E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Children with HLA risk and persistent islet autoantibody positivity which is
associated with a defined risk for type 1 diabetes |
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E.1.1.1 | Medical condition in easily understood language |
Prediabetes (the autoimmune process leading to type 1 diabetes) |
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E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to demonstrate that Diamyd® is safe in children at risk for type 1 diabetes from 4 years of age. The subjects will be followed for 5 years.
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E.2.2 | Secondary objectives of the trial |
The secondary objective is to evaluate if Diamyd® may delay or stop the autoimmune process leading to clinical type 1 diabetes in children with ongoing persistent beta-cell autoimmunity as indicated by multiple positive islet cell autoantibodies.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Children from four (4) years of age and participating in DiPiS, TEDDY or Trial Net.
2. Positive GAD65Ab (>35) and at least one additional type 1 diabetes-associated autoantibody (IA-2Ab >5, ZnT8R/W/Q/A Ab>72 or IAA>0,8).
3. Written informed consent from the child and the child’s parents or legal acceptable representative(s) according to local regulations. |
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E.4 | Principal exclusion criteria |
1.Ongoing treatment with immunosuppressant therapy (topical or inhaled steroids are accepted)
2.Diabetes.
3.Treatment with any oral or injected anti-diabetic medications.
4.Significantly abnormal hematology results at screening.
5.Clinically significant history of acute reaction to vaccines or other drugs.
6.Treatment with any vaccine, other than influenza, within one month prior to the first dose of the study drug or planned treatment with vaccine up to two months after the last injection with the study drug.
7.A history of epilepsy, serious head trauma or cerebrovascular accident, or clinical features of continuous motor unit activity in proximal muscles.
8.Participation in other clinical trials with a new chemical entity within the previous 3 months.
9.Significant illness other than diabetes within 2 weeks prior to first dosing.
10.Known human deficiency virus (HIV) or hepatitis.
11.Presence of associated serious disease or condition, including active skin infections that preclude subcutaneous injection, which in the opinion of the investigators makes the patient non-eligible for the study.
12. Diabetes-protective HLA-DQ6-genotype. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary objective is to show that the treatment is safe in children at risk for type 1 diabetes.
The primary endpoint of effect is the proportion of subjects in the two treatment groups who develop type 1 diabetes, according to the American Diabetes Association criteria, during the study period.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
As secondary variables of effect we will use 1) change in first-phase insulin response on IvGTT from baseline, 2) fasting and 2 hours C-peptide levels on OGTT as well as AUC, 3) the 120 min glucose value and AUC glucose from OGTT and 4) change in HbA1c from baseline. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |