Type 1 Diabetes MellitusPhase 4NCT01848990
CONSISTENT 1: Metabolic and Safety Outcomes of Hylenex Recombinant (Hyaluronidase Human Injection) Preadministered at CSII Infusion Site in Participants With Type 1 Diabetes Mellitus (T1DM)
A Phase 4 study testing Commercial Hylenex® recombinant (hyaluronidase human injection), Precommercial Hylenex recombinant (hyaluronidase human injection) and Insulin lispro in people with Type 1 Diabetes Mellitus, run by Halozyme Therapeutics at 39 sites in United States.
Trial summary
The primary objectives of this study are to compare the difference in glycosylated hemoglobin (HbA1c) from baseline to Month 6 using Hylenex recombinant preadministration in continuous subcutaneous insulin infusion (CSII) versus standard CSII and to evaluate the safety of Hylenex recombinant preadministration… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Type 1 Diabetes Mellitus
- What is being tested?
- Commercial Hylenex® recombinant (hyaluronidase human injection), Precommercial Hylenex recombinant (hyaluronidase human injection) and Insulin lispro
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 456 participants
- Where
- 39 sitesUnited States
- Study dates
- Mar 2013to Sep 2014
- Phase
- Phase 4
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or female of age 18 years or older with a history of T1DM for at least 12 months
- Glycosylated hemoglobin (HbA1c) 6.5% to 9.5% (inclusive) based on central laboratory results
- Fasting C-peptide <0.6 nanograms per milliliter (ng/mL)
- Current use of an insulin pump compatible with available tubing for Hylenex recombinant infusion and use of an infusion set compatible with the tubing available or willingness to switch to an infusion set compatible with tubing available for infusion of Hylenex recombinant
- Current treatment at the time of screening with insulin <300 units per day (U/day)
- Participants who routinely use continuous glucose monitoring (CGM) (defined as average CGM use 5 or more days per week over the preceding 3 months) and those who do not routinely used CGM are both eligible for inclusion in the study. Intermittent use of CGM is also acceptable but will not be a criterion use for stratified randomization.
- Participants should be in good general health based on medical history and physical examination, without medical conditions that might prevent the completion of study drug infusions and assessments required in this protocol.
Who cannot join
- Type 2 diabetes
- Known or suspected allergy to any component of any of the study drugs in this study
- Severe proliferative retinopathy or maculopathy, and/or gastroparesis, and/or severe neuropathy, in particular autonomic neuropathy, of such severity as to impede the participant's ability to comply with protocol procedures, as judged by the Investigator
- History of transmural myocardial infarction, congestive heart failure and uncontrolled hypertension (diastolic blood pressure [BP] consistently >100 millimeters of mercury [mmHg]) are exclusionary
- As judged by the Investigator, clinically significant active disease of the gastrointestinal, cardiovascular (including history of stroke, history of arrhythmia, or conduction delays on electrocardiogram [ECG]), hepatic, neurological, renal, genitourinary, pulmonary, or hematological systems of such severity as to impede the participant's ability to comply with protocol procedures
- History of any illness or disease that in the opinion of the Investigator might confound the results of the study or pose additional risk in administering the study drugs to the participant
Show all 12Show fewer
- As judged by the Investigator, clinically significant findings in routine laboratory data at screening
- Use of drugs that may interfere with the interpretation of study results or are known to cause clinically relevant interference with hyaluronidase action, insulin action, glucose utilization, or recovery from hypoglycemia (including systemic pharmacologic corticosteroid). Use of pramlintide or a glucagon-like peptide [GLP]-1 receptor agonist is not exclusionary but participants using these agents will be subjected to stratified randomization. Use of aspirin (acetylsalicylic acid [ASA]) up to 325 milligrams (mg)/day is not exclusionary but should be noted for analysis.
- Hypoglycemic unawareness of such severity as to impede the participant's ability to comply with protocol procedures, as judged by the Investigator.
- Current addiction to alcohol or substance abuse as determined by the Investigator.
- Pregnancy, breast-feeding, the intention of becoming pregnant, or not using adequate contraceptive measures (adequate contraceptive measures consist of sterilization, intra-uterine device [IUD], oral or injectable contraceptives, and/or barrier methods). Abstinence alone is not considered an adequate contraceptive measure for the purposes of this study.
- Mental incapacity, unwillingness, or language barriers precluding adequate understanding or cooperation in this study
Trial locations and contacts
39 sites in 1 country.
