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Albiglutide

Phase 3

Diabetes Mellitus, Type 2 | Monoclonal antibody | Metabolic |GSK plc|Last Updated: Nov 27, 2020

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials15
Total Enrollment6,607
FDA Designations
No designations recorded
Clinical Trials (15)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02229227Safety and Efficacy of Albiglutide + Insulin Glargine Versus Insulin Lispro + Insulin Glargine Subjects With Type 2 Diabetes MellitusPHASE3 COMPLETED 814Nov 21, 2014Jul 24, 2017Nov 27, 2020157 United States, Brazil +12
NCT01098539A Study of the Efficacy and Safety of Albiglutide in Subjects With Type 2 Diabetes With Renal Impairment.PHASE3 COMPLETED 507May 1, 2010Nov 1, 2012Feb 28, 2017218 United States, Australia +13
NCT01128894A Study to Determine the Efficacy and Safety of Albiglutide as Compared With Liraglutide.PHASE3 COMPLETED 841May 1, 2010Sep 1, 2011Feb 23, 2017173 United States, Australia +6
NCT00976391A Study to Determine the Safety and Efficacy of Albiglutide Administered in Combination With Insulin GlarginePHASE3 COMPLETED 586Sep 1, 2009May 1, 2012Jan 11, 2017209 United States, Brazil +12
NCT00838903Efficacy and Safety of Albiglutide in Treatment of Type 2 DiabetesPHASE3 COMPLETED 1,049Feb 1, 2009Apr 1, 2013Jan 9, 2017386 United States, Albania +9
NCT00838916A Study to Determine the Safety and Efficacy of Albiglutide in Patients With Type 2 DiabetesPHASE3 COMPLETED 779Feb 1, 2009May 1, 2013Jan 9, 2017337 United States, Russia +2
NCT00839527A Study to Determine the Safety and Efficacy of Albiglutide in Subjects With Type 2 DiabetesPHASE3 COMPLETED 685Feb 1, 2009Apr 1, 2013Jan 9, 2017358 United States, Germany +7
NCT00849017Safety and Efficacy Study of Albiglutide in Type 2 DiabetesPHASE3 COMPLETED 309Jan 1, 2009Feb 1, 2013Jan 9, 2017262 United States, Mexico +1
NCT00849056Safety and Efficacy of Albiglutide in Type 2 DiabetesPHASE3 COMPLETED 310Jan 1, 2009Jan 1, 2013Jan 9, 2017331 United States, India +4
NCT01475734Albiglutide Glucose Clamp Study in Subjects With Type 2 DiabetesPHASE2 COMPLETED 44Dec 1, 2011Jul 1, 2012Jan 11, 20171 United States
NCT01357889Pharmacokinetics/Pharmacodynamics of AlbiglutidePHASE2 COMPLETED 283Jul 1, 2011Oct 1, 2012Jan 9, 201730 United States
NCT01098461Dose Ranging Study of Albiglutide in Japanese SubjectsPHASE2 COMPLETED 215Apr 1, 2010May 1, 2011Jan 13, 201730 Japan
NCT01406262Albiglutide Thorough ECG Study in Healthy VolunteersPHASE1 COMPLETED 94Jul 6, 2011Dec 29, 2011Jun 8, 2017 -
NCT01077505An Evaluation of the Pharmacokinetics of an Oral Contraceptive (Brevicon) When Co-administered With Albiglutide .PHASE1 COMPLETED 16Mar 15, 2010Nov 24, 2010Jun 14, 20171 United States
NCT00938158A Study of the Pharmacokinetics of Albiglutide in Normal and Renally Impaired Subjects.PHASE1 COMPLETED 75Aug 5, 2009Apr 12, 2011Jul 21, 20177 United States, South Africa
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Study Endpoints
Primary Endpoints
Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 26
Baseline (Day -1) and Week 26

HbA1c is glycosylated hemoglobin. It was measured at Baseline and at Week 26. The analysis was conducted using mixed-effect model with repeated measures (MMRM). The model included HbA1c change from Baseline as the dependent variable; treatment, region, age category, current metformin use, visit week, treatment-by-week interaction, and Baseline HbA1c-by-week interaction as fixed effects; Baseline HbA1c as a continuous covariate; and participant as a random effect. The Baseline value was the last available non-missing value prior to the first dose of the randomized treatment, thus Baseline was Day -1. Change from Baseline is defined as the post-Baseline value minus the Baseline value.

Mean Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 32
Baseline and Week 32

HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over a 2- to 3-month period. The Baseline HbA1c value is defined as the last non-missing value before the start of treatment. Change from Baseline in HbA1c was calculated as the value at Week 32 minus the value at Baseline. The analysis was performed using an Analysis of Covariance (ANCOVA) model with treatment group, region, history of prior myocardial infarction (yes versus no), and age category (\<65 years versus ≥65 years) as factors and Baseline HbA1c as a continuous covariate. The last observation carried forward (LOCF) method was used to impute missing data, in which the last non-missing post-Baseline on-treatment measurement was used to impute the missing measurement. If a participant had missing observation(s) immediately after Baseline, the Baseline observation was not carried forward and was left as missing.

Change From Baseline (BL) in Glycosylated Hemoglobin (HbA1c) at Week 26
Baseline and Week 26

HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over a 2- to 3-month period. The BL HbA1c value is defined as the last non-missing value before the start of treatment. Change from BL was calculated as the value at Week 26 minus the value at BL. The analysis was performed using an Analysis of Covariance (ANCOVA) model with treatment group, region, history of prior myocardial infarction (yes versus no), and age category (\<65 years versus ≥65 years) as factors and Baseline HbA1c as a continuous covariate.The last observation carried forward (LOCF) method was used to impute missing post-BL HbA1c values; the last non-missing post-BL on-treatment measurement was used to impute the missing measurement. HbA1c values obtained after hyperglycemic rescue were treated as missing and were replaced with pre-rescue values.

Change From Baseline (BL) in Glycosylated Hemoglobin (HbA1c) at Week 104
Baseline and Week 104

HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over a 2- to 3-month period. The BL HbA1c value is defined as the last non-missing value before the start of treatment. Change from BL was calculated as the value at Week 104 minus the value at BL. Based on analysis of covariance (ANCOVA): change = treatment + BL HbA1c + prior myocardial infarction history + age category + region. Difference of least squares means (albiglutide - placebo, albiglutide - sitagliptin, albiglutide - glimepiride) is from the ANCOVA model. The last observation carried forward (LOCF) method was used to impute missing post-Baseline HbA1c values; the last non-missing post-BL on-treatment measurement was used to impute the missing measurement. HbA1c values obtained after hyperglycemic rescue were treated as missing and were replaced with pre-rescue values.

Change From Baseline (BL) in Glycosylated Hemoglobin (HbA1c) at Week 52
Baseline and Week 52

HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over a 2- to 3-month period. The BL HbA1c value is defined as the last non-missing value before the start of treatment. Change from BL was calculated as the value at Week 52 minus the value at BL. Based on analysis of covariance (ANCOVA): change = treatment + BL HbA1c + prior myocardial infarction history + age category + region + current antidiabetic therapy. Difference of least squares means (albiglutide - insulin glargine) is from the ANCOVA model. The last observation carried forward (LOCF) method was used to impute missing post-Baseline HbA1c values; the last non-missing post-BL on-treatment measurement was used to impute the missing measurement. HbA1c values obtained after hyperglycemic rescue were treated as missing and were replaced with pre-rescue values.

