Trial Outcomes & Findings for The Effect of TLR4 Inhibition in Obese and Type 2 Diabetic Subjects (NCT NCT02267317)

NCT ID: NCT02267317

Last Updated: 2020-03-04

Results Overview

Muscle insulin sensitivity = muscle insulin sensitivity is determined by euglycemic hyperinsulinemic clamp procedure. M value (mg glucose / kg of body weight / minute) calculated from the clamp is measured. Higher M value indicates better insulin sensitivity. There is no established reference range.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

15 participants

Primary outcome timeframe

72 hours

Results posted on

2020-03-04

Participant Flow

Participant milestones

Participant milestones
Measure
Obese Group - D5W - Eritoran
Obese subjects randomized to receive D5W first, then Eritoran
Obese Group - Eritoran - D5W
Obese subjects randomized to receive Eritoran first, then D5W.
Diabetes (T2DM) Group - D5W - Eritoran
T2DM subjects randomized to receive D5W first then Eritoran
Diabetes (T2DM) Group - Eritoran - D5W
T2DM subjects randomized to receive Eritoran first then D5W
Lean Group - D5W - Eritoran
Lean subjects randomized to receive D5W first then Eritoran
Lean Group - Eritoran - D5W
Lean subjects randomized to receive Eritoran first then d5W
Infusion1
STARTED
8
3
1
2
0
1
Infusion1
COMPLETED
8
3
1
2
0
1
Infusion1
NOT COMPLETED
0
0
0
0
0
0
Washout (3-4weeks Between Infusions)
STARTED
8
3
1
2
0
1
Washout (3-4weeks Between Infusions)
COMPLETED
6
3
1
2
0
1
Washout (3-4weeks Between Infusions)
NOT COMPLETED
2
0
0
0
0
0
Infusion2
STARTED
6
3
1
2
0
1
Infusion2
COMPLETED
6
3
1
2
0
1
Infusion2
NOT COMPLETED
0
0
0
0
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Obese Group - D5W - Eritoran
Obese subjects randomized to receive D5W first, then Eritoran
Obese Group - Eritoran - D5W
Obese subjects randomized to receive Eritoran first, then D5W.
Diabetes (T2DM) Group - D5W - Eritoran
T2DM subjects randomized to receive D5W first then Eritoran
Diabetes (T2DM) Group - Eritoran - D5W
T2DM subjects randomized to receive Eritoran first then D5W
Lean Group - D5W - Eritoran
Lean subjects randomized to receive D5W first then Eritoran
Lean Group - Eritoran - D5W
Lean subjects randomized to receive Eritoran first then d5W
Washout (3-4weeks Between Infusions)
Withdrawal by Subject
1
0
0
0
0
0
Washout (3-4weeks Between Infusions)
Lost to Follow-up
1
0
0
0
0
0

Baseline Characteristics

The Effect of TLR4 Inhibition in Obese and Type 2 Diabetic Subjects

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Obese Group
n=11 Participants
Subjects with BMI \>30 kg/m2 were enrolled to receive two infusions, the order of which was randomly assigned.
Type 2 Diabetic Subjects
n=3 Participants
Subjects with BMI \>30 kg/m2 and 2-hour Oral Glucose Tolerance Test \>200mg/dL
Lean/Healthy
n=1 Participants
Subjects with BMI \<26 kg/m2 and normal glucose tolerant
Total
n=15 Participants
Total of all reporting groups
Age, Continuous
58 years
STANDARD_DEVIATION 6.0 • n=99 Participants
55 years
STANDARD_DEVIATION 15.6 • n=107 Participants
19 years
STANDARD_DEVIATION 0 • n=206 Participants
53 years
STANDARD_DEVIATION 12.4 • n=7 Participants
Sex: Female, Male
Female
7 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
8 Participants
n=7 Participants
Sex: Female, Male
Male
4 Participants
n=99 Participants
2 Participants
n=107 Participants
1 Participants
n=206 Participants
7 Participants
n=7 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
9 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
11 Participants
n=7 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants
n=99 Participants
2 Participants
n=107 Participants
0 Participants
n=206 Participants
3 Participants
n=7 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
1 Participants
n=7 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
White
11 Participants
n=99 Participants
3 Participants
n=107 Participants
1 Participants
n=206 Participants
15 Participants
n=7 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
BMI
32.1 kg/m^2
STANDARD_DEVIATION 1.8 • n=99 Participants
33.5 kg/m^2
STANDARD_DEVIATION 3.3 • n=107 Participants
19 kg/m^2
STANDARD_DEVIATION 0 • n=206 Participants
31.5 kg/m^2
STANDARD_DEVIATION 4.0 • n=7 Participants
HbA1c
5.4 Percentage of glycated hemoglobin
STANDARD_DEVIATION 0.2 • n=99 Participants
6.3 Percentage of glycated hemoglobin
STANDARD_DEVIATION 0.7 • n=107 Participants
5.3 Percentage of glycated hemoglobin
STANDARD_DEVIATION 0 • n=206 Participants
5.6 Percentage of glycated hemoglobin
STANDARD_DEVIATION 0.5 • n=7 Participants
Fasting plasma glucose
5.1 mg/dL
STANDARD_DEVIATION 0.8 • n=99 Participants
6.9 mg/dL
STANDARD_DEVIATION 0.7 • n=107 Participants
4.5 mg/dL
STANDARD_DEVIATION 0 • n=206 Participants
5.4 mg/dL
STANDARD_DEVIATION 0.9 • n=7 Participants