39 sites in 1 country
United States39 sites
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Asheville, North Carolina, 28803
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Atlanta, Georgia, 30318
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Aurora, Colorado, 80045
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Austin, Texas, 78731
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Bartlett, Tennessee, 38133
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Butte, Montana, 59701
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Chattanooga, Tennessee, 37411
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Cincinnati, Ohio, 45219
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Concord, California, 94520
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Dallas, Texas, 75231
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Des Moines, Iowa, 50314
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Detroit, Michigan, 48202
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Durham, North Carolina, 27713
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Encino, California, 91436
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Escondido, California, 92026
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Greenbrae, California, 94904
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Henderson, Nevada, 89052
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Hollywood, Florida, 33021
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Hyattsville, Maryland, 20782
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Idaho Falls, Idaho, 83404
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La Jolla, California, 92037
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Las Vegas, Nevada, 89148
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Lexington, Kentucky, 40503
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Madison, Wisconsin, 53717
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Miami, Florida, 33136
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Miami, Florida, 33156
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Minneapolis, Minnesota, 55416
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Morehead City, North Carolina, 28557
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New Hyde Park, New York, 11042
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Olympia, Washington, 98502
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Portland, Oregon, 97210
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Renton, Washington, 98057
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Rockville, Maryland, 20852
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Roswell, Georgia, 30076
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Round Rock, Texas, 78681
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San Antonio, Texas, 78258
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San Mateo, California, 94401
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Seattle, Washington, 98105
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Wichita, Kansas, 67226
About this study
Official title: CONtinuous Subcutaneous Insulin Infusion STudy ENrolling Type 1 (CONSISTENT 1): Evaluation of Metabolic Outcomes and Safety of Hylenex Recombinant (Hyaluronidase Human Injection) Used as a Preadministration Infusion Site Treatment in Subjects With Type 1 Diabetes (T1DM) Using Continuous Subcutaneous Insulin Infusion (CSII)
The primary objectives of this study are to compare the difference in glycosylated hemoglobin (HbA1c) from baseline to Month 6 using Hylenex recombinant preadministration in continuous subcutaneous insulin infusion (CSII) versus standard CSII and to evaluate the safety of Hylenex recombinant preadministration, including local tolerability, adverse events, and hypo- and hyperglycemia rates.
Read the detailed description
This Phase 4 study is designed to demonstrate noninferiority of pretreatment with Hylenex recombinant in the CSII setting to rapid-acting analog insulin alone with respect to glycemic control as assessed by changes in HbA1c in participants with Type 1 diabetes mellitus.
Total duration of study treatment is 24 months. However, according to the study design, the primary outcome measure is to be assessed at 6 months and an interim analysis is to be completed at 6 months for the secondary outcome measures and adverse events. Therefore, data reported in this clinical trials record is for the 6-month interim analysis.
- Conditions
- Type 1 Diabetes Mellitus
- Being tested
- Commercial Hylenex® recombinant (hyaluronidase human injection), Precommercial Hylenex recombinant (hyaluronidase human injection), Insulin lispro, Insulin aspart, Insulin glulisine
- Keywords
- Type 1 Diabetes Mellitus, Sub Cutaneous Insulin Infusion, Rapid Acting Analog Insulin, Hylenex, Halozyme, Phase 4
- Medical subject headings
- Diabetes Mellitus, Type 1
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Commercial Hylenex® recombinant (hyaluronidase human injection)Drug
Also called Formulation 1, Hylenex, Recombinant human hyaluronidase (rHuPH20)
Precommercial Hylenex recombinant (hyaluronidase human injection)Drug
Also called Formulation 2, Hylenex, rHuPH20
Insulin lisproDrug
Also called Humalog, Lispro
Insulin aspartDrug
Also called Novolog, Aspart
Insulin glulisineDrug
Also called Apidra, Glulisine
| Study group | Role | What they receive |
|---|---|---|
| Commercial Hylenex Recombinant (Formulation 1) | Experimental | Hylenex Formulation 1: For 6 months, participants received their regular treatment of rapid-acting continuous subcutaneous insulin infusion (CSII) (for example, insulin lispro, insulin aspart, and insulin glulisine). Additionally, during this 6-month treatment period, the participants received a pretreatment dose of the commercial form of Hylenex recombinant, delivered at 150 units (U) through their insulin infusion cannula each time they changed infusion sets (every 2 to 3 days). Receives: Drug: Commercial Hylenex® recombinant (hyaluronidase human injection); Drug: Insulin lispro; Drug: Insulin aspart; Drug: Insulin glulisine |
| Precommercial Hylenex Recombinant (Formulation 2) | Experimental | Hylenex Formulation 2: For 6 months, participants received their regular treatment of rapid-acting CSII (for example, insulin lispro, insulin aspart, and insulin glulisine). Additionally, during this 6-month treatment period, the participants received a pretreatment dose of the precommercial form of Hylenex recombinant, delivered at 150 units (U) through their insulin infusion cannula each time they changed infusion sets (every 2 to 3 days). Receives: Drug: Precommercial Hylenex recombinant (hyaluronidase human injection); Drug: Insulin lispro; Drug: Insulin aspart; Drug: Insulin glulisine |
| Standard Rapid-Acting Insulin CSII | Active comparator | Participants received their regular treatment of rapid-acting CSII (for example, insulin lispro, insulin aspart, and insulin glulisine) for 6 months. Receives: Drug: Insulin lispro; Drug: Insulin aspart; Drug: Insulin glulisine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline to 6 Months in Glycosylated Hemoglobin (HbA1c)
Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
Measured: Baseline; 6 Months
Change From Baseline to 12 Months in HbA1c
Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
Measured: Baseline; 12 Months
Secondary outcomes (25)
Rates of Hypoglycemia Events (HE) to Month 6
Overall rates of hypoglycemia (defined as blood glucose ≤70 milligrams per deciliter [mg/dL] and <56 mg/dL) were based on measurements after 1 month up to 6 months. A severe HE was classified as an event requiring assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. A nocturnal HE was classified as an event with a blood glucose of ≤70 mg/dL with start time between 2300 and 0600, inclusive. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 6
Rates of HEs to Month 12
Overall rates of hypoglycemia (defined as blood glucose ≤70 milligrams per deciliter [mg/dL] and <56 mg/dL) were based on measurements after 1 month up to 12 months. A severe HE was classified as an event requiring assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. A nocturnal HE was classified as an event with a blood glucose of ≤70 mg/dL with start time between 2300 and 0600, inclusive. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 12
Rates of Hyperglycemia Events to Month 6
Overall rates of hyperglycemia (defined as blood glucose >240 mg/dL and >300 mg/dL) were based on measurements after 1 month up to 6 months. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 6
Rates of Hyperglycemia Events to Month 12
Overall rates of hyperglycemia (defined as blood glucose >240 mg/dL and >300 mg/dL) were based on measurements after 1 month up to 12 months. A summary of serious and other non-serious adverse events regardless of causality is located in the Reported Adverse Events module. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 12
Mean Glucose Excursions at 6 Months
A 4-hour postprandial glucose excursion was measured for 3 meals after 1 month up to 6 months. For each of the 3 meals, the mealtime (breakfast, lunch, and dinner) excursions were calculated as the post-meal glucose value minus the pre-meal (for measurements taken within 15 minutes before a meal). The average of all excursions is presented. Least Squares (LS) means were calculated from ANOVA with treatment (Hylenex, standard rapid-acting insulin CSII) as a fixed effect. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 6
Mean Glucose Excursions at 12 Months
A 4-hour postprandial glucose excursion was measured for 3 meals after 1 month up to 12 months. For each of the 3 meals, the mealtime (breakfast, lunch, and dinner) excursions were calculated as the post-meal glucose value minus the pre-meal (for measurements taken within 15 minutes before a meal). The average of all excursions is presented. LS means were calculated from ANOVA with treatment (Hylenex, standard rapid-acting insulin CSII) as a fixed effect. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 12
Standard Deviation of Self-Monitoring Blood Glucose Values at 6 Months
Standard deviation of self-monitoring blood glucose values was calculated based on measurements taken within 15 minutes before a meal, 1 month and up to 6 months after study drug administration. LS means were calculated from ANOVA with treatment (Hylenex, standard rapid-acting insulin CSII) as a fixed effect. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 6
Standard Deviation of Self-Monitoring Blood Glucose Values at 12 Months
Standard deviation of self-monitoring blood glucose values was calculated based on measurements taken within 15 minutes before a meal, 1 month and up to 12 months after study drug administration. LS means were calculated from ANOVA with treatment (Hylenex, standard rapid-acting insulin CSII) as a fixed effect. Comparisons were made by pooling all of the rHuPH20 pretreatment participants (including both Formulations 1 and 2) and comparing against the standard CSII treatment arm. Formulation 1 versus Formulation 2 was compared as a supportive analysis.
Measured: After Month 1 up to Month 12
Number of Participants Achieving HbA1c <7.0% and HbA1c ≤6.5% at Month 12
The number of participants achieving HbA1c goals of <7% and ≤6.5% was calculated.
Measured: Month 12
Change From Baseline in Body Weight to Month 12
Baseline is defined as the last measurement prior to randomization.
Measured: Baseline; Week 2; Months 1, 2, 3, 4, 6, 9, and 12
Average of Daily Insulin Doses (Bolus, Basal, and Total)
The daily bolus insulin dose is calculated as the daily prandial (occurring before a meal) insulin dose plus the daily corrective insulin dose. Cumulative basal dosage is to generally be within 40% to 60% of the total daily dose.
Measured: from Randomization up to Month 12
Average Carbohydrate Factor (CarbF) Values
CarbF is calculated as 2.6 * weight (pounds) / total daily dose of insulin (grams per unit).
Measured: Month 1 to Month 12
Average Correction Factor (CorrF) Values
CorrF is calculated as 1960 / total daily dose of insulin (milligrams/[deciliter*unit]).
Measured: Month 1 to Month 12
Average of Bolus Times Relative to Meal Times
The average meal bolus timing relative to meal time is defined as the minutes between the start time of a meal bolus and the start time of a meal.
Measured: Month 1 to Month 12
Average Glucose, Median Glucose, and Average Daily Standard Deviation
For each participant, the following continuous glucose monitoring (CGM) parameters were calculated using CGM values recorded after Randomization up to Month 12: average glucose, median glucose, and average daily standard deviation.
Measured: Randomization to Month 12
Time Per Day <56 Milligrams Per Deciliter (mg/dL), ≤70 mg/dL, >70 mg/dL, <140 mg/dL, ≥140 mg/dL, Outside of 71 to 180 mg/dL, and Outside of 71 to 139 mg/dL
For each participant, the following CGM parameters were calculated using CGM values recorded after Randomization up to Month 12: time per day spent in the pre-defined glucose classes.
Measured: Randomization to Month 12
Area Per Day <56 mg/dL, ≤70 mg/dL, ≥140 mg/dL, Outside of 71 to 180 mg/dL, and Outside of 71 to 139 mg/dL
For each participant, the following continuous glucose monitoring (CGM) parameters were calculated using CGM values recorded after Randomization up to Month 12: area per day spent in the pre-defined glucose classes. The area per day for a specific glucose concentration range (e.g., <56 mg/dL) is the sum of the area under the curve with glucose concentration falling in the specific glucose concentration range (e.g., <56 mg/dL). For example, if the glucose stays constant at 50 mg/dL for the whole day (1,440 minutes), the area per day for glucose < 56 mg/dL equals: 50*1440 = 72,000 mg*minutes/dL.
Measured: Randomization to Month 12
Change From Baseline in Weighted Impact ADDQoL Values at Month 12
The Audit of Diabetes Dependent Quality of Life (ADDQoL) is a validated, diabetes-specific questionnaire to evaluate the participant's assessment of quality of life (QoL). Participants rated the impact of diabetes on 19 applicable domains on a scale from -3 (maximum negative impact) to +3 (maximum positive impact) and then rated the importance of those domains for their QoL on a scale from 3 (very important) to 0 (not at all important). Impact ratings were multiplied by the corresponding importance ratings to provide a weighted-impact score for each domain from -9 (maximum negative impact) to +9 (maximum positive impact).
Measured: Baseline; Month 12
Change From Baseline in Average Weighted Impact ADDQoL Values at Month 12
The ADDQoL is a validated, diabetes-specific questionnaire to evaluate the participant's assessment of QoL. Participants rated the impact of diabetes on 19 applicable domains on a scale from -3 (maximum negative impact) to +3 (maximum positive impact) and then rated the importance of those domains for their QoL on a scale from 3 (very important) to 0 (not at all important). Impact ratings were multiplied by the corresponding importance ratings to provide a weighted-impact score for each domain from -9 (maximum negative impact) to +9 (maximum positive impact). Weighted impact scores were summed and divided by the number of applicable domains to give an overall Average Weighted Impact (AWI) score (higher values represent more positive impact). If there were less than 13 non-missing weighted-impact values, AWI was not to be calculated. Baseline is defined as the last measurement prior to randomization.
