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Evaluation of a Booster Administration of GAD-alum (Diamyd®) in Individuals With Type 1 Diabetes

Primary Purpose

Diabetes Mellitus, Type 1

Status
Active
Phase
Phase 1
Locations
Sweden
Study Type
Interventional
Intervention
GAD-alum (Diamyd) 40 μg/mL
Sponsored by
Linkoeping University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 1 focused on measuring Diamyd, Diabetes, Diabetes Type 1, Type 1 Diabetes, Type 1 Diabetes Mellitus, GAD65, GAD-Alum, rhGAD65 (Recombinant Human GAD with molecular mass 65,000), Vitamin D, Diabetes mellitus Type 1, Glutamic acid decarboxylase

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Informed consent given by patients and/or patient's parent(s) or legal acceptable representative(s) (guardian(s)) according to national regulations
  2. T1D according to the ADA classification
  3. Carry HLA DR3-DQ2 haplotype
  4. Prior participation in either the DIAGNODE-1 or the DIAGNODE-2, having received four or three intralymphatic injections of Diamyd, respectively.
  5. Females must agree to avoid pregnancy and have a negative urine pregnancy test.

Patients of childbearing potential must agree to use adequate contraception, until 90 days after the administration of Diamyd. Adequate contraception is as follows:

For females of childbearing potential:

  1. oral (except low-dose gestagen (lynestrenol and norestisteron)), injectable, or implanted hormonal contraceptives
  2. combined (estrogen and progestogen containing)
  3. oral, intravaginal or transdermal progesterone hormonal contraception associated with inhibition of ovulation
  4. intrauterine device
  5. intrauterine hormone-releasing system (for example, progestin-releasing coil)
  6. bilateral tubal occlusion
  7. vasectomized male (with appropriate post vasectomy documentation of the absence of sperm in the ejaculate)
  8. male partner using condom
  9. abstinence from heterosexual intercourse

For males of childbearing potential:

  1. condom (male)
  2. abstinence from heterosexual intercourse

Exclusion Criteria:

  1. Previous or current treatment with immunosuppressant therapy (although topical or inhaled steroids are accepted)
  2. Continuous treatment with anti-inflammatory drug (sporadic treatment e.g. because of headache or in connection with fever a few days will be accepted)
  3. Treatment with any oral or injected anti-diabetic medications other than insulin
  4. Treatment with Vitamin D, marketed or not, or unwilling to abstain from such medication during the supplementation period
  5. A history of anemia or significantly abnormal hematology results at screening
  6. A history of epilepsy, head trauma or cerebrovascular accident, or clinical features of continuous motor unit activity in proximal muscles
  7. Clinically significant history of acute reaction to vaccines or other drugs in the past, including Diamyd
  8. Treatment with any vaccine, including influenza or Covid19 vaccine, within 1 month prior to planned study drug dose administration or planned treatment with any vaccine up to 1 month after the injection with study drug
  9. Participation in clinical trials (other than DIAGNODE-1 and DIAGNODE-2) with a new chemical entity within the previous 3 months
  10. Inability or unwillingness to comply with the provisions of this protocol
  11. A history of alcohol or drug abuse
  12. A significant illness other than diabetes within 2 weeks prior to first dosing s
  13. Ongoing diagnosed or suspected post-Covid19 syndrome
  14. Known HIV or hepatitis
  15. Females who are lactating or pregnant (the possibility of pregnancy must be excluded by urine βHCG on-site within 24 hours prior to the Diamyd treatment)
  16. Presence of associated serious disease or condition, including active skin infections that preclude intralymphatic injection, which in the opinion of the investigator makes the patient non-eligible for the study
  17. Deemed by the investigator not being able to follow instructions and/or follow the study protocol

Sites / Locations

  • Kliniska Forskningsenheten (Hudmottagningen), Universitetssjukhuset Linköping

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GAD-Alum (DIamyd) 40 μg/mL and Vitamin D

Arm Description

Patients with a Vitamin D level <100 nmol/L (40 ng/mL) at screening will receive oral Vitamin D supplementation (2000 IU daily) for 60 days, starting 30 days prior to the injection. On Visit 2 (Day 0), patients eligible for the study will receive one intralymphatic injection of 4µg Diamyd.

