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Type1 Diabetes MellitusPhase 2NCT03117998

Multiple Dose Study to Evaluate the Efficacy, Safety and Pharmacodynamics of REMD-477 in Subjects With Type 1 Diabetes Mellitus

A Phase 2 study testing REMD-477 in people with Type1 Diabetes Mellitus, run by REMD Biotherapeutics, Inc. at 11 sites 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 a randomized, placebo-controlled, double-blind study to evaluate the efficacy, safety, and pharmacodynamics (PD) of multiple doses of REMD-477 in subjects who have Type 1 diabetes and are currently receiving insulin treatment. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Type1 Diabetes Mellitus
What is being tested?
REMD-477
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
154 participants
Where
11 sitesUnited States
Study dates
19 Sep 2017to 5 Mar 2021
Phase
Phase 2
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 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women between the ages of 18 and 65 years old, inclusive, at the time of screening;
  • Females of non-child bearing potential must be ≥1 year post-menopausal (confirmed by a serum follicle-stimulating hormone (FSH) levels ≥ 40 IU/mL) or documented as being surgically sterile. Females of child bearing potential must agree to use two methods of contraception;
  • Male subjects must be willing to use clinically acceptable method of contraception during the entire study;
  • Body mass index between 18.5 and 32 kg/m2, inclusive, at screening;
  • Diagnosed with Type 1 diabetes, based on clinical history or as defined by the current American Diabetes Association (ADA) criteria;
  • HbA1c > 7% and < 10 % at screening;
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  • Fasting C-peptide < 0.7 ng/mL;
  • Treatment with a stable insulin regimen for at least 8 weeks before screening with multiple daily insulin (MDI) injections or continue subcutaneous insulin infusion (CSII)
  • Willing to use continuous CGM system (e.g. DexCom) throughout the study;
  • Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤ 1.5x upper limit of normal (ULN) at screening;
  • Able to provide written informed consent approved by an Institutional Review Board (IRB).

Who cannot join

  • History or evidence of clinically-significant disorder or condition that, in the opinion of the Investigator, would pose a risk to subject safety or interfere with the study evaluation, procedures, or completion;
  • Significant organ system dysfunction (e.g., clinically significant pulmonary or cardiovascular disease, anemia [Hemoglobin < 10.0 g/dL], known hemoglobinopathies, and renal dysfunction [eGFR < 60 ml/min]);
  • Any severe symptomatic hypoglycemic event associated with a seizure or requiring help from other people or medical facility in the past 6 months;
  • Myocardial infarction, unstable angina, revascularization procedure, or cerebrovascular accident ≤12 weeks before screening;
  • History of New York Heart Association Functional Classification III-IV cardiac disease;
  • Current or recent (within 1 month of screening) use of diabetes medications other than insulin - subjects on an SGLT2 inhibitor should be discontinue the SGLT2 inhibitor during the Screening Period, at least 2 weeks prior to the start of the Lead-in Period;
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  • Use of steroids and/or other prescribed or over-the-counter medications that are known to affect the outcome measures in this study or known to influence glucose metabolism;
  • Smokes > 10 cigarettes/day, and/or is unwilling to abstain from smoking during admission periods;
  • Known sensitivity to mammalian-derived drug preparations, recombinant protein-based drugs or to humanized or human antibodies;
  • History of illicit drug use or alcohol abuse within the last 6 months or a positive drug urine test result at screening;
  • History of pancreatitis, pancreatic neuroendocrine tumors or multiple endocrine neoplasia (MEN) or family history of MEN;
  • History of pheochromocytoma, or family history of familial pheochromocytoma;
  • Known or suspected susceptibility to infectious disease (e.g. taking immunosuppressive agents or has a documented inherited or acquired immunodeficiency);
  • Known history of positive for human immunodeficiency virus (HIV) antibodies, hepatitis B surface antigen (HbsAg), or hepatitis C antibodies (HepC Ab);
  • Participation in an investigational drug or device trial within 30 days of screening or within 5 times the half-life of the investigational agent in the other clinical study, if known, whichever period is longer;
  • Blood donor or blood loss > 500 mL within 30 days of Day 1;
  • Women who are pregnant or lactating/breastfeeding;
  • Unable or unwilling to follow the study protocol or who are non-compliant with screening appointments or study visits;
  • Any other condition(s) that might reduce the chance of obtaining study data, or that might cause safety concerns, or that might compromise the ability to give truly informed consent
  • Other inclusion and exclusion criteria may apply.