Measured: Baseline; Month 12
Change From Baseline in DTSQs and DTSQc at Month 12
The Diabetes Treatment Satisfaction Questionnaire-status version (DTSQs) and DTSQ-change version (DTSQc) are validated tools to assess treatment satisfaction and change in treatment satisfaction after therapy changes have occurred. The scale total was computed by adding the 6 items (1, 4, 5, 6, 7, and 8) to produce the Treatment Satisfaction scale total, which has a minimum of 0 and a maximum of 36 on the DTSQs and a minimum of -18 and a maximum of 18 on the DTSQc. Higher scores represent greater satisfaction. If any of the 6 item scores were missing and the numbers of missing scores were less than the number of non-missing scores, the Treatment Satisfaction scale score was to be computed by taking the average of the existing scores and multiplying the average by 6. If there were less than 4 non-missing item scores, the Treatment Satisfaction scale score was not to be calculated. Baseline is defined as the last measurement prior to randomization.
Measured: Baseline; Month 12
Mean Time to Change Infusion Site
Participants were asked device handling questions to provide information about the impact of the Hylenex administration procedure on everyday life and to investigate perceptions of the overall efficacy and responsiveness of their insulin program.
Measured: Month 12
Mean Additional Time for Hylenex Pre-administration
Participants were asked device handling questions to provide information about the impact of the Hylenex administration procedure on everyday life and to investigate perceptions of the overall efficacy and responsiveness of their insulin program.
Measured: Month 12
Number of Participants With the Indicated Responses to the Question Regarding the Difficulty of Infusion Site Change
Participants were asked device handling questions to provide information about the impact of the Hylenex administration procedure on everyday life and to investigate perceptions of the overall efficacy and responsiveness of their insulin program.
Measured: Month 12
Number of Participants With the Indicated Responses to the Device Handling Questions
Participants were asked device handling questions to provide information about the impact of the Hylenex administration procedure on everyday life and to investigate perceptions of the overall efficacy and responsiveness of their insulin program. Question 1: Achieve excellent post meal glucose control; Question 2: Insulin responds quickly when basal rate is changed; Question 3: Insulin responds quickly when correction bolus is given.
Measured: Month 12
Mean Times Per Week Participants Said They Were Eating to Avoid Going Low Due to Late Insulin Action
Participants were asked device handling questions to provide information about the impact of the Hylenex administration procedure on everyday life and to investigate perceptions of the overall efficacy and responsiveness of their insulin program.
Measured: Month 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 May 2013 (estimated)
- Study startMar 2013
- Primary completionFeb 2014
- Study completionSep 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Type 1 Diabetes MellitusStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Enrolment
- 456 participants (actual)
Sponsor and investigators
- Lead sponsor
- Halozyme Therapeutics
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Douglas Muchmore, MD, Study director, Halozyme Therapeutics
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01848990
- Sponsor's protocol ID
- Halo-117-403
- Status last verified
- Oct 2018
- First submitted
- 29 Apr 2013
- Last updated
- 7 Nov 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 Nov 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- CONtinuous Subcutaneous Insulin Infusion STudy ENrolling Type 1 (CONSISTENT 1): Evaluation of Metabolic Outcomes and Safety of Hylenex Recombinant (Hyaluronidase Human Injection) Used as a Preadministration Infusion Site Treatment in Subjects With Type 1 Diabetes (T1DM) Using Continuous Subcutaneous Insulin Infusion (CSII)
- ClinicalTrials.gov ID
- NCT01848990
- Acronym / sponsor ID
- Halo-117-403
- Conditions
- Type 1 Diabetes Mellitus
- Keywords
- Type 1 Diabetes Mellitus, Sub Cutaneous Insulin Infusion, Rapid Acting Analog Insulin, Hylenex, Halozyme, Phase 4
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 456 participants (actual)
- Lead sponsor
- Halozyme TherapeuticsIndustry (pharma, biotech, devices)
- Study start
- Mar 2013
- Primary completion
- Feb 2014 (actual)
- Study completion
- Sep 2014 (actual)
- First posted
- 8 May 2013 (estimated)
- Results
- Posted 29 Oct 2014
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objectives of this study are to compare the difference in glycosylated hemoglobin (HbA1c) from baseline to Month 6 using Hylenex recombinant preadministration in continuous subcutaneous insulin infusion (CSII) versus standard CSII and to evaluate the safety of Hylenex recombinant preadministration, including local tolerability, adverse events, and hypo- and hyperglycemia rates.
