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Initial Clinical Evaluation of an Endoscopic Therapy for Type 2 Diabetes

Primary Purpose

Type II Diabetes

Status
Completed
Phase
Not Applicable
Locations
Chile
Study Type
Interventional
Intervention
Fractyl Duodenal Remodeling System
Sponsored by
Fractyl Laboratories, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type II Diabetes

Eligibility Criteria

28 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Participants Age > 28 years and ≤ 75 years
  2. Male or Female
  3. Participants with Type 2 Diabetes who are treated for ≤ 10 years and are on stable oral diabetic medications for a minimum of 3 months
  4. Participants with an HbA1c > 7.5 and ≤ 10.0%
  5. Participants with a BMI > 24 and < 40
  6. Participants willing to comply with study requirements and able to understand and comply with informed consent
  7. Participants who have signed an informed consent form

Exclusion Criteria:

  1. Participants diagnosed with Type I Diabetes or with a history of ketoacidosis
  2. Participants using insulin for more than 12 months
  3. Participants with probable insulin production failure (defined as fasting C Peptide serum <1ng/mL)
  4. Participants that have known autoimmune disease as evidenced by a positive anti glutamic acid decarboxylase (GAD) blood test
  5. Participants requiring prescription anticoagulation therapy and/or dual anti-platelet therapy including aspirin who cannot discontinue their medication for 14 days before and 14 days after the procedure
  6. Participants with iron deficiency anemia - either currently or in their history
  7. Participants with current symptomatic hypocalcemia or vitamin D deficiency (routine calcium and/or vitamin D supplementation would not be excluded)
  8. Participants with or a history of abnormalities of the GI tract preventing endoscopic access to the duodenum,
  9. Participants with symptomatic gallstones or kidney stones at the time of screening
  10. Participants with a history of pancreatitis
  11. Participants with an active systemic infection
  12. Participants with or a history of coagulopathy, upper gastro-intestinal bleeding c conditions such as ulcers, gastric varices, strictures, congenital or acquired intestinal telangiectasia
  13. Participants with celiac disease
  14. Participants with active malignancy. Those who have had remedial treatment and/or are cancer free for 5 years can be enrolled
  15. Participants with known active hepatitis or active liver disease
  16. Participants emotionally unstable or who exhibit psychological characteristics which, in the opinion of the Investigator, make the participant a poor candidate for clinical trial participation
  17. Participants with previous GI surgery that could affect the ability to treat the duodenum such as participants who have had a Bilroth 2, Roux-en-Y gastric bypass, or other similar procedures or conditions
  18. Participants unable to discontinue NSAIDs (non-steroidal anti-inflammatory drugs) during treatment through 2 weeks post procedure phase
  19. Participants receiving weight loss medications such as Meridia, Xenical, or over the counter weight loss medications
  20. Participant with a known diagnosis or pre-existing symptoms of systemic lupus erythematosus, scleroderma or other autoimmune connective tissue disorder
  21. Participants with active and uncontrolled gastroesophageal reflux disease (GERD) defined as grade II esophagitis or greater
  22. Participants with active illicit substance abuse or alcoholism
  23. Participants participating in another ongoing investigational clinical trial
  24. Participants taking corticosteroids or drugs known to affect GI motility (i.e. Reglan)
  25. Participants who are not potential candidates for duodenal exclusion surgery or general anesthesia

Sites / Locations

  • INDISA

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Duodenal Treatment

Arm Description

The Duodenal Remodeling procedure utilizes both a trans-oral over the wire and endoscopic approach to minimally invasively ablating and remodeling the duodenum.

Outcomes

Primary Outcome Measures

Changed in Mixed Meal Tolerance From Baseline to 3 Months
Improvement in fasting plasma glucose based on Mixed Meal Tolerance Test between baseline and 3 months

Secondary Outcome Measures

Full Information

First Posted
August 20, 2013
Last Updated
March 10, 2020
Sponsor
Fractyl Laboratories, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01927562
Brief Title
Initial Clinical Evaluation of an Endoscopic Therapy for Type 2 Diabetes
Official Title
Evaluation of the Fractyl Duodenal Remodeling System for the Treatment of Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
July 13, 2013 (Actual)
Primary Completion Date
April 7, 2017 (Actual)
Study Completion Date
March 16, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fractyl Laboratories, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and feasibility of the Fractyl Duodenal Remodeling System for the treatment of patients with poorly controlled Type 2 Diabetes.
Detailed Description
The purpose of this protocol is to evaluate the initial safety profile of the Fractyl System and its effect on participants with Type 2 Diabetes. This will be determined through the monitoring of adverse events and outcome measures including Mixed Meal Tolerance Test (MMTT).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type II Diabetes

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
57 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Duodenal Treatment
Arm Type
Experimental
Arm Description
The Duodenal Remodeling procedure utilizes both a trans-oral over the wire and endoscopic approach to minimally invasively ablating and remodeling the duodenum.
Intervention Type
Device
Intervention Name(s)
Fractyl Duodenal Remodeling System
Primary Outcome Measure Information:
Title
Changed in Mixed Meal Tolerance From Baseline to 3 Months
Description
Improvement in fasting plasma glucose based on Mixed Meal Tolerance Test between baseline and 3 months
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
28 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants Age > 28 years and ≤ 75 years Male or Female Participants with Type 2 Diabetes who are treated for ≤ 10 years and are on stable oral diabetic medications for a minimum of 3 months Participants with an HbA1c > 7.5 and ≤ 10.0% Participants with a BMI > 24 and < 40 Participants willing to comply with study requirements and able to understand and comply with informed consent Participants who have signed an informed consent form Exclusion Criteria: Participants diagnosed with Type I Diabetes or with a history of ketoacidosis Participants using insulin for more than 12 months Participants with probable insulin production failure (defined as fasting C Peptide serum <1ng/mL) Participants that have known autoimmune disease as evidenced by a positive anti glutamic acid decarboxylase (GAD) blood test Participants requiring prescription anticoagulation therapy and/or dual anti-platelet therapy including aspirin who cannot discontinue their medication for 14 days before and 14 days after the procedure Participants with iron deficiency anemia - either currently or in their history Participants with current symptomatic hypocalcemia or vitamin D deficiency (routine calcium and/or vitamin D supplementation would not be excluded) Participants with or a history of abnormalities of the GI tract preventing endoscopic access to the duodenum, Participants with symptomatic gallstones or kidney stones at the time of screening Participants with a history of pancreatitis Participants with an active systemic infection Participants with or a history of coagulopathy, upper gastro-intestinal bleeding c conditions such as ulcers, gastric varices, strictures, congenital or acquired intestinal telangiectasia Participants with celiac disease Participants with active malignancy. Those who have had remedial treatment and/or are cancer free for 5 years can be enrolled Participants with known active hepatitis or active liver disease Participants emotionally unstable or who exhibit psychological characteristics which, in the opinion of the Investigator, make the participant a poor candidate for clinical trial participation Participants with previous GI surgery that could affect the ability to treat the duodenum such as participants who have had a Bilroth 2, Roux-en-Y gastric bypass, or other similar procedures or conditions Participants unable to discontinue NSAIDs (non-steroidal anti-inflammatory drugs) during treatment through 2 weeks post procedure phase Participants receiving weight loss medications such as Meridia, Xenical, or over the counter weight loss medications Participant with a known diagnosis or pre-existing symptoms of systemic lupus erythematosus, scleroderma or other autoimmune connective tissue disorder Participants with active and uncontrolled gastroesophageal reflux disease (GERD) defined as grade II esophagitis or greater Participants with active illicit substance abuse or alcoholism Participants participating in another ongoing investigational clinical trial Participants taking corticosteroids or drugs known to affect GI motility (i.e. Reglan) Participants who are not potential candidates for duodenal exclusion surgery or general anesthesia
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Leonard R Gomez, MD
Organizational Affiliation
Centro Clinico De La Obesidad
Official's Role
Principal Investigator
Facility Information:
Facility Name
INDISA
City
Santiago
Country
Chile

12. IPD Sharing Statement

Citations:
PubMed Identifier
27519448
Citation
Rajagopalan H, Cherrington AD, Thompson CC, Kaplan LM, Rubino F, Mingrone G, Becerra P, Rodriguez P, Vignolo P, Caplan J, Rodriguez L, Galvao Neto MP. Endoscopic Duodenal Mucosal Resurfacing for the Treatment of Type 2 Diabetes: 6-Month Interim Analysis From the First-in-Human Proof-of-Concept Study. Diabetes Care. 2016 Dec;39(12):2254-2261. doi: 10.2337/dc16-0383. Epub 2016 Aug 12.
Results Reference
derived

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Initial Clinical Evaluation of an Endoscopic Therapy for Type 2 Diabetes

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