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口服拉达瑞辛治疗新发 1 型糖尿病和低残余 β 细胞功能的研究

2026年8月26日 更新者:Dompé Farmaceutici S.p.A

评估疗效的多中心、随机、双盲、安慰剂对照研究——每天两次口服拉达瑞辛 400 毫克在近期发病的 1 型糖尿病和基线低残余 β 细胞功能患者中的安全性(角斗士研究)

该临床试验的目的是评估拉达瑞辛治疗是否能有效保护青少年和成人患者的 β 细胞功能并延缓 1 型糖尿病 (T1D) 的进展。 还将评估拉达瑞辛在特定临床环境中的安全性。

研究概览

详细说明

这是一项 3 期、多中心、双盲、安慰剂对照研究。 它旨在进一步评估 ladarixin 是否能有效地保护 β 细胞功能并减缓患有更严重疾病表现的患者的 1 型糖尿病的进展。

如果合适,该研究计划在欧盟、美国和其他国家的约 40 个研究中心进行。 在每个研究中心,首席研究员 (PI) 将负责确保根据签署的研究者协议、协议、GCP 指南和当地法规进行调查。

该研究计划涉及-327 名新发 T1D 患者,包括约 200 名青少年(14-17 岁)。 患者将被随机 (2:1) 分配接受拉达瑞辛治疗(400 mg b.i.d. 13 个周期,14 天开/14 天停 - 治疗组)或匹配的安慰剂(对照组)。 这两个小组将在中心内保持平衡。

研究类型

介入性

注册 (实际的)

289

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Tbilisi、乔治亚州、48102
        • Aleksandre Aladashvili Clinic LLC
      • Tbilisi、乔治亚州、48159
        • National Center for Diabetes Research LTD
      • Tbilisi、乔治亚州、48159
        • National Institute of Endocrinology LTD
      • Tbilisi、乔治亚州、48159
        • Tbilisi Heart and Vascular Clinic LTD
      • Beersheba、以色列
        • Soroka Medical Center
      • Petah Tikva、以色列、4920235
        • Schneider Children's Medical Center, Petah Tikva
      • Tel Aviv、以色列
        • Tel Aviv Sourasky Medical Center
      • Belgrade、塞尔维亚、11000
        • Clinical Center of Serbia, Clinic for Endocrinology, Diabetes and Metabolic Diseases
      • Belgrade、塞尔维亚
        • University Children's Hospital
      • Kragujevac、塞尔维亚、34000
        • Clinical center Kragujevac, Clinic for internal diseases, Center for endocrinology, diabetes and metabolic diseases
      • Niš、塞尔维亚、18000
        • Clinical Center Nis, Clinic for endocrinology
      • Niš、塞尔维亚
        • Clinical Center Nis, Clinic for endocrinology
      • Freiburg im Breisgau、德国
        • Medical Center - University Of Freiburg
      • Glessen、德国、35392
        • Universitaetsklinikum Gessen und Marburg GmbH - Medizinische Klinik und Poliklinik III
      • Heidelberg、德国
        • Diabestesinstitut Heidelberg
      • Ludwigshafen am Rhein、德国
        • Die Praxis am Ludwigsplatz
      • Münster、德国
        • Institut fuer Diabetes forschung in Muenster (IDFM)
      • Münster、德国
        • Schwerpunktpraxis fuer Diabetes & Ernaehrungsmedizin
      • Ancona、意大利、60123
        • Ospedale Pediatrico G. Salesi - Centro Regionale di Diabetologia Clinica Pediatrica
      • Bari、意大利、70124
        • Azienda Ospedaliero-Universitaria Conzorziale Policlinico di Bari
      • Catanzaro、意大利
        • Università degli Studi Magna Graecia di Catanzaro, Azienda Ospedaliero-Universitaria Mater Domini
      • Milan、意大利、20157
        • Universitá degli Studi di Milano - Ospedale Luigi Saco
      • Naples、意大利
        • Centro regionale di Diabetologia Pediatrica "G. Stoppoloni", Azienda Ospedaliera Universitaria "Luigi Vanvitelli"
      • Palermo、意大利、90127
        • Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone"
      • Roma、意大利、00128
        • Università Campus Bio-Medico di Roma (UCBM) - Policlinico Universitario
      • Roma、意大利
        • Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) - Ospedale Pediatrico Bambino Gesu
      • Roma、意大利
        • Universita Cattolica del Sacro Cuore - Policlinico Universitario "Agostino Gemelli"
      • Rome、意大利、00161
        • "Sapienza" Università di Roma- Azienda Ospedaliero Universitaria Policlinico Umberto I
      • Ljubljana、斯洛文尼亚
        • University Children's Hospital, University Medical Center Ljubljana
      • Arlon、比利时
        • Clinique du Sud Luxembourg - Vivialia-Arlon
      • Jette、比利时
        • Universitair Ziekenhuis Brussel (UZB)
      • Sint-Niklaas、比利时
        • General Hospital AZ Nikolaas
    • Alabama
      • Birmingham、Alabama、美国、35294
        • University of Alabama at Birmingham (UAB) - The Kirklin Clinic (TKC) - Multidisciplinary Comprehensive Diabetes Clinic (MCDC)
    • Arizona
      • Phoenix、Arizona、美国、85021
        • Phoenician Centers for Research and Innovation
    • California
      • La Jolla、California、美国、92093
        • University of California San Diego
      • Sacramento、California、美国、95821-2123
        • Center of Excellence in Diabetes & Endocrinology (CEDE)
    • Colorado
      • Aurora、Colorado、美国、80045
        • University of Colorado School of Medicine - Barbara Davis Center for Childhood Diabetes (BDC) - Specialty Clinic
    • Delaware
      • Newark、Delaware、美国、19713
        • Christiana Care Endocrinology Specialists
    • Florida
      • Hudson、Florida、美国、34667-7151
        • Diabetes Care Center - Hudson
      • Miami、Florida、美国、33155
        • Global Life Research Network
      • Orlando、Florida、美国、32804
        • AdventHealth (Florida Hospital) - Diabetes Institute - Orlando
    • Georgia
      • Atlanta、Georgia、美国、30318
        • Atlanta Diabetes Associates (ADA)
    • Illinois
      • Chicago、Illinois、美国、60637
        • The University of Chicago
      • Springfield、Illinois、美国、62711
        • Prairie Education and Research Cooperative d/b/a Central Illinois Diabetes and Clinical
    • Indiana
      • Indianapolis、Indiana、美国、46202
        • Indiana University - Riley Hospital for Children
    • Kansas
      • Topeka、Kansas、美国、66606-28
        • The Cotton-O'Neil Diabetes and Endocrinology Center
    • Kentucky
      • Louisville、Kentucky、美国、40292
        • University of Louisville
    • Massachusetts
      • Boston、Massachusetts、美国、02215
        • Joslin Diabetes Center, Harvard Medical School
    • New York
      • Buffalo、New York、美国、14203
        • UBMD Physicians Group - Pediatrics - Conventus
    • North Carolina
      • Raleigh、North Carolina、美国、27610
        • "WakeMed Physician Practices - Pediatric Endocrinology - WakeMed Raleigh Medical Park Location"
    • Pennsylvania
      • Philadelphia、Pennsylvania、美国、19107
        • Thomas Jefferson University
      • Philadelphia、Pennsylvania、美国、19104
        • University of Pennsylvania Perelman School of Medicine
      • Pittsburgh、Pennsylvania、美国、15224
        • UPMC Children's Hospital of Pittsburgh
      • Pittsburgh、Pennsylvania、美国、15261
        • University of Pittsburgh - UPMC
    • Texas
      • Fort Worth、Texas、美国、76104
        • Cook Children's Endocrinology and Diabetes Program
      • Houston、Texas、美国、77030
        • Texas Children's Hospital
    • Virginia
      • Norfolk、Virginia、美国、23510
        • Eastern Virginia Medical School (EVMS) - Strelitz Diabetes Center

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

10年 至 41年 (孩子、成人)

接受健康志愿者

不

描述

纳入标准:

  1. 年龄在14-45岁(含)之间的男性和女性患者;
  2. 最近发作的 T1D(第一次胰岛素给药后 180 天内第一次服用 IMP);
  3. 至少一种糖尿病相关自身抗体阳性(抗 GAD;IAA,如果在胰岛素治疗开始后 10 天内获得;IA-2 抗体;ZnT8);
  4. 需要或曾经需要通过一次或多次单独皮下注射或连续皮下胰岛素输注 (CSII) 进行胰岛素治疗。
  5. 空腹C肽<0.205nmol/L;
  6. 根据峰值刺激 (MMTT) C 肽水平的残留 β 细胞功能 >0.2nmol/L;糖尿病酮症酸中毒事件解决后一周内不应进行 MMTT;
  7. 患者能够在研究期间遵守所有协议程序,包括预定的随访和检查;
  8. 在任何不属于标准医疗护理的研究相关程序之前给予书面知情同意的患者(18 岁以下的参与者,应根据国家要求提供对研究的同意)。 青少年必须特别同意才能被选中进行完整的 PK 分析。

排除标准:

  1. 2 型糖尿病诊断或任何其他不稳定的慢性疾病,预计在试验期间会调整特定药物的剂量;
  2. 根据估计的肾小球滤过率 (eGFR) 60 mL/min/1.73m2,中度至重度肾功能损害, 使用慢性肾脏病流行病学协作 (CKD-EPI) 肌酐方程确定(见附录 14.4.3);
  3. 肝功能障碍定义为升高的 ALT/AST > 3 x 正常上限 (ULN) 和升高的总胆红素 > 3 mg/dL [>51.3 μmol/L];
  4. 低白蛋白血症定义为血清白蛋白 < 3 g/dL;
  5. QTcF > 470 毫秒;
  6. 过去2周内发生酮症酸中毒或低血糖昏迷;
  7. 重大心血管疾病/异常病史;
  8. 已知对非甾体抗炎药过敏;
  9. 与 CYP2C9 代谢的药物联合治疗,治疗指数较窄[即 苯妥英、华法林、磺脲类降血糖药(例如 甲苯磺丁脲、格列吡嗪、格列本脲/格列本脲、格列美脲、那格列奈)和高剂量阿米替林(> 50 毫克/天)];
  10. 既往(过去 2 周)和同时使用抗糖尿病药治疗,如二甲双胍、磺脲类、格列奈类、噻唑烷二酮类、艾塞那肽、利拉鲁肽、DPP-IV 抑制剂、SGLT2 抑制剂或胰淀素,或任何已知影响葡萄糖耐量的药物(例如 β受体阻滞剂、血管紧张素转换酶抑制剂、干扰素、抗疟药奎尼丁、锂、烟酸等);
  11. 过去(上个月)或目前服用任何免疫抑制药物(包括口服或全身皮质类固醇)和使用任何研究药物,包括影响免疫反应或细胞因子系统的任何药物;
  12. 研究药物第一次给药前 4 周内出现严重的全身感染(例如,感染需要住院、大手术或静脉注射抗生素才能解决;其他感染,例如支气管炎、鼻窦炎、局部蜂窝组织炎、念珠菌病或尿路感染,必须由研究者逐案评估它们是否严重到需要排除);
  13. 甲型肝炎 (IgM)、乙型肝炎(非免疫接种)、丙型肝炎和 HIV 阳性史。
  14. 孕妇或哺乳期妇女。 在研究药物给药结束后 2 个月内不愿使用有效的避孕措施(女性和男性)。 有效的避孕措施包括激素避孕(例如 口服药、长期注射剂、阴道环、贴剂);宫内节育器 (IUD);双屏障方法(例如 避孕套或隔膜加杀精剂泡沫);节制。

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:四人间

武器和干预

参与者组/臂
干预/治疗
实验性的:拉达瑞辛
400 毫克 b.i.d. 13 周期 14 天开/14 天关
每天两次口服拉达瑞辛,共 13 个周期
其他名称:
  • CXCL8 (IL-8)、CXCR1 和 CXCR2 受体的变构抑制剂
安慰剂比较:安慰剂
匹配安慰剂 b.i.d. 13 周期 14 天开/14 天关
每天两次口服安慰剂,共 13 个周期

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Change From Baseline in 2-hour Area Under the Concentration-time Curve (AUC) of C-peptide Response to the Mixed Model Tolerance Test (MMTT)
大体时间:Baseline and at Month 6
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.
Baseline and at Month 6

次要结果测量

结果测量
措施说明
大体时间
Change From Baseline in 2-hour AUC of C-peptide Response to the MMTT at Months 12, 18, and 24
大体时间:Baseline and at Months 12, 18, and 24
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.
Baseline and at Months 12, 18, and 24
Change in Glycated Hemoglobin (HbA1c) From Baseline
大体时间: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.
Baseline and at Months 6, 12, 18 and 24
Percentage of Participants With HbA1c <7% Who Did Not Experience Severe Hypoglycemic Events During Treatment
大体时间:At Months 6, 12, 18, and 24
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.
At Months 6, 12, 18, and 24
Average (Previous 3 Days) Daily Insulin Requirement International Units Per Kilogram Per Day (IU/kg/Day)
大体时间:At Months 6, 12, 18, and 24
The average daily insulin requirement at each visit was calculated from the daily insulin requirement measured at the 3 days prior to the visit.
At Months 6, 12, 18, and 24
Percentage of Participants With HbA1c <7% and Daily Insulin Requirement <0.5 IU/kg/Day
大体时间:At Months 6, 12, 18, and 24
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.
At Months 6, 12, 18, and 24
Number of Self-reported Episodes of Severe Hypoglycemia
大体时间:Post-baseline up to Month 24
This outcome assessed the total number of self-reported episodes of severe hypoglycemia occurring across all participants.
Post-baseline up to Month 24
Percentage of Patients Not Requiring Insulin Therapy
大体时间:Months 6, 12, 18 and 24
This outcome assessed the percentage of participants who did not require an insulin therapy at the timepoint of interest.
Months 6, 12, 18 and 24
Estimated Glucose Disposal Rate (eGDR)
大体时间:Months 6, 12, 18, and 24
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).
Months 6, 12, 18, and 24

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 研究主任:Enrico Minnella, MD、Dompé Farmaceutici

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2021年1月12日

初级完成 (实际的)

2025年3月31日

研究完成 (实际的)

2025年10月21日

研究注册日期

首次提交

2020年11月9日

首先提交符合 QC 标准的

2020年11月9日

首次发布 (实际的)

2020年11月13日

研究记录更新

最后更新发布 (实际的)

2026年8月31日

上次提交的符合 QC 标准的更新

2026年8月26日

最后验证

2026年8月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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