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Hylenex

Phase 4

Pain | Small molecule | Pain |Halozyme Therapeutics, Inc.|Trials Updated: Dec 17, 2021

Hylenex development status

Highest phase Phase 4 (NCT00311519)
Phase scored for HALOPhase 3
Registered trials 46 across 14 sponsors since Apr 2006

Hylenex target and mechanism

ModalitySmall molecule

Also known as Recombinant human hyaluronidase PH20 (rHuPH20), PH20, rHuPH20, recombinant human hyaluronidase, Recombinant human hyaluronidase PH20, Formulation 1, Recombinant human hyaluronidase (rHuPH20), Formulation 2

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLED
Total Trials6
Total Enrollment378

FDA Designations

No designations recorded

Hylenex clinical trials

Hylenex · 6 trials · 6 indications

Phase 3 1Phase 2 3Phase 1 2
NCT00593281INFUSE Morphine StudyPain
COMPLETED13 Analytics
PHASE3COMPLETED
INFUSE Morphine Study
PainUnlock trial analytics

Study Endpoints

Primary Endpoints

• Determine the Tmax and other pharmacokinetic parameters of morphine injected subcutaneously with HYLENEX compared to without HYLENEX and injected intravenously
29 days
Change From Baseline in Glycosylated Hemoglobin A1C (HbA1c) at the End of Each Treatment Period
Baseline, Week 12 and Week 24

Glycosylated hemoglobin A1C (HBA1c) levels were measured at baseline (Week 0) and at the end of each treatment period (Week 12 and Week 24). Data are presented by combined treatment group (Lispro-PH20 + Aspart-PH20 = Analog-PH20) and combined comparator drug (Insulin Lispro from both cohorts). Least Squares (LS) means were calculated from mixed effects linear models with treatment (Lispro, Aspart), recombinant human hyaluronidase PH20 (rHuPH20; yes, no), and treatment sequence as fixed effects and participant within treatment sequence as a random effect.

Number of Participants With Positive Reaction Scores Based Upon ICDRG Scoring Scale: Regimen 1
Day 3 (48 hours post-dose after the patch removal for Regimen 1) up to Day 14

Cutaneous reactions at the patch test sites were scored according to the ICDRG scoring scale as Grade 0 (-)= Negative reaction, Grade 1/2 (?)= Doubtful reaction; faint macular erythema only, Grade 1 (1+)= Weak (nonvesicular) positive reaction; erythema, infiltration, papules, vesicles, Grade 2 (2+): Strong (vesicular) positive reaction; erythema, infiltration, papules, vesicles, Grade 3 (3+): Extreme positive reaction; bullous reaction Grade NA (IR): Irritant reaction of different types. Participants with positive reaction scores (\>= Grade 1) have been reported in this outcome measure.

Number of Participants With Positive Reaction Scores Based Upon ICDRG Scoring Scale: Regimen 2
Day 3 (48 hours post-dose after the patch removal for Regimen 2) up to Day 14

Cutaneous reactions at the patch test sites were scored according to the ICDRG scoring scale as Grade 0 (-)= Negative reaction, Grade 1/2 (?)= Doubtful reaction; faint macular erythema only, Grade 1 (1+)= Weak (nonvesicular) positive reaction; erythema, infiltration, papules, vesicles, Grade 2 (2+): Strong (vesicular) positive reaction; erythema, infiltration, papules, vesicles, Grade 3 (3+): Extreme positive reaction; bullous reaction Grade NA (IR): Irritant reaction of different types. Participants with positive reaction scores (\>= Grade 1) have been reported in this outcome measure.

Early Insulin Exposure (%AUC[0-60]), Stage 1
10 minutes predose up to 60 minutes postdose

Early insulin exposure, defined as the percentage of total insulin exposure (area under the insulin concentration curve \[AUC{0-360}\]) that occurs within the first hour following bolus dose of insulin during the 2 euglycemic clamps is presented. Blood samples were collected 10 minutes predose and at 0, 5, 10, 15, 20, 30, 45, 60, 120, 150, 180, 240, 300, and 360 minutes postdose during the euglycemic clamp.

