Clinical trial • Phase III • Other

INSULIN HUMAN for Intestinal malabsorption

Phase III trial of INSULIN HUMAN for Intestinal malabsorption.

Overview

Trial Therapeutic Area
Other
Trial Disease
Intestinal malabsorption
Trial Stage
Phase III
Drug Modality
Peptide/protein/enzyme
Paediatric Trial
Yes
Orphan Drug
Yes

Key dates

Initial CTIS Submission Date
02-10-2024
First CTIS Authorization Date
25-10-2024

Trial design

Randomised, elgn-2112 (insulin human) oral solution administered via enteral feeding tube; dosing unit reported as iu/kg with max daily dose 0.3 iu/kg and maximum treatment period 28 days. comparator (placebo): powder for reconstitution for enteral administration (placebo), no active substance listed.-controlled Phase III trial across 25 sites in France, Netherlands, Spain and others.

Randomised
Yes
Comparator
ELGN-2112 (INSULIN HUMAN) oral solution administered via enteral feeding tube; dosing unit reported as IU/kg with max daily dose 0.3 IU/kg and maximum treatment period 28 days. Comparator (placebo): Powder for reconstitution for enteral administration (placebo), no active substance listed.
Target Sample Size
295
Trial Duration For Participant
730

Eligibility

Recruits 295 paediatric patients.

Vulnerable Population
Trial population: preterm infants (neonates), identified as a vulnerable population. Informed consent must be provided by parent(s) or legal guardian; the documentation specifies that one of the two parents/legal guardians or both may provide consent according to local regulations. No participant assent is applicable given the neonatal population.

Inclusion criteria

  • {"criterion_text":"- Male or female preterm infants born at a gestational age 26+0 to 31+6 weeks. Gestational age matching (±2 weeks) between maternal dates and/or early antenatal ultrasound\n- Infant is expected to wean off parenteral nutrition (PN) at the primary hospital\n- Informed consent form signed by parent(s) or legal guardian\n- In the Investigator’s opinion, the infant is sufficiently stable to partake in the trial to completion\n- (France only) - only participants benefiting from a health insurance plan can participate in research\n- Birth weight ≥ 500 g\n- Singleton or twin birth\n- Postnatal age up through and including Day 5 (up to 120 hours post birth)\n- Fraction of inspired oxygen ≤ 0.60 at enrolment\n- Infant is cardiovascularly stable at time of enrolment and would be considered unstable if they require inotropic support\n- Infant is able to tolerate enteral feeds (defined as minimum of 10 ml/kg/day)"}

Exclusion criteria

  • {"criterion_text":"- Infant is consuming more than 80 ml/kg/day enterally at study entry\n- Maternal diabetes (Type I/II or gestational) requiring insulin during pregnancy or in mothers past medical history\n- Confirmed hyperinsulinemia or suspected hyperinsulinemia requiring glucose administration of more than 12 mg/kg/min at randomization\n- Any systemic insulin administration at randomization\n- Nothing per os (NPO) at study entry and enteral/oral supplements are not allowed\n- Hypersensitivity to any of the drug components- Recombinant Human Insulin (rh-Insulin), Maltodextrin, Sodium Chloride\n- Infant is receiving pharmacological treatment for a hemodynamically significant PDA at the time of randomization\n- Heart and chest compression or any resuscitation drugs given to the infant during delivery\n- Subjects at risk for significant GI complications such as twin-to-twin transfusion syndrome (TTTS) or monochorionic monoamniotic twins\n- Participation in another interventional clinical study that may interfere with the results of this trial\n- Infant is not dependent on any parenteral amino acids/lipids as nutrition\n- Major congenital malformation (e.g., infants with genetic, metabolic, and/or endocrine disorder diagnosed before enrolment)\n- Intra-uterine growth restriction (IUGR) defined as weight for gestational age less than the third percentile according to Fenton preterm growth chart\n- Confirmed NEC"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Number of days from treatment initiation to achieve full enteral feeding*, which is defined as the number of days to achieve enteral feeding of at least 150 ml/kg/day for three consecutive days during the treatment period *Defined as first day of reaching three consecutive days of EN feeds ≥150 ml/kg/day","definition_or_measurement_approach":"Defined as first day of reaching three consecutive days of enteral (EN) feeds ≥150 ml/kg/day; measured as number of days from treatment initiation to that first day."}

Secondary endpoints

  • {"endpoint_text":"- The number of days from treatment initiation to PN wean-off during the treatment period","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Incidence of severe NEC (modified Bell’s stage ≥2a) by 40 weeks post-menstrual age (PMA) or discharge home, whichever is earlier, in infants born at 26+0-28+6 weeks GA (FIT-PIV study) and infants born less than 26+0 weeks GA and IUGR infants born at 26+0-31+6 weeks GA (FIT-05 study) as assessed by central blinded reviewers and classified according to the “Modified Bell’s Staging Criteria for NEC” (Walsh-1986).","definition_or_measurement_approach":"Assessed by central blinded reviewers and classified according to the Modified Bell’s Staging Criteria for NEC (Walsh-1986); timepoint: by 40 weeks PMA or discharge home, whichever is earlier."}
  • {"endpoint_text":"- Incidence of severe NEC (modified Bell’s stage ≥2a) by 40 weeks PMA or discharge home, whichever is earlier, in infants born at 26+0-28+6 weeks GA as assessed by central blinded reviewers and classified according to the “Modified Bell’s Staging Criteria for NEC” (Walsh-1986).","definition_or_measurement_approach":"Assessed by central blinded reviewers and classified according to the Modified Bell’s Staging Criteria for NEC (Walsh-1986); timepoint: by 40 weeks PMA or discharge home."}
  • {"endpoint_text":"- The number of days from treatment initiation to discharge from primary hospital","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Distribution of severity of NEC by 40 weeks PMA or discharge home, whichever is earlier, in infants born at 26+0-28+6 weeks GA (FIT-PIV study) and infants born less than 26+0 weeks GA and IUGR infants born at 26+0-31+6 weeks GA (FIT-05 study) as assessed by central blinded reviewers and classified according to the “Modified Bell’s Staging Criteria for NEC” (Walsh-1986) - pooled analysis","definition_or_measurement_approach":"Pooled analysis; classification per Modified Bell’s Staging Criteria for NEC (Walsh-1986); timepoint by 40 weeks PMA or discharge home."}
  • {"endpoint_text":"- Distribution of severity of NEC by 40 weeks PMA or discharge home, whichever is earlier, according to modified Bell’s staging in infants born at 26+0-28+6 weeks GA as assessed by central blinded reviewers and classified according to the “Modified Bell’s Staging Criteria for NEC” (Walsh-1986).","definition_or_measurement_approach":"Classified per Modified Bell’s Staging Criteria for NEC (Walsh-1986); timepoint by 40 weeks PMA or discharge home."}
  • {"endpoint_text":"- Incidence of severe NEC by 40 weeks PMA or discharge home, whichever is earlier, in the entire study population as assessed by central blinded reviewers and classified according to the “Modified Bell’s Staging Criteria for NEC” (Walsh-1986).","definition_or_measurement_approach":"Assessed by central blinded reviewers and classified per Modified Bell’s Staging Criteria for NEC (Walsh-1986); timepoint by 40 weeks PMA or discharge home."}
  • {"endpoint_text":"- Distribution of severity of NEC by 40 weeks PMA or discharge home, whichever is earlier, in the entire study population as assessed by central blinded reviewers and classified according to the “Modified Bell’s Staging Criteria for NEC” (Walsh-1986).","definition_or_measurement_approach":"Classified per Modified Bell’s Staging Criteria for NEC (Walsh-1986); timepoint by 40 weeks PMA or discharge home."}
  • {"endpoint_text":"- Percentage of infants reaching FEF for three consecutive days within 6, 8, and 10 days from treatment initiation","definition_or_measurement_approach":"FEF defined as enteral feeding ≥150 ml/kg/day for three consecutive days; measured within specified time windows (6, 8, 10 days from treatment start)."}
  • {"endpoint_text":"- The number of days from treatment initiation to the first day the infant achieves EN volume of 120 ml/kg/day for three consecutive days during the treatment period","definition_or_measurement_approach":"Measured as number of days from treatment start to first day of three consecutive days with EN volume ≥120 ml/kg/day."}
  • {"endpoint_text":"- Percentage of infants weaned off PN within 4, 6, and 8 days from treatment initiation","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Neonatal anthropometrics measurements during the treatment period and up to 3 months CA.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Percentage of EN and PN over total nutrition during the treatment period","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Incidence of late onset sepsis (onset ≥72 hours after birth) by 40 weeks PMA or discharge home, whichever is earlier. Will be defined as either: a) culture proven late onset sepsis, OR b) clinically suspected culture negative late onset sepsis","definition_or_measurement_approach":"Defined as either culture-proven late-onset sepsis or clinically suspected culture-negative late-onset sepsis (onset ≥72 hours after birth); timepoint by 40 weeks PMA or discharge home."}
  • {"endpoint_text":"- Incidence of at least one of the adverse events of relevance by 40 weeks PMA or discharge home, whichever is earlier: • severe NEC (modified Bell’s stage ≥2a); • late-onset sepsis • death.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- The number of days from treatment initiation to discharge to home","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Incidence and severity of ROP up to 3 months CA according to the International Classification of Retinopathy of Prematurity (ICROP3)","definition_or_measurement_approach":"Assessed up to 3 months corrected age according to ICROP3."}
  • {"endpoint_text":"- Adverse Events (AEs) and Adverse Drug Reaction (ADRs); Blood glucose; Blood chemistry and haematology; Vital signs","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Major morbidities (including cerebral palsy, severe vision and hearing loss and hospitalisation) at 6, 12 and 24 months CA; Anthropometrics measurements at 6, 12 and 24 months CA; Neurodevelopmental assessment at 24 months CA","definition_or_measurement_approach":"Long-term follow-up assessments at specified corrected ages (6, 12, 24 months); neurodevelopmental assessment at 24 months CA."}

Recruitment

Planned Sample Size
295
Recruitment Window Months
95
Consent Approach
Informed consent must be signed by parent(s) or legal guardian. The documentation states that one of the two parents/legal guardians or both may provide consent in accordance with local regulations. Parental/legal guardian consent is required; assent is not applicable for the neonatal population.

Geography

Total Number Of Sites
25
Total Number Of Participants
295

France

Earliest CTIS Part Ii Submission Date
17-10-2024
Latest Decision Or Authorization Date
28-10-2024
Processing Time Days
11
Number Of Sites
4
Number Of Participants
30

Sites

Site Name
Centre Hospitalier Universitaire De Nimes
Department Name
Neonatology
Contact Person Name
Massimo DI MAIO
Contact Person Email
massimo.dimaio@chu-nimes.fr
Site Name
Centre Hospitalier Intercommunal De Poissy Saint Germain
Department Name
Neonatology
Contact Person Name
Emmanuelle MOTTE SIGNORET
Site Name
Centre Hospitalier Universitaire De Rennes
Department Name
Neonatology
Contact Person Name
Alain BEUCHEE
Contact Person Email
alain.beuchee@chu-rennes.fr
Site Name
Hopital Necker Enfants Malades
Department Name
Neonatology
Contact Person Name
Alexandre LAPILLONNE
Contact Person Email
alexandre.lapillonne@aphp.fr

Netherlands

Earliest CTIS Part Ii Submission Date
17-10-2024
Latest Decision Or Authorization Date
25-10-2024
Processing Time Days
8
Number Of Sites
3
Number Of Participants
70

Sites

Site Name
Universitair Medisch Centrum Groningen
Department Name
Neonatology
Contact Person Name
Elisabeth Kooi
Contact Person Email
e.kooi@umcg.nl
Site Name
Amsterdam UMC Stichting
Department Name
Neonatology
Contact Person Name
Chris van den Akker
Site Name
Isala Klinieken Stichting
Department Name
Neonatology
Contact Person Name
Marieke Hemels
Contact Person Email
m.a.c.hemels@isala.nl

Spain

Earliest CTIS Part Ii Submission Date
17-10-2024
Latest Decision Or Authorization Date
28-10-2024
Processing Time Days
11
Number Of Sites
6
Number Of Participants
60

Sites

Site Name
Hospital Universitario Y Politecnico La Fe
Department Name
Pediatric
Contact Person Name
Isabel Izquierdo
Contact Person Email
m.isabel.izquierdo@uv.es
Site Name
Hospital Universitario La Paz
Department Name
Pediatric
Contact Person Name
Miguel Saenz de Pipaon
Contact Person Email
miguel.saenz@salud.madrid.org
Site Name
Complejo Hospitalario Universitario Insular Materno Infantil
Department Name
Pediatric
Contact Person Name
Fermín García-Muñoz
Contact Person Email
fgarciamu@gmail.com
Site Name
Hospital Clinico Universitario Lozano Blesa
Department Name
Pediatric
Contact Person Name
Gerardo Rodríguez Martinez
Contact Person Email
gerard@unizar.es
Site Name
University Hospital Son Espases
Department Name
Pediatric
Contact Person Name
Marta Bernardino Collado
Contact Person Email
marta.bernardino@ssib.es
Site Name
Hospital Universitario Miguel Servet
Department Name
Pediatric
Contact Person Name
Segundo Rite Gracia
Contact Person Email
segundorite@gmail.com

Austria

Earliest CTIS Part Ii Submission Date
17-10-2024
Latest Decision Or Authorization Date
30-10-2024
Processing Time Days
13
Number Of Sites
1
Number Of Participants
25

Sites

Site Name
University Hospital Salzburg
Department Name
UK für Kinder- und Jugendheilkunde der PMU Salzburg - Division für Neonatalogie
Contact Person Name
Edda Hofstätter
Contact Person Email
e.hofstaetter@salk.at

Sweden

Earliest CTIS Part Ii Submission Date
17-10-2024
Latest Decision Or Authorization Date
28-10-2024
Processing Time Days
11
Number Of Sites
5
Number Of Participants
50

Sites

Site Name
Norrlands Universitetssjukhus
Department Name
Department of Pediatrics
Contact Person Name
Magnus Domellöf
Contact Person Email
magnus.domellof@umu.se
Site Name
Skanes University Hospital
Department Name
Department of Pediatrics
Contact Person Name
Ingrid Hansen Pupp
Contact Person Email
karl.dreja@skane.se
Site Name
Skane University Hospital, Malmo
Department Name
Department of Pediatrics
Contact Person Name
Ingrid Hansen Pupp
Contact Person Email
ingrid.pupp@med.lu.se
Site Name
Queen Silvia Childrens Hospital - Sahlgrenska University Hospital - Vaestra Goetalandsregionen
Department Name
Department of Women's and Children's Health
Contact Person Name
Anders Elfvin
Contact Person Email
anders.elfvin@vgregion.se
Site Name
Uppsala University Hospital
Department Name
Department of Pediatrics
Contact Person Name
Fredrik Ahlsson
Contact Person Email
fredrik.ahlsson@uu.se

Italy

Earliest CTIS Part Ii Submission Date
02-07-2025
Latest Decision Or Authorization Date
25-09-2025
Processing Time Days
85
Number Of Sites
6
Number Of Participants
60

Sites

Site Name
Azienda Ospedaliera di Padova
Department Name
Dipartimento di Salute della Donna e del Bambino
Contact Person Name
Giovanna Verlato
Site Name
Policlinico Casilino
Department Name
UO Neonatologia, Patologia Neonatale e Terapia Intensiva Neonatale
Contact Person Name
Simonetta Costa
Contact Person Email
scosta.polcas@eurosanita.it
Site Name
Azienda Ospedaliero Universitaria Delle Marche
Department Name
SOD Neonatologia
Contact Person Name
Maria Paola Bellagamba
Site Name
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Department Name
U.O.C. Neonatologia
Contact Person Name
Giovanni Vento
Site Name
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
Department Name
Unità Operativa di Neonatologia e Terapia Intensiva Neonatale
Contact Person Name
Orsola Amato
Contact Person Email
orsola.amato@policlinico.mi.it
Site Name
San Camillo Forlanini Hospital
Department Name
UOC Neonatologia e Terapia Intensiva Neonatale
Contact Person Name
Luca Maggio

Sponsor

Primary sponsor

Full Name
Elgan Pharma Ltd.
Organisation Type
Pharmaceutical company
Country Of Registered Address
Israel

Contract research organisations

Name
Bioclinica Inc.
Responsibilities
Central imaging systems
Name
Icon Clinical Research Limited
Responsibilities
sponsorDuties codes: 10, 6
Name
Premier Research Group Limited
Responsibilities
sponsorDuties codes: 1,10,11,12,2,3,5,6,7,8
Name
Medidata Solutions Inc.
Responsibilities
sponsorDuties codes: 7

Third parties

  • {"country":"Germany","full_name":"PCI Pharma Services Germany GmbH","duties_or_roles":"sponsorDuties codes: 14","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Bioclinica Inc.","duties_or_roles":"Central imaging systems","organisation_type":"Laboratory/Research/Testing facility"}
  • {"country":"United States","full_name":"Scout Clinical","duties_or_roles":"Patient travel reimbursement","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Israel","full_name":"Bioforum C.D.M.C Ltd.","duties_or_roles":"Unblinded Statistics for DMC meetings","organisation_type":"Pharmaceutical company"}
  • {"country":"Italy","full_name":"Lb Research S.r.l.","duties_or_roles":"sponsorDuties codes: 1","organisation_type":"Pharmaceutical company"}
  • {"country":"Spain","full_name":"Servicio De Asesoria A La Investigacion Y Logistica S.L.","duties_or_roles":"sponsorDuties codes: 1","organisation_type":"Non-Pharmaceutical company"}
  • {"country":"Ireland","full_name":"Icon Clinical Research Limited","duties_or_roles":"sponsorDuties codes: 10, 6","organisation_type":"Pharmaceutical company"}
  • {"country":"United Kingdom","full_name":"Premier Research Group Limited","duties_or_roles":"sponsorDuties codes: 1,10,11,12,2,3,5,6,7,8","organisation_type":"Pharmaceutical company"}
  • {"country":"United States","full_name":"Medidata Solutions Inc.","duties_or_roles":"sponsorDuties codes: 7","organisation_type":"Non-Pharmaceutical company"}

Investigational products

Investigational Product Name
ELGN-2112
Active Substance
INSULIN HUMAN
Modality
Peptide/protein/enzyme
Routes Of Administration
ENTERAL FEEDING TUBE
Route
Enteral feeding tube
Orphan Designation
Yes
Maximum Dose
0.3 IU/kg (max daily dose)
Investigational Product Name
Powder for reconstitution for enteral administration
Modality
Other

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