En undersøgelse af oral Ladarixin i type 1-diabetes og en lav resterende β-cellefunktion
Fase 3, multicenter, randomiseret, dobbeltblindt, placebokontrolleret undersøgelse for at vurdere effektiviteten - Sikkerhed af 400 mg to gange dagligt oral Ladarixin i pts med nyligt debuterende type 1-diabetes og lav residual β-cellefunktion ved baseline (GLADIATOR STUDY)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Dette er en fase 3, multicenter, dobbeltblind, placebokontrolleret undersøgelse. Det er designet til yderligere at evaluere, om ladarixin er effektivt til at bevare beta-cellefunktionen og bremse udviklingen af T1D) hos patienter med en mere alvorlig sygdomspræsentation.
Undersøgelsen er planlagt til at blive udført på omkring 40 studiecentre i EU, USA og i andre lande, hvis det er relevant. På hvert studiecenter vil hovedforskeren (PI) være ansvarlig for at sikre, at undersøgelsen udføres i overensstemmelse med den underskrevne efterforskeraftale, protokollen, GCP-retningslinjer og lokale regler.
Studiet er planlagt til at involvere -327 patienter med nyopstået T1D, til at omfatte omkring 200 unge (14-17 år). Patienter vil blive tilfældigt (2:1) tildelt til at modtage enten ladarixinbehandling (400 mg b.i.d. i 13 cyklusser af 14 dage on/14 dages fri - behandlingsgruppe) eller matchet placebo (kontrolgruppe). De to grupper vil være afbalanceret inden for centre.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Enrico Minnella, MD
- Telefonnummer: +3902583831
- E-mail: clinical.trials@dompe.com
Undersøgelse Kontakt Backup
- Navn: Marta Marelli
- Telefonnummer: +3902583831
- E-mail: clinical.trials@dompe.com
Studiesteder
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Arlon, Belgien
- Clinique du Sud Luxembourg - Vivialia-Arlon
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Jette, Belgien
- Universitair Ziekenhuis Brussel (UZB)
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Sint-Niklaas, Belgien
- General Hospital AZ Nikolaas
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Alabama
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Birmingham, Alabama, Forenede Stater, 35294
- University of Alabama at Birmingham (UAB) - The Kirklin Clinic (TKC) - Multidisciplinary Comprehensive Diabetes Clinic (MCDC)
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Arizona
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Phoenix, Arizona, Forenede Stater, 85021
- Phoenician Centers for Research and Innovation
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California
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La Jolla, California, Forenede Stater, 92093
- University of California San Diego
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Sacramento, California, Forenede Stater, 95821-2123
- Center of Excellence in Diabetes & Endocrinology (CEDE)
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Colorado
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Aurora, Colorado, Forenede Stater, 80045
- University of Colorado School of Medicine - Barbara Davis Center for Childhood Diabetes (BDC) - Specialty Clinic
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Delaware
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Newark, Delaware, Forenede Stater, 19713
- Christiana Care Endocrinology Specialists
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Florida
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Hudson, Florida, Forenede Stater, 34667-7151
- Diabetes Care Center - Hudson
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Miami, Florida, Forenede Stater, 33155
- Global Life Research Network
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Orlando, Florida, Forenede Stater, 32804
- AdventHealth (Florida Hospital) - Diabetes Institute - Orlando
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Georgia
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Atlanta, Georgia, Forenede Stater, 30318
- Atlanta Diabetes Associates (ADA)
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Illinois
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Chicago, Illinois, Forenede Stater, 60637
- The University of Chicago
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Springfield, Illinois, Forenede Stater, 62711
- Prairie Education and Research Cooperative d/b/a Central Illinois Diabetes and Clinical
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Indiana
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Indianapolis, Indiana, Forenede Stater, 46202
- Indiana University - Riley Hospital for Children
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Kansas
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Topeka, Kansas, Forenede Stater, 66606-28
- The Cotton-O'Neil Diabetes and Endocrinology Center
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Kentucky
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Louisville, Kentucky, Forenede Stater, 40292
- University of Louisville
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02215
- Joslin Diabetes Center, Harvard Medical School
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New York
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Buffalo, New York, Forenede Stater, 14203
- UBMD Physicians Group - Pediatrics - Conventus
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North Carolina
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Raleigh, North Carolina, Forenede Stater, 27610
- "WakeMed Physician Practices - Pediatric Endocrinology - WakeMed Raleigh Medical Park Location"
