- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00888628
Study of Islet Transplantation in Type 1 Diabetic Kidney Transplant Recipients
Islet Transplantation in Type 1 Diabetic Kidney Allograft Recipients
The purpose of the study is to learn if islet transplantation is an effective treatment for Type 1 diabetes in people who have had a kidney transplant.
The primary objectives of the study are:
- To set up islet transplantation in patients who have had a kidney transplant and who are using an immunosuppressive regimen that works
The Secondary objective of the study is:
- To find out if successful islet transplantation leads to improved metabolic control and reduced renal complication from diabetes
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
Patients will receive (an) infusion(s) of in vitro cultured islets with the goal of achieving insulin independence. For the first islet transplant, patients will receive induction therapy with rabbit anti-thymocyte globulin (ATG, 5 doses) and will remain on their maintenance immunosuppression regimen already in place for their renal allograft. Induction therapy for subsequent transplants will be 2doses of basiliximab.
All patients will receive Etanercept to promote engraftment.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
- Phase 1
Kontakte und Standorte
Studienorte
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Massachusetts
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Boston, Massachusetts, Vereinigte Staaten, 02114
- Massachusetts General Hospital
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- Male and female subjects
- Age 18 to 70 years of age
- Have insulin dependent Diabetes Mellitus Type 1
- Are post-renal transplant on maintenance immunosuppression with stable renal function
- HbA1c > 7.5% or < 7.5% and hypoglycemia unawareness
Exclusion Criteria:
- Weight more than 90 kg
- Insulin requirement > 60 Units/day
- Other (non-kidney) organ transplants except prior failed pancreatic graft.
- Untreated or unstable proliferative diabetic retinopathy
- Presence of de novo antibody production since the renal allograft or either Class I or Class II panel-reactive anti-HLA antibodies
- Active infection
- Negative screen for Epstein-Barr virus (EBV)
- Any history of malignancy except for completely resected squamous or basal cell carcinoma of the skin
- History of Factor V Leiden mutation
- Any coagulopathy or medical condition requiring long-term anticoagulant therapy (e.g. warfarin) after transplantation (low-dose aspirin treatment is allowed) or subjects with international normalized ratio (INR) > 1.5
- Severe co-existing cardiac disease
- Persistent elevation of liver function tests at the time of study entry
- Acute or chronic pancreatitis
- Male subjects with elevation of prostate specific antigen
- Pregnancy
- Positive screen for polyoma (BK) virus
- Untreated hyperlipidemia
- Recent hemorrhagic stroke
- Factors associated with an increased risk of bleeding
Contact PI for complete Incl-Excl criteria list.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Experimental: Islet transplant
Patients will receive (an) infusion(s) of in vitro cultured islets with the goal of achieving insulin independence. For the first islet transplant, patients will receive induction therapy with rabbit anti-thymocyte globulin (ATG, 5 doses) and will remain on their maintenance immunosuppression regimen already in place for their renal allograft. Induction therapy for subsequent transplants will be 2 doses of basiliximab. All patients will receive Etanercept to promote engraftment. |
Islet after kidney transplant in patients with type I diabetes.
Given as induction for islet cell transplant
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
---|---|
Insulin Independence With Both an HbA1c ≤ 6.5% and no Severe Hypoglycemic Events at 1 Year After the First Islet Transplant or a Reduction in HbA1c of at Least 1 Point and no Severe Hypoglycemic Events at 1 Year After the First Islet Transplant.
Zeitfenster: 1 year after the subject's first islet transplant
|
1 year after the subject's first islet transplant
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Number of Participants With a Decrease in HbA1c
Zeitfenster: 1 year after subject's first islet transplant
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Subjects will have a decrease in HbA1c of at least >1%
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1 year after subject's first islet transplant
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Stable or Decrease in Urinary Albumin and Creatinine Ratio and Serum Creatinine
Zeitfenster: 1 year after subjects initial islet transplant
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Proteinuria and serum creatinine will be stable or decreased as compared to pre-transplant values
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1 year after subjects initial islet transplant
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An Absence Cardiovascular Events, Cerebral Vascular Accident, and Myocardial Infarction
Zeitfenster: 1 year after the subject's first islet transplant
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1 year after the subject's first islet transplant
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|
Impact on Vision
Zeitfenster: 1 year after the subject's first islet transplant
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Improvement of frequency of interventions and from changes in reported visual acuity with optical refraction and severity of diabetic retinopathy
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1 year after the subject's first islet transplant
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Absence of Negative Renal Impact Measures
Zeitfenster: 1 year after the subject's first islet transplant
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Loss of allograft survivial (return to dialysis, retransplant, death) and Renal allograft function meausred by SCr
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1 year after the subject's first islet transplant
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Improvement of Metabolic Control
Zeitfenster: 1 year after the subject's first islet transplant
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Whether there is an improvement in metabolic control in IAK will be evaluated based on improvement in
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1 year after the subject's first islet transplant
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Number of Participants With a Decrease of Severe Hypoglycemic Events
Zeitfenster: 1 year after subject's first transplant
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Subjects will have a decrease in severe hypoglycemic events
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1 year after subject's first transplant
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Reduction of Insulin Requriements
Zeitfenster: 1 year after the subject's first islet transplant
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Evidence of partial success will be considered for subjects who have a reduction in insulin requirements but who are not insulin independent.
This will be assessed by comparing the pre-transplant insulin requirement expressed as insulin units per kg per day with the requirement preceding subsequent islet transplants and the insulin requirements at 6 months and 1, 2, and 3 years after the first and last transplant.
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1 year after the subject's first islet transplant
|
Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: James F Markmann, MD, PhD, Massachusetts General Hospital
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Störungen des Glukosestoffwechsels
- Stoffwechselerkrankungen
- Erkrankungen des Immunsystems
- Autoimmunerkrankungen
- Erkrankungen des endokrinen Systems
- Diabetes Mellitus
- Diabetes mellitus, Typ 1
- Physiologische Wirkungen von Arzneimitteln
- Agenten des peripheren Nervensystems
- Analgetika
- Agenten des sensorischen Systems
- Entzündungshemmende Mittel, nichtsteroidal
- Analgetika, nicht narkotisch
- Entzündungshemmende Mittel
- Antirheumatika
- Immunsuppressive Mittel
- Immunologische Faktoren
- Magen-Darm-Mittel
- Etanercept
Andere Studien-ID-Nummern
- IAK
Plan für individuelle Teilnehmerdaten (IPD)
Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?
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