E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nutritional and Metabolic Diseases [C18] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10067584 |
E.1.2 | Term | Type 1 diabetes mellitus |
E.1.2 | System Organ Class | 10027433 - Metabolism and nutrition disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To demonstrate equivalence of Gan & Lee Pharmaceuticals insulin glargine and Lantus® in terms of immunogenicity and efficacy |
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E.2.2 | Secondary objectives of the trial |
- Immunogenicity: To evaluate the percentage of subjects with negative anti-insulin antibodies (AIA) at baseline who develop confirmed positive AIA up to Week 26, mean change from baseline in AIA titers between treatment groups, the percentage of subjects with confirmed AIA who develop any anti-insulin neutralizing antibodies up to Week 26, and the percentage of subjects in each treatment group with confirmed positive AIA up to Week 26. - Safety: To evaluate the safety of Gan & Lee Pharmaceuticals insulin glargine injection in comparison with that of Lantus® - Efficacy: To evaluate the efficacy of Gan & Lee Pharmaceuticals insulin glargine injection in comparison with that of Lantus® |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or nonpregnant, nonlactating female subjects between the ages of 18 and 75 years, inclusive 2. Ability to provide written, signed, and dated informed consent to participate in the study, in accordance with the ICH GCP Guideline E6 and all applicable regulations, before completing any study-related procedures 3. Ability to understand and fully comply with all study procedures and restrictions 4. Subjects with a confirmed diagnosis of type 1 diabetes mellitus who have been on an approved basal and bolus insulin regimen for at least 6 months (the type or brand of insulin should not have changed in the 6 months before screening) 5. HbA1c < 11.0% 6. BMI ≥ 19 kg/m2 and ≤ 35 kg/m2 7. Adherence to a prudent diet and exercise regimen recommended by the medical provider, and willingness to maintain these consistently for the duration of the study 8. Concomitant medications are allowed, including medications for thyroid disease, provided that a stable dosage has been achieved for at least 90 days before screening, and no significant dosing changes are anticipated during the study |
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E.4 | Principal exclusion criteria |
1. Participation in another clinical study or use of any study drug within 30 days before screening 2. Previous use of a biosimilar insulin, either basal or bolus 3. Diabetic ketoacidosis within a year before screening 4. Brittle type 1 diabetes mellitus within the year before screening (eg, multiple hospitalizations related to diabetes mellitus and/or severe hypoglycemia for which the subject required 3rd party assistance) 5. Any severe, delayed sequela of diabetes mellitus, eg, worsening end-stage renal disease, advanced coronary artery disease, or myocardial infarction within the year before screening, or autonomic peristaltic problems, eg, gastroparesis 6. Anticipated change in insulin used during the study (change in dosage is allowed, but change in type or brand of insulin will result in the subject being withdrawn from the study) 7. Inadequately controlled thyroid disease, defined as a TSH or free T4 value > the upper limit of normal 8. BMI < 19 kg/m2 or > 35 kg/m2 9. Any clinically significant (in the opinion of the Investigator) hematology or chemistry test results at screening, including any liver function test > 3x the upper limit of normal (subjects with elevated bilirubin due to Gilbert syndrome are eligible to participate) 10. Documented history of anti-insulin antibodies 11. Treatment with glucocorticosteroids, immunosuppressants, or cytostatic agents within 60 days before screening (newly-prescribed or high-dose corticosteroids are prohibited; chronically administered oral, inhaled, topical, or intra-articular corticosteroids at a stable dosage are allowed if no increase in dose is anticipated during the study 12. Current use of medication intended to cause weight loss or weight gain 13. Alcohol or substance use disorder within the 2 years before screening 14. Any previous treatment with interferons 15. Any history of malignant disease within 5 years before screening, except for adequately treated basal cell carcinoma 16. Severe concomitant physical or psychiatric diseases or conditions 17. A history of a positive test result for HIV, hepatitis B, or hepatitis C; any subject who has a positive test result during the study may continue at the discretion of the Investigator 18. Any history of pancreatitis or pancreatectomy 19. Any diagnosis or condition that requires the subject to undergo procedures that could decrease antibodies in plasma or that would require treatment with immunosuppressant agents 20. Any condition eg, splenectomy, autoimmune disease, or rheumatologic disease, that could affect immunologic responses, could indicate an altered immune system, or could require treatment with a prohibited medication 21. Any unresolved infection or a history of active infection within 30 days before screening other than mild or viral illness (as judged by the Investigator) 22. Any other disease or condition that in the opinion of the Investigator could confound the study results or limit the subject’s ability to participate in the study or comply with follow-up procedures; or any other factor that would indicate a significant risk of loss to follow up 23. Intolerance or history of hypersensitivity to insulin glargine or any excipient of the IP 24. Inability or unwillingness to wear the CGM sensor as required for the study, or to comply with the concomitant medication requirements regarding the CGM periods |
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E.5 End points |
E.5.1 | Primary end point(s) |
- Efficacy: The change in HbA1c from baseline at 26 weeks of study treatment - Immunogenicity: The percentage of subjects in each treatment group who develop treatment induced AIA up to Week 26 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- Immunogenicity: o The percentage of subjects in each treatment group with negative AIA at baseline who develop confirmed positive AIA up to Week 26 o The mean change from baseline in each treatment group in AIA titers after Week 26 o The percentage of subjects in each treatment group with confirmed AIA who develop any anti-insulin neutralizing antibodies up to Week 26 o The percentage of subjects in each treatment group with confirmed positive AIA up to Week 26 - Safety: o The incidence and severity of all treatment-emergent adverse events and the following subgroups: • Hypoglycemia, which will be fully documented prospectively in the Hypoglycemic Events Record • Serious adverse events, including fatal events • Adverse events leading to termination of the study treatment and/or early withdrawal from the study • IP-related adverse events o The incidence of clinically significant laboratory abnormalities o The incidence of clinically significant abnormalities in ECG and vital signs - Efficacy: o The number and percentage of subjects who achieve an FBG test result of ≤ 6.0 mmol/L (< 108.0 mg/dL) at Week 26 o The number and percentage of subjects who achieve a HbA1c of < 7.0% at Week 26 o The change in the 24-hour mean weighted glucose (MWG), defined as the total area under the curve (AUC) obtained with CGM divided by the total daily dose of IP, from baseline |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 26, Safety - throughout study |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 39 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Czech Republic |
Germany |
Hungary |
Poland |
Russian Federation |
Spain |
Ukraine |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |