Title

A Study of Glucagon Administered in Different Forms and Routes to Healthy Adults
A Single Site, Randomized, Four-Way, Four-Period PK/PD Crossover Phase 1 Clinical Study in 16 Fasted Healthy Adult Volunteers Receiving 3 Dose Levels of Intranasally Administered Glucagon and One Dose Level of Glucagon Administered by Subcutaneous Injection
  • Phase

    Phase 1
  • Study Type

    Interventional
  • Intervention/Treatment

    glucagon ...
  • Study Participants

    16
The main purpose of this study was to evaluate the safety and tolerability of nasal glucagon (NG). The study drug was delivered into the participant's nostril (intranasally) or was given as an injection just under the skin (subcutaneously) once in each of four study periods. The study lasted about 23 days for each participant.
Study Started
Oct 31
2011
Primary Completion
Oct 31
2011
Study Completion
Nov 30
2011
Results Posted
Sep 19
2019
Last Update
Sep 19
2019

Drug Nasal Glucagon

Administered intranasally.

  • Other names: AMG 504-1, LY900018

Drug Glucagon

Administered SC.

Nasal Glucagon (NG) - 0.5 mg Experimental

Ng dose at 0.5 milligram (mg) administered once in one of four study periods.

NG - 1.0 mg Experimental

Ng dose at 1.0 milligram (mg) administered once in one of four study periods.

NG - 2.0 mg Experimental

Ng dose at 2.0 milligram (mg) administered once in one of four study periods.

SC Glucagon 1 mg Active Comparator

Subcutaneous (SC) glucagon dose of 1 mg, in one of four study periods.

Criteria

Inclusion Criteria:

Body mass index (BMI) greater than or equal to 20.00 and below or equal to 28.00 kg/m².
Light-, non- or ex-smokers.
Have no clinically significant diseases captured in the medical history or evidence of clinically significant findings on physical examination and/or clinical laboratory evaluations (hematology, biochemistry, ECG and urinalysis).

Exclusion Criteria:

Presence of any nose piercings.
History of significant hypersensitivity to glucagon or any related products (including excipients of the formulations) as well as severe hypersensitivity reactions (like angioedema) to any drugs.
Presence of significant gastrointestinal, liver or kidney disease, or any other conditions known to interfere with the absorption, distribution, metabolism or excretion of drugs or known to potentiate or predispose to undesired effects.
Presence of significant cardiovascular, pulmonary, hematologic, neurological, psychiatric, endocrine, immunologic or dermatologic disease.
Presence of clinically significant findings on nasal examination and bilateral anterior rhinoscopy.
Fasting blood glucose above 5.0 millimoles per liter (mmol/L) at screening, following a 12-hour fasting period.
Fasting blood glucose assessed with a glucose meter above 5.5 mmol/L 0.5 hour before each dosing.

Summary

NG 0.5 mg

NG 1 mg

NG 2 mg

SC Glucagon 1 mg

All Events

Event Type Organ System Event Term NG 0.5 mg NG 1 mg NG 2 mg SC Glucagon 1 mg

Number of Participants With One or More Serious Adverse Event(s) (SAEs)

Safety and tolerability evaluated through the assessment of adverse events. A SAE (serious adverse event) was defined as any untoward medical occurrence in a clinical investigation, which did not necessarily have a causal relationship with this treatment. A summary of other non-serious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.

NG 0.5 mg

NG 1 mg

NG 2 mg

SC Glucagon 1 mg

Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to T (AUC[0-tlast]) of Baseline Adjusted Glucagon

NG 0.5 mg

NG 1 mg

38.9
picogram*hour per milliliter (pg*h/mL) (Geometric Mean)
Geometric Coefficient of Variation: 483

NG 2 mg

293.0
picogram*hour per milliliter (pg*h/mL) (Geometric Mean)
Geometric Coefficient of Variation: 172

SC Glucagon 1 mg

2060.0
picogram*hour per milliliter (pg*h/mL) (Geometric Mean)
Geometric Coefficient of Variation: 68

