Type 1 Diabetes Mellitus-Type 2 Diabetes MellitusPhase 3GEMELLI1NCT03211858
Comparison of SAR341402 to NovoLog/NovoRapid in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine
A Phase 3 study testing Insulin aspart, NovoLog/NovoRapid and Insulin glargine (HOE901) in people with Type 1 Diabetes Mellitus-Type 2 Diabetes Mellitus, run by Sanofi at 82 sites in 7 countries.
Trial summary
Primary Objective: To demonstrate non-inferiority of SAR341402 versus NovoLog/NovoRapid in glycated hemoglobin A1c (HbA1c) change from baseline to Week 26 in participants with type 1 or type 2 diabetes mellitus (T1DM or T2DM) also using Lantus®. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Type 1 Diabetes Mellitus-Type 2 Diabetes Mellitus
- What is being tested?
- Insulin aspart, NovoLog/NovoRapid and Insulin glargine (HOE901)
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 597 participants
- Where
- 82 sitesin 7 countries
- Study dates
- 2 Aug 2017to 12 Jan 2019
- Phase
- Phase 3
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Participants with T1DM or T2DM (T2DM US only) diagnosed for at least 12 months, who have been treated with a multiple daily injection regimen with
- NovoLog/NovoRapid or insulin lispro (100 U/mL) in the last 6 months prior to screening visit AND
- insulin glargine (100 U/mL) in the last 6 months prior to screening visit OR insulin detemir (Levemir®) in the last 12 months prior to screening visit.
Who cannot join
- At screening visit, age under legal age of adulthood.
- HbA1c <7.0% or greater than (>) 10% at screening.
- Less than 1 year on continuous insulin treatment.
- Use of insulin pump in the last 3 months before screening visit.
- Participants with incomplete baseline 7-point SMPG profile, defined as participants who do not have 7-point profiles with at least 5 points on at least 2 days in the week before randomization Visit 3.
- Participants with T1DM: Use of glucose lowering agents other than insulin including use of non-insulin injectable peptides in the last 3 months prior to screening.
Show all 21Show fewer
- Participants with T2DM:
- Use of glucagon-like peptide-1 (GLP-1) receptor agonists in the last 3 months before screening visit.
- Use of oral antidiabetic drugs (OADs) not on stable dose in the last 3 months before screening visit (sulfonylureas was discontinued at baseline).
- At screening visit, body mass index (BMI) greater than or equal to (>=) 35 kilogram per meter square (kg/m^2) in participants with T1DM and >=40 kg/m^2 in participants with T2DM.
- Use of insulin other than:
- insulin glargine 100 U/mL and NovoLog/NovoRapid or insulin lispro 100 U/mL as part of a multiple injection regimen in the last 6 months before screening visit, OR
- insulin detemir 100 U/mL in the 12 months before screening visit and NovoLog/NovoRapid or insulin lispro 100 U/mL in the last 6 months before screening visit as part of a multiple injection regimen.
- Status post pancreatectomy.
- Status post pancreas and/or islet cell transplantation.
- Hospitalization for recurrent diabetic ketoacidosis in the last 3 months before screening visit.
- History of severe hypoglycemia requiring Emergency Room admission or hospitalization in the last 3 months before screening visit.
- Unstable proliferative diabetic retinopathy or any other rapidly progressive diabetic retinopathy or macular edema likely to require treatment (eg, laser, surgical treatment or injectable drugs) during the study period.
- Pregnant or breastfeeding women.
- Women of childbearing potential not protected by highly effective method(s) of birth control.
- The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Trial locations and contacts
82 sites in 7 countries.
