Trial to Confirm the Efficacy and Safety of Dasiglucagon in the Treatment of Hypoglycemia in T1DM Children
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ClinicalTrials.gov Identifier: NCT03667053 |
Recruitment Status :
Completed
First Posted : September 12, 2018
Results First Posted : May 10, 2021
Last Update Posted : June 30, 2021
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Condition or disease | Intervention/treatment | Phase |
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Hypoglycemia | Drug: dasiglucagon Drug: placebo Drug: GlucaGen HypoKit | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 42 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Phase 3, Randomized, Double-blind, Placebo/Active-controlled, Parallel-arm Trial to Assess Efficacy, Safety, and Pharmacokinetics of Dasiglucagon Relative to Placebo/GlucaGen® as Rescue Therapy for Severe Hypoglycemia in Children With T1DM Treated With Insulin |
Actual Study Start Date : | September 28, 2018 |
Actual Primary Completion Date : | June 28, 2019 |
Actual Study Completion Date : | June 28, 2019 |

Arm | Intervention/treatment |
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Experimental: dasiglucagon
Single fixed dose (s.c.injection) of dasiglucagon
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Drug: dasiglucagon
glucagon analog
Other Name: ZP4207 |
Placebo Comparator: placebo
Single fixed dose (s.c.injection) of placebo
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Drug: placebo
placebo for dasiglucagon
Other Name: placebo for dasiglucagon |
Active Comparator: GlucaGen®
Single fixed dose (s.c.injection) of GlucaGen®
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Drug: GlucaGen HypoKit
native glucagon |
- Time to Plasma Glucose Recovery [ Time Frame: 0-45 minutes after dosing ]
Plasma glucose recovery was defined as first increase in plasma glucose of ≥20 mg/dL (1.1 mmol/L) from baseline during the hypoglycemic clamp procedure without administration of rescue intravenous (IV) glucose. Patients who received rescue IV glucose before 45 minutes and patients not recovering within 45 minutes after dosing were censored at 45 minutes. Time to plasma glucose recovery was summarized for each treatment group using Kaplan Meier (KM) estimates together with the 95% confidence interval.
Note that the upper confidence limit for the placebo median was not estimable, but is set to 45 minutes (censored value) here.
- Plasma Glucose Recovery [ Time Frame: 0-30 minutes after dosing: assessed at 10, 15, 20 and 30 minutes after study drug injection ]Plasma glucose recovery within 30 minutes, within 20 minutes, within 15 minutes, and within 10 minutes after study drug injection without administration of rescue intravenous (IV) glucose. Plasma glucose recovery was defined as the first increase in plasma glucose of ≥20 mg/dL (1.1 mmol/L) from baseline without administration of rescue intravenous glucose.
- Plasma Glucose Changes From Baseline [ Time Frame: 0-30 minutes after dosing: assessed at 10, 15, 20 and 30 minutes after study drug injection ]Plasma glucose changes from baseline within 30 minutes, within 20 minutes, within 15 minutes, and within 10 minutes after trial product injection or at the time of rescue intravenous (IV) glucose
- Pharmacodynamics - Area Under the Effect Curve (0-30 Minutes) [ Time Frame: 0-30 minutes ]Plasma glucose response as area under the effect curve above baseline from time 0 to 30 minutes (AUE0-30min). Plasma glucose was determined at pre-dose and at 4, 6, 8, 10, 12, 15, 17, 20, 30, and 45 minutes (and at 60 minutes if the patient weighed ≥21 kg) after dosing.
- Administration of Rescue IV Glucose Infusion After IMP Injection [ Time Frame: 0-45 minutes ]Number of patients receiving IV rescue glucose administration for hypoglycemia after administration of IMP. IV = intravenous. IMP = investigational medicinal product.
- Time to First IV Glucose Infusion After IMP Administration [ Time Frame: 0-45 minutes ]Time to first IV rescue glucose administration for hypoglycemia after administration of IMP. IV = intravenous. IMP = investigational medicinal product.
- Pharmacokinetics: AUC0-30 Min [ Time Frame: 0-30 minutes ]Area under the plasma dasiglucagon or GlucaGen concentration versus time curve from 0 to 30 minutes post-dose. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: AUC0-300min [ Time Frame: 0-300 minutes ]Area under the plasma dasiglucagon or GlucaGen concentration versus time curve from 0 to 300 minutes post-dose. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: AUC0-inf [ Time Frame: 0-300 minutes ]Area under the plasma dasiglucagon or GlucaGen concentration versus time curve from 0 to infinitely post-dose. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: Cmax [ Time Frame: 0-300 minutes ]Maximum of all valid plasma dasiglucagon or GlucaGen concentration measurements from 0 to 300 minutes post-dose. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: Tmax [ Time Frame: 0-300 minutes ]Time to maximum of plasma dasiglucagon or GlucaGen concentration measurements. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: λz [ Time Frame: 0-300 minutes ]Terminal elimination rate constant of plasma dasiglucagon or GlucaGen. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: t½ [ Time Frame: 0-300 minutes ]Terminal plasma elimination half-life of dasiglucagon or GlucaGen. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: CL/f [ Time Frame: 0-300 minutes ]Total body clearance of plasma dasiglucagon or GlucaGen. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: Vz/f [ Time Frame: 0-300 minutes ]Volume of distribution of plasma dasiglucagon or GlucaGen. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.