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Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 19107
- Thomas Jefferson University
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Philadelphia, Pennsylvania, Forenede Stater, 19104
- University of Pennsylvania Perelman School of Medicine
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Pittsburgh, Pennsylvania, Forenede Stater, 15224
- UPMC Children's Hospital of Pittsburgh
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Pittsburgh, Pennsylvania, Forenede Stater, 15261
- University of Pittsburgh - UPMC
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Texas
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Fort Worth, Texas, Forenede Stater, 76104
- Cook Children's Endocrinology and Diabetes Program
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Houston, Texas, Forenede Stater, 77030
- Texas Children's Hospital
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Virginia
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Norfolk, Virginia, Forenede Stater, 23510
- Eastern Virginia Medical School (EVMS) - Strelitz Diabetes Center
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Tbilisi, Georgien, 48102
- Aleksandre Aladashvili Clinic LLC
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Tbilisi, Georgien, 48159
- National Center for Diabetes Research LTD
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Tbilisi, Georgien, 48159
- National Institute of Endocrinology LTD
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Tbilisi, Georgien, 48159
- Tbilisi Heart and Vascular Clinic LTD
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Beersheba, Israel
- Soroka Medical Center
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Petah Tikva, Israel, 4920235
- Schneider Children's Medical Center, Petah Tikva
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Tel Aviv, Israel
- Tel Aviv Sourasky Medical Center
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Ancona, Italien, 60123
- Ospedale Pediatrico G. Salesi - Centro Regionale di Diabetologia Clinica Pediatrica
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Bari, Italien, 70124
- Azienda Ospedaliero-Universitaria Conzorziale Policlinico di Bari
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Catanzaro, Italien
- Università degli Studi Magna Graecia di Catanzaro, Azienda Ospedaliero-Universitaria Mater Domini
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Milan, Italien, 20157
- Universitá degli Studi di Milano - Ospedale Luigi Saco
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Naples, Italien
- Centro regionale di Diabetologia Pediatrica "G. Stoppoloni", Azienda Ospedaliera Universitaria "Luigi Vanvitelli"
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Palermo, Italien, 90127
- Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone"
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Roma, Italien, 00128
- Università Campus Bio-Medico di Roma (UCBM) - Policlinico Universitario
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Roma, Italien
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Ospedale Pediatrico Bambino Gesu
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Roma, Italien
- Universita Cattolica del Sacro Cuore - Policlinico Universitario "Agostino Gemelli"
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Rome, Italien, 00161
- "Sapienza" Università di Roma- Azienda Ospedaliero Universitaria Policlinico Umberto I
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Belgrade, Serbien, 11000
- Clinical Center of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Diseases
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Belgrade, Serbien
- University Children's Hospital
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Kragujevac, Serbien, 34000
- Clinical center Kragujevac, Clinic for internal diseases, Center for endocrinology, diabetes and metabolic diseases
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Niš, Serbien, 18000
- Clinical Center Nis, Clinic for endocrinology
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Niš, Serbien
- Clinical Center Nis, Clinic for endocrinology
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Ljubljana, Slovenien
- University Children's Hospital, University Medical Center Ljubljana
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Freiburg im Breisgau, Tyskland
- Medical Center - University Of Freiburg
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Glessen, Tyskland, 35392
- Universitaetsklinikum Gessen und Marburg GmbH - Medizinische Klinik und Poliklinik III
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Heidelberg, Tyskland
- Diabestesinstitut Heidelberg
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Ludwigshafen am Rhein, Tyskland
- Die Praxis am Ludwigsplatz
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Münster, Tyskland
- Institut fuer Diabetes forschung in Muenster (IDFM)
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Münster, Tyskland
- Schwerpunktpraxis fuer Diabetes & Ernaehrungsmedizin
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Mandlige og kvindelige patienter i alderen 14-45 år inklusive;
- Nylig debut T1D (1. IMP-dosis inden for 180 dage fra 1. insulinadministration);
- Positiv for mindst ét diabetesrelateret autoantistof (anti-GAD; IAA, hvis opnået inden for 10 dage efter påbegyndelse af insulinbehandling; IA-2 antistof; ZnT8);
- Kræver eller har på et tidspunkt krævet insulinbehandling gennem en eller flere separate subkutane injektioner eller kontinuerlig subkutan insulininfusion (CSII).