Detailed description
This Phase 4 study is designed to demonstrate noninferiority of pretreatment with Hylenex recombinant in the CSII setting to rapid-acting analog insulin alone with respect to glycemic control as assessed by changes in HbA1c in participants with Type 1 diabetes mellitus.
Total duration of study treatment is 24 months. However, according to the study design, the primary outcome measure is to be assessed at 6 months and an interim analysis is to be completed at 6 months for the secondary outcome measures and adverse events. Therefore, data reported in this clinical trials record is for the 6-month interim analysis.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Commercial Hylenex Recombinant (Formulation 1) | Experimental | Drug: Commercial Hylenex® recombinant (hyaluronidase human injection), Drug: Insulin lispro, Drug: Insulin aspart, Drug: Insulin glulisineHylenex Formulation 1: For 6 months, participants received their regular treatment of rapid-acting continuous subcutaneous insulin infusion (CSII) (for example, insulin lispro, insulin aspart, and insulin glulisine). Additionally, during this 6-month treatment period, the participants received a pretreatment dose of the commercial form of Hylenex recombinant, delivered at 150 units (U) through their insulin infusion cannula each time they changed infusion sets (every 2 to 3 days). |
| Precommercial Hylenex Recombinant (Formulation 2) | Experimental | Drug: Precommercial Hylenex recombinant (hyaluronidase human injection), Drug: Insulin lispro, Drug: Insulin aspart, Drug: Insulin glulisineHylenex Formulation 2: For 6 months, participants received their regular treatment of rapid-acting CSII (for example, insulin lispro, insulin aspart, and insulin glulisine). Additionally, during this 6-month treatment period, the participants received a pretreatment dose of the precommercial form of Hylenex recombinant, delivered at 150 units (U) through their insulin infusion cannula each time they changed infusion sets (every 2 to 3 days). |
| Standard Rapid-Acting Insulin CSII | Active comparator | Drug: Insulin lispro, Drug: Insulin aspart, Drug: Insulin glulisineParticipants received their regular treatment of rapid-acting CSII (for example, insulin lispro, insulin aspart, and insulin glulisine) for 6 months. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Male or female of age 18 years or older with a history of T1DM for at least 12 months
- Glycosylated hemoglobin (HbA1c) 6.5% to 9.5% (inclusive) based on central laboratory results
- Fasting C-peptide <0.6 nanograms per milliliter (ng/mL)
- Current use of an insulin pump compatible with available tubing for Hylenex recombinant infusion and use of an infusion set compatible with the tubing available or willingness to switch to an infusion set compatible with tubing available for infusion of Hylenex recombinant
- Current treatment at the time of screening with insulin <300 units per day (U/day)
Key exclusion criteria (12 listed)
- Type 2 diabetes
- Known or suspected allergy to any component of any of the study drugs in this study
- Severe proliferative retinopathy or maculopathy, and/or gastroparesis, and/or severe neuropathy, in particular autonomic neuropathy, of such severity as to impede the participant's ability to comply with protocol procedures, as judged by the Investigator
- History of transmural myocardial infarction, congestive heart failure and uncontrolled hypertension (diastolic blood pressure [BP] consistently >100 millimeters of mercury [mmHg]) are exclusionary
- As judged by the Investigator, clinically significant active disease of the gastrointestinal, cardiovascular (including history of stroke, history of arrhythmia, or conduction delays on electrocardiogram [ECG]), hepatic, neurological, renal, genitourinary, pulmonary, or hematological systems of such severity as to impede the participant's ability to comply with protocol procedures
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Commercial Hylenex® recombinant (hyaluronidase human injection)Also: Formulation 1, Hylenex, Recombinant human hyaluronidase (rHuPH20) | Drug | Commercial Hylenex Recombinant (Formulation 1) |
