NCT02093221

Brief Summary

This is a multicenter, randomized, partial-blinded, five-arm, placebo-controlled study of human plasma-derived alpha1-proteinase inhibitor (alpha1-PI) in children (ages 6-11 years old) and teens/adults (ages 12-35 years old) with new onset Type 1 Diabetes Mellitus (T1DM). Currently enrolling ages 12-35 only. Once 25 patients are randomized and data is reviewed enrollment will be opened to the child cohort. The purpose of this study is to evaluate the safety and efficacy of four dosing regimens of human plasma-derived alpha1-PI in T1DM.

Trial Health

57
Monitor

Trial Health Score

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

Enrollment
76

participants targeted

Target at P50-P75 for phase_2

Timeline
Completed

Started Mar 2014

Typical duration for phase_2

Geographic Reach
1 country

36 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

Study Start

First participant enrolled

March 1, 2014

Completed
10 days until next milestone

First Submitted

Initial submission to the registry

March 11, 2014

Completed
9 days until next milestone

First Posted

Study publicly available on registry

March 20, 2014

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2017

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2017

Completed
11 months until next milestone

Results Posted

Study results publicly available

April 19, 2018

Completed
Last Updated

September 5, 2018

Status Verified

August 1, 2018

Enrollment Period

2.8 years

First QC Date

March 11, 2014

Results QC Date

March 23, 2018

Last Update Submit

August 6, 2018

Conditions

Keywords

Type 1 Diabetes MellitusAlpha1-Proteinase InhibitorBeta CellAlpha1-Antitrypsin

Outcome Measures

Primary Outcomes (1)

  • Change From Baseline in Mixed Meal Tolerance Test (MMTMT) Stimulated C-peptide 2 Hour Area Under the Concentration-time Curve (AUC)

    C-peptide concentration during MMTT with high protein energy drink. "Dose" for time frame refers to intake of high protein energy drink.

    Baseline, Week 52 (pre-high protein drink and 15, 30, 60, 90, 120 minutes post-drink)

Secondary Outcomes (5)

  • Change From Baseline for MMTT Stimulated C-peptide 2h AUC

    Baseline, Weeks 14, 27, 39, 69, 87, and 104 (pre-high protein drink and 15, 30, 60, 90, 120 minutes post-drink)

  • Change From Baseline for HbA1c Levels

    Baseline, Weeks 14, 27, 39, 52, 69, 87, and 104

  • Number of Subjects With Overall Severe Hypoglycemic Episodes

    104 weeks

  • Change From Baseline for Mean Daily Insulin Dose Requirements

    Baseline, Weeks 2, 4, 14, 27, 39, 52, 69, 87, and 104

  • Change From Baseline for Mean Daily Glucose Levels Prior to Meals and Bedtime

    Baseline, Weeks 2, 4, 14, 27, 39, 52, 69, 87, and 104

Study Arms (6)

Alpha1-PI 180 mg/kg/wk, 26 weeks

EXPERIMENTAL

180 mg/kg weekly infusions of Alpha1-PI for 26 weeks.

Biological: 180 mg/kg Alpha1-PI

90 mg/kg/wk Alpha1-PI, 26 weeks

EXPERIMENTAL

90 mg/kg weekly infusions of Alpha1-PI for 26 weeks.

Biological: 90 mg/kg Alpha1-PI

Placebo, 26 weeks

PLACEBO COMPARATOR

Weekly infusions of placebo for 26 weeks.

Biological: Placebo

180 mg/kg/wk Alpha1-PI, 13 weeks

EXPERIMENTAL

180 mg/kg weekly infusions of Alpha1-PI for 13 weeks.

Biological: 180 mg/kg Alpha1-PI

90 mg/kg/wk Alpha1-PI, 13 weeks

EXPERIMENTAL

90 mg/kg weekly infusions of Alpha1-PI for 13 weeks

Biological: 90 mg/kg Alpha1-PI

Placebo, 13 weeks

PLACEBO COMPARATOR

Weekly infusions of placebo for 13 weeks.

Biological: Placebo

Interventions

Also known as: Alpha1-antitrypsin, Prolastin-C, Alpha1-Proteinase Inhibitor (human), Modified Process, Alpha-1 MP
180 mg/kg/wk Alpha1-PI, 13 weeksAlpha1-PI 180 mg/kg/wk, 26 weeks
Also known as: Alpha1-antitrypsin, Prolastin-C, Alpha1-Proteinase Inhibitor (human), Modified Process, Alpha-1 MP
90 mg/kg/wk Alpha1-PI, 13 weeks90 mg/kg/wk Alpha1-PI, 26 weeks
PlaceboBIOLOGICAL
Placebo, 13 weeksPlacebo, 26 weeks

Eligibility Criteria

Age6 Years - 35 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Diagnosis of T1DM according to the ADA criteria.
  • Current use of injected insulin therapy and one positive result on testing for any of the following antibodies (If not currently on insulin therapy, must have positive result for at least two of the below antibodies):
  • Anti-islet-cell antibodies (islet cell antigen 512, insulinoma associated protein 2),
  • Anti-glutamic acid decarboxylase antibodies, or
  • Anti-insulin antibodies (unless received insulin therapy for \> 7 days).
  • Body Mass Index (BMI) ≤ 28 kg/m2 for adults (≥ 20 years of age) OR ≤ 90th percentile in accordance with the Centers for Disease Control BMI assessment for children and teens (2 through 19 years old).

You may not qualify if:

  • History of or current diabetic retinopathy, neuropathy, or nephropathy.
  • Known thrombophilia or history of thrombosis.
  • Malignant disease (including malignant melanoma; however, other forms of skin cancer are allowed) within five years of randomization.
  • Active Hepatitis A virus, Hepatitis B virus, Hepatitis C virus, or Human Immunodeficiency Virus infection.
  • History of anaphylaxis or severe systemic response to any plasma-derived alpha1-PI preparation or other blood product(s).
  • Known selective or severe Immunoglobulin A deficiency.
  • Elevated liver enzymes (aspartate transaminase, alanine aminotransferase, and alkaline phosphatase) equal to or greater than 2.5 times the upper limit of normal.
  • Therapy with exenatide or any other agents that stimulate pancreatic β cell regeneration or insulin secretion, or any antidiabetic agents (oral or parenteral) other than insulin within one month prior to screening.
  • Use of omega-3 fatty acid supplements, including fish oil, within seven days prior to screening.
  • Current or planned therapy with inhaled insulin, if it becomes available.
  • Chronic use of systemic steroids, with the exception of inhaled steroids, above a stable dose equivalent to 5 mg/day prednisone (e.g., 10 mg every 2 days) within 4 weeks prior to randomization. It is recommended to maintain the same dose throughout the study. (Note: Subjects with autoimmune conditions (i.e., asthma) necessitating treatment with systemic short-term corticosteroids and administered a rapid taper are eligible per protocol with the caveat that the tapering is complete or decreased to the minimum requirement (i.e., 5 mg/day) at least 1 week prior to the Baseline visit (when randomization occurs) to ensure the subject is stable. For longer term steroid usage, please consult the Grifols Medical Monitor before considering the subject for study participation.)
  • Treatment with immunosuppressants or cytostatic agents within 6 months of randomization.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (36)

University of Arizona

Tucson, Arizona, 85724, United States

Location

Clinica Medica San Miguel

Los Angeles, California, 90015, United States

Location

Diabetes Associates Medical Group

Orange, California, 92868, United States

Location

Rady Children's Hospital San Diego

San Diego, California, 92123, United States

Location

Metabolic Institute of America

Tarzana, California, 91356, United States

Location

Ronald H Chochinov MD

Ventura, California, 93003, United States

Location

Yale New Haven Hospital

New Haven, Connecticut, 06511, United States

Location

Christiana Care Health Services

Newark, Delaware, 19713, United States

Location

Solutions Through Advanced Research Inc.

Jacksonville, Florida, 32258, United States

Location

CCM Clinical Research

Miami, Florida, 33133, United States

Location

Advanced Pharma CR LLC

Miami, Florida, 33136, United States

Location

Atlanta Diabetes Associates

Atlanta, Georgia, 30309, United States

Location

Rocky Mountain Diabetes and Osteoporosis Center

Idaho Falls, Idaho, 83404, United States

Location

Cook County Hospital

Chicago, Illinois, 60612, United States

Location

Methodist Research Institute

Indianapolis, Indiana, 46202, United States

Location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

Location

University of Louisville

Louisville, Kentucky, 40202, United States

Location

Barry J. Reiner MD, LLC.

Baltimore, Maryland, 21229, United States

Location

UMass Memorial Medical Center

Worcester, Massachusetts, 01655, United States

Location

Wayne State University

Detroit, Michigan, 48201, United States

Location

Children's Hospitals and Clinics of Minnesota

Saint Paul, Minnesota, 55102, United States

Location

Morristown Medical Center

Morristown, New Jersey, 07962, United States

Location

University of New Mexico, Health Sciences Center

Albuquerque, New Mexico, 87131-0001, United States

Location

Women and Children's Hospital

Buffalo, New York, 14222, United States

Location

WakeMed Children's Hospital

Raleigh, North Carolina, 27610, United States

Location

Endocrinology Associates Inc

Columbus, Ohio, 43201, United States

Location

Ohio State University

Columbus, Ohio, 43210, United States

Location

Pediatric Endocrinology, Genetics & Metabolism

Oklahoma City, Oklahoma, 73112, United States

Location

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19106, United States

Location

Children's Hospital of Pittsburgh

Pittsburgh, Pennsylvania, 15224, United States

Location

Rapid City Regional Hospital/Health Clinical Research

Rapid City, South Dakota, 57701, United States

Location

Research Institute of Dallas

Dallas, Texas, 75231, United States

Location

University of Texas Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

Northeast Clinical Research of San Antonio LLC

San Antonio, Texas, 78154, United States

Location

University of Texas Health Science Center

San Antonio, Texas, 78229, United States

Location

Consano Clinical Research

San Antonio, Texas, 78232, United States

Location

Related Publications (1)

  • Lagarde WH, Courtney KL, Reiner B, Steinmann K, Tsalikian E, Willi SM. Human plasma-derived alpha1 -proteinase inhibitor in patients with new-onset type 1 diabetes mellitus: A randomized, placebo-controlled proof-of-concept study. Pediatr Diabetes. 2021 Mar;22(2):192-201. doi: 10.1111/pedi.13162. Epub 2020 Dec 13.

MeSH Terms

Conditions

Diabetes Mellitus, Type 1alpha 1-Antitrypsin Deficiency

Interventions

alpha 1-AntitrypsinMp alpha1 receptor

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose 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

Results Point of Contact

Title
Kimberly Steinmann, MD
Organization
Grifols Therapeutics LLC

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 11, 2014

First Posted

March 20, 2014

Study Start

March 1, 2014

Primary Completion

January 1, 2017

Study Completion

June 1, 2017

Last Updated

September 5, 2018

Results First Posted

April 19, 2018

Record last verified: 2018-08

Locations