- Fastende C-peptid < 0,205 nmol/L;
- Resterende beta-cellefunktion i henhold til topstimuleret (MMTT) C-peptidniveau >0,2nmol/L; MMTT bør ikke udføres inden for en uge efter ophør af en diabetisk ketoacidosehændelse;
- Patient i stand til at overholde alle protokolprocedurer i hele undersøgelsens varighed, inklusive planlagte opfølgningsbesøg og undersøgelser;
- Patienter, der har givet skriftligt informeret samtykke forud for en undersøgelsesrelateret procedure, der ikke er en del af standard medicinsk behandling (deltagere under 18 år skal give et samtykke til undersøgelsen i henhold til landets krav). Specifikt samtykke skal gives af unge for at blive udvalgt til den fulde PK-analyse.
Ekskluderingskriterier:
- En type 2-diabetesdiagnose eller enhver anden ustabil kronisk sygdom, for hvilken dosisjustering af specifik medicin forventes under forsøget;
- Moderat til svært nedsat nyrefunktion ifølge estimeret glomerulær filtrationshastighed (eGFR) 60 ml/min/1,73 m2, som bestemt ved brug af Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) kreatinin-ligning (se bilag 14.4.3);
- Leverdysfunktion defineret ved øget ALAT/ASAT > 3 x øvre normalgrænse (ULN) og øget total bilirubin > 3 mg/dL [>51,3 μmol/L];
- Hypoalbuminæmi defineret som serumalbumin < 3 g/dL;
- QTcF > 470 msek;
- Forekomst af en episode af ketoacidose eller hypoglykæmisk koma inden for de seneste 2 uger;
- En historie med betydelig kardiovaskulær sygdom/abnormitet;
- Kendt overfølsomhed over for ikke-steroide antiinflammatoriske lægemidler;
- Samtidig behandling med lægemidler metaboliseret af CYP2C9 med et snævert terapeutisk indeks [dvs. phenytoin, warfarin, sulfanylurinstof hypoglykæmi (f. tolbutamid, glipizid, glibenclamid/glyburid, glimepirid, nateglinid) og højdosis amitriptylin (> 50 mg/dag)];
- Tidligere (seneste 2 uger) og samtidig behandling med antidiabetika som metformin, sulfonylurinstoffer, glinider, thiazolidindioner, exenatid, liraglutid, DPP-IV-hæmmere, SGLT2-hæmmere eller amylin, eller andre lægemidler, der vides at påvirke glukosetolerancen (f. betablokkere, angiotensin-konverterende enzymhæmmere, interferoner, quinidin-antimalarialægemidler, lithium, niacin osv.);
- Tidligere (sidste måned) eller nuværende administration af enhver immunsuppressiv medicin (inklusive orale eller systemiske kortikosteroider) og brug af eventuelle forsøgsmidler, herunder alle midler, der påvirker immunresponset eller cytokinsystemet;
- Betydelig systemisk infektion i løbet af de 4 uger før den 1. dosis af undersøgelseslægemidlet (f.eks. infektion, der kræver hospitalsindlæggelse, større operation eller IV-antibiotika for at forsvinde; andre infektioner, f.eks. bronkitis, bihulebetændelse, lokaliseret cellulitis, candidiasis eller urinvejsinfektioner, skal vurderes fra sag til sag af efterforskeren med hensyn til, om de er alvorlige nok til at berettige udelukkelse);
- Anamnese med positiv status for hepatitis A (IgM), hepatitis B (ikke på grund af immunisering), hepatitis C og HIV.
- Gravide eller ammende kvinder. Uvilje til at bruge effektive præventionsforanstaltninger op til 2 måneder efter afslutningen af studiets lægemiddeladministration (kvinder og mænd). Effektive præventionsforanstaltninger omfatter en hormonel prævention (f.eks. orale piller, langtidsinjektioner, vaginal ring, plaster); den intrauterine anordning (IUD); en dobbeltbarrieremetode (f.eks. kondom eller mellemgulv plus sæddræbende skum); afholdenhed.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Ladarixin
400 mg b.i.d. i 13 cyklusser af 14 dage on/14 dage fri
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Oral ladarixin to gange om dagen i 13 cyklusser
Andre navne:
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Placebo komparator: Placebo
matchende placebo b.i.d. i 13 cyklusser af 14 dage on/14 dage fri
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Oral placebo to gange om dagen i 13 cyklusser
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change From Baseline in 2-hour Area Under the Concentration-time Curve (AUC) of C-peptide Response to the Mixed Model Tolerance Test (MMTT)
Tidsramme: Baseline and at Month 6
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Change from baseline in the 2-hour C-peptide Area Under the Curve (AUC) following a Mixed-Meal Tolerance Test (MMTT) at Month 6.
The analysis used an adjusted ANCOVA model with the change from baseline in log(AUC + 1) as the dependent variable.
Qualitative independent variables included treatment group, age group, sex, and BMI group, with the baseline value as a quantitative covariate.
Missing data at Month 6 were handled via multiple imputation using a retrieved dropout approach.
Missing values were imputed using a regression model based on the participant's allocated treatment arm and baseline value, utilizing data from participants who discontinued treatment but completed the Month 6 measurement.
Baseline is defined as the last visit prior to randomization.
Change from Baseline is defined as post-baseline visit value minus baseline visit value.
The adjusted mean along with its the corresponding 95% confidence interval (CI) has been presented.
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Baseline and at Month 6
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change From Baseline in 2-hour AUC of C-peptide Response to the MMTT at Months 12, 18, and 24
Tidsramme: Baseline and at Months 12, 18, and 24
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Change from baseline in the 2-hour C-peptide AUC following a MMTT at Months 6, 12, and 18.
The analysis used an adjusted ANCOVA model with the change from baseline in log(AUC + 1) as the dependent variable.
Qualitative independent variables included treatment group, age group, sex, and BMI group, with the baseline value as a quantitative covariate.
Missing data at Months 12, 18 and 24 were handled via multiple imputation using a retrieved dropout approach.
Missing values were imputed using a regression model based on the participant's allocated treatment arm and baseline value, utilizing data from participants who discontinued treatment but completed the measurement at the timepoint of interest.
Intermediate timepoints were included as covariates in the model.
Baseline is defined as the last visit prior to randomization.
Change from Baseline is defined as post-baseline visit value minus baseline visit value.
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Baseline and at Months 12, 18, and 24
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Change in Glycated Hemoglobin (HbA1c) From Baseline
Tidsramme: Baseline and at Months 6, 12, 18 and 24
|
The change from baseline in HbA1c was analyzed using an adjusted ANCOVA model.
The dependent variable is the change from baseline in HbA1c at each respective time point, with treatment, age group, sex, and BMI group as qualitative independent variables and the baseline value as a quantitative covariate. .
Missing data are addressed via Multiple Imputation (MI) using a retrieved dropout approach, where values are imputed based on a regression model incorporating treatment arm, baseline value, and intermediate assessments as covariates.
Baseline is defined as the last visit prior to randomization.
Change from Baseline is defined as post-baseline visit value minus baseline visit value.
The adjusted mean along with its the corresponding 95% confidence interval (CI) has been presented.
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Baseline and at Months 6, 12, 18 and 24
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Percentage of Participants With HbA1c <7% Who Did Not Experience Severe Hypoglycemic Events During Treatment
Tidsramme: At Months 6, 12, 18, and 24
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The proportion of participants with HbA1c < 7% was calculated by timepoint: the numerator was the number of participants with events occurring at a specific timepoint (month X visit), without cumulating participants with events up to that timepoint.
Participants with severe hypoglycemic events were considered cumulatively and only events up to month 12 were considered (condition was evaluated by considering treatment period only).
If HbA1c ≥ 7% or the participant had experienced a severe hypoglycemic event, then the endpoint was equal to "No" even in the case of one missing component.
If either the HbA1c or severe hypoglycemic event data was missing, but the other satisfied the criteria for the endpoint, then the response to the endpoint was missing.
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At Months 6, 12, 18, and 24
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Average (Previous 3 Days) Daily Insulin Requirement International Units Per Kilogram Per Day (IU/kg/Day)
Tidsramme: At Months 6, 12, 18, and 24
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The average daily insulin requirement at each visit was calculated from the daily insulin requirement measured at the 3 days prior to the visit.
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At Months 6, 12, 18, and 24
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Percentage of Participants With HbA1c <7% and Daily Insulin Requirement <0.5 IU/kg/Day
Tidsramme: At Months 6, 12, 18, and 24
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Percentage of participants with HbA1c <7% and daily insulin requirement <0.5 (IU/Kg/day) was calculated for each time point, the numerator is the number of participants in each treatment group with events occurring at a specific timepoint, and the denominator is the number of participants in each treatment group reaching the specific visit.
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At Months 6, 12, 18, and 24
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Number of Self-reported Episodes of Severe Hypoglycemia
Tidsramme: Post-baseline up to Month 24
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This outcome assessed the total number of self-reported episodes of severe hypoglycemia occurring across all participants.
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Post-baseline up to Month 24
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Percentage of Patients Not Requiring Insulin Therapy
Tidsramme: Months 6, 12, 18 and 24
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This outcome assessed the percentage of participants who did not require an insulin therapy at the timepoint of interest.
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Months 6, 12, 18 and 24
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Estimated Glucose Disposal Rate (eGDR)
Tidsramme: Months 6, 12, 18, and 24
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Estimated Glucose Disposal Rate (eGDR) is a marker for the Assessment of Insulin Resistance and a validated clinical tool for estimating insulin sensitivity in type 1 diabetes.
The eGDR was calculated using a formula incorporating Glycated Hemoglobin (HbA1c), hypertension status (blood pressure), and the Waist-to-Hip Ratio (WHR), with results expressed in milligrams per kilogram per minute (mg/kg/min).
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Months 6, 12, 18, and 24
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studieleder: Enrico Minnella, MD, Dompé Farmaceutici
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Sygdomme i det endokrine system
- Metaboliske sygdomme
- Autoimmune sygdomme
- Sygdomme i immunsystemet
- Glukosemetabolismeforstyrrelser
- Diabetes mellitus
- Diabetes mellitus, type 1
- Peptider
- Aminosyrer, peptider og proteiner
- Proteiner
- Biologiske faktorer
- Receptorer, G-protein-koblet
- Receptorer, celleoverflade
- Membranproteiner
- Intercellulære signalpeptider og proteiner
- Cytokiner
- Betændelsesformidlere
- Interleukins
- Receptorer, cytokin
- Receptorer, immunologisk
- Receptorer, interleukin-8
- Receptorer, CXCR
- Receptorer, kemokin
- Receptorer, interleukin
- Chemokines, CXC
- Kemokiner
- Kemotaktiske faktorer
- Receptorer, interleukin-8b
- Interleukin-8
- 2'-((4'-trifluorometansulfonyloxy)fenyl)-N-metansulfonylpropionamid
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- LDX0319
- 2020-001926-71 (EudraCT nummer)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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