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Allogeneic Transplantation of Expanded Pancreatic Islet Cells

Primary Purpose

Brittle Type 1 Diabetes

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
YD02-2022
Sponsored by
Shanghai Jiao Tong University School of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brittle Type 1 Diabetes

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Voluntarily sign an informed consent form and agree to comply with the trial treatment plan and visit schedule. Age ≥18 years and ≤60 years on the day of signing the informed consent form, regardless of gender. Body mass index (BMI) ≥18.0 kg/m2 and ≤35.0 kg/m2. Diagnosed with T1DM based on the World Health Organization's diabetes classification (2019). HbA1c ≥7.0% and ≤15.0% at screening. Dependence on insulin injection therapy for ≥5 years, receiving a stable insulin treatment plan for ≥3 months, and injecting insulin three or more times per day or using an insulin pump. Postprandial mixed meal stimulated C-peptide level <0.3 ng/mL. Experienced impaired awareness of hypoglycemia or significant glycemic instability during screening and in the past 6 months. Hypoglycemic episodes are associated with impaired awareness of hypoglycemia, extreme glycemic instability, or severe fear and maladaptive behavior. Sexually active males who are not surgically sterilized or have partners of childbearing potential agree to use effective contraception during the entire trial period and for at least 6 months after the study ends; sexually active females of childbearing potential agree to use effective contraception during the entire study period and for at least 6 months after the study ends. Exclusion Criteria: Types of diabetes other than T1DM. Body mass index (BMI) >35 kg/m2 or weight <50 kg. Excessive insulin sensitivity and/or insulin resistance (insulin requirement >1.0 IU/kg/day or <15 U/day). Previous pancreatic or islet transplantation. Severe trauma, severe infection, or surgery that may affect glycemic control within one month before screening. History of hypertension with systolic blood pressure (SBP) >160 mmHg and/or diastolic blood pressure (DBP) >100 mmHg after stable dose (at least 4 weeks) of antihypertensive medication. Blood transfusion or severe bleeding within the past 3 months, known hemoglobin-related diseases, anemia (moderate to severe), or other known hemoglobinopathies that interfere with HbA1c measurement (such as sickle cell disease). Impaired liver or kidney function at screening: aspartate aminotransferase (AST) ≥3 times the upper limit of normal (ULN), alanine aminotransferase (ALT) ≥3 times ULN, total bilirubin level (TBL) ≥2 times ULN (excluding Gilbert's syndrome), creatinine clearance rate <45 mL/min (calculated by the Cockcroft-Gault formula). Significant albuminuria (urinary albumin excretion rate >300 mg/g) or history thereof. Uncontrolled or untreated thyroid disease or adrenal insufficiency. Severe diabetic kidney disease or renal insufficiency, proliferative retinopathy, diabetic foot ulcers, diabetes-related amputation, and/or severe peripheral neuropathy at screening. Active hepatitis B, hepatitis C, acquired immunodeficiency syndrome, syphilis, or tuberculosis. Even without clinical evidence of active infection, participants with laboratory evidence of active infection are also excluded. Severe heart disease or a history of cardiovascular disease within 6 months before screening, including stroke, decompensated heart failure (NYHA class III or IV), myocardial infarction, unstable angina, or coronary artery bypass grafting. Previous history of coagulation disorders or requiring long-term anticoagulant therapy (e.g., warfarin) (low-dose aspirin therapy is allowed) or patients with INR >1.5. Substance abusers with a history of drug abuse/dependence or drug use within 1 year before screening. Received live vaccines within 14 days before screening or planned to receive live vaccines during the trial or within 1 month after treatment. Live vaccines include, but are not limited to, measles, mumps, rubella, varicella, yellow fever, rabies, Bacillus Calmette-Guérin, typhoid vaccine, COVID-19 vaccine, etc. Patients with a history of acute or chronic pancreatitis, symptomatic gallbladder disease, pancreatic injury, or other high-risk factors for pancreatitis, or patients with blood amylase >1.2 times ULN at screening. Other abnormal laboratory test results deemed clinically significant by the investigator. Patients with severe mental illness. Participated in a drug or medical device clinical trial within the past 3 months and received investigational drugs or medical devices; or within 5 half-lives of another drug before screening (if the half-life exceeds 3 months). Currently receiving long-term (continuous for ≥14 days) systemic pharmacological doses of glucocorticoids or other medications that may affect the participant's consciousness. Treatment (local, intra-articular, intraocular, or inhalation preparations) for any other factors or diseases not mentioned above, deemed unsuitable for participation in this clinical study by the investigator.

Sites / Locations

  • Department of Endocrinology and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-Tong UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

YD02-2022

Arm Description

Outcomes

Primary Outcome Measures

Residual β-Cell function (RBCF)
Evaluation of the magnitude of C-peptide change after transplantation

Secondary Outcome Measures

Glycemic control (HbA1c)
Evaluation of the proportion of subjects with HbA1c ≤7.0% and no severe hypoglycemic events
Treatment (insulin-independent)
Evaluation of the proportion of subjects who are insulin-independent
Treatment (insulin requirement)
Evaluation of the percentage reduction in insulin requirement
Glycemic control (MAGE)
Evaluation of the average amplitude of glycemic fluctuations (MAGE) in subjects
Hypoglycemia (HYPO)
Evaluation of the severity of hypoglycemia using the Ryan Hypoglycemia Severity Score (HYPO)
Quality of life score
Evaluation of the quality of life score in subjects

Full Information

First Posted
August 7, 2023
Last Updated
August 7, 2023
Sponsor
Shanghai Jiao Tong University School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT05990530
Brief Title
Allogeneic Transplantation of Expanded Pancreatic Islet Cells
Official Title
Evaluation of the Efficacy and Safety of Allogeneic Transplantation of Expanded Pancreatic Islet Cells in Patients With "Brittle" Type 1 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 22, 2023 (Actual)
Primary Completion Date
August 2024 (Anticipated)
Study Completion Date
August 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Jiao Tong University School of Medicine

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
This study will evaluate the efficacy and safety of allogeneic pancreatic islet cells transplantation in patients with "brittle" type 1 diabetes.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
YD02-2022
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
YD02-2022
Intervention Description
Human islet cells were isolated and expanded in vitro to generate islets containing all types of pancreatic endocrine cells and possessing comparable function of human islets. These islet cells will be infused into the hepatic portal vein.
Primary Outcome Measure Information:
Title
Residual β-Cell function (RBCF)
Description
Evaluation of the magnitude of C-peptide change after transplantation
Time Frame
12 months post-transplant
Secondary Outcome Measure Information:
Title
Glycemic control (HbA1c)
Description
Evaluation of the proportion of subjects with HbA1c ≤7.0% and no severe hypoglycemic events
Time Frame
52 weeks post-transplant
Title
Treatment (insulin-independent)
Description
Evaluation of the proportion of subjects who are insulin-independent
Time Frame
12 weeks and 52 weeks post-transplant
Title
Treatment (insulin requirement)
Description
Evaluation of the percentage reduction in insulin requirement
Time Frame
12 weeks and 52 weeks post-transplant
Title
Glycemic control (MAGE)
Description
Evaluation of the average amplitude of glycemic fluctuations (MAGE) in subjects
Time Frame
12 weeks and 52 weeks post-transplant
Title
Hypoglycemia (HYPO)
Description
Evaluation of the severity of hypoglycemia using the Ryan Hypoglycemia Severity Score (HYPO)
Time Frame
baseline and 52 weeks post-transplant
Title
Quality of life score
Description
Evaluation of the quality of life score in subjects
Time Frame
baseline and 52 weeks post-transplant

