Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Glucagon · 13 trials · 8 indications
Percentage of participants who achieved treatment success during the controlled insulin-induced hypoglycemia in participants with type 1 diabetes mellitus (T1DM) and participants with type 2 diabetes mellitus (T2DM).Treatment success is defined as an increase in plasma glucose to greater than or equal to (≥) 70 milligrams per deciliter (mg/dL) or an increase of ≥20 mg/dL from plasma glucose nadir, without receiving additional actions to increase the plasma glucose concentration. Nadir is defined as the minimum plasma glucose concentration at the time of or within 10 minutes following glucagon administration.
Responses to questions completed by the caregiver are used to assess this outcome. An episode of severe hypoglycemia is generally defined as an event associated with severe neuroglycopenia usually resulting in coma or seizure and requiring parenteral therapy (glucagon or intravenous glucose) administered by a third party. In this study moderate hypoglycemia is defined as an episode wherein the child/adolescent with diabetes has symptoms and/or signs of neuroglycopenia and has a blood glucose ≤3.9 millimoles per liter (mmol/L) (70 milligram per deciliter \[mg/dL\]) based on a blood sample taken at or close to the time of treatment.
Responses to questions completed by the caregiver were used to assess this outcome. An episode of severe hypoglycemia was defined as an episode wherein the person with diabetes is clinically incapacitated to the point where the person requires third-party assistance to treat the hypoglycemia. An episode of moderate hypoglycemia episode was defined as an episode wherein the person with diabetes was showing signs of neuroglycopenia and had a glucometer reading of approximately 60 milligrams per deciliter (mg/dL) (3.3 millimoles per liter \[mmol/L\]) or less based on a blood sample taken at or near the time of treatment.
Increase in blood glucose to ≥70 mg/dL or an increase of ≥20 mg/dL from glucose nadir within 30 minutes after receiving study glucagon, without receiving additional actions to increase the blood glucose level defines treatment success. Due to the residual activity of circulating insulin, glucose nadir was defined as the minimum glucose measurement at the time of, or within 10 minutes following glucagon administration.
Glucagon anti-drug antibodies (ADA) were assessed at baseline through study completion. Percentage of participants (Pts) with ADA=(number of Pts with treatment-emergent ADA/number of Pts assessed)\*100. Treatment-Emergent ADA includes treatment-induced ADA and treatment boosted ADA. Treatment-induced is defined as participants with 'Not Detected' ADA at baseline (drug-naive) and at least one post-baseline ADA 'Detected' sample with a corresponding titer that is one 2-fold dilution higher than the MRD (minimal required dilution) of the assay. For the nasal glucagon Tier 1-3 ADA screening assay, the MRD is 1:20. Treatment-boosted is defined as Patient with ADA 'Detected' at baseline (drug-naive) and at least one post-baseline ADA 'Detected' sample with a corresponding titer that is at least (\>or=) 4-fold higher than the baseline titer.
Safety parameters assessed included the occurrence of adverse events, the measurement of clinical laboratory parameters; vital signs, ECGs, physical examination, blood glucose, and examination of the injection site (following the IM administration). An AE was defined as any untoward medical occurrence in a clinical investigation subject administered the investigational product and which did not necessarily have a causal relationship with this treatment A summary of other nonserious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.
Participants with a blood glucose increment of ≥1.5 millimole per liter \[mmol/L) within 15 of nadir (5 minutes post dose) and for at least 10 minutes following nadir.
A TEAE is defined as an adverse event which occurs post-dose or which is present prior to dosing and becomes more severe post-dose. An SAE is any AE from the study that results in 1 of the following: Death, initial or prolonged inpatient hospitalization, a life-threatening experience (i.e., immediate risk of dying), persistent or significant disability/incapacity, congenital anomaly/birth defect, important medical events that may not be immediately life-threatening or result in death or hospitalization but may jeopardize the subject or may require intervention to prevent 1 of the other outcomes listed in the definition above. The number of participants with one or more TEAEs, SAEs considered by the investigator to be related to study drug administration is reported here. A summary of SAEs and other non-serious AEs, regardless of causality is located in the Reported Adverse Events section of this record.
Percentage of trained users who found both devices and performed a successful administration of both rescue devices for both simulations.
Safety and tolerability evaluated through the assessment of adverse events. A SAE (serious adverse event) was defined as any untoward medical occurrence in a clinical investigation participant administered the investigational product and which did not necessarily have a causal relationship with this treatment. A summary of other non-serious AEs, and all SAE's, regardless of causality, is located in the Reported Adverse Events section.
| Arm | Type | Description |
|---|---|---|
| Glucagon Nasal Powder | EXPERIMENTAL | A single dose of 3 milligram (mg) glucagon nasal powder administered intranasally. |
| Glucagon Hydrochloride Solution | ACTIVE_COMPARATOR | A single dose of 1 mg glucagon hydrochloride solution was administered intramuscular (IM) |
| Nasal Glucagon | EXPERIMENTAL | A single dose of 3mg glucagon nasal powder administered using a nasal powder delivery device for the treatment of moderate or severe hypoglycemic events; a maximum of 4 events per participant during the study. |
| Intramuscular Glucagon | ACTIVE_COMPARATOR | At a separate visit, 1 mg of glucagon was administered into the deltoid muscle of the non-dominant arm (intramuscular \[IM\]). |
| Glucagon IM | ACTIVE_COMPARATOR | Glucagon dose of 1 milligram (mg) administered intramuscularly (IM). |
| Nasal Glucagon (NG | EXPERIMENTAL | Nasal Glucagon (NG) doses of 3 mg administered intra-nasally. |
| Nasal Glucagon (NG) | EXPERIMENTAL | Nasal glucagon (NG) doses of 2.0 mg and 3.0 mg for participants 4 to less than 12 years of age and 3.0 mg for those 12 to less than 17 years of age were administered in a nostril with a prefilled delivery device that delivered a single dose upon activation. |
| Intramuscular (IM) Glucagon | ACTIVE_COMPARATOR | Participants who weighed at least 25 kilograms (kg)/55 pounds (lbs) were dosed 1 mg of IM glucagon; participants who weighed less than 25 kg/55 lbs, IM glucagon dosed with 0.5 mg |
| Nasal Glucagon 1 mg | EXPERIMENTAL | Nasal glucagon (NG) administered as single dose of 1 milligram (mg). |
| Nasal Glucagon 2 mg | EXPERIMENTAL | NG administered as single dose of 2 mg. |
| SC Glucagon | ACTIVE_COMPARATOR | Glucagon solution dose of 1 mg administered as a single subcutaneous (SC) injection. |
| Nasal Glucagon 3 mg | EXPERIMENTAL | NG administered as single dose of 3 mg (composed of one dose of 1 mg NG immediately followed by one dose of 2mg NG). |
| 3 milligram (mg) Nasal Glucagon | EXPERIMENTAL | Participants received a single dose of 3 mg glucagon powder administered intranasally on day 1. |
| Nasal Glucagon Device (NG) | EXPERIMENTAL | Empty NG device administered to a manikin during simulations of severe hypoglycaemia emergencies. No drug will be administered to humans. |
| Glucagon Emergency Kit (GEK) | ACTIVE_COMPARATOR | Commercially available GEK delivered intramuscularly to a manikin during simulations of severe hypoglycaemia emergencies. No drug will be administered to humans. |
| Nasal Glucagon (NG) - Treatment 1 | EXPERIMENTAL | One dose of 3 milligram (mg) NG administered in one of four study periods. |
| NG - Treatment 2 | EXPERIMENTAL | Two NG doses, 3 mg each dose, administered 15 minutes apart, in the same nostril, in one of four study periods. |
| NG - Treatment 3 | EXPERIMENTAL | Two NG doses, 3 mg each dose, administered 15 minutes apart, in opposite nostrils, in one of four study periods. |
| NG - Treatment 4 | EXPERIMENTAL | Two NG doses, 3 mg each dose, administered one immediately after the other, in opposite nostrils, in one of four study periods. |
| Nasal Glucagon (NG) - Common Cold | EXPERIMENTAL | Cohort 1 - Nasal Glucagon (NG) administered once in participants with a common cold. |
| Nasal Glucagon (NG) - Symptom-Free | EXPERIMENTAL | Cohort 1 - NG administered once in participants who have recovered from a common cold. |
| NG - Common Cold+Oxymetazoline | EXPERIMENTAL | Cohort 2 - NG administered once in participants with a common cold who are taking oxymetazoline. |
| Nasal Glucagon (NG) - 0.5 mg | EXPERIMENTAL | Ng dose at 0.5 milligram (mg) administered once in one of four study periods. |
| NG - 1.0 mg | EXPERIMENTAL | Ng dose at 1.0 milligram (mg) administered once in one of four study periods. |
| NG - 2.0 mg | EXPERIMENTAL | Ng dose at 2.0 milligram (mg) administered once in one of four study periods. |
| SC Glucagon 1 mg | ACTIVE_COMPARATOR | Subcutaneous (SC) glucagon dose of 1 mg, in one of four study periods. |
| Name | Type | Description |
|---|---|---|
| Glucagon Nasal Powder | DRUG | Administered intranasally |
| Glucagon Hydrochloride Solution | DRUG | Administered IM |
| Nasal Glucagon | DRUG | 3 mg nasal glucagon powder |
| Intramuscular Glucagon | DRUG | - |
| Nasal Glucagon (NG) | DRUG | - |
| Glucagon IM | DRUG | - |
| Nasal Glucagon 1 mg | DRUG | - |
| Nasal Glucagon 2 mg | DRUG | - |
| SC Glucagon | DRUG | - |
| Nasal Glucagon 3 mg | DRUG | - |
| Glucagon Nasal Powder [Baqsimi] | DRUG | Administered intranasally |
| Nasal Glucagon Device (NG) | DEVICE | NG devices will be provided empty of drug product |
| GEK | DEVICE | Used to administer glucagon intramuscularly (IM) |
| IM Glucagon | DRUG | Administered IM via GEK |
| Oxymetazoline | DRUG | Administered intranasally. |
| Glucagon | DRUG | Administered SC. |
Inclusion Criteria: * Participants with Type 1 diabetes (T1D) or Type 2 diabetes (T2D) * Body mass Index (BMI) of 18.5 to 30.0 kilograms per meter squared (kg/m2) for T1D, or 18.5 to 35.0 kg/m2 for T2D * Hemoglobin A1c (HbA1c) ≤10% Exclusion Criteria: * Have significant changes in insulin regimen...
Glucagon is an investigational small molecule being developed by Eli Lilly and Company for the treatment of hypoglycemia, a condition of low blood sugar. It is also being studied in the context of Type 1 Diabetes Mellitus, and has been evaluated in clinical trials involving patients with diabetes and related conditions.
Eli Lilly and Company (NYSE: LLY) is the developer of Glucagon. The company has sponsored clinical trials of this investigational drug for the treatment of hypoglycemia in patients with diabetes.
Glucagon is in clinical development. While the most recent trial listed is Phase 1, earlier trials were Phase 2 and Phase 3. All four trials have been completed, and Glucagon is not approved and remains investigational.
Glucagon has been studied in four completed trials. These include NCT01556594, a Phase 2 study in Canada; NCT02171130, a Phase 3 study in the US and Canada; NCT02402933, a Phase 3 study in the US; and NCT03339453, a Phase 1 study in Germany. Total enrollment across these trials was 243 participants.
Glucagon is the drug name used in clinical trials that tested intranasal and nasal formulations. The trials NCT02171130 and NCT02402933 specifically evaluated intranasal and nasal glucagon, respectively, for the treatment of hypoglycemia.