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TArgeting Type 1 Diabetes Using POLyamines (TADPOL) (TADPOL)

Primary Purpose

Type 1 Diabetes

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
DFMO
Placebo
Sponsored by
Emily K. Sims
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes

Eligibility Criteria

6 Years - 40 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males and females 6- ≥40 years of age with a clinical diagnosis of T1D
  2. T1D clinical diagnosis with insulin start date no more than 100 days prior to the time of randomization
  3. Random non-fasting C-peptide level of >0.2 pmol/mL (equivalent to >0.6ng/ml) at screening.
  4. Positive for any one of the following diabetes-related autoantibodies (IAA, GAA, IA-2, or ZnT8)
  5. Treatment naïve of any immunomodulatory agent
  6. Normal hearing at screening, defined as acceptable results of pure-tone audiometry (<20 decibel [dB] baseline thresholds for frequencies 250, 500, 1000, and 2000 Hz

Exclusion Criteria:

  1. Presence of severe, active disease that interferes with dietary intake or requires the use of chronic medication, with the exception of well-controlled hypothyroidism and mild asthma not requiring oral steroids. Presence of any psychiatric disorder that will affect ability to participate in study.
  2. Diabetes other than T1D
  3. Chronic illness known to affect glucose metabolism (e.g. Cushing syndrome, polycystic ovarian disorder, cystic fibrosis) or taking medications that affect glucose metabolism (e.g. steroids, metformin)
  4. Inability to swallow pills
  5. Psychiatric impairment or current use of anti-psychotic medication
  6. Any condition that, in the investigator's opinion, may compromise study participation or may confound the interpretation of the study results.
  7. Hematologic abnormalities at screening (anemia, leukopenia (particularly neutropenia), or thrombocytopenia)
  8. Impaired renal function (assessed by history and BUN/Creatinine, DFMO is renally excreted)
  9. Allergy to milk or soy (components of Boost® drink used for mixed meal tolerance testing)
  10. Female participants of child-bearing age with reproductive potential, must not be pregnant and agree to use 2 effective forms of birth control or be abstinent during the study period (see below)
  11. Active seizure disorder, defined as requiring chronic medication at the time of study or having had a seizure within the past 12 months at the time of screening

Sites / Locations

  • Barbara Davis CenterRecruiting
  • University of Chicago
  • IU Health Riley Hospital for ChildrenRecruiting
  • Children's Mercy Hospital
  • University of MichiganRecruiting
  • Medical College of Wisconsin

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Treatment Arm

Placebo Arm

Arm Description

Difluoromethylornithine (DFMO) pill ,1000mg/m2/day, for 6 months

Placebo pill taken twice a day orally for 6 months

Outcomes

Primary Outcome Measures

Clinical efficacy of 1000 mg/m2/day of oral DFMO after 6 months of treatment
Primary endpoint defining clinical efficacy will be based on mixed-meal stimulated C-peptide area under the curve (AUC; in arbitrary units) in the treatment group compared to placebo after 6 months of DFMO treatment
Number of participants with treatment-related adverse events as assessed by CTCAE v5
A summary of serious and non-serious adverse events (AEs) will be reported.

Secondary Outcome Measures

Clinical efficacy of 1000 mg/m2/day of oral DFMO after 3 months of treatment, 9 months after treatment (or 3 months after treatment end), and 12 months after treatment (or 6 months after treatment end).
Secondary endpoints will be based on mixed meal stimulated C-peptide AUC (arbitrary units) at 3 months after treatment, 9 months after treatment, and 12 months after treatment.
Decrease in urinary polyamides after 6 months of DFMO treatment.
Decrease in urinary putrescine (in umol/g Cr) from baseline after 6 months of DFMO treatment, measured using high performance liquid chromatography.
Biomarkers of β cell stress at 3, 6, 9, and 12 months after treatment.
Fasting and stimulated proinsulin/c-peptide ratios (%) will be measured using immunoassays and reported at baseline, 3 months after treatment, 6 months after treatment, 9 months after treatment, and 12 months after treatment.