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntarily sign an informed consent form and agree to comply with the trial treatment plan and visit schedule. Age ≥18 years and ≤60 years on the day of signing the informed consent form, regardless of gender. Body mass index (BMI) ≥18.0 kg/m2 and ≤35.0 kg/m2. Diagnosed with T1DM based on the World Health Organization's diabetes classification (2019). HbA1c ≥7.0% and ≤15.0% at screening. Dependence on insulin injection therapy for ≥5 years, receiving a stable insulin treatment plan for ≥3 months, and injecting insulin three or more times per day or using an insulin pump. Postprandial mixed meal stimulated C-peptide level <0.3 ng/mL. Experienced impaired awareness of hypoglycemia or significant glycemic instability during screening and in the past 6 months. Hypoglycemic episodes are associated with impaired awareness of hypoglycemia, extreme glycemic instability, or severe fear and maladaptive behavior. Sexually active males who are not surgically sterilized or have partners of childbearing potential agree to use effective contraception during the entire trial period and for at least 6 months after the study ends; sexually active females of childbearing potential agree to use effective contraception during the entire study period and for at least 6 months after the study ends. Exclusion Criteria: Types of diabetes other than T1DM. Body mass index (BMI) >35 kg/m2 or weight <50 kg. Excessive insulin sensitivity and/or insulin resistance (insulin requirement >1.0 IU/kg/day or <15 U/day). Previous pancreatic or islet transplantation. Severe trauma, severe infection, or surgery that may affect glycemic control within one month before screening. History of hypertension with systolic blood pressure (SBP) >160 mmHg and/or diastolic blood pressure (DBP) >100 mmHg after stable dose (at least 4 weeks) of antihypertensive medication. Blood transfusion or severe bleeding within the past 3 months, known hemoglobin-related diseases, anemia (moderate to severe), or other known hemoglobinopathies that interfere with HbA1c measurement (such as sickle cell disease). Impaired liver or kidney function at screening: aspartate aminotransferase (AST) ≥3 times the upper limit of normal (ULN), alanine aminotransferase (ALT) ≥3 times ULN, total bilirubin level (TBL) ≥2 times ULN (excluding Gilbert's syndrome), creatinine clearance rate <45 mL/min (calculated by the Cockcroft-Gault formula). Significant albuminuria (urinary albumin excretion rate >300 mg/g) or history thereof. Uncontrolled or untreated thyroid disease or adrenal insufficiency. Severe diabetic kidney disease or renal insufficiency, proliferative retinopathy, diabetic foot ulcers, diabetes-related amputation, and/or severe peripheral neuropathy at screening. Active hepatitis B, hepatitis C, acquired immunodeficiency syndrome, syphilis, or tuberculosis. Even without clinical evidence of active infection, participants with laboratory evidence of active infection are also excluded. Severe heart disease or a history of cardiovascular disease within 6 months before screening, including stroke, decompensated heart failure (NYHA class III or IV), myocardial infarction, unstable angina, or coronary artery bypass grafting. Previous history of coagulation disorders or requiring long-term anticoagulant therapy (e.g., warfarin) (low-dose aspirin therapy is allowed) or patients with INR >1.5. Substance abusers with a history of drug abuse/dependence or drug use within 1 year before screening. Received live vaccines within 14 days before screening or planned to receive live vaccines during the trial or within 1 month after treatment. Live vaccines include, but are not limited to, measles, mumps, rubella, varicella, yellow fever, rabies, Bacillus Calmette-Guérin, typhoid vaccine, COVID-19 vaccine, etc. Patients with a history of acute or chronic pancreatitis, symptomatic gallbladder disease, pancreatic injury, or other high-risk factors for pancreatitis, or patients with blood amylase >1.2 times ULN at screening. Other abnormal laboratory test results deemed clinically significant by the investigator. Patients with severe mental illness. Participated in a drug or medical device clinical trial within the past 3 months and received investigational drugs or medical devices; or within 5 half-lives of another drug before screening (if the half-life exceeds 3 months). Currently receiving long-term (continuous for ≥14 days) systemic pharmacological doses of glucocorticoids or other medications that may affect the participant's consciousness. Treatment (local, intra-articular, intraocular, or inhalation preparations) for any other factors or diseases not mentioned above, deemed unsuitable for participation in this clinical study by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Weiqiong Gu, PhD
Phone
86-21-64370045
Ext
671701
Email
Gwq10978@rjh.com.cn
Facility Information:
Facility Name
Department of Endocrinology and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao-Tong University
City
Shanghai
ZIP/Postal Code
200025
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Weiqiong Gu, PhD
Phone
86-21-64370045
Ext
672701
Email
Gwq10978@rjh.com.cn

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Allogeneic Transplantation of Expanded Pancreatic Islet Cells

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