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Clinical Trial of Efficacy and Safety of Subetta in the Combined Treatment of Patients With Type I Diabetes Mellitus

Primary Purpose

Type I Diabetes Mellitus

Status
Completed
Phase
Phase 4
Locations
Russian Federation
Study Type
Interventional
Intervention
Subetta
Placebo
Sponsored by
Materia Medica Holding
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Type I Diabetes Mellitus focused on measuring Combined treatment of patients with type I diabetes mellitus

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Diagnosed type I diabetes mellitus (according to WHO criteria, 1999 - 2006).
  2. Disease duration no less than 6 months.
  3. Patient's age from 18 to 65 years inclusive.
  4. Level of glycosylated hemoglobin 7.0- 10.0 %.
  5. Glomerular filtration rate ≥ 60 ml/ min/1.73m^2.
  6. Stable dose of basal insulin for the last 3 months. (Permissible fluctuations are ±10%.)
  7. Usage of contraceptive methods by both gender patients of reproductive age during the trial and within 30 days after ending the participation in the trial.
  8. Availability of signed patient information sheet (Informed Consent form) for participation in the clinical trial.

Exclusion Criteria:

  1. Acute diabetes mellitus complications for 3 months prior to inclusion in the trial (diabetic ketoacidosis, hyperosmolar hyperglycemic state, lacticemia, severe hypoglycemia and hypoglycemic coma).
  2. Diabetic retinopathy, preproliferative, proliferative or terminal stages (based on the results of oculist examination during screening period or 6 months prior to the trial).
  3. Diabetic nephropathy, proteinuria stage, chronic kidney disease on 3, 4 or 5 stage.
  4. Diabetic microangiopathy:

    • ishemic heart disease (medical history of a sudden coronary death with successful reanimation, medical history of myocardial infarction, stable exertional angina III or IV FC; unstable angina; post-infarction cardiosclerosis; chronic heart failure III or IV FC);
    • cerebrovascular diseases (medical history of acute cerebrovascular accident; progressive vascular leukoencephalopathy; vascular dementia);
    • chronic obliterative peripheral vascular diseases (clinically significant);
    • diabetic neuroosteoarthropathy;
    • diabetic foot (clinically significant).
  5. Heart rhythm disorder:

    • II-III atrioventricular block;
    • sick sinus syndrome;
    • long QT interval syndrome;
    • complete left bundle branch block;
    • block of 2/3 bundle branches;
    • WPW syndrome;
    • ventricular arrhythmia of III grade according Laun-Wolf;
    • paroxysmal supraventricular tachycardia;
    • paroxysmal/recurrent ventricular tachycardia;
    • atrial flutter and fibrillation;
    • ventricular flutter and fibrillation;
    • heart pacemaker implant.
  6. Uncontrolled arterial hypertension characterized by the following blood tension values: systolic blood pressure over 160 mm Hg and/or diastolic blood pressure over 100 mm Hg.
  7. Severe concomitant pathology including clinically significant cardiovascular diseases of III - IV functional class (according to New York Heart Association classification, 1964), nervous and endocrine system diseases, including morbid obesity (body mass index≥40.0 kg/m2), renal insufficiency, liver failure.
  8. Medical history of pancreatectomy or transplantation of pancreatic/islet cells.
  9. Medical history of renal transplantation.
  10. Malignant neoplasms/suspected malignant neoplasms.
  11. Exacerbations or decompensation of chronic diseases affecting a patient's ability to participate in the clinical trial.
  12. Level of fasting triglycerides >5.64 mmol/L.
  13. Medical history of bariatric surgical operations.
  14. Medical history of polyvalent allergy.
  15. Allergy/ intolerance to any of the components of medications used in the treatment.
  16. Intake of medicines listed in the section "Prohibited concomitant treatment" for 3 months prior to the inclusion in the trial.
  17. Pregnancy, breast-feeding.
  18. Drug addiction, alcohol usage in the amount exceeding 2 units of alcohol per day.
  19. Mental disorders of a patient.
  20. Night work.
  21. Participation in other clinical trials in the course of 3 months prior to the inclusion in the trial.
  22. Patients, who from the investigator's point of view, will fail to comply with the observation requirements of the trial or with the intake regimen of the investigated medicines.
  23. Other factors impeding patient's participation in the trial (for example, planned business trips or journeys).
  24. Patient is related to the research personnel of the investigative site, who are directly involved in the trial or are the immediate relative of the researcher. The immediate relative includes husband/wife, parents, children or brothers (or sisters), regardless of whether they are natural or adopted.
  25. Patient works for OOO "NPF "Materia Medica Holding" (i.e. is the company's employee, temporary contract worker or appointed official responsible for the carrying out the research) or the immediate relative.

