A Research Trial of Aralast in New Onset Diabetes (RETAIN) - Part II
This study is not yet open for participant recruitment.
Verified August 2010 by National Institute of Allergy and Infectious Diseases (NIAID)
Sponsor:
Collaborators:
Immune Tolerance Network (ITN)
Juvenile Diabetes Research Foundation
Information provided by:
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT01183455
First received: August 16, 2010
Last updated: NA
Last verified: August 2010
History: No changes posted
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Purpose
The drug Alpha-1 Antitrypsin (AAT, Aralast NP), which is being tested in this clinical trial, is an anti-inflammatory drug that affects the cells that are thought to be involved in the development of type 1 diabetes. This trial, known as RETAIN, is a clinical trial is a two-part trial investigating the effect of intravenous Alpha-1 Antitrypsin(AAT, Aralast NP) on preserving beta cell function and to determine if AAT will help slow the progression of type 1 diabetes.
Part I of this trial (NCT#) is an open-label, safety and dose level study consisting of two groups. After Part I is completed, including a satisfactory safety review, enrollment in Part II will begin. Part II is a two-arm, double-blind, placebo-controlled clinical trial, and participants will be randomly assigned to either the treatment or placebo group.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus, Type 1 |
Drug: Alpha 1-Antitrypsin (AAT, Aralast NP) Drug: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effect of Intravenous Alpha-1 Antitrypsin on Preserving Beta-cell Function in New-onset Type 1 Diabetes Mellitus - Part II |
Resource links provided by NLM:
Genetics Home Reference related topics:
type 1 diabetes
Drug Information available for:
alpha 1-Antitrypsin
U.S. FDA Resources
Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):
Primary Outcome Measures:
- Mixed-Meal Tolerance Test (MMTT)-stimulated 2-hour C-peptide Area under the curve (AUC) [ Time Frame: Week 52 ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- MMTT-stimulated peak and 4-hour C-peptide AUC [ Time Frame: Weeks 52 and 104 ] [ Designated as safety issue: No ]
- MMTT-stimulated 2-hour C-peptide AUC assessed longitudinally [ Time Frame: Weeks 0, 14, 26, 52, and 104 ] [ Designated as safety issue: No ]
- Insulin use in units per kilogram body weight per day [ Time Frame: Weeks 52 and 104 ] [ Designated as safety issue: No ]
- Hypoglycemic events occurring from randomization [ Time Frame: Throughout the trial ] [ Designated as safety issue: Yes ]
- Glycosylated hemoglobin (HbA1C) levels [ Time Frame: Weeks 52 and 104 ] [ Designated as safety issue: No ]
- Emergence of anti-AAT antibodies [ Time Frame: Throughout the study ] [ Designated as safety issue: Yes ]
- Frequency and severity of all AEs (including infusion reactions, hypersensitivity reactions, and viral infections) [ Time Frame: Throughout the trial ] [ Designated as safety issue: Yes ]
- Changes in D-dimer levels indicating alteration in coagulant/anticoagulant balance [ Time Frame: Throughout the trial ] [ Designated as safety issue: Yes ]
- Pharmacokinetic parameters of Aralast NP [ Time Frame: Throughout the trial ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 66 |
| Study Start Date: | October 2010 |
| Estimated Study Completion Date: | November 2014 |
| Estimated Primary Completion Date: | November 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Aralast NP |
Drug: Alpha 1-Antitrypsin (AAT, Aralast NP)
Participants will receive IV infusions of Aralast NP (90mg/kg) once a week for 12 weeks.
Other Names:
|
| Placebo Comparator: Placebo |
Drug: Placebo
Participants will receive IV infusions of an inactive placebo once a week for 12 weeks.
|
Detailed Description:
Type 1 diabetes mellitus is an autoimmune disease. This means that your immune system (the part of your body that helps fight infections) mistakenly attacks the cells that produce insulin (beta cells in the pancreas). As beta cells are destroyed by your immune cells, your ability to produce insulin is decreased. Insulin helps keep blood glucose levels normal.
People with type 1 diabetes who have the ability to produce some of their own insulin (even though they still need to take insulin) may be able to achieve better glucose control than people who produce no insulin at all. Better glucose control has been shown to reduce the long-term complications of diabetes. Previous research has shown that giving medicines to affect the immune system soon after type 1 diabetes is diagnosed may stop, delay or decrease the destruction of beta cells, resulting in better glucose control.
In mouse models of disease, Alpha-1 Antitrypsin (AAT, Aralast NP) has been shown to reverse new-onset diabetes and induce a state of self-tolerance. The RETAIN clinical trial is investigating the effect of intravenous Alpha-1 antitrypsin(AAT, Aralast NP) on preserving beta cell function and whether AAT will help slow the progression of type 1 diabetes.
Eligibility| Ages Eligible for Study: | 8 Years to 35 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Diagnosed with type 1 diabetes within the past 100 days
- Positive for at least one diabetes-related autoantibody (Anti-GAD; Anti-insulin, if obtained within 10 days of the onset of insulin therapy; IA-2 antibody and/or ICA, or ZnT8.)
- Peak stimulated C-peptide level > 0.2 pmol/mL following a mixed meal tolerance test (MMTT)
Exclusion Criteria:
- Serve active disease (hepatitis, cardiac or pulmonary disease, hypertension, immunodeficiency)
- History of any bleeding or clotting factor deficiencies, or stroke
- History of vascular disease or significant vascular abnormalities
- Positive serology exposure to HBV, HCV, HIV or toxoplasmosis
- Clinically active infection with EBV, CMV, or tuberculosis
- Prior or current use of oral, inhaled or intranasal glucocorticoids, or any medication known to cause a significant, ongoing change in the course of T1DM or immunologic status
- Prior treatment with AAT or hypersensitivity to AAT or human plasma-derived products
- Current or prior (within the last 30 days) use of metformin, sulfonylureas, glinides, thiazolidinediones, exenatide, liraglutide, DPP-IV inhibitors or amylin.
- Current use of any medication known to influence glucose tolerance (e.g., beta-blockers, angiotensin-converting enzyme inhibitors, interferons, quinidine anti-malarial drugs, lithium, niacin)
- Females who are pregnant or lactating, or are unwilling to defer pregnancy during study participation.
- IgA deficiency
- Uncontrolled hypertension.
- Current life-threatening malignancy.
- Any condition that in the investigator's opinion may compromise study participation or may confound the interpretation of the study results.
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01183455
Locations
| United States, California | |
| University of California San Diego | Not yet recruiting |
| La Jolla, California, United States, 92093 | |
| Principal Investigator: Michael Gottschalk, MD | |
| United States, Colorado | |
| Barbara Davis Center | Not yet recruiting |
| Aurora, Colorado, United States, 80045 | |
| Principal Investigator: Peter Gottlieb, MD | |
| United States, Connecticut | |
| Yale University | Not yet recruiting |
| New Haven, Connecticut, United States, 06511 | |
| Principal Investigator: Kevin Herold, MD | |
| United States, Georgia | |
| Emory University | Not yet recruiting |
| Atlanta, Georgia, United States, 30322 | |
| Principal Investigator: Mark Rigby, MD, PhD | |
| Principal Investigator: Eric Felner, MD | |
| Atlanta Diabetes Associates | Not yet recruiting |
| Atlanta, Georgia, United States, 30309 | |
| Principal Investigator: Bruce Bode, MD | |
| United States, Iowa | |
| University of Iowa | Not yet recruiting |
| Iowa City, Iowa, United States, 52242 | |
| Principal Investigator: Eva Tsalikian, MD | |
| United States, Maryland | |
| University of Maryland Medical Center | Not yet recruiting |
| Baltimore, Maryland, United States, 21201 | |
| Principal Investigator: Debra Counts, MD | |
| Calvert Memorial Hospital | Not yet recruiting |
| Prince Frederick, Maryland, United States, 20678 | |
| Principal Investigator: June Moore, MD | |
| United States, Massachusetts | |
| Joslin Diabetes Center | Not yet recruiting |
| Boston, Massachusetts, United States, 02215 | |
| Principal Investigator: Gordon Weir, MD | |
| Massachusetts General Hospital | Not yet recruiting |
| Boston, Massachusetts, United States, 02114 | |
| Principal Investigator: Nicole A Sherry, MD | |
| University of Massachusetts Medical School | Not yet recruiting |
| Worchester, Massachusetts, United States, 01655 | |
| Principal Investigator: Mary Lee, MD | |
| United States, New York | |
| Columbia University | Not yet recruiting |
| New York, New York, United States, 100027 | |
| Principal Investigator: Robin Goland, MD | |
| United States, Ohio | |
| Nationwide Children's Hospital | Not yet recruiting |
| Columbus, Ohio, United States, 43205 | |
| Principal Investigator: Timothy Hoffman, MD | |
| United States, Pennsylvania | |
| The Children's Hospital of Philadelphia | Not yet recruiting |
| Philadephia, Pennsylvania, United States, 19104 | |
| Principal Investigator: Steven M Willi, MD | |
| United States, Texas | |
| Cetero Research San Antonio | Not yet recruiting |
| San Antonio, Texas, United States, 78229 | |
| Principal Investigator: Jolene Berg, MD | |
Sponsors and Collaborators
Immune Tolerance Network (ITN)
Juvenile Diabetes Research Foundation
Investigators
| Study Chair: | Gordon Weir, MD | Joslin Diabetes Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | Associate Director, Clinical Research and Operations Program, DAIT, NIAID, NIH |
| ClinicalTrials.gov Identifier: | NCT01183455 History of Changes |
| Other Study ID Numbers: | DAIT ITN041AIPartII |
| Study First Received: | August 16, 2010 |
| Last Updated: | August 16, 2010 |
| Health Authority: | United States: Federal Government United States: Food and Drug Administration |
Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
|
Diabetes Mellitus, Type 1 Diabetes Mellitus, Insulin-Dependent Diabetes Mellitus, Juvenile-Onset |
Diabetes, Autoimmune Aralast NP Alpha-1 Antitrypsin |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 1 Alpha 1-Antitrypsin Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Autoimmune Diseases Immune System Diseases |
Protein C Inhibitor Trypsin Inhibitors Serine Proteinase Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013