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INHALE-3: Afrezza® Combined With Insulin Degludec Versus Usual Care in Adults With Type 1 Diabetes Phase IV 141 Randomisé

Terminé
Les détails de l'essai clinique sont principalement disponibles en anglais. Cependant, l'IA Trial Radar peut vous aider ! Cliquez simplement sur 'Expliquer l'étude' pour voir et discuter des informations sur l'étude dans la langue sélectionnée.
L'essai clinique NCT05904743 était conçu pour étudier le traitement de Diabète sucré de type 1. Il s'agissait d'une étude interventionnel en Phase IV. Son statut actuel est : terminé. L'étude a commencé le 7 juillet 2023, avec un objectif de recruter 141 participants. Dirigée par MannKind Corp, l'étude s'est terminée le 24 juin 2024. Les données du site ClinicalTrials.gov ont été mises à jour pour la dernière fois le 9 août 2024.
Résumé succinct
INHALE-3 is a Phase 4, randomized controlled trial (RCT) that will randomly assign participants ≥18 years of age with type 1 diabetes (T1D) using multiple daily injections (MDI), an automated insulin delivery (AID) system, or a pump without automation, and continuous glucose monitoring (CGM) 1:1 to an insulin regimen of insulin degludec plus inhaled insulin (Afrezza) and CGM or continuation of usual care. The primary...Afficher plus
Titre officiel

INHALE-3: A 17-Week Randomized Trial and a 13-Week Extension, Evaluating the Efficacy and Safety of Inhaled Insulin (Afrezza) Combined With Insulin Degludec Versus Usual Care in Adults With Type 1 Diabetes

Pathologies
Diabète sucré de type 1
Autres identifiants de l'étude
  • MKC-TI-193
Numéro NCT
Date de début (réel)
2023-07-07
Dernière mise à jour publiée
2024-08-09
Date de fin (estimée)
2024-06-24
Inscription (estimée)
141
Type d'étude
Interventionnel
PHASE
Phase IV
Statut
Terminé
Mots clés
Diabetes Mellitus
Insulin
Inhaled
Afrezza
Technosphere
Adults
Degludec
Glucose sensors
Insulin pumps
CGM
Objectif principal
Traitement
Méthode d'allocation
Randomisé
Modèle d'intervention
Parallèle
Masquage
Aucun (ouvert)
Bras / Interventions
Groupe de participants/BrasIntervention/Traitement
ExpérimentalAfrezza (Technosphere Insulin) + insulin degludec
The Afrezza-Degludec group will inhale Afrezza at meals and corrections and will inject insulin degludec once a day for the 17 weeks of the RCT Phase. Dexcom Continuous Glucose Monitoring (CGM) will be provided. The Afrezza-Degludec group will continue to use Afrezza and insulin degludec for an additional 13 weeks in the Extension Phase.
Afrezza
Pharmaceutical form: powder Route of administration: inhalation
insulin degludec
Pharmaceutical form: solution for injection Route of administration: subcutaneous
Comparateur actifUsual Care: Insulin delivery with either MDI, a pump without automation, or an AID system and CGM
The Usual Care group will continue to receive insulin as they did before the study. This could be by multiple daily injections (MDI) or by using an insulin pump with or without automation for the 17 weeks of the randomized controlled trial (RCT) Phase. Participants will continue to use their personal continuous glucose monitor (CGM) as they did before the study. The Usual Care group will then use Afrezza and insulin ...Afficher plus
Rapid-acting Insulin Analog
Pharmaceutical form: clear and colorless solution for injection Route of administration: subcutaneous
Basal Insulin
Pharmaceutical form: clear and colorless solution for injection Route of administration: subcutaneous
Critère principal d'évaluation
Critères d'évaluationDescription de la mesurePériode
Change in glycated hemoglobin (HbA1c)
Change in HbA1c from baseline to 17 weeks (non-inferiority margin 0.4%)
17 weeks
Critère secondaire d'évaluation
Critères d'évaluationDescription de la mesurePériode
Continuous Glucose Monitoring (CGM) measured percent time with glucose less than 54 mg/dL
CGM-measured percent time with glucose \<54 mg/dL from baseline to 17 weeks (non-inferiority, margin 0.5%)
17 weeks
Continuous Glucose Monitoring (CGM) measured percent time with glucose less than 70 mg/dL
CGM-measured percent time with glucose \<70mg/dL from baseline to 17 weeks (non-inferiority, margin 2.0%)
17 weeks
Continuous Glucose Monitoring (CGM) measured daytime (0600-midnight) percent time in range with glucose 70-180 mg/dL
CGM-measured daytime (0600-midnight) percent time in range with glucose 70-180 mg/dL from baseline to 17 weeks, for superiority assessment
17 weeks
Mean Continuous Glucose Monitoring (CGM) glucose
Mean CGM glucose from baseline to 17 weeks, for superiority assessment
17 weeks
Continuous Glucose Monitoring (CGM) measured (24-hours) percent time in range (TIR) with glucose 70-180 mg/dL
CGM-measured (24-hours) percent time in range with glucose 70-180 mg/dL from baseline to 17 weeks, for superiority assessment
17 weeks
Continuous Glucose Monitoring (CGM) measured percent time with glucose greater than 180 mg/dL
CGM-measured percent time with glucose \> 180 mg/dL from baseline to 17 weeks, for superiority assessment
17 weeks
Change in glycated hemoglobin (HbA1c) for superiority assessment
HbA1c from baseline to 17 weeks, for superiority assessment
17 weeks
Continuous Glucose Monitoring (CGM) measured time with glucose greater than 250 mg/dL
CGM-measured time with glucose \>250 mg/dL from baseline to 17 weeks, for superiority assessment
17 weeks
Continuous Glucose Monitoring (CGM) measured time with glucose less than 70 mg/dL
CGM-measured time with glucose \<70 mg/dL from baseline to 17 weeks, for superiority assessment
17 weeks
Continuous Glucose Monitoring (CGM) measured time with glucose less than 54 mg/dL
CGM-measured time with glucose \<54 mg/dL from baseline to 17 weeks, for superiority assessment
17 weeks
Continuous Glucose Monitoring (CGM) measured coefficient of variation
CGM-measured coefficient of variation from baseline to 17 weeks, for superiority assessment
17 weeks
Change in HbA1c less than 7.0% at 17 weeks
HbA1c \<7.0% at 17 weeks
17 weeks
Change in HbA1c from baseline to 17 weeks, with an improvement of greater than 0.5%
HbA1c improvement from baseline to 17 weeks \>0.5%
17 weeks
Change in HbA1c from baseline to 17 weeks, with an improvement of greater than 1.0%
HbA1c improvement from baseline to 17 weeks \>1.0%
17 weeks
Percent time in range (TIR) with glucose 70-140 mg/dL
Percent time in range with glucose 70-140 mg/dL
17 weeks
Percent time with glucose greater than 300 mg/dL
Percent time with glucose \>300 mg/dL
17 weeks
Continuous Glucose Monitoring (CGM) measured prolonged hyperglycemia events
CGM-measured prolonged hyperglycemia events
17 weeks
Continuous Glucose Monitoring (CGM) measured hypoglycemia events
CGM-measured hypoglycemia events
17 weeks
Standard Deviation (SD) of glucose
SD of glucose
17 weeks
"Fasting glucose" by Continuous Glucose Monitoring (CGM)
"Fasting glucose" by CGM (defined as closest value to 6 a.m.; assumed, but not verified, with no food during the prior 4-hour period)
17 weeks
Percent time in range (TIR) with glucose 70-180 mg/dL greater than 70%
Percent time in range with glucose 70-180 mg/dL \>70% at 17 weeks
17 weeks
Percent time in range (TIR) with glucose 70-180 mg/dL improvement from baseline to 17 weeks greater than or equal to 5%
Percent time in range with glucose 70-180 mg/dL improvement from baseline to 17 weeks ≥5%
17 weeks
Percent time in range (TIR) with glucose 70-180 mg/dL improvement from baseline to 17 weeks ≥10%
Percent time in range with glucose 70-180 mg/dL improvement from baseline to 17 weeks ≥10%
17 weeks
Percent time with glucose less than 70 mg/dL less than 4%
Percent time with glucose \<70 mg/dL \<4% at 17 weeks
17 weeks
Percent time with glucose less than 54 mg/dL less than1%
Percent time with glucose \<54 mg/dL \<1% at 17 weeks
17 weeks
Percent time in range (TIR) 70-180 mg/dL greater than 70% and time less than 54 mg/dL less than 1%
Percent time in range 70-180 mg/dL \>70% and time \<54 mg/dL \<1% at 17 weeks
17 weeks
Incidence of severe hypoglycemia events
Incidence of severe hypoclycemia events, defined as events requiring assistance of another person due to cognitive impairment to actively administer carbohydrate, glucagon, or other resuscitative actions
30 weeks
Continuous Glucose Monitoring (CGM) measured percent time with glucose less than 54 mg/dL
CGM-measured percent time with glucose less than 54 mg/dL
30 weeks
Other serious adverse events, including hospitalizations
Other serious adverse events, including hospitalizations
30 weeks
Incidence and severity of treatment-emergent adverse events (TEAEs)
Incidence and severity of treatment-emergent adverse events (TEAEs)
30 weeks
Incidence and severity of adverse events of special interest (AESIs) as well as the number of participants with AESIs and number of individual events
Incidence and severity of adverse events of special interest (AESIs) as well as the number of participants with AESIs and number of individual events
30 weeks
Change from baseline to 17 weeks in Forced Expiratory Volume in one second (FEV1)
Change from baseline to 17 weeks in FEV1
17 weeks
Proportion of participants with Forced Expiratory Volume in one second (FEV1) reduction greater than or equal to 20%
Proportions of participants in each group who have experienced ≥20% reduction in FEV1 from baseline to Week 17
30 weeks
Hypoglycemic events from logged blood glucose measurements (BGM): Level 1 events (less than 70 mg/dL) and Level 2 events (less than 54 mg/dL) separately
Hypoglycemic events from logged BGM measurements: Level 1 events (\<70 mg/dL) and Level 2 events (\<54 mg/dL)
30 weeks
Hyperglycemic events from logged blood glucose measurements (BGM)
Hyperglycemic events from logged BGM measurements
30 weeks
Continuous Glucose Monitoring (CGM) measured prolonged hyperglycemia events
CGM-measured prolonged hyperglycemia events
30 weeks
Continuous Glucose Monitoring (CGM) measured hypoglycemia events (both a safety and efficacy endpoint)
CGM-measured hypoglycemia events (both a safety and efficacy endpoint)
30 weeks
Critères d'éligibilité