PRIMARY outcome

Timeframe: 72 hours

Population: Data from T2DM subjects and Lean subject were not collected for primary outcome measure because of insufficient number of participants in the 2 groups.

Muscle insulin sensitivity = muscle insulin sensitivity is determined by euglycemic hyperinsulinemic clamp procedure. M value (mg glucose / kg of body weight / minute) calculated from the clamp is measured. Higher M value indicates better insulin sensitivity. There is no established reference range.

Outcome measures

Outcome measures
Measure
Obese Group - Placebo
n=9 Participants
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=9 Participants
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean - Placebo
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean - Eritoran
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Effect of Eritoran on Muscle Insulin Sensitivity
8.0 mg/kg/min
Standard Error 0.9
10.6 mg/kg/min
Standard Error 1.1

PRIMARY outcome

Timeframe: 72 hours

Population: Data from T2DM subjects and Lean subject were not collected for primary outcome measure because of insufficient number of participants in the 2 groups.

Hepatic insulin sensitivity = is determined by euglycemic hyperinsulinemic clamp procedure. Endogenous glucose production or EGP (mg/kg/min) calculated from the clamp is measured. Lower EGP indicates better hepatic insulin sensitivity. There is no established reference range.

Outcome measures

Outcome measures
Measure
Obese Group - Placebo
n=9 Participants
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=9 Participants
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean - Placebo
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean - Eritoran
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Effect of Eritoran on Hepatic Insulin Sensitivity
2.0 mg/kg/min
Standard Error 0.2
1.9 mg/kg/min
Standard Error 0.1

SECONDARY outcome

Timeframe: 72 hours

Population: The total number of obese subjects enrolled is 9. However, we were only able to obtain muscle biopsies from 7 subjects. In addition, data from T2DM subjects and Lean subject were not collected for this secondary outcome measure because of insufficient number of participants in the 2 groups.

TLR4 expression in muscle tissue is determined by RNAseq using arbitrary units. Higher TLR4 expression indicates higher inflammatory response. There is no reference range.

Outcome measures

Outcome measures
Measure
Obese Group - Placebo
n=7 Participants
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=7 Participants
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean - Placebo
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean - Eritoran
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Effect of Eritoran on TLR4 Expression in Muscle Tissue
1 AU
Standard Error 0.11
1.16 AU
Standard Error 0.16

SECONDARY outcome

Timeframe: 72 hours

Population: The total number of obese subjects enrolled is 9. However, we were only able to obtain fat biopsies from 4 subjects. In addition, data from T2DM subjects and Lean subject were not analyzed for this secondary outcome measure because of insufficient number of participants in the 2 groups.

TLR4 expression in the adipose tissue is determined by RNAseq using arbitrary units. Higher TLR4 expression indicates higher inflammatory response. There is no reference range.

Outcome measures

Outcome measures
Measure
Obese Group - Placebo
n=4 Participants
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=4 Participants
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean - Placebo
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean - Eritoran
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Effect of Eritoran on TLR4 Expresison in Adipose Tissue
1 AU
Standard Deviation 0.11
1.22 AU
Standard Deviation 0.07

SECONDARY outcome

Timeframe: 72 hours

Population: Data from T2DM subjects and Lean subject were not analyzed because the number of participants was insufficient in the 2 groups.

TLR4 expression in the peripheral blood monocytes is determined by flow cytometry using arbitrary units. Higher TLR4 expression indicates higher inflammatory response. There is no reference range.

Outcome measures

Outcome measures
Measure
Obese Group - Placebo
n=9 Participants
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=9 Participants
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean - Placebo
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean - Eritoran
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Effect of Eritoran on TLR4 Expression in Peripheral Blood Monocytes
1.1 AU
Standard Error 0.1
1.2 AU
Standard Error 0.1

SECONDARY outcome

Timeframe: 72 hours

Population: Data from T2DM subjects and Lean subject were not analyzed because the number of participants was insufficient in the 2 groups.

TNF-alpha levels are determined by ELISA. Higher level indicates higher inflammatory response. There is no established reference range.

Outcome measures

Outcome measures
Measure
Obese Group - Placebo
n=9 Participants
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=9 Participants
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean - Placebo
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean - Eritoran
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Effect of Eritoran on Plasma TNF-alpha (Tumor Necrosis Factor-alpha) Concentration
2.4 pg/ml
Standard Error 0.3
2.3 pg/ml
Standard Error 0.2

SECONDARY outcome

Timeframe: 72 hours

Population: Data were not collected due to lack of funding.

Intramyocellular diacylglycerol and ceramide content are determined by mass spectrometry. Higher levels have been associated with diabetes.

Outcome measures

Outcome data not reported

Adverse Events

Obese Group - Placebo

Serious events: 0 serious events
Other events: 9 other events
Deaths: 0 deaths

Obese Group - Eritoran

Serious events: 0 serious events
Other events: 9 other events
Deaths: 0 deaths

Diabetes (T2DM) Group - Placebo

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Diabetes (T2DM) Group - Eritoran

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Lean/Healthy Group - Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Lean/Healthy Group - Eritoran

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Obese Group - Placebo
n=11 participants at risk
Obese subjects - IV administration of D5W (5% Dextrose in water)
Obese Group - Eritoran
n=11 participants at risk
Obese subjects - IV administration of Eritoran 12 mg every 12 hours
Diabetes (T2DM) Group - Placebo
n=3 participants at risk
T2DM subjects - IV administration of D5W (5% Dextrose in water)
Diabetes (T2DM) Group - Eritoran
n=3 participants at risk
T2DM subjects - IV administration of Eritoran 12 mg every 12 hours
Lean/Healthy Group - Placebo
n=1 participants at risk
Lean subjects - IV administration of D5W (5% Dextrose in water)
Lean/Healthy Group - Eritoran
n=1 participants at risk
Lean subjects - IV administration of Eritoran 12 mg every 12 hours
Vascular disorders
Phlebitis Grade 1, 2 or 3
63.6%
7/11 • 19 months
81.8%
9/11 • 19 months
33.3%
1/3 • 19 months
66.7%
2/3 • 19 months
0.00%
0/1 • 19 months
0.00%
0/1 • 19 months
Skin and subcutaneous tissue disorders
Dermatology
9.1%
1/11 • 19 months
0.00%
0/11 • 19 months
0.00%
0/3 • 19 months
0.00%
0/3 • 19 months
0.00%
0/1 • 19 months
0.00%
0/1 • 19 months
Reproductive system and breast disorders
Hot flashes
0.00%
0/11 • 19 months
9.1%
1/11 • 19 months
0.00%
0/3 • 19 months
0.00%
0/3 • 19 months
0.00%
0/1 • 19 months
0.00%
0/1 • 19 months
Blood and lymphatic system disorders
Hypokalemia
9.1%
1/11 • 19 months
0.00%
0/11 • 19 months
0.00%
0/3 • 19 months
0.00%
0/3 • 19 months
0.00%
0/1 • 19 months
0.00%
0/1 • 19 months
Musculoskeletal and connective tissue disorders
Pain
27.3%
3/11 • 19 months
18.2%
2/11 • 19 months
0.00%
0/3 • 19 months
0.00%
0/3 • 19 months
0.00%
0/1 • 19 months
0.00%
0/1 • 19 months
Nervous system disorders
Headache
36.4%
4/11 • 19 months
27.3%
3/11 • 19 months
0.00%
0/3 • 19 months
0.00%
0/3 • 19 months
0.00%
0/1 • 19 months
0.00%
0/1 • 19 months

Additional Information

Hanyu Liang

University of Texas Health San Antonio

Phone: 210-617-5300

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place