NCT01183468

Brief Summary

The drug Alpha-1 Antitrypsin (AAT, Aralast NP) is being tested in this study as an anti-inflammatory drug (a medication that decreases inflammation, which is part of the body's normal ability to fight infection and respond to injuries) that affects the cells thought to be involved in the development of type 1 diabetes mellitus (T1DM, T1D). All subjects enrolled in this study have new-onset T1DM (diagnosis of T1DM within 100 days of Visit 0; T1DM diagnosis fulfilling American Diabetes Association standard T1DM criteria). The focus of Part I of this trial (NCT01183468) is pharmacokinetics (PK), pharmacodynamics (PD) and safety. Upon completion of Part I, including a satisfactory safety review, enrollment in Part II (NCT01183455, Phase II Clinical Trial) will begin.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
17

participants targeted

Target at below P25 for phase_1

Timeline
Completed

Started Oct 2010

Typical duration for phase_1

Geographic Reach
1 country

15 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 16, 2010

Completed
1 day until next milestone

First Posted

Study publicly available on registry

August 17, 2010

Completed
2 months until next milestone

Study Start

First participant enrolled

October 1, 2010

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2013

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2013

Completed
1.5 years until next milestone

Results Posted

Study results publicly available

January 16, 2015

Completed
Last Updated

June 13, 2018

Status Verified

May 1, 2018

Enrollment Period

2.8 years

First QC Date

August 16, 2010

Results QC Date

January 6, 2015

Last Update Submit

May 14, 2018

Conditions

Keywords

Diabetes Mellitus, Type 1 (new-onset)Diabetes Mellitus, Insulin-Dependent (new-onset)new-onset T1DMnew-onset T1DDiabetes Mellitus, Juvenile-OnsetDiabetes, AutoimmuneAralast NPAlpha-1 AntitrypsinAAT

Outcome Measures

Primary Outcomes (1)

  • C-peptide 2-hour AUC in Response to a Mixed-meal Tolerance Test at Week 52

    No results for the primary outcome measure are available since the study was terminated prior to reaching the outcome measure time frame of 52 weeks.

    Week 52

Study Arms (4)

Part 1a(Aralast NP)-Subjects Aged 16-35 Yrs

EXPERIMENTAL

Subjects aged 16-35 years at enrollment with new-onset type 1 diabetes mellitus (T1DM) received Aralast NP 45 mg/kg by intravenous (IV) infusion once a week for 6 weeks. Following the Week 6 infusion, participants underwent a minimum 3-week washout period. After the washout period, each participant proceeded to a high dose of Aralast NP 90 mg/kg by IV infusion for the next 6 weeks, for a total of 12 infusions.

Biological: Aralast NP 45 mg doseBiological: Aralast NP 90 mg dose

Part 1a (Aralast NP)-Subjects 8-15 Yrs

EXPERIMENTAL

Subjects aged 8-15 years at enrollment with new-onset type 1 diabetes mellitus (T1DM) received Aralast NP 45 mg/kg by IV infusion once a week for 6 weeks. Following the Week 6 infusion, participants underwent a minimum 3-week washout period. After the washout period, each participant proceeded to a high dose of Aralast NP 90 mg/kg by IV infusion for the next 6 weeks, for a total of 12 infusions.

Biological: Aralast NP 45 mg doseBiological: Aralast NP 90 mg dose

Part 1b (Aralast NP)--Subjects Aged 18-35 Yrs

EXPERIMENTAL

Aralast NP 90 mg/kg/wk by IV infusion once a week for 6 weeks. Following the Week 6 infusion, participants undergo a minimum 3-wk washout period than then, each participant proceeds to high dose Aralast NP 180 mg/kg/wk by IV infusion for the next 6 weeks, for a total of 12 infusions.

Biological: Aralast NP 90 mg doseBiological: Aralast NP 180 mg dose

Part 1b (Aralast NP)-Subjects 8-17 Yrs

EXPERIMENTAL

Aralast NP 90 mg/kg/wk by IV infusion once a week for 6 weeks. Following the Week 6 infusion, participants undergo a minimum 3-wk washout period than then, each participant proceeds to high dose Aralast NP 180 mg/kg/wk by IV infusion for the next 6 weeks, for a total of 12 infusions.

Biological: Aralast NP 90 mg doseBiological: Aralast NP 180 mg dose

Interventions

\- 45 mg/kg/week

Also known as: Alpha 1-Antitrypsin, AAT
Part 1a (Aralast NP)-Subjects 8-15 YrsPart 1a(Aralast NP)-Subjects Aged 16-35 Yrs

\- 90 mg/kg/week

Also known as: Alpha 1-Antitrypsin, AAT
Part 1a (Aralast NP)-Subjects 8-15 YrsPart 1a(Aralast NP)-Subjects Aged 16-35 YrsPart 1b (Aralast NP)--Subjects Aged 18-35 YrsPart 1b (Aralast NP)-Subjects 8-17 Yrs

\- 180 mg/kg/week

Also known as: Alpha-1 Antitrypsin, AAT
Part 1b (Aralast NP)--Subjects Aged 18-35 YrsPart 1b (Aralast NP)-Subjects 8-17 Yrs

Eligibility Criteria

Age8 Years - 35 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Diagnosed with T1DM within the past 100 days (of enrollment)
  • Positive for at least one diabetes-related autoantibody (Anti-GAD; Anti-insulin, if obtained within 10 days of the onset of insulin therapy; IA-2 antibody and/or ICA, or ZnT8.)
  • Peak stimulated C-peptide level \> 0.2 pmol/mL following a mixed meal tolerance test (MMTT)

You may not qualify if:

  • Severe active disease (chronic active hepatitis; cardiac, pulmonary disease, hepatic, renal or immunodeficiency)
  • History of any bleeding or clotting factor deficiencies, or stroke
  • History of vascular disease or significant vascular abnormalities
  • Positive serology of exposure to (hepatitis B virus) HBV, HCV (hepatitis C virus), HIV (human immunodeficiency virus) or toxoplasmosis
  • Clinically active infection with EBV (Epstein-Barr virus), CMV (cytomegalovirus), or tuberculosis(TB)
  • Prior or current use of oral, inhaled or intranasal glucocorticoids, or any medication known to cause a significant, ongoing change in the course of T1DM or immunologic status
  • Prior treatment with Alpha 1-Antitrypsin (Aralast NP, AAT) or hypersensitivity to alpha 1-antitrypsin or human plasma-derived products
  • Current or prior (within the last 30 days) use of metformin, sulfonylureas, glinides, thiazolidinediones, exenatide, liraglutide, DPP-IV inhibitors or amylin
  • Current use of any medication known to influence glucose tolerance (e.g., beta-blockers, angiotensin-converting enzyme inhibitors, interferons, quinidine anti-malarial drugs, lithium, niacin)
  • Females who are pregnant or lactating, or are unwilling to defer pregnancy during study participation
  • IgA (immunoglobulin A) deficiency
  • Uncontrolled hypertension
  • Current life-threatening malignancy
  • Any condition that in the investigator's opinion may compromise study participation or may confound the interpretation of the study results.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (15)

RADY Children's Hospital (University of California, San Diego)

San Diego, California, 92093, United States

Location

Barbara Davis Center (University of Colorado)

Aurora, Colorado, 80045, United States

Location

Yale University

New Haven, Connecticut, 06520, United States

Location

Atlanta Diabetes Associates

Atlanta, Georgia, 30309, United States

Location

Children's Hospital of Atlanta (Emory University)

Atlanta, Georgia, 30322, United States

Location

University of Iowa Children's Hospital

Iowa City, Iowa, 52242, United States

Location

University of Maryland Medical Center

Baltimore, Maryland, 21201, United States

Location

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Joslin Diabetes Center

Boston, Massachusetts, 02215, United States

Location

University of Massachusetts Memorial Medical Center

Worcester, Massachusetts, 01655, United States

Location

Children's Mercy Hospital

Kansas City, Missouri, 64108, United States

Location

Naomi Berrie Diabetes Center (Columbia University)

New York, New York, 10032, United States

Location

Nationwide Children's Hospital

Columbus, Ohio, 43205, United States

Location

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States

Location

Pacific Northwest Research Institute-University of Washington

Seattle, Washington, 98122, United States

Location

Related Publications (1)

  • Ozeri E, Mizrahi M, Shahaf G, Lewis EC. alpha-1 antitrypsin promotes semimature, IL-10-producing and readily migrating tolerogenic dendritic cells. J Immunol. 2012 Jul 1;189(1):146-53. doi: 10.4049/jimmunol.1101340. Epub 2012 May 25.

Related Links

MeSH Terms

Conditions

Diabetes Mellitus, Type 1Diabetes Mellitusalpha 1-Antitrypsin Deficiency

Interventions

alpha 1-Antitrypsin

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System DiseasesLiver DiseasesDigestive System DiseasesLung DiseasesRespiratory Tract DiseasesGenetic Diseases, InbornCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesSubcutaneous EmphysemaEmphysemaPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

GlycoproteinsGlycoconjugatesCarbohydratesSerpinsPeptidesAmino Acids, Peptides, and ProteinsAcute-Phase ProteinsBlood ProteinsProteinsAlpha-GlobulinsSerum GlobulinsGlobulins

Limitations and Caveats

This (Part 1) was the drug dosing portion of the study; however, due to lack of a mechanistic signal and competing industry studies, the study was terminated and the trial portion (Part II, NCT01183455) was withdrawn.

Results Point of Contact

Title
Director, Clinical Research Operations Program
Organization
DAIT/NIAID

Study Officials

  • Gordon Weir, MD

    Joslin Diabetes Center

    STUDY CHAIR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 16, 2010

First Posted

August 17, 2010

Study Start

October 1, 2010

Primary Completion

July 1, 2013

Study Completion

July 1, 2013

Last Updated

June 13, 2018

Results First Posted

January 16, 2015

Record last verified: 2018-05

Data Sharing

IPD Sharing
Will share

Participant level data and additional relevant materials are available to the public in TrialShare, the Immune Tolerance Network (ITN) Clinical Trials Research Portal.

Time Frame
IPD is now available in TrialShare.
Access Criteria
Open to the public.
More information

Available IPD Datasets

Individual Participant Data Set (RETAIN ITN041AI)Access

Locations