Glucagon Concentration (Nanomoles Per Liter [Nmol/L]) During the Hypoglycemic Periods of the Glucose Clamp Procedure
Day 4

Plasma glucagon levels were measured for the estimation of glucagon secretion during the hypoglycemic periods. Glucagon response was measured at each clamped glucose concentration: 9 millimoles per liter (mmol/L) (0 hour \[hr\], 1hr, 1 hr 15 minutes \[min\]), 5 mmol/L (1 hr 45 min, 2 hr), 4 mmol/L (2 hr 45 min, 3 hr), 3.3 mmol/L (3 hr 30 min, 3 hr 45 min), and 2.8 mmol/L (4 hr 15 min, 4 hr 30 min), and clamp released (4 hr 45 min, 5 hr, 5 hr 15 min, 5 hr 30 min). Repeated-measures analysis of variance was performed on non-transformed pharmacodynamic parameters using a model with treatment, time, and treatment-by-time as fixed effects, and participant as a random effect. Values below the lower limit of quantification (0.03780 nmol/L) were set to the quantification limit for summary.

Area Under the Plasma Concentration Versus Time Curve (AUC) From Time Zero to Infinity (0-inf) of Albiglutide in the Bioequivalence (BE) Phase
Pre-dose at Baseline; 24 hours (hr), 48 hr, 96 hr, 216 hr, 312 hr, 480 hr, and 672 hr post-dose

To assess the bioequivalence of the two formulations of albiglutide, an analysis of variance (ANOVA) model with treatment as a fixed effect was applied to the natural-log-transformed parameter AUC(0-inf) estimated from the BE Phase. AUC is a measure of how much albiglutide is in the blood at certain time points. The Process 2 treatment group (albiglutide derived from process 2) was the reference group and was compared with the Process 3 treatment group (albiglutide derived from process 3) as the test group (i.e., treatment comparisons based on the ratio of Process 3:Process 2). Blood samples for pharmacokinetic analysis were collected prior to dosing at Baseline and 24 hours (hr), 48 hr, 96 hr, 120 hr, 216 hr, 312 hr, 480 hr, and 672 hr after administration of the Baseline study medication.

Maximum Observed Plasma Concentration (Cmax) of Albiglutide in the BE Phase
Pre-dose at Baseline; 24 hr, 48 hr, 96 hr, 216 hr, 312 hr, 480 hr, and 672 hr post-dose

To assess the bioequivalence of the two formulations of study drug, an analysis of variance (ANOVA) model with treatment as a fixed effect was applied to the natural-log-transformed parameter Cmax estimated from the BE phase. The Process 2 treatment group (albiglutide derived from process 2) was the reference group and was compared with the Process 3 treatment group (albiglutide derived from process 3) as the test group (i.e., treatment comparisons based on the ratio of Process 3:Process 2). Blood samples for pharmacokinetic analysis were collected prior to dosing at Baseline and 24 hours (hr), 48 hr, 96 hr, 120 hr, 216 hr, 312 hr, 480 hr, and 672 hr after administration of the Baseline study medication.

Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 16
Baseline and Week 16

HbA1c is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over a 2- to 3-month period. The Baseline HbA1c value is defined as the last non-missing value before the start of treatment. Change from Baseline was calculated as the value at Week 16 minus the value at Baseline. Based on Analysis of Covariance (ANCOVA): Change = treatment + Baseline HbA1c + prior therapy. The last observation carried forward (LOCF) method was used to impute missing data, in which the last non-missing post-Baseline on-treatment measurement was used to impute the missing measurement. If a participant had missing observation(s) immediately after Baseline, the Baseline observation was not carried forward and was left as missing.

