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Pramlintide

Phase 3

Diabetes Mellitus, Type 1 | Small molecule | Metabolic |AstraZeneca PLC|Last Updated: Nov 2, 2018

Success Probability

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials4
Total Enrollment612

FDA Designations

No designations recorded

Clinical trial landscape

Pramlintide · 16 trials · 8 indications

Phase 3 3Phase 2 11Phase 1 2
NCT00108004Clinical Utility and Safety of Pramlintide in Subjects With Type 1 and Type 2 Diabetes MellitusType 1 Diabetes Mellitus
COMPLETED400 Analytics
NCT00107107Study of the Long-Term Safety of Pramlintide in Subjects With Type 1 Diabetes MellitusDiabetes Mellitus, Type 1
COMPLETED190 Analytics
NCT00042458Evaluation of Dose-titration of Pramlintide During Initiation of Therapy in Patients Trying to Improve Glucose ControlDiabetes Mellitus, Type 1
COMPLETED296 Analytics
PHASE3COMPLETED
Clinical Utility and Safety of Pramlintide in Subjects With Type 1 and Type 2 Diabetes Mellitus
Type 1 Diabetes MellitusUnlock trial analytics
PHASE3COMPLETED
Study of the Long-Term Safety of Pramlintide in Subjects With Type 1 Diabetes Mellitus
Diabetes Mellitus, Type 1Unlock trial analytics
PHASE3COMPLETED
Evaluation of Dose-titration of Pramlintide During Initiation of Therapy in Patients Trying to Improve Glucose Control
Diabetes Mellitus, Type 1Unlock trial analytics

Study Endpoints

Primary Endpoints

To investigate the clinical utility and safety of pramlintide in subjects with type 1 and type 2 diabetes mellitus
6 months

To investigate the clinical utility (change in HbA1c, seven-point glucose profile, body weight, and insulin use) and safety of pramlintide in subjects with type 1 and type 2 diabetes mellitus who have not achieved glycemic targets with insulin therapy.

Understand management issues in subjects with type 1 and type 2 diabetes mellitus
6 months

To collect data regarding the selection of subjects for pramlintide administration by healthcare professionals and to further understand management issues in subjects with type 1 and type 2 diabetes mellitus who have not achieved glycemic targets with insulin therapy

To investigate the long term safety profile of pramlintide treatment in subjects with type 1 diabetes completing protocol 137-150.
participant will be followed for the duration of the study, an average of 6 months or until Pramlintide is commercially available
To examine the long-term effect of subcutaneously (SC) injected pramlintide on body weight
participant will be followed for the duration of the study, an average of 6 months or until Pramlintide is commercially available
- To investigate the safety of pramlintide treatment employing dose titration upon initiation of pramlintide followed by insulin dose optimization in subjects with type 1 diabetes.
29 Weeks
LS Mean Percent Change in Body Weight From Original Study DFA102 (NCT00673387) Baseline (Day 1) at Week 52 in Extension Study DFA102E - Evaluable Treatment Stable Population
Original Study Baseline to Week 52

Original study DFA102 (NCT00673387) baseline refers to Visit 5 (Day 1). If Day 1 value was missing or after the first dose date of randomized study medication, the last available value on or prior to Day 1 was used. Least Squares (LS) Mean based on a repeated measures mixed model with treatment, sex, DFA102 baseline BMI category, nominal week, treatment by nominal week interaction as factors, and DFA102 baseline weight value as a covariate, with a heterogeneous compound symmetry error covariance structure within each treatment group. Stable population consists of all ITT participants (received at least one injection of treatment) who had the same treatment group assignment in Study DFA102 and Study DFA102E, ie, ITT participants who were in Study DFA102 treatment groups Placebo, Pramlintide 360 + Metreleptin 1.25, Pramlintide 360 + Metreleptin 2.5 and Pramlintide 360 + Metreleptin 5.0.

Least Squares (LS) Mean Percent Change in Body Weight From Baseline to Week 28 - Evaluable Population
Baseline to Week 28

Body weight was measured in kilogram (kg). Baseline is defined as Day 1. If Day 1 was missing or after the first dose date of randomized treatment, the last available value prior to Day 1 was used. Drug Randomization stratified by sex and 3 categories baseline BMI (12 arms); 3 treatment arms combined for summaries as single placebo treatment group; 3 combined for summaries as single pramlintide monotherapy treatment group (total: 8 treatment groups).

All treatment-emergent adverse events occurring during the 24-week treatment period
24 weeks
Absolute change in body weight from baseline to Week 12
12 weeks
Mean Absolute Change From Baseline to Week 16 in Body Weight - Evaluable Population
Baseline to Week 16

Absolute change in body weight as measured in kilograms (kg) from baseline to Week 16. Baseline defined as Day 1 of randomized treatment.

To evaluate the pharmacokinetics of Symlin in adolescent subjects with type 1 diabetes
single doses
To assess the safety and tolerability of Symlin in adolescent subjects with type 1 diabetes
single doses
Examine the long-term effect of subcutaneously (SC) injected pramlintide on body weight in obese subjects.
open ended
Examine the long-term safety and tolerability of SC injected pramlintide in obese subjects.
open ended
To examine the effect of pramlintide on body weight in obese subjects
Approximately 16 weeks
To examine the safety and tolerability of pramlintide in obese subjects
Approximately 16 weeks
To evaluate various pharmacodynamic effects (including effects on body weight, food intake, and other parameters) of subcutaneously (SC) infused or injected pramlintide in obese subjects.
73 Days
To determine the effect of pramlintide on the PK of an oral medication
7 Days

To determine the effect of pramlintide on the pharmacokinetics of an orally administered concomitant medication (acetaminophen) when administered at various times in relation to subcutaneous (SC) pramlintide dosing. The noncompartmental plasma acetaminophen pharmacokinetic (PK) parameters used in the analyses are defined as follows: AUC(0-12hr): Area under the plasma acetaminophen concentration-time curve. Cmax : The peak acetaminophen concentrationd. Tmax : Duration from the time of acetaminophen dosing to the time of the first maximum observed concentration, Cmax. t½: Terminal half-life The primary study endpoints include: * pharmacokinetic parameters AUC(0-12 hr) and Cmax of plasma acetaminophen concentrations Secondary Study Endpoints * pharmacokinetic parameters Tmax and t1/2 of plasma acetaminophen concentrations

Change in satiety of participants on Pramlintide
2 Weeks

To assess the acute effect of pramlintide administered subcutaneously (SC) on satiety in normal-weight and obese non-diabetic subjects and in insulin-treated subjects with type 1 and type 2 diabetes. To be measured by Total caloric intake, macronutrient intake (carbohydrate, fat, protein, and other), duration of buffet meal, aand satiety data measured via a satiety assessment at Period 1 (Visit 2) and Period 2 (Visit 3).

Change in food intake of participants on Pramlintide
2 Weeks

To assess the acute effect of pramlintide administered SC on food intake in normal-weight and obese non-diabetic subjects and in insulin-treated subjects with type 1 and type 2 diabetes. To be measured by Total caloric intake, macronutrient intake (carbohydrate, fat, protein, and other), duration of buffet meal, aand satiety data measured via a satiety assessment at Period 1 (Visit 2) and Period 2 (Visit 3).

Effect of varying needle length on bioavailability of Pramlintide
approximately 6days but not to exceed 14days

To determine the effect of various anatomical injection sites and varying needle lengths upon the absolute bioavailability of pramlintide when injected subcutaneously (SC) in non-obese and obese subjects with type 1 and type 2 diabetes mellitus using insulin.

Efficacy of Pramlintide by Measurement of 24-hour Tissue Mean Weighted Glucose (MWG) Obtained With Continuous Glucose Monitoring (CGM)
24 h

24-hour MWG mg/dL, defined as total area under the 24-hour tissue glucose curve obtained with CGM, divided by actual time span in the 24-hour period.

Incremental area under the concentration-time curve (AUC(0-3 h)) of plasma glucose concentrations for each treatment
AUC 0-3 hrs compared to Placebo

Secondary Endpoints

To examine the effects of long term pramlintide treatment on HbA1c in subjects with type 1 diabetes completing protocol 137-150.
participant will be followed for the duration of the study, an average of 6 months or until Pramlintide is commercially available
- To examine the change in HbA1c, postprandial glucose concentration, and body weight over the course of the study.
29 Weeks
- To examine the pattern of daily insulin use over the course of the study.
29 Weeks
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
PramlintideEXPERIMENTALPramlintide acetate injection is a clear, colorless, sterile solution for SC injection. It consists of pramlintide in sodium acetate buffer, pH 4.0, containing 43-mg/mL mannitol as an iso-osmolality modifier and 2.25 mg/mL metacresol as a preservative
Pramlintide AcetateACTIVE_COMPARATORPramlintide acetate injection is a clear, colorless, sterile solution for SC injection. It consists of pramlintide in sodium acetate buffer, pH 4.0, containing 43 mg/mL mannitol as an iso-osmolality modifier and 2.25 mg/mL metacresol as a preservative. The concentration of pramlintide injection to be used in this study is 0.6 mg/mL.
PlaceboPLACEBO_COMPARATORPlacebo injection will be supplied in the same 5-mL multidose glass vials with a rubber stopper.Ingredients: D-Mannitol 43.0 mg/mL Metacresol 2.25 mg/mL Glacial acetic acid 1.53 mg/mL Sodium acetate trihydrate 0.61 mg/mL pH 4.0 Water for injection qs to 5.0 mL
Pramlintide Acetate (AC137)ACTIVE_COMPARATORPramlintide acetate (AC137) injection is a clear, colorless, sterile solution for SC injection. It consists of pramlintide in sodium acetate buffer, pH 4.0, containing 43 mg/mL mannitol as an iso-osmolality modifier and 2.25 mg/mL metacresol as a preservative. The strength of pramlintide injection is 0.6 mg/mL
1PLACEBO_COMPARATOR -
2EXPERIMENTALPramlintide and 1.25mg Metreleptin
3EXPERIMENTALPramlintide and 2.5mg Metreleptin
4EXPERIMENTALPramlintide and 5.0mg Metreleptin
Placebo-P + Placebo-MPLACEBO_COMPARATORPlacebo matched to pramlintide BID plus placebo matched to metreleptin BID
Pramlintide 360 mcg + Placebo-MEXPERIMENTAL360 mcg pramlintide given twice per day (BID) plus Placebo matched to Metreleptin given BID
Placebo-P + Metreleptin 5.0 mgEXPERIMENTALPlacebo matched to pramlintide BID plus metreleptin 5.0 mg BID
Pramlintide 180 mcg + Metreleptin 2.5 mgEXPERIMENTALPramlintide 180 mcg BID plus Metreleptin 2.5 mg BID
Pramlintide 180 mcg + Metreleptin 5.0 mgEXPERIMENTALPramlintide 180 mcg BID plus Metreleptin 5.0 mg BID
Pramlintide 360 mcg + Metreleptin 1.25 mgEXPERIMENTALPramlintide 360 mcg BID plus Metreleptin 1.25 mg BID
Pramlintide 360 mcg + Metreleptin 2.5 mgEXPERIMENTALPramlintide 360 mcg BID plus Metreleptin 2.5 mg BID
Pramlintide 360 mcg + Metreleptin 5.0 mgEXPERIMENTALPramlintide 360 mcg BID plus Metreleptin 5.0 mg BID
Placebo and MetreleptinEXPERIMENTALPlacebo-pramlintide 600 microliters (µL) twice a day (BID) and metreleptin (recombinant-methionyl human leptin) 5 milligram (mg) BID, 20 weeks
Pramlintide Acetate and PlaceboEXPERIMENTALLead-in period: 2 weeks pramlintide acetate 180 mcg BID, then 2 weeks pramlintide acetate 360 mcg BID Study period: Pramlintide acetate 360 mcg BID and placebo-metreleptin 1 mL BID, 20 weeks
Pramlintide Acetate and MetreleptinEXPERIMENTALLead-in period: 2 weeks pramlintide acetate 180 mcg BID, then 2 weeks pramlintide acetate 360 mcg BID Study period: Pramlintide acetate 360 mcg BID and metreleptin (recombinant-methionyl human leptin) 5 mg BID, 20 weeks
Lead-In PeriodOTHERDuring the Lead-In Period before a participant was randomized to a study arm, the participant received 180 mcg pramlintide acetate twice a day (BID) for 2 weeks, followed by 360 mcg pramlintide acetate BID for 2 weeks (total of 4 weeks in the Lead-In Period).
Pramlintide acetate (AC137) injectionEXPERIMENTALPramlintide acetate (AC137) injection is a clear, colorless, sterile solution for injection. It consists of pramlintide in sodium acetate buffer, pH 4.0, containing 43mg/mL mannitol as an iso-osmolality modifier and 2.25 mg/mL metacresol as a preservative. The strength of pramlintide is 1.0 mg/mL for SC injection and 0.6 mg/mL for IV bolus injection.
Pramlintide acetate & regular insulinEXPERIMENTALPramlintide will be adiministered by sc infusion at a concentration of 1000ug/mL
Placebo and regular insulinPLACEBO_COMPARATORPlacebo is similar sterile solution without pramlintide.
Pramlintide 6 mcg per unit of insulin doseEXPERIMENTALThe pramlintide dose will be calculated based on the subjects' individual insulin units. Dose ratio to be examined is pramlintide 6 mcg for each unit of insulin.
Pramlintide 9 mcg per unit of insulin doseEXPERIMENTALThe pramlintide dose will be calculated based on the subjects' individual insulin units. Dose ratio to be examined is pramlintide 9 mcg for each unit of insulin.
Pramlintide 12 mcg per unit of insulin doseEXPERIMENTALThe pramlintide dose will be calculated based on the subjects' individual insulin units. Dose ratio to be examined is pramlintide 12 mcg for each unit of insulin.

