Safety, Tolerability and Potential Efficacy of AVT001 in Patients With Type 1 Diabetes
Primary Purpose
Type 1 Diabetes Mellitus
Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AVT001
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Type 1 Diabetes Mellitus
Eligibility Criteria
Key Inclusion Criteria:
Diagnosis of type 1 diabetes, within 12 months of first dosing, confirmed by positive lab result for one or more of the following types of autoantibodies:
- Glutamic acid decarboxylase (GAD65)
- Insulinoma associated protein 2 (IA-2, also known as ICA-512)
- Zinc transporter 8 (ZnT8).
- Age 16 or older and able to provide informed consent/assent.
- If a participant is female with reproductive potential, willing to avoid pregnancy through the duration of the trial.
- Signed and dated written informed consent/assent.
Key Exclusion Criteria:
- Poorly controlled diabetes despite insulin therapy, who in the opinion of the investigator would not be a good candidate for participation in a clinical trial
- Screening hemoglobin <10.0 g/dL; leukocytes <3,000/uL; neutrophils <1,500/uL; lymphocytes <800/uL; platelets <100,000/uL
- Screening Urine Albumin Excretion > 300mg/gmCr
- Screening eGFR < 60 mL/min/1.73m2
- Screening ALT or AST > 1.5x upper limit of normal (ULN)
- Screening bilirubin > 2.0 mg / dL, or > 3.0 mg / dL for participants with Gilbert's Syndrome
- Current use of immunosuppressive or immunomodulatory therapies, including pharmacologic doses of systemic steroids. However, topical steroidal creams and inhaled steroids without large systemic absorption are allowed.
- Coincident medical condition likely to require immunosuppressive or immunomodulatory therapies.
- Coincident medical condition likely to limit short term (5 year) life expectancy (malignancy, symptomatic coronary artery disease, recent stroke)
- Prior radiation therapy, immunotherapy (within 1 year of screening), or chemotherapy
- Serologic evidence of current HIV-1 or HIV-2 infection
- Serologic evidence of hepatitis C infection
- Serologic evidence of acute or chronic active hepatitis B as measured by Core Ab positive and / or Surface Antibody antigen positive
- Subjects with other autoimmune conditions (except compensated or treated autoimmune thyroid, celiac, alopecia, or vitiligo diseases)
- Women who are pregnant (pregnancy testing during screening), breastfeeding, or planning pregnancy during the study period
- Inadequate venous access to support leukapheresis
- Any condition that in the opinion of the investigator(s) would preclude the subject from participating in a clinical trial.
- Abnormal screening ECG that in the opinion of the investigator or sponsor would pose a safety risk.
Sites / Locations
- Joslin Diabetes Center, Harvard Medical School
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
AVT001 (Treatment)
Matched placebo
Arm Description
Infusion of AVT001 (treatment)
Infusion of AVT001-matched placebo
Outcomes
Primary Outcome Measures
The incidence of treatment-emergent adverse events
Safety/tolerability outcomes
Changes from baseline of clinical parameters on CBC/differential, chemistry panel
Safety/tolerability outcomes - the clinical parameters tested include creatinine, AST, ALT, and total bilirubin
The incidence and severity of local i.v.-site reactions,
Safety/tolerability outcomes
Secondary Outcome Measures
Assessment of the HLA-E-restricted CD8+ T cell regulatory activity ("potency assay")
Efficacy outcomes - "potency assay" measures the activity of CD8+ T regulatory cells
Changes from baseline in the area under the curve (AUC) of the stimulated C-peptide levels over a 4-hour mixed meal tolerance test (MMTT)
Efficacy outcomes
Changes from baseline in HbA1c
Efficacy outcomes
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03895996
Brief Title
Safety, Tolerability and Potential Efficacy of AVT001 in Patients With Type 1 Diabetes
Official Title
A Phase 1 / 2 Double-Blind, Randomized, Placebo Controlled Study of Safety, Tolerability and Potential Efficacy of AVOTRES Cell-Based Therapy (AVT001) in Patients With Type 1 Diabetes
Study Type
Interventional
2. Study Status
Record Verification Date
December 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 20, 2019 (Actual)
Primary Completion Date
May 17, 2022 (Actual)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Avotres 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
This is a double-blind, randomized , placebo-controlled study to evaluate the safety and tolerability of AVT001, and to assess AVT001 as a potential treatment for type 1 diabetes (T1D). The trial will involve approximately 24 new-onset T1D subjects.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
AVT001 (Treatment)
Arm Type
Experimental
Arm Description
Infusion of AVT001 (treatment)
Arm Title
Matched placebo
Arm Type
Placebo Comparator
Arm Description
Infusion of AVT001-matched placebo
Intervention Type
Drug
Intervention Name(s)
AVT001
Intervention Description
autologous dendritic cell therapy
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
matched placebo
Primary Outcome Measure Information:
Title
The incidence of treatment-emergent adverse events
Description
Safety/tolerability outcomes
Time Frame
5 months post first dose
Title
Changes from baseline of clinical parameters on CBC/differential, chemistry panel
Description
Safety/tolerability outcomes - the clinical parameters tested include creatinine, AST, ALT, and total bilirubin
Time Frame
5 months post first dose
Title
The incidence and severity of local i.v.-site reactions,
Description
Safety/tolerability outcomes
Time Frame
5 months post first dose
Secondary Outcome Measure Information:
Title
Assessment of the HLA-E-restricted CD8+ T cell regulatory activity ("potency assay")
Description
Efficacy outcomes - "potency assay" measures the activity of CD8+ T regulatory cells
Time Frame
5 months post first dose
Title
Changes from baseline in the area under the curve (AUC) of the stimulated C-peptide levels over a 4-hour mixed meal tolerance test (MMTT)
Description
Efficacy outcomes
Time Frame
5 months post first dose
Title
Changes from baseline in HbA1c
Description
Efficacy outcomes
Time Frame
5 months post first dose
10. Eligibility
Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria:
Diagnosis of type 1 diabetes, within 12 months of first dosing, confirmed by positive lab result for one or more of the following types of autoantibodies:
Glutamic acid decarboxylase (GAD65)
Insulinoma associated protein 2 (IA-2, also known as ICA-512)
Zinc transporter 8 (ZnT8).
Age 16 or older and able to provide informed consent/assent.
If a participant is female with reproductive potential, willing to avoid pregnancy through the duration of the trial.
Signed and dated written informed consent/assent.
Key Exclusion Criteria:
Poorly controlled diabetes despite insulin therapy, who in the opinion of the investigator would not be a good candidate for participation in a clinical trial
Screening hemoglobin <10.0 g/dL; leukocytes <3,000/uL; neutrophils <1,500/uL; lymphocytes <800/uL; platelets <100,000/uL
Screening Urine Albumin Excretion > 300mg/gmCr
Screening eGFR < 60 mL/min/1.73m2
Screening ALT or AST > 1.5x upper limit of normal (ULN)
Screening bilirubin > 2.0 mg / dL, or > 3.0 mg / dL for participants with Gilbert's Syndrome
Current use of immunosuppressive or immunomodulatory therapies, including pharmacologic doses of systemic steroids. However, topical steroidal creams and inhaled steroids without large systemic absorption are allowed.
Coincident medical condition likely to require immunosuppressive or immunomodulatory therapies.
Coincident medical condition likely to limit short term (5 year) life expectancy (malignancy, symptomatic coronary artery disease, recent stroke)
Prior radiation therapy, immunotherapy (within 1 year of screening), or chemotherapy
Serologic evidence of current HIV-1 or HIV-2 infection
Serologic evidence of hepatitis C infection
Serologic evidence of acute or chronic active hepatitis B as measured by Core Ab positive and / or Surface Antibody antigen positive
Subjects with other autoimmune conditions (except compensated or treated autoimmune thyroid, celiac, alopecia, or vitiligo diseases)
Women who are pregnant (pregnancy testing during screening), breastfeeding, or planning pregnancy during the study period
Inadequate venous access to support leukapheresis
Any condition that in the opinion of the investigator(s) would preclude the subject from participating in a clinical trial.
Abnormal screening ECG that in the opinion of the investigator or sponsor would pose a safety risk.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jason Gaglia, MD
Organizational Affiliation
Joslin Diabetes Center, Harvard Medical School
Official's Role
Principal Investigator
Facility Information:
Facility Name
Joslin Diabetes Center, Harvard Medical School
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Safety, Tolerability and Potential Efficacy of AVT001 in Patients With Type 1 Diabetes
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