82 sites in 7 countries
United States42 sites
Investigational Site Number 8400038
Arlington Heights, Illinois, 60005
Investigational Site Number 8400007
Atlanta, Georgia, 30318
Investigational Site Number 8400037
Aurora, Colorado, 80045
Investigational Site Number 8400044
Austin, Texas, 78731
Investigational Site Number 8400029
Bend, Oregon, 97701
Investigational Site Number 8400039
Bridgeport, West Virginia, 26330
Investigational Site Number 8400033
Chattanooga, Tennessee, 37404
Investigational Site Number 8400022
Columbus, Georgia, 31904
Investigational Site Number 8400012
Concord, California, 94520
Investigational Site Number 8400009
Dallas, Texas, 75230
Investigational Site Number 8400035
Dallas, Texas, 75230
Investigational Site Number 8400021
Dallas, Texas, 75246
Investigational Site Number 8400005
Des Moines, Iowa, 50314
Investigational Site Number 8400018
Englewood, Colorado, 80113
Investigational Site Number 8400002
Escondido, California, 92025
Investigational Site Number 8400023
Fargo, North Dakota, 58104
Investigational Site Number 8400019
Flint, Michigan, 48532-3447
Investigational Site Number 8400030
Fresno, California, 93720
Investigational Site Number 8400004
Greenbrae, California, 94904
Investigational Site Number 8400024
Henderson, Nevada, 89052
Investigational Site Number 8400017
Houston, Texas, 77043
Investigational Site Number 8400001
Houston, Texas, 77079
Investigational Site Number 8400020
Houston, Texas, 77089
Investigational Site Number 8400014
La Jolla, California, 92037
Investigational Site Number 8400040
Little Rock, Arkansas, 72211
Investigational Site Number 8400043
Los Angeles, California, 90057
Investigational Site Number 8400016
Mesquite, Texas, 75149
Investigational Site Number 8400041
Metairie, Louisiana, 70006
Investigational Site Number 8400025
Morehead City, North Carolina, 28557
Investigational Site Number 8400031
New Port Richey, Florida, 34652
Investigational Site Number 8400028
New York, New York, 10001
Investigational Site Number 8400027
Ocoee, Florida, 34761
Investigational Site Number 8400003
Omaha, Nebraska, 68131
Investigational Site Number 8400036
Pomona, California, 91766
Investigational Site Number 8400008
Renton, Washington, 98057
Investigational Site Number 8400015
Rockville, Maryland, 20852-4267
Investigational Site Number 8400032
Roswell, Georgia, 30076
Investigational Site Number 8400034
Salt Lake City, Utah, 84102
Investigational Site Number 8400011
Santa Barbara, California, 93105
Investigational Site Number 8400013
Ventura, California, 93003
Investigational Site Number 8400042
Waltham, Massachusetts, 02453
Investigational Site Number 8400010
Wilmington, North Carolina, 28401
Hungary10 sites
Investigational Site Number 3480012
Balatonfüred, 8230
Investigational Site Number 3480011
Budapest, 1036
Investigational Site Number 3480008
Budapest, 1042
Investigational Site Number 3480001
Budapest, 1062
Investigational Site Number 3480005
Budapest, 1062
Investigational Site Number 3480004
Budapest, 1139
Investigational Site Number 3480007
Debrecen, 4031
Investigational Site Number 3480003
Nagykanizsa, 8800
Investigational Site Number 3480010
Nyíregyháza, 4400
Investigational Site Number 3480009
Szentendre, 2000
Japan10 sites
Investigational Site Number 3920009
Fukuyama-Shi
Investigational Site Number 3920008
Higashiosaka-Shi
Investigational Site Number 3920007
Kashiwara-Shi
Investigational Site Number 3920001
Koriyama-Shi
Investigational Site Number 3920005
Kumamoto
Investigational Site Number 3920003
Mito
Investigational Site Number 3920010
Osaka
Investigational Site Number 3920002
Sagamihara-Shi
Investigational Site Number 3920004
Shinjuku-Ku
Investigational Site Number 3920006
Ushiku-Shi
Poland7 sites
Investigational Site Number 6160004
Bialystok, 15-435
Investigational Site Number 6160003
Krakow, 31-501
Investigational Site Number 6160005
Krakow, 31-548
Investigational Site Number 6160007
Lublin, 20-538
Investigational Site Number 6160006
Nowy Sącz, 33-300
Investigational Site Number 6160001
Poznan, 60-834
Investigational Site Number 6160002
Warsaw, 02-507
Germany5 sites
Investigational Site Number 2760001
Berlin, 10115
Investigational Site Number 2760006
Essen, 45136
Investigational Site Number 2760004
Heidelberg, 69115
Investigational Site Number 2760005
Oldenburg in Holstein, 23758
Investigational Site Number 2760002
Pirna, 01796
Finland4 sites
Investigational Site Number 2460006
Jyväskylä, 40100
Investigational Site Number 2460002
Kuopio, 70100
Investigational Site Number 2460004
Pori, 28500
Investigational Site Number 2460003
Seinäjoki, 60100
Russia4 sites
Investigational Site Number 6430001
Saint Petersburg, 194358
Investigational Site Number 6430002
Samara, 443041
Investigational Site Number 6430003
Saratov, 410030
Investigational Site Number 6430004
Tomsk, 634050
About this study
Official title: Six-month, Randomized, Open-label, Parallel-group Comparison of SAR341402 to NovoLog®/NovoRapid® in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine, With a 6-month Safety Extension Period
Primary Objective:
To demonstrate non-inferiority of SAR341402 versus NovoLog/NovoRapid in glycated hemoglobin A1c (HbA1c) change from baseline to Week 26 in participants with type 1 or type 2 diabetes mellitus (T1DM or T2DM) also using Lantus®.
Read more
Secondary Objectives:
- To assess the immunogenicity of SAR341402 and NovoLog/NovoRapid in terms of positive/negative status and anti-insulin antibody (AIA) titers during the course of the study.
- To assess the relationship of AIAs with efficacy and safety.
- To assess the efficacy of SAR341402 and NovoLog/NovoRapid in terms of proportion of participants reaching HbA1c lesser than (<) 7.0% and change in HbA1c, fasting plasma glucose (FPG), and self-measured plasma glucose (SMPG) profiles from baseline to Week 26 and Week 52 (only Week 52 for HbA1c).
- To assess safety of SAR341402 and NovoLog/NovoRapid.
Read the detailed description
The study consisted of a 2-week screening period, a 26-week treatment period, a 26-week comparative safety extension period, and a 1-day follow-up period. The maximum study duration was 54 weeks per participant and a 1 day safety follow-up.
- Being tested
- Insulin aspart, NovoLog/NovoRapid, Insulin glargine (HOE901)
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Insulin aspartDrug
SAR341402 100 units per milliliters (U/mL) (dose range of 1 unit to 80 units) self-administered by SC injection, immediately (within 5-10 minutes) before meal intake. Dose adjusted to achieve a 2-hour postprandial plasma glucose (PPG <10 millimoles/liter [mmol/L] [<180 milligram/deciliter {mg/dL}]) while avoiding hypoglycemia.
NovoLog/NovoRapidDrug
Also called Insulin aspart
NovoLog/NovoRapid 100 U/mL (dose range of 1 unit to 60 units) self-administered by SC injection, immediately (within 5-10 minutes) before meal intake. Dose adjusted to achieve a 2-hour postprandial plasma glucose (PPG <10 mmol/L [<180 mg/dL]) while avoiding hypoglycemia.
Insulin glargine (HOE901)Drug
Also called Lantus
Insulin glargine 100 U/mL injected QD subcutaneously consistent with the local label. Doses adjusted to achieve glycemic target for fasting, preprandial plasma glucose between 4.4 to 7.2 mmol/L (80 to 130 mg/dL) without hypoglycemia.
