Safety and Efficacy of PEG-Encapsulated Islet Allografts Implanted in Type I Diabetic Recipients

September 8, 2014 updated by: Novocell

A Single-Center Phase I/II Study Of Peg-Encapsulated Islet Allografts Implanted In Patients With Type I Diabetes

Insulin dependent Type I diabetics require daily insulin therapy to normalize blood glucose but may have difficulty with significant glycemic excursions and hypoglycemic episodes and crises. Islet cell transplantation can provide relief from daily insulin therapy, normalize blood glucose and reduce or eliminate short and long-term diabetes-related complications. "PEG-Encapsulated Islet Allografts" is a new islet transplant product under development that does not require the ongoing use of immunosuppressive drugs after the implant. This study will test the safety and efficacy of PEG-Encapsulated Islet Allografts in the treatment of Type I diabetes and provide functional outcome measurements.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

Allogeneic Cultured Islet Cells (human, Novocell); Encapsulated in Polyethylene Glycol; Administered Subcutaneously are a combination biologic and device product in which the pharmacologically active agent is human insulin that is released from the functional islet cells by natural production and release, stimulated by control mechanisms in response to blood glucose concentrations. The device component is a uniform and conformal polymer coating around each islet. Islet cells are isolated from multiple human pancreases procured from human organ donors who meet a specific human donor profile established by the UNOS and the FDA's requirements for Good Tissue Practices. Because the pancreases used for islet cell isolation are not intended for whole-organ transplantation, specific procurement, surgical removal, packaging and shipping protocols are provided by Novocell, Inc. to the Organ Procurement Organizations.

The primary outcome is demonstration that encapsulated islet allografts can be implanted safely in the subcutaneous tissues without the use of long-term immunosuppression. The expected functional outcomes from the implantation of the encapsulated islets are significant reductions in the average blood glucose daily glycemic excursions and in insulin requirements as well as significant increases in C-peptide levels in response to meal challenges. The ultimate expected outcome is that patients who receive these implants will have reduced hemoglobin A1c levels that may be associated with reduced long-term diabetic complications. An important outcome should be reduction in hypoglycemic episodes and crises with significantly functioning grafts without having the risks associated with hepatic portal vein infusion and long-term immunosuppression.

Study Type

Interventional

Enrollment

12

Phase

  • Phase 2
  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Texas
      • San Antonio, Texas, United States, 78229
        • CHRISTUS Santa Rosa Transplant Institute
      • San Antonio, Texas, United States, 78229
        • Diabetes & Glandular Disease Research Associates, P.A.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Male or non-pregnant non-lactating female subjects > 20 years of age
  • Diagnosed with insulin-dependent type I diabetes for at least 20 years
  • BMI less than 28 kg/m2
  • Insulin requirement less than or equal to 0.7 U/kg/day
  • HbA1c greater than or equal to 7.0 %
  • Serum C-peptide concentration less than or equal to 0.5 ng/mL stimulated by an OGTT
  • Female subjects with childbearing potential must have a negative serum pregnancy test prior to enrollment and must agree to use an effective contraceptive method during the study
  • One year of stable diabetes care established in the PI's database without significant changes in insulin requirement or HbA1c or diabetic complication profile

Exclusion Criteria:

  • Diagnosis of type II diabetes or maturity onset diabetes of youth (MODY)
  • Serum C-peptide greater than 0.5 ng/mL stimulated by OGTT
  • Sustained hypertension greater than or equal to 100 mmHg diastolic and/or greater than or equal to 160 mmHg systolic
  • History of myocardial infarction or current active cardiac disease
  • Current active infection
  • Significant renal dysfunction as indicated by GFR less than 80 mL/min/1.73 m2 and/or urinary albumin greater than 500 µg/mL
  • Significant liver dysfunction as indicated by ALT or AST more than 3X the upper limit of normal
  • Prior whole organ or islet cell transplant
  • Concurrent immunosuppressive therapy
  • Severe gastroparesis, severe peripheral neuropathy, diabetic foot ulcers, or prior amputations due to diabetic complications
  • Any other active autoimmune disease other than autoimmune thyroid disease
  • HIV, HBV or HCV positive status
  • Uncontrolled or untreated proliferative retinopathy
  • Known hypersensitivity or other intolerance to cyclosporine or the inactive ingredients in the product
  • Behavioral activities that place the subject at risk in the opinion of the investigator
  • Any significant concurrent disease, illness, or psychiatric disorder that would, in the opinion of the investigator, compromise subject safety or compliance, or interfere with consent, study participation, follow-up, or the interpretation of study results
  • History of any kind of cancer other than skin cancers (except for melanoma which is exclusionary)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PEG Islet Cells
Biological: Allogeneic Cultured Islet Cells (human); Encapsulated

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Safety - will be evaluated by the incidence, grade, and type of adverse events, changes in laboratory parameters, evaluation of the implant site and physical exams.

Secondary Outcome Measures

Outcome Measure
Efficacy - will be assessed by:
Blood glucose levels
Daily glycemic excursions
Pre-prandial glucose levels
Post-prandial glucose levels
Glucose responses from OGTT (mg/dL and AUC:glucose
Stimulated C-peptide levels from OGTT (ng/mL and
AUC:C-Peptide
HbA1c (%)
Insulin requirements (units/day)
Arginine stimulation tests
Numbers of hypoglycemic and hyperglycemic episodes
Functional duration - will be determined by stimulated C-peptide from OGTT.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Novocell

Collaborators

CHRISTUS Health
Diabetes & Glandular Disease Research Associates, P.A., San Antonio, TX

Investigators

  • Principal Investigator: Sherwyn Schwartz, M.D., Diabetes & Glandular Disease Research Associates, P.A., San Antonio, TX
  • Principal Investigator: Paraic Mulgrew, M.D., CHRISTUS Santa Rosa Transplant Institute, San Antonio, TX

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2005

Primary Completion (Actual)

December 1, 2007

Study Completion (Actual)

December 1, 2007

Study Registration Dates

First Submitted

November 28, 2005

First Submitted That Met QC Criteria

November 28, 2005

First Posted (Estimate)

December 1, 2005

Study Record Updates

Last Update Posted (Estimate)

September 9, 2014

Last Update Submitted That Met QC Criteria

September 8, 2014

Last Verified

September 1, 2014

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NC-PCIA-04-001
  • WIRB #20041068

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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