Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ACZ885 in Patients With Type 2 Diabetes | RxWiki

Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ACZ885 in Patients With Type 2 Diabetes

Overview[ - collapse ][ - ]

Purpose	The purpose of this study was to evaluate, in patients with Type 2 Diabetes Mellitus, whether Canakinumab can lower Glycosylated hemoglobin / hemoglobin A1c (HbA1c) and/or peak glucose levels in response to an oral glucose tolerance test (OGTT).
Condition	Type 2 Diabetes Mellitus
Intervention	Drug: Canakinumab Drug: Placebo Drug: Metformin
Phase	Phase 2
Sponsor	Novartis
Responsible Party	Novartis
ClinicalTrials.gov Identifier	NCT00605475
First Received	January 18, 2008
Last Updated	January 10, 2012
Last verified	January 2012

Tracking Information[ + expand ][ + ]

First Received Date	January 18, 2008
Last Updated Date	January 10, 2012
Start Date	December 2007
Estimated Primary Completion Date	September 2010
Current Primary Outcome Measures	Mean Change From Baseline in Plasma HbA1c (Glycosylated Hemoglobin / Hemoglobin A1c) [Time Frame: Baseline, Day 28, Day 84, Day 126, End of Study (168 [+/- 5] days after dosing)] [Designated as safety issue: No]Blood was drawn after an overnight fast to measure plasma HbA1c levels. End of Study is defined as the last Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Change From Baseline in Plasma Glucose Area Under the Curve (AUC) 0 - 4 Hours Following Oral Glucose Tolerance Test (OGTT ) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Mean Change in Glucose level stimulated by OGTT. Blood samples were taken at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes. Glucose levels over 4 hrs were shown as Area Under the Curve, (AUC). Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed.
Current Secondary Outcome Measures	Mean Change From Baseline in Plasma C-peptide AUC ( Area Under the Curve) 0-4 Hours, Following Oral Glucose Tolerance Test (OGTT) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Blood samples were drawn after an overnight fast and standard OGTT at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. C-peptide levels over 4 hrs were shown as Area Under the Curve, (AUC). Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Change From Baseline in Plasma Insulin AUC ( Area Under the Curve) 0-4 Hours, Following Oral Glucose Tolerance Test ( OGTT ) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Blood samples were drawn after an overnight fast and OGTT at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Insulin levels over 4 hrs were shown as Area Under the Curve, (AUC). Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Change From Baseline in Plasma Proinsulin AUC ( Area Under the Curve) 0-4 Hours, Following Oral Glucose Tolerance Test ( OGTT ) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Blood samples were drawn after an overnight fast and OGTT at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Insulin levels over 4 hrs were shown as Area Under the Curve, (AUC). Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Change From Baseline in Plasma Glucagon AUC ( Area Under the Curve) 0-4 Hours, Following Oral Glucose Tolerance Test [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Blood samples were drawn after an overnight fast and OGTT at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Glucagon levels over 4 hrs were shown as Area Under the Curve, (AUC). Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Change From Baseline in Peak Plasma Insulin/Proinsulin Level, Following Oral Glucose Tolerance Test (OGTT) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Blood samples were drawn after an overnight fast and OGTT at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min. Insulin and proinsulin levels were measured. The insulin/proinsulin level was calculated by dividing the insulin level by the proinsulin level. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Insulin Secretion Rate ( ISR ) Relative to Glucose, 0 - 4 Hours [Time Frame: Day 28, Day 84] [Designated as safety issue: No]Blood samples were taken at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes. Mean ISR relative to glucose over 0-4 hours was calculated as follows: Mean ISR relative to glucose = mean ISR / (glucose AUC/time interval). The mean ISR was computed as an AUC (area under the curve) using the linear trapezoidal rule divided by the corresponding time interval. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Insulin Secretion Rate ( ISR ), 0 - 4 Hours [Time Frame: Day 28, Day 84] [Designated as safety issue: No]Blood samples were taken at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes. The mean ISR over 0 - 4 hours was computed as an AUC (area under the curve) using the linear trapezoidal rule divided by the corresponding time interval. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Insulin Sensitivity Index ( ISI ) at Day 28, Day 48 [Time Frame: Day 28, Day 84] [Designated as safety issue: No]Insulin sensitivity index (ISI) = 10000 / [fasting insulin (μIU/mL) x fasting glucose (mg/dL) x mean 2 hour insulin(μIU/mL) x mean 2 hour glucose (mg/dL)]1/2 where mean 2 hour insulin (or glucose) was defined as the insulin (or glucose)AUC(0-2 hr) divided by the time period (2 hr). In normal subjects the mean score ± SE is 0.366 ± 0.029. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed on log transformed data. Insulinogenic Index, 0 - 30 Minutes [Time Frame: Day 28, Day 84] [Designated as safety issue: No]Insulinogenic index (0-30 min) [Change in insulin (0-30 min) (μIU/mL)] / [Change in glucose (0-30 min) (mg/dL)] [insulin (μIU/mL) at 30 min - insulin (μIU/mL) at 0 min] / [glucose (mg/dL) at 30 min - glucose (mg/dL) at 0 min), where insulin (or glucose) at 0 min was defined as the arithmetic mean of the -15, -10 and 0 min pre-glucose load values. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed on log transformed data.. Mean Change From Baseline in Peak Plasma Glucose Following Oral Glucose Tolerance Test ( OGTT ) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Mean Change in Peak Glucose level stimulated by OGTT. Blood samples were taken at sample times: -20, -10, -1 and 10, 20, 30, 60, 90, 120, 180, and 240 minutes. Change from baseline assessed at Day 28 and 84. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Mean Change From Baseline in Peak Plasma Fructosamine Level [Time Frame: Baseline, Day 14, Day 28, Day 56, Day 84, Day 126, End of Study (168 [+/- 5] days after dosing)] [Designated as safety issue: No]Blood was drawn to measure change in plasma Fructosamine Level, from baseline to Day 14, 28, 56, 84, 126 and End of Study ( defined as the final available post-randomization assessment up to the last regularly scheduled visit at Day 168 [+/- 5]). Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed. Insulin Resistance as Measured by the Homeostatic Model Assessment (HOMA-IR) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]Insulin Resistance is measured via the Homeostatic Model Assessment (HOMA-IR) using a computer to model insulin sensitivity. Insulin Sensitivity (HOMA-%S), where 100% is normal, is the reciprocal of insulin resistance (100/S%). HOMA IR = [fasting insulin (μU/mL)] x [fasting plasma glucose (mmol/L)] / 22.5 where fasting insulin (or glucose) was defined as the arithmetic mean of the -15, -10 and 0 min pre-glucose load values. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed on log transformed data. β-cell Function as Measured by the Homeostatic Model Assessment (HOMA-β ) [Time Frame: Baseline, Day 28, Day 84] [Designated as safety issue: No]β cell function is measured by the Homeostatic Model Assessment(HOMA-β) using a computer to model β cell function and insulin sensitivity . β cell function is related to Insulin Sensitivity (HOMA-%S) and is the reciprocal of insulin resistance (100/S%). HOMA β = [20 x fasting insulin (μU/mL)] / [fasting plasma glucose (mmol/L) - 3.5] where fasting insulin (or glucose) was defined as the arithmetic mean of the -15, -10 and 0 min pre-glucose load values. Analysis of covariance with treatment as a fixed effect and baseline as the covariate was performed on log transformed data. Number of Participants Reporting Death, Serious Adverse Events (SAEs), Adverse Events (AE) Above 5% Frequency [Time Frame: Baseline to End of Study (56[+/-2] and 168 [+/- 5] days after dosing for Cohort 1 and Cohorts 2-4, respectively)] [Designated as safety issue: Yes]An adverse event is any unwanted event, whether related to study drug or not occurring during the study period. A Serious Adverse Event (SAE) is an event resulting in death, requiring or prolonging hospitalization, a congenital anomaly or other important medical event. AEs and SAEs were recorded at each visit.