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • Atlanta Diabetes Assoicates

    Atlanta, Georgia, 30318

  • University of Colorado, Denver/Barbara Davis Center for Diabetes

    Aurora, Colorado, 80045

  • Texas Diabetes & Endocrinology

    Austin, Texas, 78749

  • Dallas Diabetes Research Center

    Dallas, Texas, 75230

  • AMCR Institute

    Escondido, California, 92025

  • Marin Endocrine Care & Research

    Greenbrae, California, 94904

  • Rainer Clinical Research Center

    Renton, Washington, 98057

  • Clinical Trials of Texas

    San Antonio, Texas, 78229

  • Altman Clinical and Translational Research Institute

    San Diego, California, 92037

  • Washington University School of Medicine

    St Louis, Missouri, 63110

  • Diablo Clinical Research

    Walnut Creek, California, 94598

Other trials in United States

About this study

Official title: A Randomized, Placebo-controlled, Double-blind Study to Evaluate the Efficacy, Safety, and Pharmacodynamics of Multiple Doses of REMD-477 in Subjects With Type 1 Diabetes Mellitus

This is a randomized, placebo-controlled, double-blind study to evaluate the efficacy, safety, and pharmacodynamics (PD) of multiple doses of REMD-477 in subjects who have Type 1 diabetes and are currently receiving insulin treatment. This study will determine whether REMD-477 can decrease daily insulin requirements and improve glycemic control after 12 weeks of treatment in subjects diagnosed with Type 1 diabetes with fasting C-peptide < 0.7 ng/mL at Screening.

The study will be conducted at multiple sites in the United States. Approximately 150 subjects with type 1 diabetes on stable doses of insulin will be randomized in a 1:1:1 fashion into one of three treatment groups.

Being tested
REMD-477, Placebo Comparator

What participants receive

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

  • REMD-477Biological

    Administered as repeated SC doses in subjects with Type 1 Diabetes

  • Placebo ComparatorBiological

    Administered as a repeated SC doses in subjects with Type 1 Diabetes

Study groups in NCT03117998
Study groupRoleWhat they receive
35 mg REMD-477ExperimentalAdministered as a repeated subcutaneous (SC) doses in subjects with Type 1 Diabetes
Receives: Biological: REMD-477
70 mg REMD-477ExperimentalAdministered as a repeated SC doses in subjects with Type 1 Diabetes
Receives: Biological: REMD-477
Matching placeboPlacebo comparatorAdministered as a repeated SC doses in subjects with Type 1 Diabetes
Receives: Biological: Placebo Comparator

What is being measured

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

  1. Change in Average Daily Total Insulin Use

    Change from Baseline in average daily total insulin use at Week 12

    Measured: Baseline and 12 weeks

Secondary outcomes (16)
  1. Change From Baseline Difference in AUC Glucose Concentrations Following Mixed Meal Tolerance Test (MMTT) - Part A Only

    Difference from baseline at Week 13 in AUC glucose concentration following the Mixed Meal Tolerance Test (MMTT) after repeated doses of REMD-477.

    Measured: Baseline and 13 weeks; AUC glucose timepoints: 10 minutes prior and just before (time ) initiating the mixed-meal ingestion and at 30, 60 and 120 minutes after the mixed meal ingestion.

  2. Continuous Glucose Monitoring (CGM) - Change in Average Daily 24-hour Glucose Concentration at Week 12

    Change from baseline at Week 12 in average daily 24-h blood glucose as assessed by CGM after repeated doses of REMD-477.

    Measured: Baseline and 12 weeks

  3. Seven-Point Glucose Profile - Change in Average 24-h Glucose Concentrations

    Change from baseline at Week 12 in the average daily 24-h blood glucose concentration as assessed by seven-point glucose profile after repeated doses of REMD-477. The 7-point blood glucose profiles includes measuring glucose via finger stick, at the following times of the day: before each meal, 2 hours after each meal, and at bedtime. The 7-point glucose profiles were obtained for 3 consecutive days before (Day 1) and for 3 consecutive days during week 12.

    Measured: Baseline and 12 weeks

  4. Summary of the Product of Average Daily 24-h Glucose Ratio and Daily Insulin Use Ratio (Day 78 [Week 12]/Baseline)

    The product of the ratio of average glucose (Week 12/Baseline) and ratio of average insulin use (Week 12/Baseline).

    Measured: Baseline and week 12

  5. Change in Hemoglobin A1c From Baseline at Week 13

    Change in Hemoglobin A1c from baseline at Week 13, after repeated doses of REMD-477.

    Measured: Baseline and 13 weeks

  6. Percentage of Subjects With HbA1c Reduction of ≥ 0.4% at Week 13

    Proportion (percentage) of subjects who achieve HbA1c reduction of ≥ 0.4%, after repeated doses of REMD-477

    Measured: Baseline and 13 weeks

  7. Change in C-peptide Adjusted AUC Following Mixed Meal Tolerance Test (MMTT)

    Change from baseline at Week 13 in the C-peptide adjusted AUC following MMTT after repeated doses of REMD-477.

    Measured: Baseline and 13 weeks; AUC C-peptide timepoints: 10 minutes prior and just before (time 0) initiating the mixed-meal ingestion and at 30, 60 and 120 minutes after the mixed meal ingestion.

  8. Change in Baseline Difference in Glucagon Adjusted AUC Following Mixed Meal Tolerance Test (MMTT) - Part A Only

    Change from baseline at Week 13 in glucagon adjusted AUC after MMTT challenge, after repeated doses of REMD-477.

    Measured: Baseline and 13 weeks; AUC glucagon timepoints: 10 minutes prior and just before (time ) initiating the mixed-meal ingestion and at 30, 60 and 120 minutes after the mixed meal ingestion.

  9. Proportion of Subjects With Positive Anti-REMD-477 Antibodies

    Proportion of subjects positive for anti-REMD-477 antibody formation.

    Measured: Day 1 (pre-dose), Day 85 (Week 13) and Day 162 (Week 24)

  10. Summary of REMD-477 Plasma Concentrations

    REMD-477 serum-concentration after repeated doses of REMD-477.

    Measured: Baseline (Day 1 pre-dose) and Weeks 2, 5, 9, 13 and 16.

  11. Change in Hemoglobin A1c at Week 13 in Subjects With Baseline HbA1c ≥7.5%

    Change in Hemoglobin A1c from baseline at Week 13, after repeated doses of REMD-477.

    Measured: Baseline and 13 weeks

  12. Proportion of Subjects With Targeted Hemoglobin A1C (HbA1c) of ≤ 7.0% at Week 13

    Proportion (percentage) of subjects who achieve target HbA1c reduction of ≤ 7.0% at Week 13, after repeated doses of REMD-477

    Measured: Baseline and 13 weeks

  13. Continuous Glucose Monitoring (CGM) - Change in Percent Time Spent in Target Blood Glucose Range (70-180 mg/dL) at Week 12

    Change from baseline at Week 12 in percent time spent in target blood glucose range (70-180 mg/dL) after repeated doses of REMD-477.

    Measured: Baseline and 12 weeks

  14. Continuous Glucose Monitoring (CGM) - Change in Percent Time Spent in Hyperglycemia (Blood Glucose Range >180 mg/dL) at Week 12

    Change from baseline at Week 12 in percent time spent in Hyperglycemia (Blood Glucose Range >180 mg/dL) after repeated doses of REMD-477.

    Measured: Baseline and 12 weeks

  15. Continuous Glucose Monitoring (CGM) - Change in Percent Time Spent in Hypoglycemia (Blood Glucose Range <70 mg/dL) at Week 12

    Change from baseline at Week 12 in percent time spent in Hypoglycemia (Blood Glucose Range <70 mg/dL) after repeated doses of REMD-477.

    Measured: Baseline and 12 weeks

  16. Continuous Glucose Monitoring (CGM) - Change in Percent Time Spent in Hypoglycemia (Blood Glucose Range <55 mg/dL) at Week 12

    Change from baseline at Week 12 in percent time spent in Hypoglycemia (Blood Glucose Range <55 mg/dL) after repeated doses of REMD-477.

    Measured: Baseline and 12 weeks

Timeline

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

  1. First posted18 Apr 2017
  2. Study start19 Sep 2017
  3. Primary completion5 Mar 2021
  4. Study completion5 Mar 2021

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
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
154 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03117998
Sponsor's protocol ID
R477-202
Status last verified
May 2023
First submitted
10 Apr 2017
Last updated
25 May 2023
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Santiago Padilla L, Schiattarella GG. Targeting HFpEF: Unlocking the Potential of Glucagon Receptor Blockade. Circ Res. 2024 Aug 16;135(5):629-631. doi: 10.1161/CIRCRESAHA.124.325130. Epub 2024 Aug 15. No abstract available.

    PubMed 39146397

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing REMD-477 in people with Type1 Diabetes Mellitus, run by REMD Biotherapeutics, Inc. at 11 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 11 inclusion and 20 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 25 May 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 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. Some participants in this study may receive a placebo. 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?

Yes. Results are posted in the registry (first posted 25 May 2023). 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 in Average Daily Total Insulin Use (time frame: Baseline and 12 weeks). 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 NCT03117998, 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 25 May 2023.

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Clinical Trial NCT03117998 | AzTrials