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Safety and Efficacy of PEG-Encapsulated Islet Allografts Implanted in Type I Diabetic Recipients

Primary Purpose

Diabetes Mellitus, Type 1

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Allogeneic Cultured Islet Cells (human); Encapsulated
Sponsored by
Novocell
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 1 focused on measuring Transplantation, Pancreatic Islets, Diabetes Mellitus, Type 1, Insulin Dependent, Islet Transplant

Eligibility Criteria

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

Inclusion Criteria: Male or non-pregnant non-lactating female subjects > 20 years of age Diagnosed with insulin-dependent type I diabetes for at least 20 years BMI less than 28 kg/m2 Insulin requirement less than or equal to 0.7 U/kg/day HbA1c greater than or equal to 7.0 % Serum C-peptide concentration less than or equal to 0.5 ng/mL stimulated by an OGTT Female subjects with childbearing potential must have a negative serum pregnancy test prior to enrollment and must agree to use an effective contraceptive method during the study One year of stable diabetes care established in the PI's database without significant changes in insulin requirement or HbA1c or diabetic complication profile Exclusion Criteria: Diagnosis of type II diabetes or maturity onset diabetes of youth (MODY) Serum C-peptide greater than 0.5 ng/mL stimulated by OGTT Sustained hypertension greater than or equal to 100 mmHg diastolic and/or greater than or equal to 160 mmHg systolic History of myocardial infarction or current active cardiac disease Current active infection Significant renal dysfunction as indicated by GFR less than 80 mL/min/1.73 m2 and/or urinary albumin greater than 500 µg/mL Significant liver dysfunction as indicated by ALT or AST more than 3X the upper limit of normal Prior whole organ or islet cell transplant Concurrent immunosuppressive therapy Severe gastroparesis, severe peripheral neuropathy, diabetic foot ulcers, or prior amputations due to diabetic complications Any other active autoimmune disease other than autoimmune thyroid disease HIV, HBV or HCV positive status Uncontrolled or untreated proliferative retinopathy Known hypersensitivity or other intolerance to cyclosporine or the inactive ingredients in the product Behavioral activities that place the subject at risk in the opinion of the investigator Any significant concurrent disease, illness, or psychiatric disorder that would, in the opinion of the investigator, compromise subject safety or compliance, or interfere with consent, study participation, follow-up, or the interpretation of study results History of any kind of cancer other than skin cancers (except for melanoma which is exclusionary)

Sites / Locations

  • CHRISTUS Santa Rosa Transplant Institute
  • Diabetes & Glandular Disease Research Associates, P.A.

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PEG Islet Cells

Arm Description

Outcomes

Primary Outcome Measures

Safety - will be evaluated by the incidence, grade, and type of adverse events, changes in laboratory parameters, evaluation of the implant site and physical exams.

Secondary Outcome Measures

Efficacy - will be assessed by:
Blood glucose levels
Daily glycemic excursions
Pre-prandial glucose levels
Post-prandial glucose levels
Glucose responses from OGTT (mg/dL and AUC:glucose
Stimulated C-peptide levels from OGTT (ng/mL and
AUC:C-Peptide
HbA1c (%)
Insulin requirements (units/day)
Arginine stimulation tests
Numbers of hypoglycemic and hyperglycemic episodes
Functional duration - will be determined by stimulated C-peptide from OGTT.

Full Information

First Posted
November 28, 2005
Last Updated
September 8, 2014
Sponsor
Novocell
Collaborators
Diabetes & Glandular Disease Research Associates, P.A., San Antonio, TX, CHRISTUS Health
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1. Study Identification

Unique Protocol Identification Number
NCT00260234
Brief Title
Safety and Efficacy of PEG-Encapsulated Islet Allografts Implanted in Type I Diabetic Recipients
Official Title
A Single-Center Phase I/II Study Of Peg-Encapsulated Islet Allografts Implanted In Patients With Type I Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
September 2014
Overall Recruitment Status
Terminated
Why Stopped
Stopped in December 2007
Study Start Date
November 2005 (undefined)
Primary Completion Date
December 2007 (Actual)
Study Completion Date
December 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novocell
Collaborators
Diabetes & Glandular Disease Research Associates, P.A., San Antonio, TX, CHRISTUS Health

