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دراسة واحدة تطابق معايير الفلتر
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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) المرحلة الرابعة ٤٥٦

مكتمل
تفاصيل التجربة السريرية متاحة بشكل أساسي باللغة الإنجليزية. ومع ذلك، يمكن لـ رادار التجارب AI مساعدتك؛ ما عليك سوى النقر على «وصف الدراسة» لعرض ومناقشة معلومات الدراسة باللغة التي اخترتها.
التجربة السريرية NCT01848990 كانت مصممة لدراسة علاج لـداء السكري من النوع 1. كانت دراسة تدخُّلية من المرحلة الرابعة وهي الآن مكتمل. بدأت في ١٩ ربيع الآخر ١٤٣٤ هـ مع خطة لتجنيد ٤٥٦ مشاركًا. بقيادة هالوزيم ثيرابيوتيكس، وكان من المتوقع اكتمالها في ٦ ذو القعدة ١٤٣٥ هـ. تم تحديث البيانات الأخيرة من ClinicalTrials.gov في ٢٩ صفر ١٤٤٠ هـ.
الملخص
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.
وصف مفصل
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 an...

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العنوان الرسمي

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)

الحالات الطبية
داء السكري من النوع 1
معرّفات دراسة أخرى
  • Halo-117-403
NCT معرّف
تاريخ البدء (فعلي)
2013-03
آخر تحديث مُنشور
2018-11-07
تاريخ الاكتمال (المقدر)
2014-09
عدد المشاركين المخطط لهم
٤٥٦
نوع الدراسة
تدخُّلية
المرحلة
المرحلة الرابعة
الحالة
مكتمل
الكلمات الرئيسية
Type 1 Diabetes Mellitus
Sub Cutaneous Insulin Infusion
Rapid Acting Analog Insulin
Hylenex
Halozyme
Phase 4
الغرض الأساسي
العلاج
طريقة توزيع المشاركين
عشوائي
نموذج التدخل
التصميم العاملي
التعمية
لا شيء (تجربة مفتوحة)
مجموعات/التدخلات
مجموعة المشاركين/الذراعالتدخل/العلاج
تجريبيةCommercial Hylenex Recombinant (Formulation 1)
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 ...عرض المزيد
Commercial Hylenex® recombinant (hyaluronidase human injection)
Insulin lispro
Insulin aspart
Insulin glulisine
تجريبيةPrecommercial Hylenex Recombinant (Formulation 2)
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 ...عرض المزيد
Precommercial Hylenex recombinant (hyaluronidase human injection)
Insulin lispro
Insulin aspart
Insulin glulisine
مقارن نشطStandard Rapid-Acting Insulin CSII
Participants received their regular treatment of rapid-acting CSII (for example, insulin lispro, insulin aspart, and insulin glulisine) for 6 months.
Insulin lispro
Insulin aspart
Insulin glulisine
النتيجة الرئيسية
مقياس النتيجةوصف القياسالإطار الزمني
Change From Baseline to 6 Months in Glycosylated Hemoglobin (HbA1c)
Change from Baseline was calculated as the post-Baseline value minus the Baseline value.
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.
Baseline; 12 Months
النتيجة الثانوية
مقياس النتيجةوصف القياسالإطار الزمني
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.
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.
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.
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.
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.
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.
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.
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.
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.
Month 12
Change From Baseline in Body Weight to Month 12
Baseline is defined as the last measurement prior to randomization.
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.
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).
Month 1 to Month 12
Average Correction Factor (CorrF) Values
CorrF is calculated as 1960 / total daily dose of insulin (milligrams/\[deciliter\*unit\]).
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
Month 12
معايير الأهلية

الأعمار المؤهلة للدراسة
بالغ, كبار السن
العمر الأدنى للدراسة
18 Years
الجنس المؤهل
الكل
  1. Male or female of age 18 years or older with a history of T1DM for at least 12 months
  2. Glycosylated hemoglobin (HbA1c) 6.5% to 9.5% (inclusive) based on central laboratory results
  3. Fasting C-peptide <0.6 nanograms per milliliter (ng/mL)
  4. 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
  5. Current treatment at the time of screening with insulin <300 units per day (U/day)
  6. 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.
  7. 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.

  1. Type 2 diabetes
  2. Known or suspected allergy to any component of any of the study drugs in this study
  3. 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
  4. History of transmural myocardial infarction, congestive heart failure and uncontrolled hypertension (diastolic blood pressure \[BP\] consistently >100 millimeters of mercury \[mmHg\]) are exclusionary
  5. 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
  6. 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
  7. As judged by the Investigator, clinically significant findings in routine laboratory data at screening
  8. 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.
  9. Hypoglycemic unawareness of such severity as to impede the participant's ability to comply with protocol procedures, as judged by the Investigator.
  10. Current addiction to alcohol or substance abuse as determined by the Investigator.
  11. 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.
  12. Mental incapacity, unwillingness, or language barriers precluding adequate understanding or cooperation in this study
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39 مواقع الدراسة في 1 بلدان

California

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Concord, California, 94520, United States
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For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, La Jolla, California, 92037, United States
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Colorado

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Florida

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Georgia

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Atlanta, Georgia, 30318, United States
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Idaho

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Iowa

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Des Moines, Iowa, 50314, United States

Kansas

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Wichita, Kansas, 67226, United States

Kentucky

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Maryland

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Hyattsville, Maryland, 20782, United States
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Michigan

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Minnesota

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Minneapolis, Minnesota, 55416, United States

Montana

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Nevada

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New York

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North Carolina

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Asheville, North Carolina, 28803, United States
For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Durham, North Carolina, 27713, United States
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Ohio

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Oregon

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Tennessee

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Bartlett, Tennessee, 38133, United States
For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Chattanooga, Tennessee, 37411, United States

Texas

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For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Dallas, Texas, 75231, United States
For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Round Rock, Texas, 78681, United States
For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, San Antonio, Texas, 78258, United States

Washington

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Olympia, Washington, 98502, United States
For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Renton, Washington, 98057, United States
For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Seattle, Washington, 98105, United States

Wisconsin

For additional information regarding investigative sites for this trial, call (858) 794-8889 8 AM to 5 PM Mon-Fri Pacific Standard Time, Madison, Wisconsin, 53717, United States