PK: Area Under the Curve Extrapolated to Infinity (AUC[0-inf]) of Baseline Adjusted Glucagon

NG 0.5 mg

NG 1 mg

NG 2 mg

589.0
pg*h/mL (Geometric Mean)
Geometric Coefficient of Variation: 50

SC Glucagon 1 mg

2250.0
pg*h/mL (Geometric Mean)
Geometric Coefficient of Variation: 66

PK: Time to Maximum Concentration (Tmax) of Baseline Adjusted Glucagon

NG 0.5 mg

0.17
hour (h) (Median)
Full Range: 0.17 to 0.17

NG 1 mg

0.25
hour (h) (Median)
Full Range: 0.17 to 0.28

NG 2 mg

0.25
hour (h) (Median)
Full Range: 0.17 to 0.67

SC Glucagon 1 mg

0.33
hour (h) (Median)
Full Range: 0.11 to 0.67

PK: Maximum Change From Baseline Concentration (Cmax) of Glucagon

NG 0.5 mg

NG 1 mg

217.0
picogram per milliliter (pg/mL) (Geometric Mean)
Geometric Coefficient of Variation: 231

NG 2 mg

1000.0
picogram per milliliter (pg/mL) (Geometric Mean)
Geometric Coefficient of Variation: 104

SC Glucagon 1 mg

3260.0
picogram per milliliter (pg/mL) (Geometric Mean)
Geometric Coefficient of Variation: 59

Pharmacodynamics (PD): Area Under the Effect Concentration Time Curve (AUEC₀-₄) of Glucose

NG 0.5 mg

-0.168
millimole*hour per liter (mmol*h/L) (Mean)
Standard Error: 0.202

NG 1 mg

0.0617
millimole*hour per liter (mmol*h/L) (Mean)
Standard Error: 0.177

NG 2 mg

0.566
millimole*hour per liter (mmol*h/L) (Mean)
Standard Error: 0.324

SC Glucagon 1 mg

0.448
millimole*hour per liter (mmol*h/L) (Mean)
Standard Error: 0.490

PD: Time to Maximum Concentration (Tmax) of Baseline-Adjusted Glucose

SC Glucagon 1 mg

0.37
hour (h) (Median)
Full Range: 0.25 to 0.67

NG 0.5 mg

0.33
hour (h) (Median)
Full Range: 0.17 to 0.67

NG 1 mg

0.36
hour (h) (Median)
Full Range: 0.25 to 0.5

NG 2 mg

0.5
hour (h) (Median)
Full Range: 0.33 to 0.67

PD: Baseline-Adjusted Glucose Maximum Concentration (BGmax)

NG 0.5 mg

0.811
millimole per liter (mmol/L) (Mean)
Standard Error: 0.119

NG 1 mg

1.92
millimole per liter (mmol/L) (Mean)
Standard Error: 0.173

NG 2 mg

3.2
millimole per liter (mmol/L) (Mean)
Standard Error: 0.252

SC Glucagon 1 mg

3.28
millimole per liter (mmol/L) (Mean)
Standard Error: 0.326

Age, Continuous

33
years (Mean)
Standard Deviation: 9

Race/Ethnicity, Customized

Region of Enrollment

Sex: Female, Male

Study Period One

Sequence 1 (T1/T2/T3/T4)

Sequence 2 (T2/T3/T4/T1)

Sequence 3 (T3/T4/T1/T2)

Sequence 4 (T4/T1/T2/T3)

Study Period Two

Sequence 1 (T1/T2/T3/T4)

Sequence 2 (T2/T3/T4/T1)

Sequence 3 (T3/T4/T1/T2)

Sequence 4 (T4/T1/T2/T3)

Study Period Three

Sequence 1 (T1/T2/T3/T4)

Sequence 2 (T2/T3/T4/T1)

Sequence 3 (T3/T4/T1/T2)

Sequence 4 (T4/T1/T2/T3)

Study Period Four

Sequence 1 (T1/T2/T3/T4)

Sequence 2 (T2/T3/T4/T1)

Sequence 3 (T3/T4/T1/T2)

Sequence 4 (T4/T1/T2/T3)