| Precommercial Hylenex recombinant (hyaluronidase human injection)Also: Formulation 2, Hylenex, rHuPH20 | Drug | Precommercial Hylenex Recombinant (Formulation 2) |
| Insulin lisproAlso: Humalog, Lispro | Drug | Commercial Hylenex Recombinant (Formulation 1), Precommercial Hylenex Recombinant (Formulation 2), Standard Rapid-Acting Insulin CSII |
| Insulin aspartAlso: Novolog, Aspart | Drug | Commercial Hylenex Recombinant (Formulation 1), Precommercial Hylenex Recombinant (Formulation 2), Standard Rapid-Acting Insulin CSII |
| Insulin glulisineAlso: Apidra, Glulisine | Drug | Commercial Hylenex Recombinant (Formulation 1), Precommercial Hylenex Recombinant (Formulation 2), Standard Rapid-Acting Insulin CSII |
Primary outcome
Change From Baseline to 6 Months in Glycosylated Hemoglobin (HbA1c)
Time frame: Baseline; 6 Months
Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
Change From Baseline to 12 Months in HbA1c
Time frame: Baseline; 12 Months
Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
25 secondary outcomes
Rates of Hypoglycemia Events (HE) to Month 6
Time frame: After Month 1 up to Month 6
Rates of HEs to Month 12
Time frame: After Month 1 up to Month 12
Rates of Hyperglycemia Events to Month 6
Time frame: After Month 1 up to Month 6
Rates of Hyperglycemia Events to Month 12
Time frame: After Month 1 up to Month 12
Mean Glucose Excursions at 6 Months
Time frame: After Month 1 up to Month 6
Mean Glucose Excursions at 12 Months
Time frame: After Month 1 up to Month 12
Standard Deviation of Self-Monitoring Blood Glucose Values at 6 Months
Time frame: After Month 1 up to Month 6
Standard Deviation of Self-Monitoring Blood Glucose Values at 12 Months
Time frame: After Month 1 up to Month 12
Number of Participants Achieving HbA1c <7.0% and HbA1c ≤6.5% at Month 12
Time frame: Month 12
Change From Baseline in Body Weight to Month 12
Time frame: Baseline; Week 2; Months 1, 2, 3, 4, 6, 9, and 12
Average of Daily Insulin Doses (Bolus, Basal, and Total)
Time frame: from Randomization up to Month 12
Average Carbohydrate Factor (CarbF) Values
Time frame: Month 1 to Month 12
Average Correction Factor (CorrF) Values
Time frame: Month 1 to Month 12
Average of Bolus Times Relative to Meal Times
Time frame: Month 1 to Month 12
Average Glucose, Median Glucose, and Average Daily Standard Deviation
Time frame: Randomization to Month 12
Time Per Day <56 Milligrams Per Deciliter (mg/dL), ≤70 mg/dL, >70 mg/dL, <140 mg/dL, ≥140 mg/dL, Outside of 71 to 180 mg/dL, and Outside of 71 to 139 mg/dL
Time frame: Randomization to Month 12
Area Per Day <56 mg/dL, ≤70 mg/dL, ≥140 mg/dL, Outside of 71 to 180 mg/dL, and Outside of 71 to 139 mg/dL
Time frame: Randomization to Month 12
Change From Baseline in Weighted Impact ADDQoL Values at Month 12
Time frame: Baseline; Month 12
Change From Baseline in Average Weighted Impact ADDQoL Values at Month 12
Time frame: Baseline; Month 12
Change From Baseline in DTSQs and DTSQc at Month 12
Time frame: Baseline; Month 12
Mean Time to Change Infusion Site
Time frame: Month 12
Mean Additional Time for Hylenex Pre-administration
Time frame: Month 12
Number of Participants With the Indicated Responses to the Question Regarding the Difficulty of Infusion Site Change
Time frame: Month 12
Number of Participants With the Indicated Responses to the Device Handling Questions
Time frame: Month 12
Mean Times Per Week Participants Said They Were Eating to Avoid Going Low Due to Late Insulin Action
Time frame: Month 12
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Nov 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Related InfoLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Douglas Muchmore, MD study director
Halozyme Therapeutics
39 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Commercial Hylenex® recombinant (hyaluronidase human injection), Precommercial Hylenex recombinant (hyaluronidase human injection) and Insulin lispro in people with Type 1 Diabetes Mellitus, run by Halozyme Therapeutics at 39 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Nov 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 39 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change From Baseline to 6 Months in Glycosylated Hemoglobin (HbA1c) (time frame: Baseline; 6 Months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Nov 2018.