Full Information

First Posted
October 12, 2022
Last Updated
August 31, 2023
Sponsor
Emily K. Sims
Collaborators
Juvenile Diabetes Research Foundation, Cancer Prevention Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05594563
Brief Title
TArgeting Type 1 Diabetes Using POLyamines (TADPOL)
Acronym
TADPOL
Official Title
TArgeting Type 1 Diabetes Using POLyamines (TADPOL): A Randomized, Double-Masked, Placebo-Controlled Phase 2 Study to Evaluate the Efficacy and Safety of Difluoromethylornithine (DFMO) to Preserve Insulin Production in Type 1 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 14, 2023 (Actual)
Primary Completion Date
December 2027 (Anticipated)
Study Completion Date
December 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Emily K. Sims
Collaborators
Juvenile Diabetes Research Foundation, Cancer Prevention Pharmaceuticals, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of this clinical trial is to test a drug known as DFMO in people with Type 1 Diabetes (T1D). The main question[s] it aims to answer are: Does it reduce stress on the cells that make insulin? Does it preserve what is left of the body's insulin production? Participants will take either DFMO or a placebo (looks like DFMO but has no active ingredients) two times a day for about 6 months. Participants will have 6 in person visits and 1 phone visit over a period of 12 months. Visits will include blood draws urine collection and other tests.
Detailed Description
This study will be a multicenter, double-blind, placebo-controlled, 2:1 random assigned, phase II clinical trial for individuals with recent onset type 1 diabetes. The investigators are conducting a double masked placebo-controlled intention to treat study enrolling persons with new onset T1D with documented continued residual C-peptide production. Within 45 days of screening and a run-in period during which eligibility will be determined and glycemic control optimized, subjects will have a 6-month double-masked treatment period with either DFMO or placebo. After a 6-month wash-out period the durability of effect will be assessed. Subjects will be randomly assigned either 1000mg/m2/day oral DFMO or placebo treatment at a 2:1 ratio.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subject are randomized to either treatment or placebo arm.
Masking
ParticipantCare ProviderInvestigator
Masking Description
Participant, Care provider and Investigator blinded
Allocation
Randomized
Enrollment
70 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm
Arm Type
Active Comparator
Arm Description
Difluoromethylornithine (DFMO) pill ,1000mg/m2/day, for 6 months
Arm Title
Placebo Arm
Arm Type
Placebo Comparator
Arm Description
Placebo pill taken twice a day orally for 6 months
Intervention Type
Drug
Intervention Name(s)
DFMO
Other Intervention Name(s)
Difluoromethylornithine
Intervention Description
DFMO orally twice a day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo orally twice a day
Primary Outcome Measure Information:
Title
Clinical efficacy of 1000 mg/m2/day of oral DFMO after 6 months of treatment
Description
Primary endpoint defining clinical efficacy will be based on mixed-meal stimulated C-peptide area under the curve (AUC; in arbitrary units) in the treatment group compared to placebo after 6 months of DFMO treatment
Time Frame
6 month
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v5
Description
A summary of serious and non-serious adverse events (AEs) will be reported.
Time Frame
through study completion, an average of one year
Secondary Outcome Measure Information:
Title
Clinical efficacy of 1000 mg/m2/day of oral DFMO after 3 months of treatment, 9 months after treatment (or 3 months after treatment end), and 12 months after treatment (or 6 months after treatment end).
Description
Secondary endpoints will be based on mixed meal stimulated C-peptide AUC (arbitrary units) at 3 months after treatment, 9 months after treatment, and 12 months after treatment.
Time Frame
through study completion, an average of one year
Title
Decrease in urinary polyamides after 6 months of DFMO treatment.
Description
Decrease in urinary putrescine (in umol/g Cr) from baseline after 6 months of DFMO treatment, measured using high performance liquid chromatography.
Time Frame
up to 24 weeks after treatment
Title
Biomarkers of β cell stress at 3, 6, 9, and 12 months after treatment.
Description
Fasting and stimulated proinsulin/c-peptide ratios (%) will be measured using immunoassays and reported at baseline, 3 months after treatment, 6 months after treatment, 9 months after treatment, and 12 months after treatment.
Time Frame
through study completion, an average of one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females 6- ≥40 years of age with a clinical diagnosis of T1D T1D clinical diagnosis with insulin start date no more than 100 days prior to the time of randomization Random non-fasting C-peptide level of >0.2 pmol/mL (equivalent to >0.6ng/ml) at screening. Positive for any one of the following diabetes-related autoantibodies (IAA, GAA, IA-2, or ZnT8) Treatment naïve of any immunomodulatory agent Normal hearing at screening, defined as acceptable results of pure-tone audiometry (<20 decibel [dB] baseline thresholds for frequencies 250, 500, 1000, and 2000 Hz Exclusion Criteria: Presence of severe, active disease that interferes with dietary intake or requires the use of chronic medication, with the exception of well-controlled hypothyroidism and mild asthma not requiring oral steroids. Presence of any psychiatric disorder that will affect ability to participate in study. Diabetes other than T1D Chronic illness known to affect glucose metabolism (e.g. Cushing syndrome, polycystic ovarian disorder, cystic fibrosis) or taking medications that affect glucose metabolism (e.g. steroids, metformin) Inability to swallow pills Psychiatric impairment or current use of anti-psychotic medication Any condition that, in the investigator's opinion, may compromise study participation or may confound the interpretation of the study results. Hematologic abnormalities at screening (anemia, leukopenia (particularly neutropenia), or thrombocytopenia) Impaired renal function (assessed by history and BUN/Creatinine, DFMO is renally excreted) Allergy to milk or soy (components of Boost® drink used for mixed meal tolerance testing) Female participants of child-bearing age with reproductive potential, must not be pregnant and agree to use 2 effective forms of birth control or be abstinent during the study period (see below) Active seizure disorder, defined as requiring chronic medication at the time of study or having had a seizure within the past 12 months at the time of screening
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Maria L Spall, BSN
Phone
317-278-7034
Email
malnicho@iu.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Operations Manager
Phone
317-278-8879
Email
tadpol@iu.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Emily K Sims, MD,MS
Organizational Affiliation
Indiana University School of Medicine
Official's Role
Study Chair
Facility Information:
Facility Name
Barbara Davis Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lexie Chesshir, RN
Phone
303-724-1755
Email
lexie.chesshir@cuanschutz.edu
First Name & Middle Initial & Last Name & Degree
Kimber Simmons, MD
Facility Name
University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Triniece Pearson, PhD,RN
Phone
773-359-7556
Email
tpearson1@medicine.bsd.uchicago.edu
First Name & Middle Initial & Last Name & Degree
Siri Greeley, MD
Facility Name
IU Health Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ellie M Ryan
Phone
317-278-7037
Email
elmryan@iu.edu
First Name & Middle Initial & Last Name & Degree
T1D Research
Phone
317-278-8879
Email
tadpol@iu.edu
First Name & Middle Initial & Last Name & Degree
Emily K Sims, MD, MS
First Name & Middle Initial & Last Name & Degree
Linda A DiMeglio, MD, MPH
Facility Name
Children's Mercy Hospital
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
64108
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heather Harding, RN
First Name & Middle Initial & Last Name & Degree
Mark Clements, MD, PhD
Facility Name
University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sheree Nicholson
Phone
734-232-4213
Email
nsheree@med.umich.edu
First Name & Middle Initial & Last Name & Degree
Inas Thomas, MD
Facility Name
Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joanne Kramer, BS
Phone
414-955-8486
Email
jkramer@mcw.edu
First Name & Middle Initial & Last Name & Degree
Susanne Cabrera, MD

12. IPD Sharing Statement

Plan to Share IPD
No
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TArgeting Type 1 Diabetes Using POLyamines (TADPOL)

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