Outcomes

Primary Outcome Measures

Number of Clinically Significant Abnormal Results from Physical examinations, including neurological and Vital Signs assessments
Injection site reactions
Occurrence of AEs and SAEs
Number of Clinically Significant Abnormal Results From Laboratory measurements (hematology, clinical chemistry) and Urine analysis.

Secondary Outcome Measures

Change in Stimulated C-peptide During a MMTT
Change in HbA1c
Change in daily exogenous insulin consumption
Change in insulin-dose-adjusted HbA1c (IDAA1c)
Change in time in glycemic target range 3.9 to 10 mmol/L
Change in time in hyperglycemic range > 10 mmol/L

Full Information

First Posted
April 14, 2022
Last Updated
October 7, 2022
Sponsor
Linkoeping University
Collaborators
Diamyd Medical AB
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1. Study Identification

Unique Protocol Identification Number
NCT05351879
Brief Title
Evaluation of a Booster Administration of GAD-alum (Diamyd®) in Individuals With Type 1 Diabetes
Official Title
A Phase I/II Open Label Pilot Study to Evaluate the Safety and Feasibility of an Additional Intralymphatic Booster Administration of GAD-alum (Diamyd®) in Individuals With Type 1 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 9, 2022 (Actual)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
November 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Linkoeping University
Collaborators
Diamyd Medical AB

4. Oversight

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

5. Study Description

Brief Summary
The objective of the study is to evaluate the feasibility and safety of administering a 4th or 5th intralymphatic booster dose of GAD-alum (Diamyd®) to T1D patients carrying HLA DR3-DQ2, who have earlier been treated with three or four intralymphatic doses of GAD-alum (Diamyd®) respectively.
Detailed Description
The study is a phase I/II, single arm, open label pilot clinical trial. Eligible patients will receive one booster injection of Diamyd® administered into an inguinal lymph node. The patients will be assessed for eligibility at the screening visit (Visit 1). Patients with a Vitamin D level <100 nmol/L (40 ng/mL) at screening will receive oral Vitamin D supplementation (2000 IU daily) for 60 days, starting 30 days prior to the injection. On Visit 2 (Day 0), patients eligible for the study will receive one intralymphatic injection of 4µg Diamyd®

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 1
Keywords
Diamyd, Diabetes, Diabetes Type 1, Type 1 Diabetes, Type 1 Diabetes Mellitus, GAD65, GAD-Alum, rhGAD65 (Recombinant Human GAD with molecular mass 65,000), Vitamin D, Diabetes mellitus Type 1, Glutamic acid decarboxylase

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GAD-Alum (DIamyd) 40 μg/mL and Vitamin D
Arm Type
Experimental
Arm Description
Patients with a Vitamin D level <100 nmol/L (40 ng/mL) at screening will receive oral Vitamin D supplementation (2000 IU daily) for 60 days, starting 30 days prior to the injection. On Visit 2 (Day 0), patients eligible for the study will receive one intralymphatic injection of 4µg Diamyd.
Intervention Type
Biological
Intervention Name(s)
GAD-alum (Diamyd) 40 μg/mL
Intervention Description
Recombinant Human Glutamic Acid Decarboxylase (rhGAD65) adsorbed to Alhydrogel at a concentration of 40 μg/mL and is given as a sterile solution for intralymphatic injection
Primary Outcome Measure Information:
Title
Number of Clinically Significant Abnormal Results from Physical examinations, including neurological and Vital Signs assessments
Time Frame
12 months
Title
Injection site reactions
Time Frame
3 months
Title
Occurrence of AEs and SAEs
Time Frame
12 months
Title
Number of Clinically Significant Abnormal Results From Laboratory measurements (hematology, clinical chemistry) and Urine analysis.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Change in Stimulated C-peptide During a MMTT
Time Frame
Baseline and 12 months
Title
Change in HbA1c
Time Frame
Baseline and 12 months
Title
Change in daily exogenous insulin consumption
Time Frame
Baseline and 12 months
Title
Change in insulin-dose-adjusted HbA1c (IDAA1c)
Time Frame
Baseline and 12 months
Title
Change in time in glycemic target range 3.9 to 10 mmol/L
Time Frame
Baseline and 12 months
Title
Change in time in hyperglycemic range > 10 mmol/L
Time Frame
Baseline and 12 months

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Informed consent given by patients and/or patient's parent(s) or legal acceptable representative(s) (guardian(s)) according to national regulations T1D according to the ADA classification Carry HLA DR3-DQ2 haplotype Prior participation in either the DIAGNODE-1 or the DIAGNODE-2, having received four or three intralymphatic injections of Diamyd, respectively. Females must agree to avoid pregnancy and have a negative urine pregnancy test. Patients of childbearing potential must agree to use adequate contraception, until 90 days after the administration of Diamyd. Adequate contraception is as follows: For females of childbearing potential: oral (except low-dose gestagen (lynestrenol and norestisteron)), injectable, or implanted hormonal contraceptives combined (estrogen and progestogen containing) oral, intravaginal or transdermal progesterone hormonal contraception associated with inhibition of ovulation intrauterine device intrauterine hormone-releasing system (for example, progestin-releasing coil) bilateral tubal occlusion vasectomized male (with appropriate post vasectomy documentation of the absence of sperm in the ejaculate) male partner using condom abstinence from heterosexual intercourse For males of childbearing potential: condom (male) abstinence from heterosexual intercourse Exclusion Criteria: Previous or current treatment with immunosuppressant therapy (although topical or inhaled steroids are accepted) Continuous treatment with anti-inflammatory drug (sporadic treatment e.g. because of headache or in connection with fever a few days will be accepted) Treatment with any oral or injected anti-diabetic medications other than insulin Treatment with Vitamin D, marketed or not, or unwilling to abstain from such medication during the supplementation period A history of anemia or significantly abnormal hematology results at screening A history of epilepsy, head trauma or cerebrovascular accident, or clinical features of continuous motor unit activity in proximal muscles Clinically significant history of acute reaction to vaccines or other drugs in the past, including Diamyd Treatment with any vaccine, including influenza or Covid19 vaccine, within 1 month prior to planned study drug dose administration or planned treatment with any vaccine up to 1 month after the injection with study drug Participation in clinical trials (other than DIAGNODE-1 and DIAGNODE-2) with a new chemical entity within the previous 3 months Inability or unwillingness to comply with the provisions of this protocol A history of alcohol or drug abuse A significant illness other than diabetes within 2 weeks prior to first dosing s Ongoing diagnosed or suspected post-Covid19 syndrome Known HIV or hepatitis Females who are lactating or pregnant (the possibility of pregnancy must be excluded by urine βHCG on-site within 24 hours prior to the Diamyd treatment) Presence of associated serious disease or condition, including active skin infections that preclude intralymphatic injection, which in the opinion of the investigator makes the patient non-eligible for the study Deemed by the investigator not being able to follow instructions and/or follow the study protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Johnny Ludvigsson, Professor
Organizational Affiliation
Linkoeping University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kliniska Forskningsenheten (Hudmottagningen), Universitetssjukhuset Linköping
City
Linköping
ZIP/Postal Code
581 85
Country
Sweden

12. IPD Sharing Statement

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Evaluation of a Booster Administration of GAD-alum (Diamyd®) in Individuals With Type 1 Diabetes

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