4. Oversight

5. Study Description

Brief Summary
Insulin dependent Type I diabetics require daily insulin therapy to normalize blood glucose but may have difficulty with significant glycemic excursions and hypoglycemic episodes and crises. Islet cell transplantation can provide relief from daily insulin therapy, normalize blood glucose and reduce or eliminate short and long-term diabetes-related complications. "PEG-Encapsulated Islet Allografts" is a new islet transplant product under development that does not require the ongoing use of immunosuppressive drugs after the implant. This study will test the safety and efficacy of PEG-Encapsulated Islet Allografts in the treatment of Type I diabetes and provide functional outcome measurements.
Detailed Description
Allogeneic Cultured Islet Cells (human, Novocell); Encapsulated in Polyethylene Glycol; Administered Subcutaneously are a combination biologic and device product in which the pharmacologically active agent is human insulin that is released from the functional islet cells by natural production and release, stimulated by control mechanisms in response to blood glucose concentrations. The device component is a uniform and conformal polymer coating around each islet. Islet cells are isolated from multiple human pancreases procured from human organ donors who meet a specific human donor profile established by the UNOS and the FDA's requirements for Good Tissue Practices. Because the pancreases used for islet cell isolation are not intended for whole-organ transplantation, specific procurement, surgical removal, packaging and shipping protocols are provided by Novocell, Inc. to the Organ Procurement Organizations. The primary outcome is demonstration that encapsulated islet allografts can be implanted safely in the subcutaneous tissues without the use of long-term immunosuppression. The expected functional outcomes from the implantation of the encapsulated islets are significant reductions in the average blood glucose daily glycemic excursions and in insulin requirements as well as significant increases in C-peptide levels in response to meal challenges. The ultimate expected outcome is that patients who receive these implants will have reduced hemoglobin A1c levels that may be associated with reduced long-term diabetic complications. An important outcome should be reduction in hypoglycemic episodes and crises with significantly functioning grafts without having the risks associated with hepatic portal vein infusion and long-term immunosuppression.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 1
Keywords
Transplantation, Pancreatic Islets, Diabetes Mellitus, Type 1, Insulin Dependent, Islet Transplant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (false)

8. Arms, Groups, and Interventions

Arm Title
PEG Islet Cells
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Allogeneic Cultured Islet Cells (human); Encapsulated
Primary Outcome Measure Information:
Title
Safety - will be evaluated by the incidence, grade, and type of adverse events, changes in laboratory parameters, evaluation of the implant site and physical exams.
Secondary Outcome Measure Information:
Title
Efficacy - will be assessed by:
Title
Blood glucose levels
Title
Daily glycemic excursions
Title
Pre-prandial glucose levels
Title
Post-prandial glucose levels
Title
Glucose responses from OGTT (mg/dL and AUC:glucose
Title
Stimulated C-peptide levels from OGTT (ng/mL and
Title
AUC:C-Peptide
Title
HbA1c (%)
Title
Insulin requirements (units/day)
Title
Arginine stimulation tests
Title
Numbers of hypoglycemic and hyperglycemic episodes
Title
Functional duration - will be determined by stimulated C-peptide from OGTT.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant non-lactating female subjects > 20 years of age Diagnosed with insulin-dependent type I diabetes for at least 20 years BMI less than 28 kg/m2 Insulin requirement less than or equal to 0.7 U/kg/day HbA1c greater than or equal to 7.0 % Serum C-peptide concentration less than or equal to 0.5 ng/mL stimulated by an OGTT Female subjects with childbearing potential must have a negative serum pregnancy test prior to enrollment and must agree to use an effective contraceptive method during the study One year of stable diabetes care established in the PI's database without significant changes in insulin requirement or HbA1c or diabetic complication profile Exclusion Criteria: Diagnosis of type II diabetes or maturity onset diabetes of youth (MODY) Serum C-peptide greater than 0.5 ng/mL stimulated by OGTT Sustained hypertension greater than or equal to 100 mmHg diastolic and/or greater than or equal to 160 mmHg systolic History of myocardial infarction or current active cardiac disease Current active infection Significant renal dysfunction as indicated by GFR less than 80 mL/min/1.73 m2 and/or urinary albumin greater than 500 µg/mL Significant liver dysfunction as indicated by ALT or AST more than 3X the upper limit of normal Prior whole organ or islet cell transplant Concurrent immunosuppressive therapy Severe gastroparesis, severe peripheral neuropathy, diabetic foot ulcers, or prior amputations due to diabetic complications Any other active autoimmune disease other than autoimmune thyroid disease HIV, HBV or HCV positive status Uncontrolled or untreated proliferative retinopathy Known hypersensitivity or other intolerance to cyclosporine or the inactive ingredients in the product Behavioral activities that place the subject at risk in the opinion of the investigator Any significant concurrent disease, illness, or psychiatric disorder that would, in the opinion of the investigator, compromise subject safety or compliance, or interfere with consent, study participation, follow-up, or the interpretation of study results History of any kind of cancer other than skin cancers (except for melanoma which is exclusionary)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sherwyn Schwartz, M.D.
Organizational Affiliation
Diabetes & Glandular Disease Research Associates, P.A., San Antonio, TX
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Paraic Mulgrew, M.D.
Organizational Affiliation
CHRISTUS Santa Rosa Transplant Institute, San Antonio, TX
Official's Role
Principal Investigator
Facility Information:
Facility Name
CHRISTUS Santa Rosa Transplant Institute
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Diabetes & Glandular Disease Research Associates, P.A.
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.novocell.com
Description
Sponsor's website
URL
http://www.dgdclinic.com
Description
Diabetes & Glandular Disease Research Associates website
URL
http://www.christussantarosa.org
Description
CHRISTUS Santa Rosa website

Learn more about this trial

Safety and Efficacy of PEG-Encapsulated Islet Allografts Implanted in Type I Diabetic Recipients

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