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Comparison of Glucose Values and Variability Between TOUJEO and TRESIBA During Continuous Glucose Monitoring in Type 1 Diabetes Patients (inRange) Phase 4 343

Completed
Clinical Trial NCT04075513 (inRange) was designed to study Treatment for Type 1 Diabetes Mellitus. This was a Phase 4 interventional study that is now completed. The study started on 9 October 2019, with plans to enroll 343 participants. Led by Sanofi, the expected completion date was 16 September 2021. The latest data from ClinicalTrials.gov was last updated on 14 November 2022.
Brief Summary
Primary Objective:

To demonstrate the non-inferiority of insulin glargine 300 units per milliliter (U/ml) in comparison to insulin degludec 100 U/ml on glycemic control and variability in participants with diabetes mellitus.

Secondary Objective:

To evaluate the glycemic control and variability parameters in each treatment group at Week 12 using Continuous Glucose Monitoring.

To evaluate the safety of insulin glar...

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Detailed Description
The duration of the study per participant was around 18 weeks: 1 or 2 weeks of screening followed by a 4-week run-in period, a 12-week treatment period and a 2 to 4 days follow-up period.
Official Title

A 12-week Randomized, Controlled Trial to Compare TOUJEO® and TRESIBA® in Terms of Glucose Values in Target Range and Variability During Continuous Glucose Monitoring in Patients With Type 1 Diabetes Mellitus

Conditions
Type 1 Diabetes Mellitus
Publications
Scientific articles and research papers published about this clinical trial:
Other Study IDs
  • inRange
  • LPS14947
  • 2017-002756-91 (EudraCT Number)
  • U1111-1197-8171 (Other Identifier) (UTN)
NCT ID Number
NCT04075513
Start Date (Actual)
2019-10-09
Last Update Posted
2022-11-14
Completion Date (Estimated)
2021-09-16
Enrollment (Estimated)
343
Study Type
Interventional
PHASE
Phase 4
Status
Completed
Primary Purpose
Treatment
Design Allocation
Randomized
Interventional Model
Parallel
Masking
None (Open Label)
Arms / Interventions
Participant Group/ArmIntervention/Treatment
ExperimentalToujeo
Toujeo (Insulin Glargine, 300 U/ml) subcutaneous (SC) injection, once daily in the morning before breakfast for 12 weeks on top of rapid acting insulin analog.
Insulin glargine, 300 U/ml
Pharmaceutical form: solution for injection in a prefilled pen Route of administration: SC injection
Background therapy: Rapid acting insulin analogs
Route of administration: SC injection
Active ComparatorTresiba
Tresiba (Insulin Degludec, 100U/ml) SC injection, once daily in the morning before breakfast for 12 weeks on top of rapid acting insulin analog.
Insulin degludec, 100U/ml
Pharmaceutical form: solution for injection in a prefilled pen Route of administration: SC injection
Background therapy: Rapid acting insulin analogs
Route of administration: SC injection
Primary Outcome Measures
Outcome MeasureMeasure DescriptionTime Frame
Percentage of Time of Glucose Concentration Within the Target Range of Greater Than or Equal to (>=) 70 to Less Than or Equal to (<=) 180 Milligrams Per Deciliter: Non-inferiority Analysis
The Continuous Glucose Monitoring (CGM) system combined frequent interstitial glucose measurements (every 5 minutes) with ability to analyze glucose levels in real time. Adjusted least square (LS) means and standard error (SE) were obtained using analysis of covariance (ANCOVA) model on data obtained from the multiple imputations during Week 10 to Week 12.
During Week 10 up to Week 12
Secondary Outcome Measures
Outcome MeasureMeasure DescriptionTime Frame
Glucose Total Coefficient of Variation (CV%)
CV% was a measure of spread of variability relative to mean of population. For CGM glucose values, CV% was measure of glycemic variability across 20 days and calculated as ratio of standard deviation of glucose values to mean of glucose values. LS means and SE were obtained using ANCOVA model using fixed categorical effects of treatment groups (Toujeo, Tresiba), randomization stratum of screening HbA1c (\<8.0% versus \>=8.0%), and the continuous fixed covariate of Baseline value.
During Week 10 up to Week 12
Percentage of Time of Glucose Concentration Within the Target Range of >=70 to <=180 Milligrams Per Deciliter: Superiority Analysis
The CGM system combined frequent interstitial glucose measurements (every 5 minutes) with ability to analyze glucose levels in real time. Adjusted LS means and SE were obtained using ANCOVA model on data obtained from the multiple imputations during Week 10 to Week 12.
During Week 10 up to Week 12
Glucose Within-day CV% and Between-day CV%
CV% was a measure of spread of variability relative to mean of population. For CGM glucose values, CV% was measure of glycemic variability across 20 days and calculated within day and between days as ratio of standard deviation of glucose values to mean of glucose values. LS mean and SE were obtained from ANCOVA model including fixed categorical effects of treatment groups (TOUJEO, TRESIBA), randomization stratum of screening HbA1c (\<8.0% versus \>=8.0%), and as well as, the continuous fixed covariate of Baseline value.
During Week 10 up to Week 12
Change From Baseline in Glycated Hemoglobin A1c (HbA1c) at Week 12
Change in HbA1c at Week 12 was analyzed using an ANCOVA model including the fixed categorical effects of treatment groups (Toujeo, Tresiba), and the continuous fixed covariate of Baseline HbA1c value.
Baseline, Week 12
Change From Baseline in Fasting Plasma Glucose (FPG) at Week 12
Change in FPG was analyzed using an ANCOVA model including the fixed categorical effects of treatment groups (Toujeo, Tresiba) and the randomization stratum of HbA1c at screening (\<8.0%, \>=8.0%) and the continuous fixed covariate of Baseline FPG value.
Baseline, Week 12
Percentage of Time With Glucose Level <70 Milligrams Per Deciliter (All Time and During the Night)
The CGM system combined frequent interstitial glucose measurements (every 5 minutes) with ability to analyze glucose levels in real time. "All time" represent the time between 00.00 hour to 23.59 hours and "night" represent the time between 00.00 hour to 05.59 hours. LS means and SE were obtained using ANCOVA model using fixed categorical effects of treatment groups (Toujeo, Tresiba), randomization stratum of screening HbA1c (\<8.0% versus \>=8.0%), and the continuous fixed covariate of Baseline value.
During Week 10 up to Week 12
Mean Hours Per Day With Glucose Level <70 Milligrams Per Deciliter (All Time and During the Night)
"All time" represent the time between 00.00 hour to 23.59 hours and "night" represent the time between 00.00 hour to 05.59 hours. Mean hours per day with glucose level \<70 milligrams per deciliter during "all time" and only "during night" for the duration of Week 10 to Week 12 is reported in this outcome measure.
During Week 10 up to Week 12
Percentage of Time With Glucose Level >180 Milligrams Per Deciliter
The CGM system combined frequent interstitial glucose measurements (every 5 minutes) with ability to analyze glucose levels in real time. LS means and SE were obtained using ANCOVA model using fixed categorical effects of treatment groups (Toujeo, Tresiba), randomization stratum of screening HbA1c (\<8.0% versus \>=8.0%), and the continuous fixed covariate of Baseline value.
During Week 10 up to Week 12
Mean Hours Per Day With Glucose Level >180 Milligrams Per Deciliter
Mean hours per day with glucose level \>180 milligrams per deciliter for the duration of Week 10 to Week 12 is reported in this outcome measure.
During Week 10 up to Week 12
Number of Participants With at Least One Hypoglycemic Event During the On-treatment Period
Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of \<3.9 millimoles per liter (mmol/L) (\<70 milligrams per deciliter). On-treatment period was defined as the time from the first injection of IMP (included) up to 2 days after the last injection of IMP.
From the first injection of IMP up to 2 days after the last injection of IMP (i.e., up to 86 days)
Number of Hypoglycemic Events Per Participant Year During the On-treatment Period
Number of hypoglycemia events (any, severe and documented) per participant-year of exposure were reported. Severe hypoglycemia was an event in which the participant required the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions, because the participant was not capable of helping self. Documented symptomatic hypoglycemia was an event during which typical symptoms of hypoglycemia were accompanied by a measured plasma glucose concentration of \<3.9 mmol/L (\<70 milligrams per deciliter). On-treatment period was defined as the time from the first injection of IMP (included) up to 2 days after the last injection of IMP. Total participant years = The sum of the duration of exposure for all participants, expressed in participant years.
From the first injection of IMP up to 2 days after the last injection of IMP (i.e., up to 86 days)
Eligibility Criteria

