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Afrezza Safety and Pharmacokinetics Study in Pediatric Patients

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT02527265
Recruitment Status : Completed
First Posted : August 18, 2015
Results First Posted : April 6, 2021
Last Update Posted : April 6, 2021
Information provided by (Responsible Party):
Mannkind Corporation

Brief Summary:

Primary Objective:

-To assess the safety and tolerability of Afrezza in children ages 4 to 17 years with type 1 diabetes mellitus (T1DM).

Secondary Objectives:

  • To assess the ability to titrate the prandial and supplemental doses of Afrezza at each meal.
  • To assess pharmacokinetics (PK) following a prandial dose of Afrezza in children ages 4 to 17 years with T1DM.

Condition or disease Intervention/treatment Phase
Type 1 Diabetes Mellitus Biological: Afrezza Phase 2

Detailed Description:
The patients are expected to participate in the study for approximately 6 to 8 weeks from Screening to final follow-up visit.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 30 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Open-label, Single-arm, Multiple-dose Safety, Titration, and Pharmacokinetic Trial of Afrezza® in Pediatric Patients Ages 4 to 17 Years With Type 1 Diabetes Mellitus
Actual Study Start Date : September 28, 2017
Actual Primary Completion Date : March 17, 2020
Actual Study Completion Date : June 25, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Diabetes Type 1

Arm Intervention/treatment
Experimental: Afrezza (Technosphere Insulin)

Individualized dose of Afrezza (Technosphere Insulin) for each patient at each meal (breakfast, lunch, and dinner) for 30 days.

During the trial, all patients will receive multiple injections of basal long acting insulin, in general at bedtime every day.

Biological: Afrezza

Pharmaceutical form: powder

Route of administration: inhalation

Other Name: Technosphere Insulin

Primary Outcome Measures :
  1. Insulin Maximum Observed Concentration (Cmax) [ Time Frame: 250 minutes post-dose ]
    Insulin Cmax after a dose of Afrezza

Secondary Outcome Measures :
  1. Insulin Time to Reach Cmax (Tmax) [ Time Frame: 250 minutes post-dose ]
    Insulin Tmax after a dose of Afrezza

  2. Insulin Area Under Concentration Time Curve (AUC) [ Time Frame: 250 minutes post-dose ]
    Insulin AUC after a dose of Afrezza

  3. Assessment of Fumaryl Diketopiperazine (FDKP) Elimination Half-life (t1/2) [ Time Frame: Using PK data collected over 250 minutes post-dose of Afrezza ]
    FDKP (inert carrier excipient) calculated half life t1/2

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   4 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion criteria :

  1. Written or oral assent from the pediatric subject and written informed consent from the parent(s) or legal guardian and a witness, as required by both state and federal laws and the local Institutional Review Board;
  2. Children aged ≥4 and ≤17 years (enrolled sequentially into 3 age cohorts: 13 to 17, 8 to 12, and 4 to 7 years);
  3. Clinical diagnosis of T1DM and using insulin for at least 1 year;
  4. Currently receiving a regimen of basal/bolus insulin administered by MDI for at least 6 weeks prior to enrollment;
  5. Subjects with pre-breakfast self monitored blood glucose values between 80 and 250 mg/dL for 5 of 7 documented daily readings obtained in the week prior to Visit 2 (readings to be taken using glucometer provided at Screening Visit 1) and reported via the e Diary;
  6. Subjects on a regimen of insulin via continuous SC insulin infusion may be enrolled if they satisfy all other enrollment criteria and are willing to convert to MDI for the duration of the study, beginning 6 weeks prior to enrollment. They must continue to meet all enrollment criteria after converting to the MDI regimen;
  7. Total daily insulin dose ≤1.5 units/kg/day with a minimum of 3 units of RAA at every meal.
  8. Hemoglobin A1c (HbA1c) ≥7.0% to <10.0% at the time of screening;
  9. Fasting serum C-peptide ≤0.3 ng/mL;
  10. Forced expiratory volume in 1 second (FEV1) ≥70% of National Health and Nutrition Examination Survey (NHANES) III predicted for children ≥8 years of age or Wang predicted for children <8 years of age;
  11. Forced vital capacity ≥70% of NHANES III predicted for children ≥8 years of age or Wang predicted for children <8 years of age;
  12. Females of childbearing potential, must use "highly effective" methods of contraception throughout conduct of the trial

Exclusion criteria:

  1. Body mass index below 25th or above 95th percentile for age and gender according to Centers for Disease Control and Prevention growth charts;
  2. History of physician diagnosis of asthma or any other clinically important pulmonary disease, or use of any medications to treat such conditions within the last year;
  3. Allergy or known hypersensitivity for AFREZZA or to drugs with similar chemical structure;
  4. Unstable diabetes control, defined as 2 or more episodes of severe hypoglycemia (i.e., an episode associated with a seizure, coma, or loss of consciousness) or any hospitalization or emergency room visit for poor diabetes control, ketoacidosis, hypoglycemia, or hyperglycemia within the preceding 3 months from screening;
  5. Serum creatinine ≥ the upper limit of normal for age;
  6. Respiratory tract infection within 30 days before screening or between screening and initiation of treatment period; subject may return 4 weeks after resolution of the infection for rescreening;
  7. Evidence of any complication of diabetes (proliferative retinopathy, autonomic neuropathy, nephropathy, etc), or likelihood of requiring laser photocoagulation, vitrectomy, or other specific treatment for diabetic retinopathy in the coming year;
  8. Smoking of tobacco or other substances or positive urine cotinine testing (>100 ng/mL);
  9. Positive urine drug screen;
  10. Positive urine pregnancy test for female subjects of childbearing potential;
  11. Inability to perform study procedures including pulmonary function testing;
  12. Exposure to any investigational product(s) in the past 3 months or 5 half-lives, whichever is more;
  13. History of eating disorder;
  14. Any disease or exposure to any medication which, in the judgment of the principal Investigator, may impact glucose metabolism;
  15. Any concurrent medical or major psychiatric condition that makes the subject unsuitable for the clinical study or impairs the subject's ability to participate in the study.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Information from the National Library of Medicine

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): NCT02527265

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United States, California
Children's Hospital Los Angeles
Los Angeles, California, United States, 90027
United States, Colorado
Barbara Davis Center for Childhood Diabetes
Aurora, Colorado, United States, 80045
United States, Connecticut
Yale University Hospital
New Haven, Connecticut, United States, 06510
United States, Florida
University of Florida
Gainesville, Florida, United States, 32610
USF Diabetes Center
Tampa, Florida, United States, 33612
United States, Georgia
Atlanta Diabetes Associates
Atlanta, Georgia, United States, 30318
Van Meter Pediatric Endocrinology, P.C.
Atlanta, Georgia, United States, 30318
Emory University Children's Center
Atlanta, Georgia, United States, 30322
United States, Indiana
Indiana University, Riley Hospital for Children
Indianapolis, Indiana, United States, 46202
United States, Maryland
Barry J. Reiner, MD, LLC
Baltimore, Maryland, United States, 21229
United States, Nevada
Diabetes, Obesity, Cardiovascular Clinical Specialists (DOCS)
Las Vegas, Nevada, United States, 89113
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
United States, Tennessee
Le Bonheur Children's Hospital
Memphis, Tennessee, United States, 38105
Sponsors and Collaborators
Mannkind Corporation
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Study Director: Clinical Operations Mannkind Corporation
  Study Documents (Full-Text)

Documents provided by Mannkind Corporation:
Study Protocol  [PDF] February 14, 2018
Statistical Analysis Plan  [PDF] January 17, 2020

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Responsible Party: Mannkind Corporation
ClinicalTrials.gov Identifier: NCT02527265    
Other Study ID Numbers: MKC-TI-155 Part 1
U1111-1166-5528 ( Other Identifier: UTN )
First Posted: August 18, 2015    Key Record Dates
Results First Posted: April 6, 2021
Last Update Posted: April 6, 2021
Last Verified: March 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Diabetes Mellitus
Diabetes Mellitus, Type 1
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases
Hypoglycemic Agents
Physiological Effects of Drugs