QTc interval
6 weeks

Measurement of cardiac repolarization after albiglutide dosing

AUC0-24 of norethindrone and ethinyl estradiol after OC alone in Period 1 and after OC with albiglutide in Period 2.
Day 21
The primary objective is to characterize the PK of albiglutide in subjects with type 2 diabetes and varying degrees of renal impairment, including subjects requiring hemodialysis, and in age, gender and BMI-matched subjects.
42 days
Secondary Endpoints
Number of Participants Treated With Once-weekly Albiglutide That Were Able to Discontinue Insulin Lispro at Week 4 and Did Not Meet Prespecified Criteria for Severe, Persistent Hyperglycemia Through Week 26
Up to Week 26
Percentage of Participants With Severe or Documented Symptomatic Hypoglycemia Through Week 26
Up to Week 26
Change From Baseline in Body Weight at Week 26
Baseline (Day -1) and Week 26
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Albiglutide + Insulin Glargine ArmEXPERIMENTALDuring standardization period, subjects will transit from basal bolus regimen received during screening period to insulin glargine plus insulin lispro. During treatment period, subject will receive Albiglutide 30 milligrams (mg) weekly subcutaneous (SC) injection and insulin lispro dose will be downtitrated to half that used in the standardization period. At Week 4, Albiglutide will be uptitrated to 50 mg weekly SC injection and insulin lispro will be stopped for the remainder of the treatment Period. Insulin lispro may be re-introduced after Week 8 according to pre-defined hyperglycemia thresholds. Insulin will be adjusted according to protocol-defined insulin titration algorithms
Insulin Glargine + Insulin Lispro ArmEXPERIMENTALDuring standardization period, subjects will transit from basal bolus regimen received during screening period to insulin glargine plus insulin lispro. During treatment period, subject will continue with the same doses as at the end of the standardization period and doses will be adjusted according to protocol-defined insulin titration algorithms
albiglutideACTIVE_COMPARATORalbiglutide weekly subcutaneous injection + sitagliptin matching placebo
sitagliptinACTIVE_COMPARATORalbiglutide matching placebo + sitagliptin
liraglutideACTIVE_COMPARATORliraglutide daily subcutaneous injection, starting at 0.6mg, then up-titrating to 1.2mg then 1.8mg in accordance with prescribing information.
albiglutide + insulin glargineACTIVE_COMPARATORalbiglutide in combination with insulin glargine
insulin glargine + preprandial lispro insulinACTIVE_COMPARATORinsulin glargine in combination with preprandial lispro insulin
albiglutide + metforminEXPERIMENTALAlbiglutide + metformin + placebo sitagliptin + placebo glimepiride
sitagliptin + metforminACTIVE_COMPARATORSitagliptin + metformin + placebo albiglutide + placebo glimepiride
glimepiride + metforminACTIVE_COMPARATORGlimepiride + metformin + placebo albiglutide + placebo sitagliptin
metformin + placeboACTIVE_COMPARATORMetformin + placebo albiglutide + placebo sitagliptin + placebo glimepiride
albiglutide weekly injectionEXPERIMENTALalbiglutide weekly subcutaneous injection
insulin glargineACTIVE_COMPARATORinsulin glargine daily injection
metformin + glimepiride + pioglitazone + albiglutide placeboACTIVE_COMPARATORMetformin + glimepiride + pioglitazone + matching albiglutide placebo
metformin + glimepiride + pioglitazone placebo + albiglutideEXPERIMENTALMetformin + open-label glimepiride + pioglitazone matching placebo + albiglutide
met + glimepiride + pioglitazone placebo + albiglutide placeboACTIVE_COMPARATORmetformin + open-label glimepiride + pioglitazone placebo + albiglutide placebo
placeboPLACEBO_COMPARATORalbiglutide matching placebo
albiglutide up-titrationEXPERIMENTALalbiglutide weekly injection uptitration at week 12
placebo + pioglitazone (with or without metformin)PLACEBO_COMPARATORPlacebo albiglutide weekly injection + pioglitazone (with or without metformin)
albiglutide + pioglitazone (with or without metformin)EXPERIMENTALalbiglutide weekly injection + pioglitazone (with or without meformin)
