Trial Outcomes & Findings for 24/7 Closed-loop in Older Subjects With Type 1 Diabetes (NCT NCT04025762)

NCT ID: NCT04025762

Last Updated: 2024-12-06

Results Overview

Proportion of time spent in the target glucose range from 3.9 to 10.0 mmol/l (70 to 180mg/dl) based on continuous glucose monitoring (CGM)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

38 participants

Primary outcome timeframe

16 weeks

Results posted on

2024-12-06

Participant Flow

One participant withdrew during the run-in period

Participant milestones

Participant milestones
Measure
Initial Use of Day and Night Hybrid Closed Loop Control Followed by Sensor Augmented Pump Therapy
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Initial Use of Sensor Augmented Pump Therapy Followed by Day and Night Hybrid Closed-loop Control
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Run-in (3-4 Weeks)
STARTED
20
17
Run-in (3-4 Weeks)
COMPLETED
20
17
Run-in (3-4 Weeks)
NOT COMPLETED
0
0
Crossover Study Period 1 (16 Weeks)
STARTED
20
17
Crossover Study Period 1 (16 Weeks)
COMPLETED
20
16
Crossover Study Period 1 (16 Weeks)
NOT COMPLETED
0
1
Washout Period (4 Weeks)
STARTED
20
16
Washout Period (4 Weeks)
COMPLETED
20
16
Washout Period (4 Weeks)
NOT COMPLETED
0
0
Crossover Study Period 2 (16 Weeks)
STARTED
20
16
Crossover Study Period 2 (16 Weeks)
COMPLETED
20
16
Crossover Study Period 2 (16 Weeks)
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Initial Use of Day and Night Hybrid Closed Loop Control Followed by Sensor Augmented Pump Therapy
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Initial Use of Sensor Augmented Pump Therapy Followed by Day and Night Hybrid Closed-loop Control
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Crossover Study Period 1 (16 Weeks)
Death
0
1

Baseline Characteristics

24/7 Closed-loop in Older Subjects With Type 1 Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Initial Use of Day and Night Hybrid Closed Loop Control Followed by Sensor Augmented Pump Therapy
n=20 Participants
Run-in period (3-4 weeks) 16 weeks of day and night hybrid closed-loop system (CamAPS FX) consisting of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system Washout period (4 weeks)
Initial Use of Sensor Augmented Pump Therapy Followed by Day and Night Hybrid Closed Loop Control
n=17 Participants
Run-in period (3-4 weeks) 16 weeks of the comparator consisting of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy Washout period (4 weeks) 16 weeks of day and night hybrid closed-loop system (CamAPS FX) consisting of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Total
n=37 Participants
Total of all reporting groups
Age, Continuous
68 years
n=5 Participants
67 years
n=7 Participants
68 years
n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
8 Participants
n=7 Participants
16 Participants
n=5 Participants
Sex: Female, Male
Male
12 Participants
n=5 Participants
9 Participants
n=7 Participants
21 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
20 Participants
n=5 Participants
17 Participants
n=7 Participants
37 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United Kingdom
16 Participants
n=5 Participants
15 Participants
n=7 Participants
31 Participants
n=5 Participants
Region of Enrollment
Austria
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Duration of diabetes
38 years
n=5 Participants
38 years
n=7 Participants
38 years
n=5 Participants
Duration of pump therapy
11 years
n=5 Participants
9 years
n=7 Participants
10 years
n=5 Participants
Charlson comorbidity index (lower value indicates less comorbidity burden)
4 points on a scale (minimum 0 maximum 37)
STANDARD_DEVIATION 2 • n=5 Participants
4 points on a scale (minimum 0 maximum 37)
STANDARD_DEVIATION 1 • n=7 Participants
4 points on a scale (minimum 0 maximum 37)
STANDARD_DEVIATION 1 • n=5 Participants
Continuous glucose monitor user
13 participants
n=5 Participants
12 participants
n=7 Participants
25 participants
n=5 Participants
HbA1c, mmol/mol
58 mmol/mol
STANDARD_DEVIATION 10 • n=5 Participants
57 mmol/mol
STANDARD_DEVIATION 9 • n=7 Participants
57 mmol/mol
STANDARD_DEVIATION 10 • n=5 Participants
HbA1c, %
7.5 % of glycated hemoglobin
STANDARD_DEVIATION 1.0 • n=5 Participants
7.4 % of glycated hemoglobin
STANDARD_DEVIATION 0.9 • n=7 Participants
7.4 % of glycated hemoglobin
STANDARD_DEVIATION 0.9 • n=5 Participants
Total daily insulin, units per day
45.8 units/day
n=5 Participants
40.0 units/day
n=7 Participants
45.1 units/day
n=5 Participants

PRIMARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Proportion of time spent in the target glucose range from 3.9 to 10.0 mmol/l (70 to 180mg/dl) based on continuous glucose monitoring (CGM)

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Proportion of Time Spent in the Target Sensor Glucose Range During the 16 Week Intervention Period (%)
79.9 % of time
Standard Deviation 7.9
71.4 % of time
Standard Deviation 13.2

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
HbA1c at the End of the 16 Week Intervention Period (mmol/Mol)
49.3 mmol/mol
Standard Deviation 7.9
52.1 mmol/mol
Standard Deviation 9.2

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Proportion of Time Spent Below Target Glucose (3.9mmol/l) (70mg/dl) Based on CGM During the 16 Week Intervention Period (%)
1.7 % of time
Interval 1.3 to 2.4
1.7 % of time
Interval 0.9 to 2.7