| Study group | Role | What they receive |
|---|---|---|
| SAR341402 | Experimental | SAR341402 subcutaneous (SC), before meals intake on top of once daily (QD) Insulin Glargine, up to Week 52. Receives: Drug: Insulin aspart; Drug: Insulin glargine (HOE901) |
| NovoLog/NovoRapid | Active comparator | NovoLog/NovoRapid SC, before meals intake on top of QD Insulin Glargine, up to Week 52. Receives: Drug: NovoLog/NovoRapid; Drug: Insulin glargine (HOE901) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Glycated Hemoglobin A1c (HbA1c) From Baseline to Week 26
All values up to Week 26 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 26 value. Missing changes at Week 26 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted least square (LS) means and standard errors (SE) were obtained using an analysis of covariance (ANCOVA) model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Measured: Baseline, Week 26
Secondary outcomes (11)
Change in HbA1c From Baseline to Week 52
All values up to Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 52 value. Missing changes at Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Measured: Baseline, Week 52
Percentage of Participants With HbA1c <7% at Week 26 and Week 52
Participants who had no available assessment at Week 26 and Week 52 were considered as non-responders.
Measured: Week 26 and Week 52
Change in Fasting Plasma Glucose (FPG) From Baseline to Week 26 and Week 52
All values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in FPG at Week 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Measured: Baseline, Week 26, and Week 52
Change in the Mean 24-hour Plasma Glucose Concentration From Baseline to Week 26 and Week 52
Mean 24-hour plasma glucose concentration was calculated based on 7-point self-measured plasma glucose (SMPG) profiles with plasma glucose measurements before and 2-hours after each main meal and at bedtime. Mean 24-hour plasma glucose concentration was calculated for each profile and then averaged across profiles performed in the week before a visit. All calculated values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in mean 24-hour plasma glucose concentration at Weeks 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a return-to-baseline multiple imputation method (values imputed as participant baseline plus an error). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Measured: Baseline, Week 26, and Week 52
Change in Postprandial Plasma Glucose (PPG) Excursion From Baseline to Week 26 and Week 52
Plasma glucose excursions were calculated at breakfast, lunch and dinner for each 7-point SMPG profile, as 2-hour PPG minus plasma glucose value obtained 30 minutes prior to start of the meal. Values of plasma glucose excursions at each visit were then calculated as the average across profiles performed in the week before the visit. All calculated values up to Week 26 and Week 52 were taken into account in the analysis, regardless of adherence to treatment. Change in PPG excursions at Weeks 26 and 52 was calculated by subtracting baseline value from Week 26 and Week 52 values, respectively. Missing changes at Week 26 and Week 52 were imputed using a return-to-baseline multiple imputation method (values imputed as participant baseline plus an error). Adjusted LS means and SE were obtained using ANCOVA analysis on data obtained from the multiple imputations (results were combined using Rubin's formulae).
Measured: Baseline, Week 26, and Week 52
Change in 7-Point SMPG Profiles From Baseline to Week 26 and Week 52 Per Time Point
7-point SMPG profiles were measured at the following 7 points at each visit (Baseline, Week 26, and Week 52): before breakfast, 2 hours after breakfast, before lunch, 2 hours after lunch, before dinner, 2 hours after dinner, and bedtime. For each time point, the value at each visit was calculated as the average of values obtained for the same time point across profiles performed in the week before the visit.
Measured: Baseline, Week 26, and Week 52
Number of Participants With at Least One Hypoglycemic Event
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 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Measured: From first injection of investigational medicinal product (IMP) up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Number of Hypoglycemia Events Per Participant-Year
Number of hypoglycemia events (any, severe and documented [both thresholds]) 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 mg/dL) or plasma glucose level of <3.0 mmol/L (<54 mg/dL).
Measured: From first injection of investigational medicinal product (IMP) up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Percentage of Participants With Hypersensitivity Reactions and Injection Site Reactions
Participants with at least one treatment-emergent adverse event linked to hypersensitivity reaction and injection site reaction regardless of relationship to IMP during the main 6-month and the 12-month on-treatment periods was assessed and reported.
Measured: From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Percentage of Participants With at Least One Positive Anti-Insulin Aspart Antibodies (AIA) Sample
Participants with at least one positive AIA sample at baseline or at any time during the on-treatment period (Prevalence).