Eligible Ages
Adult, Older Adult
Minimum Age
18 Years
Eligible Sexes
All
  • Participants with Type 1 Diabetes mellitus.
  • Participants treated with multiple daily injections using basal insulin analog once daily and rapid acting insulin analogs for at least one year.
  • HbA1c greater than or equal to (>=) 7 percent (%) (53 millimoles per mole \[mmol/mol\]) and less than or equal to (<=) 10% (86 mmol/mol) at screening.

  • Participants not on stable dose of basal insulin analog.
  • Participants having received Toujeo or Tresiba as basal insulin within 30 days prior to screening.
  • Participants not having used the same insulins (both basal and rapid) within 30 days prior to screening.
  • Participants having received basal insulin dose >= 0.6 units per kilogram body weight within 30 days prior to screening.
  • Participants having received any glucose lowering drugs (including any premixed insulins, human regular insulin as mealtime insulins, any others injectable or oral), other than basal and rapid insulin analogs, within 3 months prior to screening.
  • End stage renal disease or on renal replacement treatment.
  • Retinopathy or maculopathy with one of the following treatments, either recent (within 3 months prior to screening) or planned: intravitreal injections or laser or vitrectomy surgery.
  • Body weight change >=5 kilogram within 3 months prior to screening.

The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

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7 Study Locations in 7 Countries

Texas

United States, Dallas, Texas, 75000, United States
Investigational site BRAZIL, Brazil, Brazil
Investigational site Germany, Germany, Germany
Investigational site Hungary, Hungary, Hungary
Investigational site Netherlands, Netherlands, Netherlands
Investigational site Turkey, Turkey, Turkey (Türkiye)
Investigational site United Kingdom, United Kingdom, United Kingdom