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Proportion of Time Spent Above Target Glucose (10.0 mmol/l) (180 mg/dl) Based on CGM During the 16 Week Intervention Period (%)
16.7 % of time
Interval 11.4 to 23.9
21.4 % of time
Interval 16.9 to 36.5

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Average (mmol/L) of CGM Glucose Levels During the 16 Week Intervention Period
7.8 mmol/L
Standard Deviation 0.7
8.5 mmol/L
Standard Deviation 1.1

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Proportion of Time With Glucose Levels < 3.5 mmol/l (63mg/dl) Based on CGM During the 16 Week Intervention Period (%)
0.7 % of time
Interval 0.5 to 1.1
0.7 % of time
Interval 0.4 to 1.2

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Proportion of Time With Glucose Levels in the Significant Hyperglycaemia (Glucose Levels > 16.7 mmol/l) (300mg/dl) Based on CGM During the 16 Week Intervention Period (%)
0.5 % of time
Interval 0.2 to 0.8
0.8 % of time
Interval 0.2 to 2.8

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Total Daily Insulin Dose During the 16 Week Intervention Period (Units/Day)
46.3 units/day
Interval 36.9 to 53.5
42.9 units/day
Interval 36.6 to 53.0

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Standard Deviation (mmol/L) of CGM Glucose Levels During the 16 Week Intervention Period
2.6 mmol/L
Standard Deviation 0.5
2.8 mmol/L
Standard Deviation 0.6

SECONDARY outcome

Timeframe: 16 weeks

Population: Crossover study design

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
n=37 Participants
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
Proportion of Time With Glucose Levels < 3.0 mmol/l (54mg/dl) Based on CGM During the 16 Week Intervention Period (%)
0.2 % of time
Interval 0.1 to 0.3
0.2 % of time
Interval 0.1 to 0.3

OTHER_PRE_SPECIFIED outcome

Timeframe: 16 weeks

Population: Closed-loop use was only measured during the closed-loop period.

Utility evaluation

Outcome measures

Outcome measures
Measure
Day and Night Hybrid Closed Loop Control
n=36 Participants
The day and night hybrid closed-loop system (CamAPS FX) will consist of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm Hybrid closed-loop system (CamAPS FX): Hybrid closed-loop system
Sensor Augmented Pump Therapy
The comparator will consist of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom) Sensor augmented pump therapy: Sensor augmented pump therapy
The Proportion of Time of Use of the Closed-loop System at Home During the 16 Week Intervention Period (%)
96.7 % of time
Interval 95.1 to 98.0

OTHER_PRE_SPECIFIED outcome

Timeframe: 5-7 days

Holter monitor data at the fourth month in the two treatment groups

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 14 days

Sleep quality assessment using data collected by Actiwatch

Outcome measures

Outcome data not reported

Adverse Events

Day and Night Hybrid Closed Loop Control

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Sensor Augmented Pump Therapy

Serious events: 1 serious events
Other events: 7 other events
Deaths: 1 deaths

Run-in Period

Serious events: 1 serious events
Other events: 2 other events
Deaths: 0 deaths

Washout Period

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Day and Night Hybrid Closed Loop Control
n=36 participants at risk
16 weeks of the day and night hybrid closed-loop system (CamAPS FX) which consists of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm
Sensor Augmented Pump Therapy
n=37 participants at risk
16 weeks of the comparator which consists of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom)
Run-in Period
n=37 participants at risk
3-4 week run-in period with Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom)
Washout Period
n=36 participants at risk
4 week washout period between treatment periods when participants could continue to use the study devices with auto mode disabled or they could continue to use their pre-study devices
Cardiac disorders
Death
0.00%
0/36 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
2.7%
1/37 • Number of events 1 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
0.00%
0/37 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
0.00%
0/36 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
Endocrine disorders
Unplanned hospital admission
0.00%
0/36 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
0.00%
0/37 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
2.7%
1/37 • Number of events 1 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
0.00%
0/36 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.

Other adverse events

Other adverse events
Measure
Day and Night Hybrid Closed Loop Control
n=36 participants at risk
16 weeks of the day and night hybrid closed-loop system (CamAPS FX) which consists of: * Dana RS insulin pump (Sooil) * G6 real-time CGM sensor (Dexcom) * An unlocked android smartphone hosting the CamAPS FX app with Cambridge control algorithm
Sensor Augmented Pump Therapy
n=37 participants at risk
16 weeks of the comparator which consists of Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom)
Run-in Period
n=37 participants at risk
3-4 week run-in period with Dana RS insulin pump (Sooil) and G6 real-time CGM sensor (Dexcom)
Washout Period
n=36 participants at risk
4 week washout period between treatment periods when participants could continue to use the study devices with auto mode disabled or they could continue to use their pre-study devices
General disorders
Other
11.1%
4/36 • Number of events 6 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
18.9%
7/37 • Number of events 9 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
5.4%
2/37 • Number of events 2 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.
2.8%
1/36 • Number of events 1 • Safety evaluation comprised the frequency of severe hypoglycaemia and diabetic ketoacidosis, and other adverse events or serious adverse events. Data were collected from recruitment until the final study visit, up to 10 months.
Crossover study design Adverse events reported during the run-in period (pre-randomization) are reported for the whole study cohort and not by group as this was not determined at the time of the adverse event.

Additional Information

Dr Charlotte Boughton

University of Cambridge

Phone: +441223769066

Results disclosure agreements

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