Interventions

NameTypeDescription
pramlintide acetateDRUGPramlintide (0.6 mg/mL) in 5.0-mL multiple-draw glass vials for SC injection for 12weekes and after Pramlintide (1.0 mg/mL) 1.5 mL pen-cartridge. Subjects who do not switch to the pen-cartridge device at Week 12 will continue to administer pramlintide using a syringe and vial.
PlaceboDRUGThe placebo injection will be supplied in the same 5-mL multidose glass vials with a rubber stopper.
Pramlintide and MetreleptinDRUGSubcutaneous injection, twice daily
metreleptinDRUGsubcutaneous injection, twice a day
placebo-PDRUGsubcutaneous injection, twice a day
placebo-MDRUGsubcutaneous injection, twice a day
sibutramineDRUGoral tablet, once a day, 10mg
phentermineDRUGoral tablet, once a day, 37.5mg
pramlintide acetate 360 mcgDRUGsubcutaneous injection, twice a day, 360mcg
placebo-pramlintide 600 uLDRUGtwice a day
placebo-metreleptin 1 mLDRUGtwice a day
Pramlintide acetate 180 mcgDRUGsubcutaneous injection twice a day, 180 mcg
Lispro insulin U-100DRUGSubjects will be stabilized on a separate insulin pump and administered lispro insulin throughout the study, except during both inpatient treatment periods (Visit 4 and Visit 5)
Regular insulin U-100DRUGUse during two in-patient treatment periods (visits 4 and 5) and administered by separate pump
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites48

Inclusion Criteria: * The subject has a clinical diagnosis of type 1 diabetes mellitus requiring treatment with insulin for a minimum of 6 months at Screening; -OR- The subject has a clinical diagnosis of type 2 diabetes requiring treatment with insulin with or without oral antidiabetic agents for ...

Countries:United StatesAustralia
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Frequently asked questions about Pramlintide

What is Pramlintide used for?

Pramlintide is an investigational small molecule being developed for obesity, overweight, and diabetes mellitus, including non-insulin-dependent (Type 2) and Type 1 diabetes. It is in Phase 2 clinical development and has not been approved by the FDA.

Who makes Pramlintide?

Pramlintide is being developed by AstraZeneca PLC, a biopharmaceutical company listed on the stock exchange under the ticker symbol AZN. The company is conducting clinical trials to evaluate the drug's safety and efficacy in metabolic conditions.

What phase is Pramlintide in?

Pramlintide is currently in Phase 2 clinical development. It has completed four clinical trials, including Phase 2 and Phase 3 studies, but it remains investigational and has not received FDA approval for any indication.

What clinical trials is Pramlintide in?

Pramlintide has completed four clinical trials, including NCT00042458, a Phase 3 study in Type 1 diabetes; NCT00042471, a Phase 2 bioavailability study; NCT00042601, a Phase 2 study on satiety and food intake; and NCT00107107, a Phase 3 long-term safety study. All trials are completed.

Is Pramlintide the same as Symlin?

Pramlintide is also known by the brand name Symlin. It is an investigational drug being studied for diabetes and obesity. AstraZeneca is developing it, and it is currently in Phase 2 clinical trials.