Early Exposure to Insulin (%AUC[0-60]), Stage 3
10 minutes predose up to 60 minutes postdose on Days 2/7, 3/8, and 5/10

Early insulin exposure, defined as the percentage of total insulin exposure (area under the insulin concentration curve \[AUC{0-360}) that occurs within the first hour following bolus dose of insulin during the 2 euglycemic clamps is presented. Blood samples were collected 10 minutes predose and at 0, 5, 10, 15, 20, 30, 45, 60, 120, 150, 180, 240, 300, and 360 minutes postdose during the euglycemic clamp.

Assessment of local tolerability of injected drug product
Over a 7 day period

Secondary Endpoints

Compare the safety and tolerability of these three methods of injections of morphine
29 days
Mean Daily Insulin Dose
Week 10 and Week 22
Percentage of Participants Meeting Glucose Targets
Baseline through Week 24, excluding 10-point glucose monitoring days
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelCROSSOVER
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
1NO_INTERVENTIONIV Morphine
2EXPERIMENTALSC Morphine with Hylenex
3ACTIVE_COMPARATORSC Morphine with Saline
Lispro-PH20 / Insulin LisproEXPERIMENTALAll enrolled participants underwent a titration period of 4-6 weeks in which they received 100 units per milliliter (U/mL) insulin glulisine, injected subcutaneously (SC), pre-meals, with doses titrated to each participant individually. Next participants were randomly assigned to 1 of 2 study treatments (Treatment A or B) for the first of two, 3-month treatment cycles. Each participant then received the second treatment for the second cycle with no washout period. Lispro-PH20 (Treatment A): 100 U/mL insulin lispro with 5.0 micrograms per milliliter (µg/mL) recombinant human hyaluronidase PH20, injected SC, pre-meals, with doses titrated to each participant individually Insulin Lispro (Treatment B): 100 U/mL insulin lispro, injected SC, pre-meals, with doses titrated to each participant individually Throughout the study, participants requiring basal insulin used twice daily SC injections of 100 U/mL insulin glargine.
Aspart-PH20 / Insulin LisproEXPERIMENTALAll enrolled participants underwent a titration period of 4-6 weeks in which they received 100 units per milliliter (U/mL) insulin glulisine, injected subcutaneously (SC), pre-meals, with doses titrated to each participant individually. Next participants were randomly assigned to 1 of 2 study treatments (Treatment A or B) for the first of two, 3-month treatment cycles. Each participant then received the second treatment for the second cycle with no washout period. Aspart-PH20 (Treatment A): 100 U/mL insulin aspart with 5.0 micrograms per milliliter (µg/mL) recombinant human hyaluronidase PH20, injected SC, pre-meals, with doses titrated to each participant individually Insulin Lispro (Treatment B): 100 U/mL insulin lispro, injected SC, pre-meals, with doses titrated to each participant individually Throughout the study, participants requiring basal insulin used twice daily SC injections of 100 U/mL insulin glargine.
Lispro-PH20/Insulin lisproEXPERIMENTALAll enrolled participants underwent a titration period of 4 to 6 weeks in which they received 100 units per milliliter (U/mL) insulin glulisine, injected subcutaneously (SC), pre-meals, with doses titrated to each participant individually. Next, participants were randomly assigned to 1 of 2 study treatments (Treatment A or B) for the first of two, 3-month treatment cycles. Each participant then received the second treatment for the second cycle. Lispro-PH20 (Treatment A): 100 U/mL insulin lispro with 5.0 micrograms per milliliter (µg/mL) recombinant human hyaluronidase PH20 (rHuPH20) (combined: Lispro-PH20), injected SC, pre-meals, with doses titrated to each participant individually. Insulin Lispro (Treatment B): 100 U/mL insulin lispro, injected SC, pre-meals, with doses titrated to each participant individually. Throughout the study, participants requiring basal insulin used twice daily SC injections of 100 U/mL insulin glargine.
Aspart-PH20/Insulin LisproEXPERIMENTALAll enrolled participants underwent a titration period of 4 to 6 weeks in which they received 100 U/mL insulin glulisine, injected SC, pre-meals, with doses titrated to each participant individually. Next participants were randomly assigned to 1 of 2 study treatments (Treatment A or B) for the first of two, 3-month treatment cycles. Each participant then received the second treatment for the second cycle. Aspart-PH20 (Treatment A): 100 U/mL insulin aspart with 5.0 µg/mL rHuPH20 (combined: Aspart-PH20), injected SC, pre-meals, with doses titrated to each participant individually. Insulin lispro (Treatment B): 100 U/mL insulin lispro, injected SC, pre-meals, with doses titrated to each participant individually. Throughout the study, participants requiring basal insulin used twice daily SC injections of 100 U/mL insulin glargine.