Descriptive Information[ + expand ][ + ]

Brief Title	Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ACZ885 in Patients With Type 2 Diabetes
Official Title	A Multi Center, Randomized, Double Blind, Placebo-controlled, Dose Escalation Study of the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ACZ885 Administered Intravenously to Patients With Type 2 Diabetes Mellitus
Brief Summary	The purpose of this study was to evaluate, in patients with Type 2 Diabetes Mellitus, whether Canakinumab can lower Glycosylated hemoglobin / hemoglobin A1c (HbA1c) and/or peak glucose levels in response to an oral glucose tolerance test (OGTT).
Detailed Description	Not Provided
Study Type	Interventional
Study Phase	Phase 2
Study Design	Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
Condition	Type 2 Diabetes Mellitus
Intervention	Drug: Canakinumab Canakinumab given as single dose IV injection of 0.03 mg/kg, or single dose IV infusion at doses of 0.1 mg/kg 0.3 mg/kg, 1.5 mg/kg or 10 mg/kg. Other Names: ACZ885Drug: Placebo Placebo to Canakinumab given as single dose IV injection of 0.03 mg/kg, or single dose IV infusion at doses of 0.1 mg/kg 0.3 mg/kg, 1.5 mg/kg or 10 mg/kg. Other Names: PlaceboDrug: Metformin Participants continued on their stable daily dose of metformin throughout the study Other Names: Glucophage Glumetza
Study Arm (s)	Experimental: Canakinumab Eligible participants were assigned to receive canakinumab in one of four cohorts; 1) Single IV infusion of canakinumab 0.3 mg/kg; 2) Singe IV infusion of canakinumab 10 mg/kg; 3) single IV infusion of canakinumab 0.1 mg/kg or 0.3 mg/kg, or 1.5 mg/kg; 4) Single IV injection of canakinumab 0.03 mg/kg. All participants were required to take a concomitant stable daily dose of metformin during the study. Placebo Comparator: Placebo Eligible participants were assigned to receive placebo to canakinumab in one of four cohorts; 1) Single IV infusion of placebo to canakinumab 0.3 mg/kg; 2) Singe IV infusion of placebo to canakinumab 10 mg/kg; 3) single IV infusion of placebo to canakinumab 0.1 mg/kg or 0.3 mg/kg, or 1.5 mg/kg; 4) Single IV injection of placebo to canakinumab 0.03 mg/kg. All participants were required to take a concomitant stable daily dose of metformin during the study.

Recruitment Information[ + expand ][ + ]

Recruitment Status	Completed
Estimated Enrollment	231
Estimated Completion Date	September 2010
Estimated Primary Completion Date	September 2010
Eligibility Criteria	Inclusion Criteria: - Male or female patients aged 18 to 70 years, with type 2 diabetes mellitus (non-insulin dependent diabetes) for at least 6 months prior to study start - HbA1c between 7.0 and 9.5% - On stable dose metformin monotherapy - Stable body weight Exclusion Criteria: - Poorly controlled type 2 diabetes (very low or very high blood sugar levels, or other indicators of poor control) - Acute infections prior to dosing - Patients with type 1 diabetes (insulin-dependent diabetes) - Taking diabetes medication (other than metformin) Other protocol-defined inclusion/exclusion criteria may apply
Gender	Both
Ages	18 Years
Accepts Healthy Volunteers	No
Contacts	Not Provided
Location Countries	United States, Germany, Russian Federation

Administrative Information[ + expand ][ + ]

NCT Number	NCT00605475
Other Study ID Numbers	CACZ885A2213
Has Data Monitoring Committee	No
Information Provided By	Novartis
Study Sponsor	Novartis
Collaborators	Not Provided
Investigators	Principal Investigator: NOVARTIS Novartis investigator site
Verification Date	January 2012

Locations[ + expand ][ + ]

Arkansas Research Medical Testing	Little Rock, Arkansas, United States, 72202
Allied Research International - Cetero Research Miami	Miami, Florida, United States, 33169
Elite Research Institute Miami	Miami, Florida, United States, 33169
International Research Center Towson	MD, Maryland, United States, 21286
Covance Clinical Research Unit Inc	Portland, Oregon, United States, 97239
Charles River Clinical Services	NW Tacoma, Washington, United States, 98418
Novartis Investigator Site	Berlin, Germany
Novartis Investigator Site	Kiel, Germany
Novartis Investigator Site	Moenchengladbach, Germany
Novartis Investigator Site	Munich, Germany
Novartis Investigative Site	Neuss, Germany
Novartis Investigative Site	Moscow, Russian Federation
Novartis Investigative Site	St. Petersberg, Russian Federation