An Observational Study Evaluating SYMLIN® (Pramlintide Acetate) Injection Use in Insulin Using Patients With Type 2 and Type 1 Diabetes

Study Description

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

This is an open label, observational study designed to collect data that characterize the use of SYMLIN following the introduction of the medication into the marketplace. Health care providers and subjects selected for study participation are intended to be representative of those providers prescribing, and subjects receiving, SYMLIN therapy.

Condition or disease	Intervention/treatment
Type 1 Diabetes Mellitus; Type 2 Diabetes Mellitus	Drug: pramlintide acetate

Study Design

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Study Type :	Observational
Actual Enrollment :	1297 participants
Time Perspective:	Prospective
Official Title:	A Prospective, Open-Label, Observational Study Evaluating SYMLIN® (Pramlintide Acetate) Injection Use in Insulin Using Patients With Type 2 and Type 1 Diabetes Following SYMLIN Introduction Into the Marketplace
Study Start Date :	September 2005
Actual Primary Completion Date :	May 2008
Actual Study Completion Date :	May 2008

Groups and Cohorts

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Group/Cohort	Intervention/treatment
Type 1; Patients with type 1 diabetes	Drug: pramlintide acetate; Subcutaneous injection prior to each major meal; Other Name: Symlin
Type 2; Patients with type 2 diabetes	Drug: pramlintide acetate; Subcutaneous injection prior to each major meal; Other Name: Symlin

Outcome Measures

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Primary Outcome Measures :

1. Incidence of Patient-Ascertained Severe Hypoglycemia (PASH) During the Adjustment Period [ Time Frame: 0-3 months ]
   PASH is defined as episodes of hypoglycemia requiring the assistance of another individual (including aid in ingestion of oral carbohydrate); and/or requiring the administration of glucagon injection, intravenous glucose, or other medical intervention. The adjustment period represents the initial 0-3 months of pramlintide treatment
2. Annual Event Rate of Patient-Ascertained Severe Hypoglycemia (PASH) During the Adjustment Period [ Time Frame: 0-3 months ]

   The annual event rate was calculated as the total number of events during the time period divided by the total years of exposure to pramlintide for all patients during the time period. The adjustment period represents the initial 0-3 months of pramlintide treatment.

   PASH is defined as episodes of hypoglycemia requiring the assistance of another individual (including aid in ingestion of oral carbohydrate); and/or requiring the administration of glucagon injection, intravenous glucose, or other medical intervention.

Secondary Outcome Measures :

1. The Incidence of Patient-Ascertained Severe Hypoglycemia (PASH) During the Steady State Period [ Time Frame: >3-6 months ]

   The steady state period represents the >3-6 months of pramlintide treatment following the adjustment period.

   PASH is defined as episodes of hypoglycemia requiring the assistance of another individual (including aid in ingestion of oral carbohydrate); and/or requiring the administration of glucagon injection, intravenous glucose, or other medical intervention.

2. The Annual Event Rate of Patient-Ascertained Severe Hypoglycemia (PASH) During the Steady State Period [ Time Frame: >3-6 months ]

   The annual event rate was calculated as the total number of events during the time period divided by the total years of exposure to pramlintide for all patients during the time period. The steady state period represents the >3-6 months of pramlintide treatment following the adjustment period.

   PASH is defined as episodes of hypoglycemia requiring the assistance of another individual (including aid in ingestion of oral carbohydrate); and/or requiring the administration of glucagon injection, intravenous glucose, or other medical intervention.

3. Incidence of Medically Assisted Severe Hypoglycemia (MASH) During the Adjustment Period [ Time Frame: 0-3 months ]
   MASH is defined as episodes of severe hypoglycemia requiring IM glucagon, IV glucose, hospitalization, paramedic assistance, emergency room visit, and/or is assessed as a serious adverse event (SAE) by the investigator. MASH is a subset of PASH. The adjustment period represents the initial 0-3 months of pramlintide treatment
4. The Annual Event Rate of Medically Assisted Severe Hypoglycemia (MASH) During the Adjustment Period [ Time Frame: 0-3 months ]

   The annual event rate was calculated as the total number of events during the time period divided by the total years of exposure to pramlintide for all patients during the time period. The adjustment period represents the initial 0-3 months of pramlintide treatment.

   MASH is defined as episodes of severe hypoglycemia requiring IM glucagon, IV glucose, hospitalization, paramedic assistance, emergency room visit, and/or is assessed as a serious adverse event (SAE) by the investigator. MASH is a subset of PASH.