Âges éligibles
Adulte, Adulte âgé
Âge minimum
18 Years
Sexes éligibles
Tous
  • Ability to provide informed consent for study participation

  • Clinical diagnosis of T1D (per the Investigator)

  • Treatment with insulin for at least 6 months prior to the collection of the baseline continuous glucose monitoring (CGM) data

  • Same treatment regimen (MDI, an AID system, or an insulin pump without automation) for the 3 months prior to screening

    1. Current (at time of screening) rapid-acting insulin analog (RAA) in use for at least 4 weeks
    2. If AID system used, automated insulin delivery must be active >85% of the time in the 4 weeks prior to screening
    3. If MDI used, participant must be using a long-acting basal insulin plus injecting a RAA bolus for meals, per Investigator
  • Total daily insulin dose 20-100 units

  • Age ≥ 18 years

  • HbA1c <11.0%

  • Participant uses real-time CGM (any type of real-time CGM) on a regular basis (at least 70% of the time in the 4 weeks prior to screening)

  • No use of inhaled insulin in the 3 months prior to screening

  • If female of childbearing potential, willing and able to have pregnancy testing

  • Investigator believes that the participant can safely use the study treatment and will follow protocol

  • No medical, psychiatric,or other conditions, or medications being taken that in the Investigator's judgement would be a safety concern for participation in the study

    1. This includes considering the potential impact of medical conditions known to be present including cardiovascular, liver, kidney disease, thyroid disease, adrenal disease, malignancies, vision difficulties, active proliferative retinopathy, and other medical conditions; psychiatric conditions including eating disorders; drug or alcohol abuse.

  • History of recent blood transfusions (within previous 3 months prior to randomization), hemoglobinopathies, (sickle cell trait is not an exclusion), or any other conditions that affect HbA1c measurements
  • Recent history of asthma (defined as using any medications to treat within the last year), chronic obstructive pulmonary disease (COPD), or any other clinically important pulmonary disease (e.g., cystic fibrosis or bronchopulmonary dysplasia), or significant congenital or acquired cardiopulmonary disease as judged by the Investigator
  • Exposure to any investigational product(s), including drugs or devices, in the 90 days prior to the start of screening
  • Any disease other than diabetes or current use (or anticipated use during the study) of any medication that, in the judgment of the Investigator, may impact glucose metabolism
  • Current or anticipated acute uses of oral, inhaled or injectable glucocorticoids during the time period of the trial (topical glucocorticoid use is acceptable)
  • Use of a non-insulin glucose-lowering medication within 3 months prior to signing informed consent
  • Smoking (includes cigarettes, cigars, pipes, marijuana, and vaping devices) within 3 months prior to screening
  • Pregnant or lactating, planning to become pregnant during the study, or is a woman of childbearing potential and not on an acceptable form of birth control (acceptable includes abstinence, condoms, oral/injectable contraceptives, IUD, or implant); childbearing means that menstruation has started, and the participant is not surgically sterile or greater than 12 months post-menopausal
  • No known stage 4/5 renal failure or on dialysis
  • Taking Hydroxyurea medication
  • An event of severe hypoglycemia, as judged by the Investigator, within the last 90 days prior to screening
  • An episode of diabetic ketoacidosis (DKA) diagnosed at a health care facility within the 90 days prior to screening or severe hypoglycemia event within the 90 days prior to screening
  • Employed by, or having immediate family members employed by MannKind Corporation or JAEB Center for Health Research, or having a direct supervisor at place of employment who is also directly involved in conducting the clinical trial (as Study Investigator, coordinator, etc.); or having a first-degree relative who is directly involved in in conducting the clinical trial
  • Have a history or current diagnosis of lung cancer
Jaeb Center for Health Research logoJaeb Center for Health Research
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19 Centres de l'étude dans 1 pays

California

Loma Linda University-Diabetes Treatment Center, Loma Linda, California, 92354, United States
Sansum Diabetes Research, Santa Barbara, California, 93105, United States

Colorado

Barbara Davis Center, Aurora, Colorado, 80045, United States

Georgia

Atlanta Diabetes Associates, Atlanta, Georgia, 30318, United States

Illinois

Northwestern University Division of Endocrinology, Metabolism and Molecular Medicine, Chicago, Illinois, 60611, United States

Iowa

Iowa Diabetes Research, West Des Moines, Iowa, 50265, United States

Massachusetts

Boston Medical Center, Boston, Massachusetts, 02118, United States
Joslin Diabetes Center, Boston, Massachusetts, 02215, United States

Minnesota

Mayo Clinic, Rochester, Minnesota, 55905, United States

Nevada

Las Vegas Endocrinology, Henderson, Nevada, 89074, United States

New York

Endocrine Associate of West Village, PC, Long Island City, New York, 11106, United States
Mount Sinai Diabetes Center, New York, New York, 10075, United States
SUNY Upstate Medical University, Syracuse, New York, 13210, United States

North Carolina

University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 27514, United States

Texas

Texas Diabetes & Endocrinology, P.A., Austin, Texas, 78731, United States
The University of Texas Southwestern Medical Center, Dallas, Texas, 75390, United States
Diabetes and Glandular Disease Clinic, P.A., San Antonio, Texas, 78229, United States

Washington

University of Washington Diabetes Institute, Seattle, Washington, 98119, United States

West Virginia

Mountain State Diabetes, Parkersburg, West Virginia, 26101, United States