Clinical trial • Phase IV • Endocrinology

ANTI-T LYMPHOCYTE IMMUNOGLOBULIN FOR HUMAN USE, RABBIT for Type 1 diabetes mellitus

Phase IV trial of ANTI-T LYMPHOCYTE IMMUNOGLOBULIN FOR HUMAN USE, RABBIT for Type 1 diabetes mellitus.

Overview

Trial Therapeutic Area
Endocrinology
Trial Disease
Type 1 diabetes mellitus
Trial Stage
Phase IV
Drug Modality
Other antibody
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
28-09-2023
First CTIS Authorization Date
11-01-2024

Trial design

Randomised, grafalon (anti-t lymphocyte immunoglobulin, rabbit) at two dosages (two atlg dosage arms described in trial objective; specific dose levels not specified in the ctis record) versus placebo (physiological saline/placebo).-controlled Phase IV trial across 2 sites in Czechia.

Randomised
Yes
Comparator
Grafalon (anti-T lymphocyte immunoglobulin, rabbit) at two dosages (two ATLG dosage arms described in trial objective; specific dose levels not specified in the CTIS record) versus placebo (physiological saline/placebo).
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
80
Trial Duration For Participant
730

Eligibility

Recruits 80 paediatric patients.

Pregnancy Exclusion
Female patients who are pregnant, lactating, or who want to get pregnant during the study period.
Vulnerable Population
Children and young adults are included. Age-specific participant information and consent/assent documents are provided (e.g. 'PIC_Children_12-14_CZ', 'PIC_Adolescents_15-17_CZ', 'PIC_Adults_CZ', 'PIC_Parents_CZ') and parent consent forms/GDPR consent forms exist (e.g. 'GDPR Consent Form_Parent_CZ', 'GDPR Consent Form_Adult_Adolescent_CZ'). 'isVulnerablePopulationSelected' is false in the CTIS record.

Inclusion criteria

  • {"criterion_text":"- from the beginning of Screening to Visit 14."}

Exclusion criteria

  • {"criterion_text":"- 1.\tHistory of recurrent (e.g., several times a year) of severe (e.g., pneumonia) or chronic infections or conditions predisposing to chronic infections"}
  • {"criterion_text":"- 2.\tHistory of severe systemic fungal infection within the past 12 months prior to screening unless treated and resolved with appropriate documented therapy"}
  • {"criterion_text":"- 3.\tVaccination within 4 weeks before randomization"}
  • {"criterion_text":"- 4.\tPositive Viral PCR for EBV, CMV, COVID"}
  • {"criterion_text":"- 5.\tPatients with HIV or HTLV I/II infection or HepB/C"}
  • {"criterion_text":"- 6.\tReceipt of any other concomitant medications or herbal products that can influence the immune system within 90 days prior to screening"}
  • {"criterion_text":"- 7.\tHistory of pancreatitis (acute or chronic)"}
  • {"criterion_text":"- 8.\tAny past or current diagnosis of malignant neoplasms"}
  • {"criterion_text":"- 9.\tKnown impairment of the immune system, except for T1D, coeliac disease, alopecia, autoimmune antibodies not considered clinical important (e.g. thyroid antibodies without any clinically important thyroid disease or well-balanced Hashimoto’s disease), and vitiligo"}
  • {"criterion_text":"- 10.\tPatients with a psychiatric condition (e.g., severe anxiety, psychosis) that would interfere with the study as determined by the primary investigator. Stable psychiatric conditions such as chronic anxiety or depression will be allowed."}
  • {"criterion_text":"- 11.\tPatients with known allergy to one or more of the study drug components or rabbit proteins."}
  • {"criterion_text":"- 12.\tFemale patients who are pregnant, lactating, or who want to get pregnant during the study period."}
  • {"criterion_text":"- 13.\tPatients with a history of alcohol or any psychoactive substance abuse or dependence (including alcohol but excluding nicotine and caffeine)."}
  • {"criterion_text":"- 14.\tPatients with any other significant chronic disease, according to the investigator discretion, exclude rare forms of diabetes (MODY) according to history and clinical judgement."}
  • {"criterion_text":"- 15.\tObesity (BMI more than 35 kg/m2)"}
  • {"criterion_text":"- 16.\tOther forms of diabetes"}
  • {"criterion_text":"- 17.\tPatients unable or unwilling to comply with the protocol"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- AUC0-2h for a mixed meal tolerance test (MMTT) stimulated C-peptide concentration-time curve (C-peptideAUC) at 12 months relative to baseline","definition_or_measurement_approach":"Measured as AUC0-2h of the MMTT-stimulated C‑peptide concentration-time curve at 12 months compared to baseline (mixed meal tolerance test)."}

Secondary endpoints

  • {"endpoint_text":"- Peak MMTT stimulated C-peptide concentration (C-peptidemax) at months 6, 12 and 24 relative to baseline Change in fasting C-peptide from baseline to months 6 and 12 Change in HbA1c from baseline to month 12 HbA1c at 12 and 24 months Change in fasting plasma glucose from baseline to month 12 Total insulin treatment administered over the period of 12 months calculated as AUC (insulinAUC). Total daily insulin dose per kg at 1, 3, 6 and 12 months Percentage of patients that maintain stimulated pea","definition_or_measurement_approach":"Includes peak MMTT-stimulated C-peptide (C-peptidemax) at months 6, 12, 24; changes in fasting C-peptide at months 6 and 12; change in HbA1c at month 12 and HbA1c at 12 and 24 months; change in fasting plasma glucose at month 12; total insulin administered over 12 months calculated as insulin AUC; total daily insulin dose per kg at 1, 3, 6, 12 months; percentage of patients maintaining stimulated ... (text truncated in source). Measurements based on MMTT, laboratory assays and routine clinical measures."}

Recruitment

Planned Sample Size
80
Recruitment Window Months
48
Consent Approach
Informed consent uses age-specific documents: GDPR Consent Form_Adult_Adolescent_CZ and GDPR Consent Form_Parent_CZ; Participant Information/Consent (PIC) documents for Adults, Adolescents (15-17), Children (12-14) and Parents are available (documents named in CTIS). Documents are in Czech (CZ). Parent consent and child/adolescent assent processes are provided via the PIC and GDPR consent form documents.

Geography

Total Number Of Sites
2
Total Number Of Participants
80

Czechia

Earliest CTIS Part Ii Submission Date
05-10-2023
Latest Decision Or Authorization Date
06-05-2026
Processing Time Days
944
Number Of Sites
2
Number Of Participants
18

Sites

Site Name
Institute For Clinical And Experimental Medicine
Department Name
IKEM
Principal Investigator Name
Frantisek Saudek
Principal Investigator Email
frsa@ikem.cz
Contact Person Name
Frantisek Saudek
Contact Person Email
frsa@ikem.cz
Site Name
Fakultní Nemocnice Královské Vinohrady
Department Name
FKNV
Principal Investigator Name
Jan Vosahlo
Principal Investigator Email
jan.vosahlo@fnkv.cz
Contact Person Name
Jan Vosahlo
Contact Person Email
jan.vosahlo@fnkv.cz

Sponsor

Primary sponsor

Full Name
Institute For Clinical And Experimental Medicine
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Czechia

Third parties

  • {"country":"Czechia","full_name":"Institute of Clinical and Experimental Medicine (IKEM), Prague, CZ","duties_or_roles":"Source of monetary support / funding","organisation_type":"Hospital/Clinic/Other health care facility"}
  • {"country":"Czechia","full_name":"University Hospital of Kralovske Vinohrady (FNKV)","duties_or_roles":"Source of monetary support / funding","organisation_type":"Educational Institution / Hospital"}

Co-sponsors

  • University Hospital Kralovske Vinohrady

Investigational products

Investigational Product Name
Grafalon 20 mg/ml koncentrát pro infuzní roztok
Active Substance
ANTI-T LYMPHOCYTE IMMUNOGLOBULIN FOR HUMAN USE, RABBIT
Modality
Other antibody
Routes Of Administration
INFUSION
Route
INFUSION
Authorisation Status
Authorised in Czechia (marketing authorisation number 59/256/97-C)
Maximum Dose
max daily 4 mg; max total 12 mg

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