Measured: From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Percentage of Participants With Treatment-Induced, Treatment-Boosted and Treatment-Emergent Anti-insulin Aspart Antibodies (AIAs)
AIA incidence were categorized as: treatment-induced, treatment-boosted AIAs, and treatment-emergent AIA. 1) Participants with treatment-induced AIAs were those who developed AIA following IMP administration (participants with at least one positive AIA sample at any time during on-treatment period, in those participants without pre-existing AIA or with missing baseline sample). 2) Participants with treatment-boosted AIAs were those with pre-existing AIAs that were boosted to a significant higher titer following IMP administration (participants with at least one AIA sample with at least a 4-fold increase in titers compared to baseline value at any time during on-treatment period). 3) Participants with treatment-emergent AIA were defined as participants with treatment-induced, or treatment-boosted AIAs.
Measured: From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Jul 2017
- Study start2 Aug 2017
- Primary completion16 Jul 2018
- Study completion12 Jan 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Type 1 Diabetes Mellitus-Type 2 Diabetes MellitusStudies of the same condition, open and under way.
- More trials run by SanofiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 597 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sanofi
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Sciences & Operations, Study director, Sanofi
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03211858
- Sponsor's protocol ID
- EFC15081
- Other IDs
- 2017-000091-28, U1111-1191-5775, 2017
- Acronym
- GEMELLI1
- Status last verified
- Mar 2022
- First submitted
- 6 Jul 2017
- Last updated
- 28 Mar 2022
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
Publications
Garg SK, Wernicke-Panten K, Wardecki M, Kramer D, Delalande F, Franek E, Sadeharju K, Monchamp T, Mukherjee B, Shah VN. Efficacy and Safety of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Treated for 26 Weeks with Multiple Daily Injections in Combination with Insulin Glargine: A Randomized Open-Label Trial (GEMELLI 1). Diabetes Technol Ther. 2020 Feb;22(2):85-95. doi: 10.1089/dia.2019.0382.
PubMed 31804851Garg SK, Wernicke-Panten K, Wardecki M, Kramer D, Delalande F, Franek E, Sadeharju K, Monchamp T, Miossec P, Mukherjee B, Shah VN. Safety, Immunogenicity, and Glycemic Control of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Also Using Insulin Glargine: 12-Month Results from the GEMELLI 1 Trial. Diabetes Technol Ther. 2020 Jul;22(7):516-526. doi: 10.1089/dia.2020.0008. Epub 2020 Mar 31.
PubMed 32068436Shah VN, Franek E, Wernicke-Panten K, Pierre S, Mukherjee B, Sadeharju K. Efficacy, Safety, and Immunogenicity of Insulin Aspart Biosimilar SAR341402 Compared with Originator Insulin Aspart in Adults with Diabetes (GEMELLI 1): A Subgroup Analysis by Prior Type of Mealtime Insulin. Diabetes Ther. 2021 Feb;12(2):557-568. doi: 10.1007/s13300-020-00992-x. Epub 2021 Jan 11.
PubMed 33432547
Study at a glance
From the registry record, last updated by the sponsor on 28 Mar 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Six-month, Randomized, Open-label, Parallel-group Comparison of SAR341402 to NovoLog®/NovoRapid® in Adult Patients With Diabetes Mellitus Also Using Insulin Glargine, With a 6-month Safety Extension Period
- ClinicalTrials.gov ID
- NCT03211858
- Acronym / sponsor ID
- GEMELLI1 / EFC15081
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 597 participants (actual)
- Lead sponsor
- SanofiIndustry (pharma, biotech, devices)
- Study start
- 2 Aug 2017 (actual)
- Primary completion
- 16 Jul 2018 (actual)
- Study completion
- 12 Jan 2019 (actual)
- First posted
- 7 Jul 2017 (actual)
- Results
- Posted 8 Aug 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Primary Objective:
To demonstrate non-inferiority of SAR341402 versus NovoLog/NovoRapid in glycated hemoglobin A1c (HbA1c) change from baseline to Week 26 in participants with type 1 or type 2 diabetes mellitus (T1DM or T2DM) also using Lantus®.
Secondary Objectives:
- To assess the immunogenicity of SAR341402 and NovoLog/NovoRapid in terms of positive/negative status and anti-insulin antibody (AIA) titers during the course of the study.
- To assess the relationship of AIAs with efficacy and safety.
- To assess the efficacy of SAR341402 and NovoLog/NovoRapid in terms of proportion of participants reaching HbA1c lesser than (<) 7.0% and change in HbA1c, fasting plasma glucose (FPG), and self-measured plasma glucose (SMPG) profiles from baseline to Week 26 and Week 52 (only Week 52 for HbA1c).
- To assess safety of SAR341402 and NovoLog/NovoRapid.
Detailed description
The study consisted of a 2-week screening period, a 26-week treatment period, a 26-week comparative safety extension period, and a 1-day follow-up period. The maximum study duration was 54 weeks per participant and a 1 day safety follow-up.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| SAR341402 | Experimental | Drug: Insulin aspart, Drug: Insulin glargine (HOE901)SAR341402 subcutaneous (SC), before meals intake on top of once daily (QD) Insulin Glargine, up to Week 52. |
| NovoLog/NovoRapid | Active comparator | Drug: NovoLog/NovoRapid, Drug: Insulin glargine (HOE901)NovoLog/NovoRapid SC, before meals intake on top of QD Insulin Glargine, up to Week 52. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Participants with T1DM or T2DM (T2DM US only) diagnosed for at least 12 months, who have been treated with a multiple daily injection regimen with
- NovoLog/NovoRapid or insulin lispro (100 U/mL) in the last 6 months prior to screening visit AND
- insulin glargine (100 U/mL) in the last 6 months prior to screening visit OR insulin detemir (Levemir®) in the last 12 months prior to screening visit.
Key exclusion criteria (21 listed)
- At screening visit, age under legal age of adulthood.
- HbA1c <7.0% or greater than (>) 10% at screening.
- Less than 1 year on continuous insulin treatment.
- Use of insulin pump in the last 3 months before screening visit.
- Participants with incomplete baseline 7-point SMPG profile, defined as participants who do not have 7-point profiles with at least 5 points on at least 2 days in the week before randomization Visit 3.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Insulin aspartSAR341402 100 units per milliliters (U/mL) (dose range of 1 unit to 80 units) self-administered by SC injection, immediately (within 5-10 minutes) before meal intake. Dose adjusted to achieve a 2-hour postprandial plasma glucose (PPG <10 millimoles/liter [mmol/L] [<180 milligram/deciliter {mg/dL}]) while avoiding hypoglycemia. | Drug | SAR341402 |
| NovoLog/NovoRapidAlso: Insulin aspartNovoLog/NovoRapid 100 U/mL (dose range of 1 unit to 60 units) self-administered by SC injection, immediately (within 5-10 minutes) before meal intake. Dose adjusted to achieve a 2-hour postprandial plasma glucose (PPG <10 mmol/L [<180 mg/dL]) while avoiding hypoglycemia. | Drug | NovoLog/NovoRapid |
| Insulin glargine (HOE901)Also: LantusInsulin glargine 100 U/mL injected QD subcutaneously consistent with the local label. Doses adjusted to achieve glycemic target for fasting, preprandial plasma glucose between 4.4 to 7.2 mmol/L (80 to 130 mg/dL) without hypoglycemia. | Drug | NovoLog/NovoRapid, SAR341402 |
Primary outcome
Change in Glycated Hemoglobin A1c (HbA1c) From Baseline to Week 26
Time frame: Baseline, Week 26
All values up to Week 26 were taken into account in the analysis, regardless of adherence to treatment. Change in HbA1c was calculated by subtracting baseline value from Week 26 value. Missing changes at Week 26 were imputed using a retrieved dropout multiple imputation method (separately for participants who prematurely discontinued or completed treatment). Adjusted least square (LS) means and standard errors (SE) were obtained using an analysis of covariance (ANCOVA) model on data obtained from the multiple imputations (results were combined using Rubin's formulae).
