 Participants
Race (NIH/OMB)
White
11 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Region of Enrollment
United States
12 participants
n=5 Participants
Body weight
80.28 kg
STANDARD_DEVIATION 18.357 • n=5 Participants
BMI
27.36 kg/m^2
STANDARD_DEVIATION 5.301 • n=5 Participants
Diabetes duration
28.2 years
STANDARD_DEVIATION 14.72 • n=5 Participants
HbA1c
7.18 %
STANDARD_DEVIATION 1.462 • n=5 Participants

PRIMARY outcome

Timeframe: Up to 50 days

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Safety and tolerability of ZP4207 in the BP using either the iPhone or the iLet platform, as measured by adverse events (AEs), local tolerability of infusion site reactions, and clinical laboratory parameters. See adverse events section for results on AEs by system organ class and preferred term. Clinical laboratory parameters in terms of overall 'investigations' AEs and abnormal hematology parameters that did not resolve by the follow-up visit are presented below. LLN = lower limit of the normal range. Investigations and vital signs AEs by preferred term are presented in the AE section. Participants with infusion site pain and nausea measured by visual analog scales (VAS) are presented below; mean values are presented under secondary outcomes. For the VAS, individuals marked on a 10-cm line corresponding to the amount of pain or nausea being experienced, with low scores (cm) indicating no feelings of pain or nausea and high scores (cm) indicating high feelings of pain or nausea.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with AEs
8 Participants
12 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with antibodies
0 Participants
0 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with edema infusion site reactions
0 Participants
0 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with erythema infusion site reactions
0 Participants
0 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with investigations AEs
2 Participants
2 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with erythrocytes <LLN
0 Participants
1 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with hematocrit <LLN
0 Participants
1 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with hemoglobin <LLN
0 Participants
2 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with lymphocytes <LLN
0 Participants
1 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with infusion site pain (VAS)
0 Participants
2 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with nausea (VAS)
4 Participants
2 Participants
Safety and Tolerability as Measured by Adverse Events, Local Tolerability of Infusion Site Reactions, and Clinical Laboratory Parameters
Participants with vascular disorders
1 Participants
1 Participants

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

The VAS scale was used to measure pain at the end of the visit (16 hours) for patients in both treatment groups. The VAS was a psychometric response scale used to measure subjective characteristics of pain. Patients marked a location on a 0 to 10-cm line that corresponded to the amount of pain being experienced, with low scores (cm) indicating no feelings of pain and high scores (cm) indicating high feelings of pain. Actual values are shown. The maximum value in the Lilly glucagon group was recorded at hour 3.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Pain Measured on a Visual Analog Scale (VAS)
Baseline
0.00 cm
Standard Deviation 0.00
0.01 cm
Standard Deviation 0.0029
Pain Measured on a Visual Analog Scale (VAS)
Hour 1
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Pain Measured on a Visual Analog Scale (VAS)
Hour 2
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Pain Measured on a Visual Analog Scale (VAS)
Hour 3
0.00 cm
Standard Deviation 0.00
0.06 cm
Standard Deviation 0.202
Pain Measured on a Visual Analog Scale (VAS)
Hour 4
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Pain Measured on a Visual Analog Scale (VAS)
Hour 5
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Pain Measured on a Visual Analog Scale (VAS)
Hour 6
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Pain Measured on a Visual Analog Scale (VAS)
Hour 7
0.00 cm
Standard Deviation 0.00
0.02 cm
Standard Deviation 0.058
Pain Measured on a Visual Analog Scale (VAS)
Visit end (16 hours)
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

