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Single‐dose euglycaemic clamp studies demonstrating pharmacokinetic and pharmacodynamic similarity between MK‐1293 insulin glargine and originator insulin glargine (Lantus) in subjects with type 1 diabetes and healthy subjects
Authors:Michael F. Crutchlow MD  John S. Palcza MS  Kate M. Mostoller PhD  Chantal D. Mahon MS  Michael C. Marcos MS  Yang Xu PhD  Elaine Watkins DO  MSPH  Linda Morrow MD  Marcus Hompesch MD
Affiliation:1. Merck & Co., Inc, Kenilworth, New Jersey;2. ProSciento, Inc, Chula Vista, California
Abstract:

Aims

MK‐1293 is an insulin glargine that has an amino acid sequence identical to that of Lantus, the originator insulin glargine. Two euglycaemic clamp studies, 1 in subjects with type 1 diabetes (T1D) and 1 in healthy subjects, were conducted to demonstrate pharmacokinetic (PK) and pharmacodynamic (PD) similarity between MK‐1293 and Lantus commercially procured in both the European Union (EU‐Lantus) and the USA (US‐Lantus).

Materials and Methods

Both studies were single‐dose, randomized, double‐blind, single‐centre, crossover studies with ≥7 days between dosing periods. A 2‐treatment, 4‐period replicate crossover study in T1D subjects (N = 76) compared the PK and PD of MK‐1293 to EU‐Lantus for 30 hours after dosing. A 3‐period crossover study in healthy subjects (N = 109) compared the PK and PD of MK‐1293, EU‐Lantus and US‐Lantus for 24 hours after dosing. In both studies, all subjects received single 0.4 units/kg subcutaneous doses of MK‐1293 or Lantus in all dosing periods. Pharmacokinetic assessment was based on LC‐MS/MS‐based measurement of the major insulin glargine metabolite (M1) and PD was characterized using the euglycaemic clamp platform.

Results

In both studies, pre‐specified similarity criteria were met between MK‐1293 and Lantus for comparison of PK (AUC0‐24 and Cmax of M1) and PD (GIR‐AUC0‐24, GIR‐AUC0‐12, GIR‐AUC12‐24, and GIRmax) primary endpoints. All treatments were well tolerated.

Conclusion

Based on comparative assessment in both T1D and healthy subjects, it can be concluded that the PK and PD properties of MK‐1293 are highly similar to those of Lantus. (ClinicalTrials.gov: NCT02059174).
Keywords:biosimilar insulin  glycaemic control  insulin analogues  pharmacodynamics  pharmacokinetics  type 1 diabetes
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