5. Incidence of Medically Assisted Severe Hypoglycemia (MASH) During the Steady State Period [ Time Frame: >3-6 months ]

   The steady state period represents the >3-6 months of pramlintide treatment following the adjustment period.

   MASH is defined as episodes of severe hypoglycemia requiring IM glucagon, IV glucose, hospitalization, paramedic assistance, emergency room visit, and/or is assessed as a serious adverse event (SAE) by the investigator. MASH is a subset of PASH.

6. Annual Event Rate of Medically Assisted Severe Hypoglycemia (MASH) During the Steady State Period [ Time Frame: >3-6 months ]

   The annual event rate was calculated as the total number of events during the time period divided by the total years of exposure to pramlintide for all patients during the time period. The steady state period represents the >3-6 months of pramlintide treatment following the adjustment period.

   MASH is defined as episodes of severe hypoglycemia requiring IM glucagon, IV glucose, hospitalization, paramedic assistance, emergency room visit, and/or is assessed as a serious adverse event (SAE) by the investigator. MASH is a subset of PASH.

7. Change in HbA1c From Baseline at Month 3 [ Time Frame: 3 months ]
   Change in HbA1c from baseline at month 3. The HbA1c test measures the percent of glycosylated hemoglobin in the blood.
8. Change in HbA1c From Baseline at Month 6 [ Time Frame: 6 months ]
   Change in HbA1c from baseline at month 6. The HbA1c test measures the percent of glycosylated hemoglobin in the blood.
9. Change in Body Weight From Baseline at Month 3 [ Time Frame: 3 months ]
   Mean change in body weight from baseline at month 3
10. Change in Body Weight From Baseline at Month 6 [ Time Frame: 6 months ]
    Mean change in body weight from baseline at month 6

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

cross-section of clinical practice settings

Criteria

Inclusion Criteria:

• The following inclusion criteria are consistent with information in the SYMLIN package insert and apply to insulin using patients with type 2 or type 1 diabetes who:

  • Have failed to achieve the desired or optimal level of glycemic control despite utilizing appropriate, individualized insulin regimens
  • Have A1C <=9.0% within 3 months of study enrollment
  • Are receiving ongoing diabetes care under the guidance of a Health Care Provider (HCP) trained in the use of SYMLIN

Exclusion Criteria:

• The following exclusion criteria are consistent with the SYMLIN package insert and specifically exclude patients who:

  • Are poorly compliant with their current insulin regimen, as defined by their HCP
  • Are poorly compliant with prescribed blood glucose self monitoring, as defined by their HCP
  • Have experienced recurrent patient-ascertained severe hypoglycemia requiring assistance during the past 6 months
  • Have hypoglycemia unawareness
  • Have a confirmed diagnosis of gastroparesis
  • Require the use of drugs that stimulate gastrointestinal motility
  • Are female and pregnant or lactating and for whom the HCP determines the potential benefit does not justify the potential risk to the fetus or infant
  • Have been treated with SYMLIN within 3 months prior to study start

Contacts and Locations

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

  Show 107 Study Locations

Sponsors and Collaborators

AstraZeneca

Investigators

Study Director:	Vice President, Medical Development, MD	Amylin Pharmaceuticals, LLC.

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Pencek R, Roddy T, Peters Y, De Young MB, Herrmann K, Meller L, Nguyen H, Chen S, Lutz K. Safety of pramlintide added to mealtime insulin in patients with type 1 or type 2 diabetes: a large observational study. Diabetes Obes Metab. 2010 Jun;12(6):548-51. doi: 10.1111/j.1463-1326.2010.01201.x.

Responsible Party:	AstraZeneca
ClinicalTrials.gov Identifier:	NCT00229658 History of Changes
Other Study ID Numbers:	137-161
First Posted:	September 30, 2005
Results First Posted:	June 24, 2009
Last Update Posted:	March 25, 2015
Last Verified:	February 2015

Keywords provided by AstraZeneca:

diabetes; pramlintide; Symlin; Amylin; phase 4

Additional relevant MeSH terms:

Diabetes Mellitus; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1; Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Autoimmune Diseases; Immune System Diseases	Pramlintide; Islet Amyloid Polypeptide; Hypoglycemic Agents; Physiological Effects of Drugs; Appetite Depressants; Anti-Obesity Agents; Amylin Receptor Agonists; Molecular Mechanisms of Pharmacological Action