Sites / Locations

  • Municipal budgetary authority "Khimki Central Clinical Hospital"
  • State Healthcare Institution of Moscow "Central research institute of gastroenterology" of Department of health care of Moscow
  • State Educational Institution of Higher Professional Education "Moscow State Medical Academy named after I.M. Sechenov"
  • Nonstate Health Care Institution "Central Clinical Hospital №2 named after N.A. Semashko of Public Limited Company "Russian Railways"
  • The State Budgetary Institution of Health Care of the Nizhny Novgorod Region "City clinical hospital No. 10 "
  • Nizhny Novgorod regional State Budgetary Health Institution " Nizhny Novgorod regional Clinical Hospital named after N.A. Semashko "
  • State Budgetary Educational Institution of High Professional Training "Rostov State Medical University" of Ministry of Health of Russian Federation, Department of Endocrinology
  • Co.Ltd " Diabet Center"
  • Private company "Polyclinic Complex"
  • St. Petersburg State Budgetary Health Care Institution "City Polyclinic №6"
  • St. Petersburg State Budgetary Health Care Institution "Saint Venerable Martyr Elizaveta Municipal Hospital"
  • State Budgetary Educational Institution of High Professional Training "St. Petersburg State Medical University named after academician I.P. Pavlov" of Ministry of Health of Russian Federation, Therapy Faculty Board
  • St. Petersburg Sate Budgetary Institution "Consultative-Diagnostic Polyclinic №1 of Coastal Area"
  • Independent Health Care Institution of Voronezh Region "Voronezh Regional Clinical Consultative-Diagnostic Center"
  • State Budgetary Health Care Institution of Yaroslavl Region "Regional Сlinical Hospital"

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Subetta group

Placebo group

Arm Description

Patients with poor glycemic control (HbA1c=7.0-10.0%) in basal-bolus insulin regimen with a stable basal insulin dose (permissible fluctuations are ±10%) during the previous 3 months are included

Patients with poor glycemic control (HbA1c=7.0-10.0%) in basal-bolus insulin regimen with a stable basal insulin dose (permissible fluctuations are ±10%) during the previous 3 months are included.

Outcomes

Primary Outcome Measures

Changes in the Mean Value of HbA1c
The HbA1C test was performed using a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) (www.ngsp.org) and standardized or traceable to the Diabetes Control and Complications Trial (DCCT) reference assay.

Secondary Outcome Measures

Change in Fasting Plasma Glucose (Based on the Data of Biochemical Analysis)
Change in Average Daily Blood Glucose From a 7-point Patient Self-monitoring of Blood Glucose (SMBG)
A 7-point patient self-monitoring of blood glucose (SMBG): three measurements of blood glucose before the meal; three measurements of postprandial blood glucose (1-2 h after the start of the meal) and one measurement at 3:00 a.m.
Changes in Lipids (Concentrations of Plasma Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides)
Blood samples (for measurement of fasting plasma glucose, concentrations of plasma total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides) are taken under standard conditions: after night break in food taking (at least 12 hours) and prior to administering of insulin morning dose (prandial), prior to any morning medicines intake (including the study drug and permitted concomitant therapy).
Changes in Dosage of Insulin (Basal, Prandial and Total Daily Dose Insulin Measured in IU)
Insulin dose should be corrected by a patient on a daily basis taking into consideration data on blood glucose self- monitoring during a day and amount of food carbohydrates. Physician can correct insulin dose based on the same data.
Changes in Dosage of Total Insulin Measured in IU/kg of Body Weight
Insulin dose should be corrected by a patient on a daily basis taking into consideration data on blood glucose self- monitoring during a day and amount of food carbohydrates. Physician can correct insulin dose based on the same data.
Satisfaction of Diabetes Treatment Based on Diabetes Treatment Satisfaction Questionnaire Data
The Diabetes Treatment Satisfaction Questionnaire allows to assess the degree of satisfaction with treatment for diabetes and its complications - retinopathy and nephropathy, how patients' satisfaction and perceived hyper- and hypoglycemia have changed compared to the initial period (before the treatment). The Diabetes Treatment Satisfaction Questionnaire contains six items scored on 7-point scales from +3 (equals "very satisfied") to -3 (equals "very dissatisfied"), with 0 (equals "no change"). These are summed to produce a total Treatment Satisfaction score. Two questions concerning "Perceived Hyperglycaemia" and "Perceived Hypoglycaemia" respectively, are calculated separately. According to these two items, low scores represent good perceived blood glucose control (+3 means "most of the time" of Hyperglycaemia or Hypoglycaemia whereas -3 means "none of the time" of Hyperglycaemia or Hypoglycaemia).

Full Information

First Posted
May 27, 2013
Last Updated
May 15, 2019
Sponsor
Materia Medica Holding
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1. Study Identification

Unique Protocol Identification Number
NCT01868594
Brief Title
Clinical Trial of Efficacy and Safety of Subetta in the Combined Treatment of Patients With Type I Diabetes Mellitus
Official Title
Multicentre Double-blind Placebo-controlled Parallel-group Randomized Clinical Trial of Efficacy and Safety of Subetta in the Combined Treatment of Patients With Type I Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Completed
Study Start Date
May 7, 2013 (Actual)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 10, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Materia Medica Holding

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is: to assess clinical efficacy of Subetta in the combined treatment of type I diabetes mellitus; to assess safety of Subetta in the combined treatment of type I diabetes mellitus.
Detailed Description
Patients with type I diabetes mellitus are included in the trial. It is concerned those patients, who by the time of the trial receive basal bolus insulin therapy of type I diabetes mellitus, including basal insulin (using long acting medications) and prandial insulin (short and ultra short acting medications), and with poor glycemic control (HbA1c=7.0-10.0%). For patients, which will be included in the trial (mainly middle aged patients without severe complications of diabetes), HbA1c>7.0% is the marker showing that optimal individual goal of glycemic control is not achieved. HbA1c, fasting plasma glucose, microalbuminuria, estimated glomerular filtration rate, ophthalmoscopy, blood pressure measurement, patient self-monitoring of blood glucose, frequency of hypoglycemia, endocrinologist examination were performed within screening period. Patients without severe diabetes complications are randomized in 2 groups. If a patient meets inclusion criteria and does not show exclusion criteria he/she is randomized in one of 2 groups: Group 1 - patients receiving standard type I diabetes mellitus therapy + Subetta at a dose of 1 tablet 4 times a day; Group 2 - the group receiving standard type I diabetes mellitus therapy + Placebo under the regimen used for Subetta. The invented names of the drugs containing basal and prandial (meal) insulin should be unchanged for each patient during the whole trial. All patients will receive glucometers and the appropriate glucose test strips, so they could self monitor blood glucose and register this data in their diaries. The trial duration is 38 weeks; the main stages of the trial are conducted during screening, then in 4 weeks (Visit 2), in 12 weeks (Visit 3), in 24 weeks (Visit 4) and in 36 weeks (Visit 5). In 1 week after randomization and the onset of the trial therapy and between the visits to the study site (on weeks 8±1, 18±1 and 30±1) an investigator collects data on patient's health and complaints (phone visits) to decide whether it is necessary to arrange unplanned visit to the site.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type I Diabetes Mellitus
Keywords
Combined treatment of patients with type I diabetes mellitus

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Subetta group
Arm Type
Experimental
Arm Description
Patients with poor glycemic control (HbA1c=7.0-10.0%) in basal-bolus insulin regimen with a stable basal insulin dose (permissible fluctuations are ±10%) during the previous 3 months are included
Arm Title
Placebo group
Arm Type
Placebo Comparator
Arm Description
Patients with poor glycemic control (HbA1c=7.0-10.0%) in basal-bolus insulin regimen with a stable basal insulin dose (permissible fluctuations are ±10%) during the previous 3 months are included.
Intervention Type
Drug
Intervention Name(s)
Subetta
Intervention Description
Each Subetta tablet contains a mixture of affinity purified polyclonal antibodies to β-subunit of the rINS (6 mg) and antibodies to eNOS (6 mg) in released-active form produced by the patented technology in accordance with the applicable European Pharmacopeia requirements. Standard therapy of type I diabetes mellitus + Subetta (1 tablet 4 times a day) for 36 weeks. Subetta: oral administration, per 1 intake - 1 tablet (keep in the mouth until complete dissolution, not at mealtime).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo (identical to Subetta in shape and taste tablet containing exсipients). Standard therapy of type I diabetes mellitus + Placebo (1 tablet 4 times a day) for 36 weeks. Placebo: oral administration, per 1 intake - 1 tablet (keep in the mouth until complete dissolution, not at mealtime).
Primary Outcome Measure Information:
Title
Changes in the Mean Value of HbA1c
Description
The HbA1C test was performed using a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) (www.ngsp.org) and standardized or traceable to the Diabetes Control and Complications Trial (DCCT) reference assay.
Time Frame
baseline and 12, 24 and 36 weeks of the treatment
Secondary Outcome Measure Information:
Title
Change in Fasting Plasma Glucose (Based on the Data of Biochemical Analysis)
Time Frame
baseline and 4, 12, 24 and 36 weeks of the treatment
Title
Change in Average Daily Blood Glucose From a 7-point Patient Self-monitoring of Blood Glucose (SMBG)
Description
A 7-point patient self-monitoring of blood glucose (SMBG): three measurements of blood glucose before the meal; three measurements of postprandial blood glucose (1-2 h after the start of the meal) and one measurement at 3:00 a.m.
Time Frame
baseline and 4, 8, 12, 18, 24, 30 and 36 weeks of the treatment
Title
Changes in Lipids (Concentrations of Plasma Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides)
Description
Blood samples (for measurement of fasting plasma glucose, concentrations of plasma total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides) are taken under standard conditions: after night break in food taking (at least 12 hours) and prior to administering of insulin morning dose (prandial), prior to any morning medicines intake (including the study drug and permitted concomitant therapy).
Time Frame
baseline and 12, 24 and 36 weeks of the treatment
Title
Changes in Dosage of Insulin (Basal, Prandial and Total Daily Dose Insulin Measured in IU)
Description
Insulin dose should be corrected by a patient on a daily basis taking into consideration data on blood glucose self- monitoring during a day and amount of food carbohydrates. Physician can correct insulin dose based on the same data.
Time Frame
baseline and 36 weeks of the treatment
Title
Changes in Dosage of Total Insulin Measured in IU/kg of Body Weight
Description
Insulin dose should be corrected by a patient on a daily basis taking into consideration data on blood glucose self- monitoring during a day and amount of food carbohydrates. Physician can correct insulin dose based on the same data.
Time Frame
baseline and 36 weeks of the treatment
Title
Satisfaction of Diabetes Treatment Based on Diabetes Treatment Satisfaction Questionnaire Data
Description
The Diabetes Treatment Satisfaction Questionnaire allows to assess the degree of satisfaction with treatment for diabetes and its complications - retinopathy and nephropathy, how patients' satisfaction and perceived hyper- and hypoglycemia have changed compared to the initial period (before the treatment). The Diabetes Treatment Satisfaction Questionnaire contains six items scored on 7-point scales from +3 (equals "very satisfied") to -3 (equals "very dissatisfied"), with 0 (equals "no change"). These are summed to produce a total Treatment Satisfaction score. Two questions concerning "Perceived Hyperglycaemia" and "Perceived Hypoglycaemia" respectively, are calculated separately. According to these two items, low scores represent good perceived blood glucose control (+3 means "most of the time" of Hyperglycaemia or Hypoglycaemia whereas -3 means "none of the time" of Hyperglycaemia or Hypoglycaemia).
Time Frame
36 weeks of the treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosed type I diabetes mellitus (according to WHO criteria, 1999 - 2006). Disease duration no less than 6 months. Patient's age from 18 to 65 years inclusive. Level of glycosylated hemoglobin 7.0- 10.0 %. Glomerular filtration rate ≥ 60 ml/ min/1.73m^2. Stable dose of basal insulin for the last 3 months. (Permissible fluctuations are ±10%.) Usage of contraceptive methods by both gender patients of reproductive age during the trial and within 30 days after ending the participation in the trial. Availability of signed patient information sheet (Informed Consent form) for participation in the clinical trial. Exclusion Criteria: Acute diabetes mellitus complications for 3 months prior to inclusion in the trial (diabetic ketoacidosis, hyperosmolar hyperglycemic state, lacticemia, severe hypoglycemia and hypoglycemic coma). Diabetic retinopathy, preproliferative, proliferative or terminal stages (based on the results of oculist examination during screening period or 6 months prior to the trial). Diabetic nephropathy, proteinuria stage, chronic kidney disease on 3, 4 or 5 stage. Diabetic microangiopathy: ishemic heart disease (medical history of a sudden coronary death with successful reanimation, medical history of myocardial infarction, stable exertional angina III or IV FC; unstable angina; post-infarction cardiosclerosis; chronic heart failure III or IV FC); cerebrovascular diseases (medical history of acute cerebrovascular accident; progressive vascular leukoencephalopathy; vascular dementia); chronic obliterative peripheral vascular diseases (clinically significant); diabetic neuroosteoarthropathy; diabetic foot (clinically significant). Heart rhythm disorder: II-III atrioventricular block; sick sinus syndrome; long QT interval syndrome; complete left bundle branch block; block of 2/3 bundle branches; WPW syndrome; ventricular arrhythmia of III grade according Laun-Wolf; paroxysmal supraventricular tachycardia; paroxysmal/recurrent ventricular tachycardia; atrial flutter and fibrillation; ventricular flutter and fibrillation; heart pacemaker implant. Uncontrolled arterial hypertension characterized by the following blood tension values: systolic blood pressure over 160 mm Hg and/or diastolic blood pressure over 100 mm Hg. Severe concomitant pathology including clinically significant cardiovascular diseases of III - IV functional class (according to New York Heart Association classification, 1964), nervous and endocrine system diseases, including morbid obesity (body mass index≥40.0 kg/m2), renal insufficiency, liver failure. Medical history of pancreatectomy or transplantation of pancreatic/islet cells. Medical history of renal transplantation. Malignant neoplasms/suspected malignant neoplasms. Exacerbations or decompensation of chronic diseases affecting a patient's ability to participate in the clinical trial. Level of fasting triglycerides >5.64 mmol/L. Medical history of bariatric surgical operations. Medical history of polyvalent allergy. Allergy/ intolerance to any of the components of medications used in the treatment. Intake of medicines listed in the section "Prohibited concomitant treatment" for 3 months prior to the inclusion in the trial. Pregnancy, breast-feeding. Drug addiction, alcohol usage in the amount exceeding 2 units of alcohol per day. Mental disorders of a patient. Night work. Participation in other clinical trials in the course of 3 months prior to the inclusion in the trial. Patients, who from the investigator's point of view, will fail to comply with the observation requirements of the trial or with the intake regimen of the investigated medicines. Other factors impeding patient's participation in the trial (for example, planned business trips or journeys). Patient is related to the research personnel of the investigative site, who are directly involved in the trial or are the immediate relative of the researcher. The immediate relative includes husband/wife, parents, children or brothers (or sisters), regardless of whether they are natural or adopted. Patient works for OOO "NPF "Materia Medica Holding" (i.e. is the company's employee, temporary contract worker or appointed official responsible for the carrying out the research) or the immediate relative.
Facility Information:
Facility Name
Municipal budgetary authority "Khimki Central Clinical Hospital"
City
Moscow region
ZIP/Postal Code
141400
Country
Russian Federation
Facility Name
State Healthcare Institution of Moscow "Central research institute of gastroenterology" of Department of health care of Moscow
City
Moscow
ZIP/Postal Code
111123
Country
Russian Federation
Facility Name
State Educational Institution of Higher Professional Education "Moscow State Medical Academy named after I.M. Sechenov"
City
Moscow
ZIP/Postal Code
119991
Country
Russian Federation
Facility Name
Nonstate Health Care Institution "Central Clinical Hospital №2 named after N.A. Semashko of Public Limited Company "Russian Railways"
City
Moscow
ZIP/Postal Code
129128
Country
Russian Federation
Facility Name
The State Budgetary Institution of Health Care of the Nizhny Novgorod Region "City clinical hospital No. 10 "
City
Nizhny Novgorod
ZIP/Postal Code
603011
Country
Russian Federation
Facility Name
Nizhny Novgorod regional State Budgetary Health Institution " Nizhny Novgorod regional Clinical Hospital named after N.A. Semashko "
City
Nizhny Novgorod
ZIP/Postal Code
603126
Country
Russian Federation
Facility Name
State Budgetary Educational Institution of High Professional Training "Rostov State Medical University" of Ministry of Health of Russian Federation, Department of Endocrinology
City
Rostov-on-Don
ZIP/Postal Code
344022
Country
Russian Federation
Facility Name
Co.Ltd " Diabet Center"
City
Samara
ZIP/Postal Code
443067
Country
Russian Federation
Facility Name
Private company "Polyclinic Complex"
City
St. Petersburg
ZIP/Postal Code
190013
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Health Care Institution "City Polyclinic №6"
City
St. Petersburg
ZIP/Postal Code
191482
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Health Care Institution "Saint Venerable Martyr Elizaveta Municipal Hospital"
City
St. Petersburg
ZIP/Postal Code
195257
Country
Russian Federation
Facility Name
State Budgetary Educational Institution of High Professional Training "St. Petersburg State Medical University named after academician I.P. Pavlov" of Ministry of Health of Russian Federation, Therapy Faculty Board
City
St. Petersburg
ZIP/Postal Code
197022
Country
Russian Federation
Facility Name
St. Petersburg Sate Budgetary Institution "Consultative-Diagnostic Polyclinic №1 of Coastal Area"
City
St. Petersburg
ZIP/Postal Code
197183
Country
Russian Federation
Facility Name
Independent Health Care Institution of Voronezh Region "Voronezh Regional Clinical Consultative-Diagnostic Center"
City
Voronezh
ZIP/Postal Code
394018
Country
Russian Federation
Facility Name
State Budgetary Health Care Institution of Yaroslavl Region "Regional Сlinical Hospital"
City
Yaroslavl
ZIP/Postal Code
150062
Country
Russian Federation

12. IPD Sharing Statement

Citations:
PubMed Identifier
29807102
Citation
Mkrtumyan A, Romantsova T, Vorobiev S, Volkova A, Vorokhobina N, Tarasov S, Putilovskiy M, Andrianova E, Epstein O. Efficacy and safety of Subetta add-on therapy in type 1 diabetes mellitus: The results of a multicenter, double-blind, placebo-controlled, randomized clinical trial. Diabetes Res Clin Pract. 2018 Aug;142:1-9. doi: 10.1016/j.diabres.2018.04.044. Epub 2018 May 26.
Results Reference
derived

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Clinical Trial of Efficacy and Safety of Subetta in the Combined Treatment of Patients With Type I Diabetes Mellitus

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