11 secondary outcomes
Change in HbA1c From Baseline to Week 52
Time frame: Baseline, Week 52
Percentage of Participants With HbA1c <7% at Week 26 and Week 52
Time frame: Week 26 and Week 52
Change in Fasting Plasma Glucose (FPG) From Baseline to Week 26 and Week 52
Time frame: Baseline, Week 26, and Week 52
Change in the Mean 24-hour Plasma Glucose Concentration From Baseline to Week 26 and Week 52
Time frame: Baseline, Week 26, and Week 52
Change in Postprandial Plasma Glucose (PPG) Excursion From Baseline to Week 26 and Week 52
Time frame: Baseline, Week 26, and Week 52
Change in 7-Point SMPG Profiles From Baseline to Week 26 and Week 52 Per Time Point
Time frame: Baseline, Week 26, and Week 52
Number of Participants With at Least One Hypoglycemic Event
Time frame: From first injection of investigational medicinal product (IMP) up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Number of Hypoglycemia Events Per Participant-Year
Time frame: From first injection of investigational medicinal product (IMP) up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Percentage of Participants With Hypersensitivity Reactions and Injection Site Reactions
Time frame: From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Percentage of Participants With at Least One Positive Anti-Insulin Aspart Antibodies (AIA) Sample
Time frame: From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Percentage of Participants With Treatment-Induced, Treatment-Boosted and Treatment-Emergent Anti-insulin Aspart Antibodies (AIAs)
Time frame: From first injection of IMP up to Week 26 or up to 1 day after last injection of IMP, whichever comes earlier, for Week 26 analysis, and from first injection of IMP up to 1 day after last injection of IMP for Week 52
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Mar 2022.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 31804851Garg SK, Wernicke-Panten K, Wardecki M, Kramer D, Delalande F, Franek E, Sadeharju K, Monchamp T, Mukherjee B, Shah VN. Efficacy and Safety of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Treated for 26 Weeks with Multiple Daily Injections in Combination with Insulin Glargine: A Randomized Open-Label Trial (GEMELLI 1). Diabetes Technol Ther. 2020 Feb;22(2):85-95. doi: 10.1089/dia.2019.0382.
- Background: PubMed 32068436Garg SK, Wernicke-Panten K, Wardecki M, Kramer D, Delalande F, Franek E, Sadeharju K, Monchamp T, Miossec P, Mukherjee B, Shah VN. Safety, Immunogenicity, and Glycemic Control of Insulin Aspart Biosimilar SAR341402 Versus Originator Insulin Aspart in People with Diabetes Also Using Insulin Glargine: 12-Month Results from the GEMELLI 1 Trial. Diabetes Technol Ther. 2020 Jul;22(7):516-526. doi: 10.1089/dia.2020.0008. Epub 2020 Mar 31.
- Derived from this study: PubMed 33432547Shah VN, Franek E, Wernicke-Panten K, Pierre S, Mukherjee B, Sadeharju K. Efficacy, Safety, and Immunogenicity of Insulin Aspart Biosimilar SAR341402 Compared with Originator Insulin Aspart in Adults with Diabetes (GEMELLI 1): A Subgroup Analysis by Prior Type of Mealtime Insulin. Diabetes Ther. 2021 Feb;12(2):557-568. doi: 10.1007/s13300-020-00992-x. Epub 2021 Jan 11.
- Individual participant dataSharing planned: Yes. Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Clinical Sciences & Operations study director
Sanofi
82 sites in 7 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Insulin aspart, NovoLog/NovoRapid and Insulin glargine (HOE901) in people with Type 1 Diabetes Mellitus-Type 2 Diabetes Mellitus, run by Sanofi at 82 sites in 7 countries.
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 3 inclusion and 21 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 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 82 sites in United States, Hungary, Japan, Poland, Germany and 2 more countries. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
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 8 Aug 2019). 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 Glycated Hemoglobin A1c (HbA1c) From Baseline to Week 26 (time frame: Baseline, Week 26). 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 NCT03211858, which also lists 3 linked publications.
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 Mar 2022.