- Pharmacokinetics: MRT [ Time Frame: 0-300 minutes ]Mean residence time of plasma dasiglucagon or GlucaGen. Samples were collected before dosing and at 10, 20, 30, 40, 60, 90, 140, 220, and 300 minutes after dosing.

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Ages Eligible for Study: | 6 Years to 17 Years (Child) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Following receipt of verbal and written information about the trial, patient, parent(s) or guardian(s) of the patient must provide signed informed consent before any trial-related activity is carried out
- Female or male patients with T1DM for at least 1 year, diagnostic criteria as defined by the American Diabetes Association; and receiving daily insulin
- At least 6.0 years of age (inclusive) and less than 18.0 years
- Body weight ≥20 kg
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Female patients must meet one of the following criteria:
a. Participant is of childbearing potential and agrees to use one of the accepted contraceptive regimens throughout the entire duration of the trial from screening until last follow-up visit. An acceptable method of contraception includes at least one of the following: i. Abstinence from heterosexual intercourse ii. Systemic contraceptives (birth control pills, injectable/implant/ insertable hormonal birth control products, transdermal patch); if the participant is using systemic contraceptives, she must use an additional form of acceptable contraception (iii or iv, below) iii. Intrauterine device (with and without hormones) iv. Condom with spermicide or b. Participant is of non-childbearing potential due to pre-puberty status or a medical condition confirmed by the investigator
- Male patients must meet the following criteria: If sexually active, uses condom and partner practices contraception during the trial from screening and until last follow-up visit
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Willingness to adhere to the protocol requirements
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Exclusion Criteria:
1. Females who are pregnant according to a positive urine pregnancy test, actively attempting to get pregnant, or are lactating 2. Known or suspected allergy to trial product(s) or related products 3. History of anaphylaxis or symptoms of severe systemic allergy (such as angioedema) 4. Previous randomization in this trial 5. History of an episode of severe hypoglycemia that required a third party assistance within a month prior to screening visit 6. History of hypoglycemic events associated with seizures or hypoglycemia unawareness in the last year prior to screening 7. History of epilepsy or seizure disorder 8. Receipt of any investigational drug within 3 months prior to screening 9. Active malignancy within the last 5 years 10. Congestive heart failure, New York Heart Association class II-IV 11. Current bleeding disorder, including anti-coagulant treatment 12. Known presence or history of pheochromocytoma (i.e. adrenal gland tumor) or insulinoma (i.e. insulin secreting pancreas tumor) 13. Use of a daily systemic beta-blocker drug, indomethacin, warfarin or anticholinergic drugs in the previous 28 days before Day 1 of this trial 14. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >2.5 × the upper limit of the normal range (ULN), bilirubin >1.5 × ULN, estimated glomerular filtration rate <30 mL/min/1.73 m2 according to the Modification of Diet in Renal Disease study definition, or altered electrolyte values of clinical relevance for cardiac conduction, as judged by the investigator 15. Clinically significant abnormal electrocardiogram (ECG) at screening as judged by the investigator 16. Clinically significant illness within 4 weeks before screening, as judged by the investigator 17. Surgery or trauma with significant blood loss within the last 2 months prior to screening 18. Patients with mental incapacity or language barriers which preclude adequate understanding or cooperation, who are unwilling to participate in the trial, or who in the opinion of the investigator should not participate in the trial 19. Any condition interfering with trial participation or evaluation or that could be hazardous to the patient 20. The use of prescription or non-prescription medications known to cause QT prolongation
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To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03667053
United States, California | |
AMCR Institute, Inc | |
Escondido, California, United States, 92025 | |
United States, Connecticut | |
Yale University School of Medicine | |
New Haven, Connecticut, United States, 06520 | |
United States, Indiana | |
Indiana University, Department of Pediatrics | |
Indianapolis, Indiana, United States, 46202 | |
Germany | |
Auf der Bult - Diabetes Center for Children | |
Hannover, Germany, 30173 | |
Slovenia | |
University Medical Center Ljubljana, Children's Hospital, Department for Endocrinology, Diabetes and Metabolism | |
Ljubljana, Slovenia, 1000 |
Study Director: | Christina M Sylvest, MSc Pharm | Zealand Pharma A/S |
Documents provided by Zealand Pharma:
Responsible Party: | Zealand Pharma |
ClinicalTrials.gov Identifier: | NCT03667053 |
Other Study ID Numbers: |
ZP4207-17086 |
First Posted: | September 12, 2018 Key Record Dates |
Results First Posted: | May 10, 2021 |
Last Update Posted: | June 30, 2021 |
Last Verified: | May 2021 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Glucagon Dasiglucagon |
Hypoglycemia Glucose Metabolism Disorders Metabolic Diseases Glucagon |
Gastrointestinal Agents Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs |