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DiabetesPhase 2NCT04956263

A Comparison of Postprandial Glucose After a MMTT, and the Metabolic Effects of Insulin Withdrawal in a Crossover Study in Subjects With Type 1 Diabetes

A Phase 2 study testing YG1699 and Dapagliflozin in people with Diabetes and Diabetes Mellitus, Type 1, run by Youngene Therapeutics Inc., Ltd. at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is an inpatient treatment, double-blind, randomized, 3-way crossover study in T1DM subjects using insulin pump therapy. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Diabetes, Diabetes Mellitus, Type 1, Type1diabetes
What is being tested?
YG1699 and Dapagliflozin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
1 siteUnited States
Study dates
17 Jun 2021to 19 Jul 2022
Phase
Phase 2
Are there results?
None posted in the registry

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 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Subjects ≥ 18 to ≤ 60 years of age at the time of signing the informed consent.
  • Subjects diagnosed with T1DM for ≥ 12 months.
  • Subjects who are currently using an approved insulin pump, with a stable basal insulin dose. Stable is defined as < 20% change of dose during the last 2 weeks prior to Screening.
  • HbA1c < 9.5%.
  • C-peptide after carbohydrate ingestion of < 0.3 nmol/L, with simultaneous plasma glucose > 90 mg/dL. (If necessary, subjects may consume carbohydrates to raise blood glucose over 90 mg/dL as measured by YSI prior to drawing blood for C-peptide. This may be repeated as needed to ensure C-peptide is assessed when plasma glucose concentration is > 90 mg/dL).
  • Fasting BOHB ≤ 0.6 mmol/L.
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  • Body mass index (BMI) within the range ≥ 18.5 to ≤ 27.0 kg/m2.
  • Female subjects must be non-pregnant and non-lactating.
  • Females of childbearing potential must use highly effective contraceptive methods, stable at least 2 months prior to the screening. Male subjects must be surgically sterile, abstinent or if engaged in sexual relations of childbearing potential, the subject and his partner must be using acceptable methods of contraception.
  • Capable of giving signed informed consent and willing to follow study procedures and commitment to the study duration

Who cannot join

  • Subject has a diagnosis of type 2 diabetes (T2DM).
  • Subject who has acute proliferative retinopathy or maculopathy, requiring acute treatment within 3 months of Screening.
  • Subject who has ≥ 3 Level 2 or ≥ 1 Level 3 hypoglycemic events, or hypoglycemic unawareness, or had a severe hypoglycemic event (Level 3) within 1 month prior to Screening.
  • Subject who has had DKA or nonketotic hyperosmolar state within 1 month of Screening, OR ≥ 2 events of DKA or nonketotic hyperosmolar state within 6 months of Screening.
  • Subject with uncontrolled hypertension, defined as persistent blood pressure (BP) systolic or diastolic > 150/90 mmHg, or hypotension, defined as BP < 90/60 mmHg. (Subjects BP may be re-checked per site SOP)
  • Subject with any clinically significant active disease of the gastrointestinal system (peptic ulcers, severe GERD, gastroparesis, any malabsorption/motility disorders, or chronic constipation). severe gastroparesis, and/or severe neuropathy, especially autonomic neuropathy, as judged by the Investigator.
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  • Subject with history of heart disease, defined as symptomatic heart failure (New York Heart Association class III or IV), myocardial infarction, coronary artery bypass graft surgery, or angioplasty, unstable angina requiring medication, transient ischemic attack, cerebral infarct, or cerebral hemorrhage.
  • Subject with presence of clinically significant ECG findings (eg, QTcF > 450 msec for males, QTcF > 470 msec for females, left bundle branch block [LBBB],cardiac arrythmia) at Screening that, in the opinion of the Investigator, may interfere with any aspect of study conduct or interpretation of results, or may present a safety issue to that particular subject.
  • Subject with history of renal disease or abnormal kidney function tests at Screening (eGFR < 60 mL/min/1.73m2 as estimated using the CKD-EPI Creatinine equation).
  • History of hereditary glucose-galactose malabsorption or primary renal glucosuria
  • Subjects with a thyroid disease, not adequately controlled. (Subjects with TSH outside of reference range due to incorrect treatment may be re-screened and included after successful treatment correction.)
  • Subject with a history of significant liver disease, transaminases (AST, ALT) ≥ 2 x upper limit normal (ULN), or total bilirubin >1.5x ULN. (Laboratory results may be re-checked once on a separate day per Investigator discretion)
  • Subject shows evidence of significant active neuropsychiatric disease, or chronic seizures, or major neurological disorders. Subjects that are stable and controlled by stable doses of selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), antipsychotics and lithium for ≥ 3 months prior to screening may be allowed based on the judgement of the investigator.
  • Subject with a history of neoplastic disease within the past 5 years, except for adequately treated non-melanomatous skin carcinoma or other malignancies which have been successfully treated ≥10 years prior to screening.
  • Subject with a previous surgical treatment for obesity (bariatric surgery, gastric banding, etc.) or any other gastrointestinal surgery that may induce malabsorption, history of bowel resection > 20 cm, or any GI procedure for weight loss (including LAP-BAND®).
  • Subject with history of any major surgery within 6 months.
  • Subject with current use of any prescribed or non-prescribed drugs (other than the allowed current treatment for T1DM).
  • Subject with a history of any serious adverse reaction or hypersensitivity to any of the investigational product components or medicinal products with similar chemical structure, a history of significant multiple and/or severe allergies or has had an anaphylactic reaction or significant intolerability to prescription or non-prescription drugs or food.
  • Subject with a history or positive test of hepatitis B surface antigen (HBsAg), or positive test for Hepatitis C, or presence of human immunodeficiency virus type 1 (HIV-1) or 2 (HIV-2) antibodies.
  • Subject with history of any active infection, including Coronavirus disease (COVID-19), other than mild viral illness within 30 days prior to the first dosing. (Subjects will follow site specific COVID-19 protocols during the entire study)
  • Subjects with immunizations within 14 days prior to first dosing. Administration of coronavirus (Covid-19) vaccine within 5 days prior to first dosing or if scheduled during any in-house periods. Vaccination for COVID-19 is allowed during the study if a washout period of 5 days after vaccine administration is followed before any dosing.
  • Subject with history of alcohol abuse as judged by the Investigator within approximately 1 year. Average daily alcohol intake > 2 drinks of alcoholic beverages for men and > 1 drinks of alcoholic beverages for women. (One drink is defined as 12 fluid ounces of beer (5% alcohol), 5 fluid ounces of wine (12% alcohol) or 1.5 fluid ounces of distilled spirits (40% alcohol).
  • Positive alcohol breath test at Screening and check-in.
  • Subjects with a history of smoking > 5 cigarettes per day or equivalent use of any tobacco product (e.g., nicotine patch) within 6 months prior to Screening. Subjects must be able to refrain from smoking during each in-house period.
  • Subject with a history of illicit drug abuse, including marijuana, within approximately 3 months or evidence of current use as judged by the Investigator. Positive drug test, including marijuana, at Screening and check-in.
  • Subject who participated in an investigational drug/device study within 30 days or 5 half-lives within the last dose of any study drug, whichever is longer.
  • Subjects unwilling to use study-supplied CGM throughout the study duration or to abstain from using > 1000 mg acetaminophen every 6 hours, per CGM safety information, or is unable to tolerate adhesive tape or has any unresolved adverse skin reaction in the area of the sensor placement.
  • Subject with donation or loss of > 500 mL of blood within 56 days.
  • Subject who is unwilling to adhere to the protocol requirements during the study or unwilling to cooperate, or comply with the requirements of this study, or is considered by the Investigator to be an unsuitable candidate for the study.

Trial locations and contacts

1 site in 1 country.

United States1 site

  • ProSciento, Inc

    Chula Vista, California, 91911

Other trials in United States

About this study

Official title: A Comparison of Postprandial Glucose After a Mixed Meal Tolerance Test, and the Metabolic Effects of Insulin Withdrawal in a Crossover Study of the Dual Systemic SGLT1 and SGLT2 Inhibitor YG1699, and the Selective SGLT2 Inhibitor Dapagliflozin in Subjects With Type 1 Diabetes

This is an inpatient treatment, double-blind, randomized, 3-way crossover study in T1DM subjects using insulin pump therapy.

Read the detailed description

Subjects will be randomized to one of 6 treatment sequences. The randomized study drug will be administered once daily for 7 days throughout each of 3 treatment periods. Each subject will attend an in-house baseline period, the NoTreatment period, and 3 in-house treatment periods, The Active Periods, where the same assessments will be performed. At each of the in-house periods, a MMTT will be carried out on the sixth day of dosing and an insulin withdrawal test will be carried out on the seventh day of dosing.

Postprandial glycemic excursion after a MMTT will be evaluated one day prior to an insulin withdrawal test. An insulin pumps with different modes (such as open loop/closed loop) the mode used at screening will be the mode used throughout the study. Unblinded continuous glucose monitoring (CGM) will be initiated at the start of the 7-day Baseline Period (Day -7) and discontinued at End of Treatment (Day 34).

Being tested
YG1699, Dapagliflozin
Keywords
Mixed Meal Tolerance Test, Insulin Withdrawal
Medical subject headings
Diabetes Mellitus, Diabetes Mellitus, Type 1

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • YG1699Drug

    YG1699 is a novel investigational dual inhibitor of sodium-dependent glucose cotransporters, SGLT1 and SGLT2, indicated as an adjunct to diet and exercise to improve glycemic control and weight loss in adults with T2DM. A subsequent indication will be developed for YG1699 to improve glycemic control in adults with T1DM.

    The proposed dosage form is a yellow, film-coated tablet for oral administration. The proposed tablet strengths for the current clinical research are 5 mg and 25 mg. The tablets are packaged in high-density polyethylene (HDPE) bottles with HDPE caps and desiccant inserters. Each HDPE bottle contains 30 tablets of drug product.

    The study drug YG1699 is manufactured by Youngene Therapeutics Inc., Ltd., China.

  • DapagliflozinDrug

    Also called Farxiga

    Farxiga® is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. Faxiga® is available as a film-coated tablet for oral administration containing the equivalent of 5 mg dapagliflozin as dapagliflozin propanediol and the following inactive ingredients: microcrystalline cellulose, anhydrous lactose, crospovidone, silicon dioxide, and magnesium stearate. In addition, the film coating contains the following inactive ingredients: polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, and yellow iron oxide.

Study groups in NCT04956263
Study groupRoleWhat they receive
Treatment AExperimentalYG1699 10 mg
Receives: Drug: YG1699
Treatment BExperimentalYG1699 25 mg
Receives: Drug: YG1699
Treatment CActive comparatorDapagliflozin 10 mg
Receives: Drug: Dapagliflozin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Concentration-time curve in plasma glucose (AUC(0-120min) )

    To demonstrate that either dose of YG1699 produces a lower area under the concentration-time curve in plasma glucose (AUC(0-120min) ) [mg/dL*ml] expressed as percent of No Treatment mean versus Dapagliflozin after a standardized Mixed Meal Tolerance Test (MMTT), performed on the 6th day of treatment.

    Measured: 6th day of treatment

Secondary outcomes (3)

  1. Objectives for MMTT

    • To evaluate the change from the No Treatment Period versus the Active Treatment Periods in plasma glucose after the MMTT, performed on the 6th day of treatment, at 2-hour postprandial (120 minutes) of YG1699 doses versus Dapagliflozin (This endpoint may become primary endpoint after interim analysis)
    • To evaluate the change from the No Treatment Period versus the Active Treatment Periods in urinary glucose excretion (UGE) after the MMTT on the 6th day of treatment, (UGE 0-180 minutes) of YG1699 doses versus Dapagliflozin
    • To evaluate the change from the No Treatment Period versus the Active Treatment Periods in plasma glucose after the MMTT, performed on the 6th day of treatment, during 3-hour postprandial (180 minutes) at individual time points, and maximum plasma glucose of YG1699 doses versus Dapagliflozin

    Measured: 6th day of treatment

  2. Objectives for Insulin Withdrawal

    • To evaluate the increment and ratio of changes from the No Treatment Period versus the Active Treatment Periods during insulin withdrawal performed on the 7th day of treatment, in:
    • Treatment Ratios (95% CI) of the following: Serum beta-hydroxybutyrate (BOHB) , plasma glucagon , plasma glucose , plasma free fatty acids (FFA)
    • Duration of insulin withdrawal

    Measured: 7th day of treatment

  3. Objectives for Insulin Requirements

    To evaluate the change from the No Treatment Period versus the Active Treatment Periods in basal, bolus and total daily insulin dose requirements

    Measured: over 3 days prior to the MMTT

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Jul 2021
  2. Study start17 Jun 2021
  3. Primary completion2 Feb 2022
  4. Study completion19 Jul 2022

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
During the No Treatment Period prior to the baseline MMTT performed on Day -2, subjects will be randomized 1:1:1:1:1:1 to one of six Treatment Sequences A/B/C, A/C/B, B/C/A, B/A/C, C/B/A or C/A/B: * Treatment A is YG1699 10 mg * Treatment B is YG1699 25 mg * Treatment C is dapagliflozin 10 mg
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04956263
Sponsor's protocol ID
YG1699-201
Status last verified
Jul 2022
First submitted
15 Jun 2021
Last updated
28 Jul 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lapuerta P, Urbina S, He J, Wittle A, Li C, Li T, Wang H, Hompesch M. A Randomized Crossover Trial of Mixed Meal Tolerance Test Response in People with Type 1 Diabetes on Insulin Pump Therapy and YG1699 or Dapagliflozin. Clin Pharmacol Ther. 2024 Jun;115(6):1383-1390. doi: 10.1002/cpt.3225. Epub 2024 Mar 8.

    PubMed 38456487

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing YG1699 and Dapagliflozin in people with Diabetes and Diabetes Mellitus, Type 1, run by Youngene Therapeutics Inc., Ltd. at 1 site 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 10 inclusion and 29 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 28 Jul 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Concentration-time curve in plasma glucose (AUC(0-120min) ) (time frame: 6th day of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04956263, which also lists 1 linked publication.

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 28 Jul 2022.

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