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The Effects of Alpha-1 Antitrypsin (AAT) on the Progression of Type 1 Diabetes

Primary Purpose

Diabetes, Type 1 Diabetes

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Alpha 1-Antitrypsin (AAT, Aralast NP)
Sponsored by
University of Colorado, Denver
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes focused on measuring diabetes, type 1 diabetes, AAT, Alpha-1 Antitrypsin

Eligibility Criteria

6 Years - 45 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of Type 1 Diabetes Mellitus based on ADA Criteria for fewer than 5 years but more than 100 days
  • 6-45 years of age, inclusive. To assess safety, we will initially enroll 8 patients over the age of 16. Following the last infusion of the 8th patient, we will assess adverse events. As long as there are no stopping criteria met for these 8 patients we will decrease the age criteria down to 6 years old.
  • C-peptide increase during screening mixed meal tolerance test with a minimal stimulated value of ≥ 0.2 pmol/mL.
  • Positive for antibodies to insulin (if insulin autoantibody positive only, determination must be within two weeks of insulin initiation), GAD-65, IA-2 or ZnT8
  • Agree to intensive management of diabetes with an HgbA1c goal of < 7.0%
  • If female, (a) surgically sterile or (b) postmenopausal or (c) if of reproductive potential, willing to use medically acceptable birth control (e.g. female hormonal contraception, barrier methods or sterilization. ) until 3 months after completion of any treatment period
  • If male and of reproductive potential, willing to use medically acceptable birth control until 3 months after completion of any treatment period, unless the female partner is postmenopausal or surgically sterile
  • Serum creatinine ≤ 1.5 x upper limit of normal
  • AST < 2 times the upper limit of normal
  • Hematology:WBC > 3000 x 109/L; platelets > 100 x 109/L; hemoglobin > 10.0 g/dL.

Exclusion Criteria:

  • Unable or unwilling to comply with the requirements of the study protocol
  • Body Mass Index (BMI) > 30 kg/m2
  • Unstable blood sugar control defined as one or more episodes of severe hypoglycemia (defined as hypoglycemia that required the assistance of another person) within the last 30 days
  • Previous immunotherapy for T1D
  • Administration of an experimental agent for T1D at any time or use of an experimental device for T1D within 30 days of screening, unless approved by the study PI
  • History of any organ transplant, including islet cell transplant
  • Active autoimmune or immune deficiency disorder (e.g. sarcoidosis, rheumatoid arthritis)
  • Serum bilirubin > ULN, except those subjects whose abnormal values were attributed to any stable, benign condition (such as Gilbert's Syndrome) may be included
  • TSH outside the normal range at screening, except those subjects on stable doses of thyroid hormone replacement therapy may be included
  • Known HIV positivity, active hepatitis B or active hepatitis C infection
  • Anticipated pregnancy during active dosing or within 3 months after completion of active dosing phase
  • History of a malignant neoplasm within the previous 5 years (except in situ cervical cancer and curable non-melanoma skin malignancy)
  • Any social condition or medical condition that would, in the opinion of the investigator, prevent complete participation in the study or that would pose a significant hazard to the subjects' participation
  • History of active substance abuse within 12 months of screening
  • A psychiatric or medical disorder that would prevent giving informed consent
  • Individuals with a history of IgA deficiency
  • Individuals with a history of hypersensitivity to AAT

Sites / Locations

  • Barbara Davis Center for Childhood Diabetes

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Alpha-1 Antitrypsin (AAT, Aralast NP)

Arm Description

Alpha-1 Antitrypsin (AAT, Aralast NP) as prescribed for study duration

Outcomes

Primary Outcome Measures

To assess participant safety & feasibility of study drug administration

Secondary Outcome Measures

To assess AAT treatment on the maintenance of c-peptide production
Assess the effects of AAT on glycemic variability and A1c.

Full Information

First Posted
March 17, 2011
Last Updated
March 23, 2017
Sponsor
University of Colorado, Denver
Collaborators
Omni Bio Pharmaceutical, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01319331
Brief Title
The Effects of Alpha-1 Antitrypsin (AAT) on the Progression of Type 1 Diabetes
Official Title
The Effects of Open Label Alpha-1 Antitrypsin on the Progression of Type 1 Diabetes in Subjects With Detectable C-peptide
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
May 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Colorado, Denver
Collaborators
Omni Bio Pharmaceutical, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if the drug Alpha-1 Antitrypsin (AAT, Aralast NP) will preserve beta-cell function and help slow the progression of type 1 diabetes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes, Type 1 Diabetes
Keywords
diabetes, type 1 diabetes, AAT, Alpha-1 Antitrypsin

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Alpha-1 Antitrypsin (AAT, Aralast NP)
Arm Type
Experimental
Arm Description
Alpha-1 Antitrypsin (AAT, Aralast NP) as prescribed for study duration
Intervention Type
Drug
Intervention Name(s)
Alpha 1-Antitrypsin (AAT, Aralast NP)
Other Intervention Name(s)
Alpha-1 Antitrypsin, AAT, Aralast NP
Intervention Description
Eligible subjects will be treated once a week for 8 weeks (8 total treatments).
Primary Outcome Measure Information:
Title
To assess participant safety & feasibility of study drug administration
Time Frame
Study duration is 2 years
Secondary Outcome Measure Information:
Title
To assess AAT treatment on the maintenance of c-peptide production
Time Frame
Stimulated c-peptide at year one and two.
Title
Assess the effects of AAT on glycemic variability and A1c.
Time Frame
Continuous Glucose Monitoring at one and two years.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of Type 1 Diabetes Mellitus based on ADA Criteria for fewer than 5 years but more than 100 days 6-45 years of age, inclusive. To assess safety, we will initially enroll 8 patients over the age of 16. Following the last infusion of the 8th patient, we will assess adverse events. As long as there are no stopping criteria met for these 8 patients we will decrease the age criteria down to 6 years old. C-peptide increase during screening mixed meal tolerance test with a minimal stimulated value of ≥ 0.2 pmol/mL. Positive for antibodies to insulin (if insulin autoantibody positive only, determination must be within two weeks of insulin initiation), GAD-65, IA-2 or ZnT8 Agree to intensive management of diabetes with an HgbA1c goal of < 7.0% If female, (a) surgically sterile or (b) postmenopausal or (c) if of reproductive potential, willing to use medically acceptable birth control (e.g. female hormonal contraception, barrier methods or sterilization. ) until 3 months after completion of any treatment period If male and of reproductive potential, willing to use medically acceptable birth control until 3 months after completion of any treatment period, unless the female partner is postmenopausal or surgically sterile Serum creatinine ≤ 1.5 x upper limit of normal AST < 2 times the upper limit of normal Hematology:WBC > 3000 x 109/L; platelets > 100 x 109/L; hemoglobin > 10.0 g/dL. Exclusion Criteria: Unable or unwilling to comply with the requirements of the study protocol Body Mass Index (BMI) > 30 kg/m2 Unstable blood sugar control defined as one or more episodes of severe hypoglycemia (defined as hypoglycemia that required the assistance of another person) within the last 30 days Previous immunotherapy for T1D Administration of an experimental agent for T1D at any time or use of an experimental device for T1D within 30 days of screening, unless approved by the study PI History of any organ transplant, including islet cell transplant Active autoimmune or immune deficiency disorder (e.g. sarcoidosis, rheumatoid arthritis) Serum bilirubin > ULN, except those subjects whose abnormal values were attributed to any stable, benign condition (such as Gilbert's Syndrome) may be included TSH outside the normal range at screening, except those subjects on stable doses of thyroid hormone replacement therapy may be included Known HIV positivity, active hepatitis B or active hepatitis C infection Anticipated pregnancy during active dosing or within 3 months after completion of active dosing phase History of a malignant neoplasm within the previous 5 years (except in situ cervical cancer and curable non-melanoma skin malignancy) Any social condition or medical condition that would, in the opinion of the investigator, prevent complete participation in the study or that would pose a significant hazard to the subjects' participation History of active substance abuse within 12 months of screening A psychiatric or medical disorder that would prevent giving informed consent Individuals with a history of IgA deficiency Individuals with a history of hypersensitivity to AAT
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter A Gottlieb, MD
Organizational Affiliation
University of Colorado, Denver
Official's Role
Principal Investigator
Facility Information:
Facility Name
Barbara Davis Center for Childhood Diabetes
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
22634621
Citation
Ozeri E, Mizrahi M, Shahaf G, Lewis EC. alpha-1 antitrypsin promotes semimature, IL-10-producing and readily migrating tolerogenic dendritic cells. J Immunol. 2012 Jul 1;189(1):146-53. doi: 10.4049/jimmunol.1101340. Epub 2012 May 25.
Results Reference
derived
Links:
URL
http://www.barbaradaviscenter.org/
Description
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The Effects of Alpha-1 Antitrypsin (AAT) on the Progression of Type 1 Diabetes

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