process 2 albiglutideACTIVE_COMPARATORalbiglutide 30mg from process 2 drug substance
process 3 albiglutideACTIVE_COMPARATORalbiglutide 30mg from process 3 drug substance
albiglutide 15mg weeklyACTIVE_COMPARATORonce weekly subcutaneous injection of albiglutide 15mg
albiglutide 30mg weeklyACTIVE_COMPARATORonce weekly subcutaneous injection of albiglutide 30mg
albiglutide 30mg every other weekACTIVE_COMPARATORsubcutaneous injection of 30mg albiglutide every other week
Albiglutide + moxifloxacin placeboACTIVE_COMPARATOROnce weekly subcutaneous injection of albiglutide for 6 weeks plus oral tablet of moxifloxacin matching placebo on Days -1 and 40
Albiglutide matching placebo + moxifloxacinACTIVE_COMPARATOROnce weekly subcutaneous injection of albiglutide matching placebo for 6 weeks, given with oral 400mg moxifloxacin tablet on Day -1 and moxifloxacin matching placebo on Day 40, or weekly albiglutide matching placebo for 6 weeks plus oral moxifloxacin matching placebo on Day -1 then oral 400mg moxifloxacin on Day 40
Stage 1 normal renal functionEXPERIMENTALSubject with estimated glomerular filtration rate (GFR) greater than 80 milliliter per minute (mL/min)
Stage 1 moderate/severe renal functionEXPERIMENTALSubject with estimated GFR \>= 20 mL/min and less than 50 mL/min
Stage 2 normal renal functionEXPERIMENTALSubject with GFR greater than 80 mL/min
Stage 2 moderate renal impairmentEXPERIMENTALSubject with estimated GFR \>= 30 mL/min and less than 50 mL/min
Stage 2 subjects requiring hemodialysisEXPERIMENTALSubjects who require hemodialysis
Stage 2 severe renal impairment not requiring hemodialysisEXPERIMENTALSubjects with GFR less than 30 mL/min
Stage 2 mild renal impairmentEXPERIMENTALSubjects with GFR \>= 50 mL/min and \<= 80 mL/min
Interventions
NameTypeDescription
AlbiglutideDRUGAlbiglutide is intended for self-administration as a SC injection. It is provided as a fixed dose of 30 mg of albiglutide or 50 mg of albiglutide in a 0.5 mL injection volume, fully disposable pen injector
Insulin Glargine and Insulin LisproDRUGInsulin glargine and insulin lispro will be provided as injection pens for SC injection
sitagliptinDRUGalbiglutide matching placebo + sitagliptin (25mg, 50mg or 100mg depending on level of renal impairment)
liraglutideDRUGliraglutide daily subcutaneous injection, starting at 0.6mg, then up-titrating to 1.2mg then 1.8mg in accordance with prescribing information.
albiglutide + insulin glargineBIOLOGICALalbiglutide in combination with insulin glargine
insulin glargine + preprandial lispro insulinDRUGinsulin glargine in combination with preprandial lispro insulin
glimepirideDRUGGlimepiride
metforminDRUGMetformin
placebo albiglutideBIOLOGICALplacebo to match albiglutide
placebo sitagliptinDRUGplacebo to match sitagliptin
placebo glimepirideDRUGplacebo to match glimepiride
insulin glargineDRUGinsulin glargine
placebo to match albiglutideDRUGalbiglutide matching placebo weekly subcutaneous injection
pioglitazoneDRUGpioglitazone
placebo to match pioglitazoneDRUGpioglitazone matching placebo
albiglutide uptitrationBIOLOGICALalbiglutide uptitration at week 12
placeboBIOLOGICALmatching albiglutide placebo weekly injection
albiglutide (GSK716155)BIOLOGICALsubcutaneous injection administered once a week
MoxifloxacinDRUGoral tablet
Oral contraceptive (Brevicon)DRUGOral contraceptive (Brevicon)
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites157

Inclusion Criteria: * Male or female, 18 years of age or older (inclusive at the time of Screening) with T2DM * HbA1c \>= 7.0% and \<= 9.0% at Screening. * Currently treated with a basal-bolus insulin regimen (with or without metformin) for at least 3 months before Screening. The subject must be ta...

Countries:United StatesBrazilCanadaFranceGermanyHungaryItalyMexicoPhilippinesPolandSouth AfricaSouth KoreaSpainUnited KingdomAustraliaColombiaIndiaIsraelPeruRussiaTaiwanHong KongAlbaniaJapan
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