The VAS scale was used to measure nausea at the end of the visit (16 hours) for patients in both treatment groups. The VAS was a psychometric response scale used to measure subjective characteristics of nausea. Patients marked a location on a 0 to 10-cm line that corresponded to the amount of nausea being experienced, with low scores (cm) indicating no feelings of nausea and high scores (cm) indicating high feelings of nausea. Actual values are shown. The maximum values in both groups were recorded at hour 6, the start of the exercise period.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Nausea Measured on a Visual Analog Scale (VAS)
Baseline
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Nausea Measured on a Visual Analog Scale (VAS)
Hour 1
0.12 cm
Standard Deviation 0.379
0.00 cm
Standard Deviation 0.00
Nausea Measured on a Visual Analog Scale (VAS)
Hour 2
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Nausea Measured on a Visual Analog Scale (VAS)
Hour 3
0.11 cm
Standard Deviation 0.348
0.04 cm
Standard Deviation 0.144
Nausea Measured on a Visual Analog Scale (VAS)
Hour 4
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Nausea Measured on a Visual Analog Scale (VAS)
Hour 5
0.02 cm
Standard Deviation 0.063
0.09 cm
Standard Deviation 0.215
Nausea Measured on a Visual Analog Scale (VAS)
Hour 6
0.29 cm
Standard Deviation 0.917
0.18 cm
Standard Deviation 0.522
Nausea Measured on a Visual Analog Scale (VAS)
Hour 7
0.00 cm
Standard Deviation 0.00
0.00 cm
Standard Deviation 0.00
Nausea Measured on a Visual Analog Scale (VAS)
Visit end (16 hours)
0.11 cm
Standard Deviation 0.348
0.00 cm
Standard Deviation 0.00

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Measure glycemic regulation, including hypoglycemia exposure (percent of time spent with continuous glucose monitor \[CGM\] glucose\<60mg/dL)

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Glycemic Regulation
12.78 percentage of time points
Standard Deviation 17.262
17.60 percentage of time points
Standard Deviation 14.080

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Secondary endpoint of bionic pancreas function, presented by treatment group. The analysis of bionic pancreas function endpoints was on an intention-to-treat basis.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Average Percent Glucagon Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.
96.73 Percentage of treatment delivered
Standard Deviation 4.021
97.01 Percentage of treatment delivered
Standard Deviation 2.851

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Secondary endpoint of bionic pancreas function, presented by treatment group. The analysis of bionic pancreas function endpoints was on an intention-to-treat basis.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Average Percent Insulin Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.
98.36 Percentage of treatment delivered
Standard Deviation 1.114
97.73 Percentage of treatment delivered
Standard Deviation 2.051

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Secondary endpoint of bionic pancreas function, presented by treatment group. The analysis of bionic pancreas function endpoints was on an intention-to-treat basis.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Average Percentage of Time During Which the Bionic Pancreas is Functioning Nominally in All Respects Based on Real-time Continuous Glucose Monitoring (CGM) Data
95.41 percentage of time functioning nominally
Standard Deviation 1.846
94.26 percentage of time functioning nominally
Standard Deviation 3.966

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Secondary endpoint of bionic pancreas function, presented by treatment group. The analysis of bionic pancreas function endpoints was on an intention-to-treat basis.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Average Percentage of Time During Which the Bionic Pancreas is Functioning Nominally With or Without a New CGM Glucose Reading Captured
97.86 percentage of time functioning nominally
Standard Deviation 1.125
96.31 percentage of time functioning nominally
Standard Deviation 3.891

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Secondary endpoint of bionic pancreas function, presented by treatment group. The analysis of bionic pancreas function endpoints was on an intention-to-treat basis.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
CGM Reliability Index, Calculated as Percentage of Possible Values Actually Recorded by CGM
97.55 percentage of recorded values
Standard Deviation 1.219
97.94 percentage of recorded values
Standard Deviation 1.076

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Secondary endpoint of bionic pancreas function, presented by treatment group. The analysis of bionic pancreas function endpoints was on an intention-to-treat basis.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
CGM Mean Absolute Relative Difference Versus Time-stamped Blood Glucose (BG) Values From Meter Download
12.6 mg/dL
Standard Deviation 4.13
12.7 mg/dL
Standard Deviation 5.43

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Technical faults in terms of calibration issues were listed by patient.

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Number of Patients With Technical Faults Associated With the BP Including Cause and Resolution: Calibration Issues
9 Participants
11 Participants

SECONDARY outcome

Timeframe: 16 hours

Population: The full analysis set (intent-to-treat population) consisted of all randomized patients: 10 patients received ZP4207 treatment and 12 patients received Lilly Glucagon treatment in a crossover design. Results are presented by treatment received. Only Part 1 of the trial was conducted.

Technical faults related to connectivity issues were listed

Outcome measures

Outcome measures
Measure
Part 1, ZP4207
n=10 Participants
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 Participants
In Part 1, 12 patients received treatment with Lilly glucagon in the iPhone-based Bionic Pancreas with insulin lispro according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Number of Patients With Technical Faults Associated With the BP Including Cause and Resolution: Connectivity Issues
3 Participants
2 Participants

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 3 months

Population: This questionnaire was not assessed as per protocol amendment 7.

This questionnaire was not assessed as per protocol amendment 7.

Outcome measures

Outcome data not reported

Adverse Events

Part 1, ZP4207

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Part 1, Lilly Glucagon

Serious events: 0 serious events
Other events: 12 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Part 1, ZP4207
n=10 participants at risk
In Part 1, 10 patients received treatment with ZP4207 (dasiglucagon) {experimental drug} with insulin lispro in the iPhone-based Bionic Pancreas according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. ZP4207 (dasiglucagon): A glucagon analog not yet approved by the FDA. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Part 1, Lilly Glucagon
n=12 participants at risk
In Part 1, 12 patients received treatment with Lilly glucagon and insulin lispro in the iPhone-based Bionic Pancreas according to a pre-generated randomization scheme. Insulin Lispro: Used to lower blood glucose. Commercially available by prescription and is indicated for patients with T1DM, but not for use in a bionic pancreas. Individualized dose based on metabolic needs and frequent monitoring of blood glucose. Glucagon: A hormone normally made by the pancreas to raise blood glucose. Used to treat low blood sugar. Commercially available by prescription and is indicated for patients with T1DM in severe hypoglycemia, but not for use in a BP. Subcutaneous administration in one BP arm. iPhone-based bionic pancreas: An experimental device.
Cardiac disorders
Bradycardia
0.00%
0/10 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Cardiac disorders
Palpitations
10.0%
1/10 • Number of events 1 • Up to 50 days
0.00%
0/12 • Up to 50 days
Ear and labyrinth disorders
Tinnitus
0.00%
0/10 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Gastrointestinal disorders
Nausea
50.0%
5/10 • Number of events 5 • Up to 50 days
16.7%
2/12 • Number of events 3 • Up to 50 days
Gastrointestinal disorders
Vomiting
10.0%
1/10 • Number of events 1 • Up to 50 days
0.00%
0/12 • Up to 50 days
General disorders
Infusion site pain
10.0%
1/10 • Number of events 1 • Up to 50 days
16.7%
2/12 • Number of events 5 • Up to 50 days
General disorders
Asthenia
10.0%
1/10 • Number of events 1 • Up to 50 days
0.00%
0/12 • Up to 50 days
Investigations
Neutrophil count increased
20.0%
2/10 • Number of events 3 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Investigations
White blood cell count increased
20.0%
2/10 • Number of events 2 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Investigations
Blood glucose decreased
10.0%
1/10 • Number of events 1 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Investigations
Lymphocyte count increased
10.0%
1/10 • Number of events 1 • Up to 50 days
0.00%
0/12 • Up to 50 days
Metabolism and nutrition disorders
Hypoglycemia
60.0%
6/10 • Number of events 14 • Up to 50 days
75.0%
9/12 • Number of events 20 • Up to 50 days
Nervous system disorders
Lethargy
10.0%
1/10 • Number of events 1 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Skin and subcutaneous tissue disorders
Hyperhidrosis
0.00%
0/10 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Skin and subcutaneous tissue disorders
Rash
0.00%
0/10 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Vascular disorders
Orthostatic hypotension
10.0%
1/10 • Number of events 1 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days
Vascular disorders
Hypotension
0.00%
0/10 • Up to 50 days
8.3%
1/12 • Number of events 1 • Up to 50 days

Additional Information

Kim Mark Knudsen

Zealand Pharma A/S

Phone: +45 5060 3780

Results disclosure agreements

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