rHuPH20EXPERIMENTALParticipant's upper back will be divided into 2 equal spaces and will receive Regimen 1 and 2 in 4 spaces respectively. In Regimen 1, a single row of 4 patches, each with the nickel sulfate concentration (NSC) (1, 2.5, or 5%) determined at screening, will be applied to the upper space at Day 1. After 48 hours, the patches will be removed and the reactions will be graded on the ICDRG scale. An ID injection containing rHuPH20 (3,000 Units \[U\]) will be administered once daily (QD) for 5 days at the center of each area of reaction. In Regimen 2, a single row of 4 sites in the lower space will be injected intradermally with drug rHuPH20 (3,000 U) at Day 1. Ten minutes after the injections, patches with the NSC (1, 2.5, or 5%) determined at screening will be applied to the injection sites. After 48 hours, the patches will be removed and the reactions will be graded on the ICDRG scale. As during pretreatment, an ID injection containing rHuPH20 will be then administered QD for 5 days.
PlaceboPLACEBO_COMPARATORParticipant's upper back will be divided into 2 equal spaces and will receive Regimen 1 and 2 in 4 spaces respectively. In Regimen 1, a single row of 4 patches, each with the NSC (1, 2.5, or 5%) determined at screening, will be applied to the upper space at Day 1. After 48 hours, the patches will be removed and the reactions will be graded on the ICDRG scale. An ID injection containing placebo will be administered QD for 5 days at the center of each area of reaction. In Regimen 2, a single row of 4 sites in the lower space will be injected intradermally with placebo at Day 1. Ten minutes after the injections, patches with the NSC (1, 2.5, or 5%) determined at screening will be applied to the injection sites. After 48 hours, the patches will be removed and the reactions will be graded on the ICDRG scale. As during pretreatment, an ID injection containing placebo will be then administered QD for 5 days.
Stage 1: Insulin aspart first, then insulin aspart-rHuPH20ACTIVE_COMPARATORParticipants first received 0.15 units per kilogram (U/kg) insulin aspart administered as a continuous subcutaneous insulin infusion (CSII), for 4 days (Days 1-4; Period 1), including during a 6-hour (hr) euglycemic clamp on Days 2 and 4. After a 5- to 14-day washout period, participants received 0.15 U/kg insulin aspart and 5 micrograms per milliliter (μg/mL) recombinant human hyaluronidase PH20 (rHuPH20) (insulin aspart-rHuPH20) coadministered as a CSII, for 4 days (Days 5-8; Period 2), including during a 6-hr euglycemic clamp on Days 6 and 8.
Stage 1: Insulin aspart-rHuPH20 first, then insulin aspartACTIVE_COMPARATORParticipants first received 0.15 units per kilogram (U/kg) insulin aspart and 5 micrograms per milliliter (μg/mL) recombinant human hyaluronidase PH20 (rHuPH20) (insulin aspart-rHuPH20) coadministered as a continuous subcutaneous insulin infusion (CSII), for 4 days (Days 1-4; Period 1), including during a 6-hour (hr) euglycemic clamp on Days 2 and 4. After a 5- to 14-day washout period, participants received 0.15 U/kg insulin aspart alone as a CSII, for 4 days (Days 5-8; Period 2), including during a 6-hr euglycemic clamp on Days 6 and 8.
Stage 3: Insulin aspart first, then insulin aspart + rHuPH20ACTIVE_COMPARATORParticipants first received 0.12 units per kilogram (U/kg) insulin aspart administered as a continuous subcutaneous insulin infusion (CSII), for 5 days (Days 1-5; Period 1), including during a 6-hour (hr) euglycemic clamp on Days 2, 3, and 5. On Day 2 only, a sham injection was administered 2.5 hr prior to the 6-hr euglycemic clamp. After a 5- to 14-day washout period, participants received 0.12 U/kg insulin aspart administered as a CSII, for 5 days (Days 6-10; Period 2), including during a 6-hr euglycemic clamp on Days 7, 8, and 10. On Day 7 only, a 1.0-milliliter (mL) subcutaneous (SC) injection of 1.25 micrograms per milliliter (μg/mL) recombinant human hyaluronidase PH20 (rHuPH20) was administered 2.5 hr prior to the 6-hr euglycemic clamp.
Stage 3: Insulin aspart + rHuPH20 first, then insulin aspartACTIVE_COMPARATORParticipants first received 0.12 units per kilogram (U/kg) insulin aspart administered as a continuous subcutaneous insulin infusion (CSII), for 5 days (Days 1-5; Period 1), including during a 6- hour (hr) euglycemic clamp on Days 2, 3, and 5. On Day 2 only, a 1.0-milliliter (mL) subcutaneous (SC) injection of 1.25 micrograms per milliliter (μg/mL) recombinant human hyaluronidase PH20 (rHuPH20) was administered 2.5 hr prior to the euglycemic clamp . After a 5- to 14- day washout period, participants received 0.12 U/kg insulin aspart administered as a CSII, for 5 days (Days 6-10; Period 2), including during a 6-hr euglycemic clamp on Days 7, 8, and 10. On Day 7 only, a sham injection was administered 2.5 hr prior to the 6-hour euglycemic clamp.
Stage 1: rHuPH20 plus ZAEXPERIMENTALParticipants will receive one of several dose/concentrations of recombinant human hyaluronidase PH20 (rHuPH20) with zoledronic acid (ZA).
Stage 2: ZAEXPERIMENTALParticipants will receive a dose/concentration of ZA administered without rHuPH20.
Stage 3: rHuPH20 plus ZAEXPERIMENTALParticipants will receive one of several dose/concentrations of rHuPH20 with ZA.
Stage 4: ZAEXPERIMENTALParticipants will receive an intravenous (IV) dose of 5 milligrams (mg) ZA.
Stage 4: ZA with rHuPH20EXPERIMENTALParticipants will receive a subcutaneous (SC) dose of ZA with rHuPH20.

Interventions

NameTypeDescription
HylenexDRUGAdd Hylenex to SC injection of Morphine
Insulin lisproDRUG -
recombinant human hyaluronidase PH20DRUG -
Insulin aspartDRUG -
Insulin glulisineDRUG -
Insulin glargineDRUG -
rHuPH20DRUG0.25 milliliter (mL) Intradermal (ID) syringe push bolus injection of rHuPH20
PlaceboDRUG0.25 mL ID syringe push bolus injection of placebo control
Recombinant human hyaluronidase PH20 (rHuPH20)DRUG -
zoledronic acidDRUGsubcutaneous injection
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites2

Inclusion Criteria: 1. Males or females at least 18 years of age who are patients of San Diego Hospice \& Palliative Care or recruited through San Diego Hospice \& Palliative Care or the UCSD Center for Pain and Palliative Medicine. 2. During the treatment days of the study, on opioid therapy other...

Countries:United States
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Frequently asked questions about Hylenex

What is Hylenex used for?

Hylenex is an investigational small molecule developed by Halozyme Therapeutics for pain. It has been studied in a Phase 3 trial in patients with pain, though no active trials are currently listed. The completed trial enrolled 13 adults aged 18 years and older in the United States.

Who makes Hylenex?

Hylenex is developed by Halozyme Therapeutics, Inc., which trades under the ticker HALO. The company is responsible for the clinical development of Hylenex in pain indications.

What phase is Hylenex in?

Hylenex is in Phase 3 development for pain. One Phase 3 trial has been completed, and there are currently no active trials listed. Hylenex is investigational and has not been approved by the FDA for any indication.

What clinical trials is Hylenex in?

Hylenex has been evaluated in one completed Phase 3 trial, NCT00593281, titled INFUSE Morphine Study. The trial enrolled 13 participants with pain in the United States. It was randomized, double-blind, and active-controlled, with participants aged 18 years and older.

Is Hylenex FDA approved?

Hylenex is not FDA approved. It is an investigational small molecule still in clinical development, with a completed Phase 3 trial in pain. No approval has been granted for any indication based on the available development information.