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| ID | Type | Description | Link |
|---|---|---|---|
| 2017-002766-50 | EudraCT Number |
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To investigate the safety and tolerance after allogeneic infusion of WJMSCs intravenously in adult patients diagnosed with type 1 diabetes.
This is a combined phase I and phase II study, where the first part is an open, dose escalating study consisting of 9 male patients, 18-40 years of age. The second part is a randomized, double-blinded, placebo-controlled, phase I/II study in parallel design comparing allogeneic WJMSC treatment to placebo in adult patients diagnosed with type 1 diabetes. Besides safety, preservation of endogenous insulin production (measured as C-peptide concentrations) together with metabolic control, diabetes treatment satisfaction and immunological profile will be assessed.
A total number of 24 patients will be enrolled in the study and followed for one year after WJMSC/placebo treatment. Patients 18-40 years of age, both male and female, diagnosed for type 1 diabetes will be eligible. Providing informed consent and fulfillment of inclusion criteria and no exclusion criteria, they will within two years of diagnosis be randomized.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Allogeneic transplantation with WJMSCs | Experimental | Single infusion of 200 million cells per patient. |
|
| Sham transplantation (placebo) | Placebo Comparator | Single infusion with albumin and dmso in sodium chloride (identical concentrations as active treatment) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ProTrans: Allogeneic transplantation with WJMSCs | Drug | The drug is a cell suspension with allogeneic mesenchymal stromal cells derived from umbilical cord tissue. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety; measured through set safety parameters | measured through the registration of adverse events and other safety parameters such as hypoglycemia, allergic reactions, ophthalmologic examination, ECG, vital signs and laboratory assessments. | throughout the study untill day 372 |
| Efficacy; comparison of the intervention versus placebo at day 372 versus start of treatment | Delta-change of C-peptide Area Under the Curve (AUC) (0-120 min) for Mixed Meal Tolerance Test (MMTT) at day 372 following WJMSC/Placebo infusion when compared to test performed before start of treatment. | Day 372 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients insulin independent (ADA criteria) at days 187 and 372 | Insulin doses and measured plasma glucose values are written down in the subject's diary every day by the subject. Amount of insulin, recorded plasma glucose values, time and date will be included | Days 187 and 372 following WJMSC/Placebo infusion |
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Inclusion Criteria:
Written informed consent for participation of the study, given before undergoing any study-specific procedures
Clinical history compatible with type 1 diabetes diagnosed less than 2 years before enrolment
In the first part of the study patients 1-9 only male patients between 18-40 years of age will be included. In the second part of the study, patients 10-24, both male and female patients 18 to 40 years of age (inclusive at both ends) will be included.
Mentally stable and, in the opinion of the investigator, able to comply with the procedures of the study protocol
Fasting plasma C-peptide concentration >0.12 nmol/L.
Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, if they are using effective methods of contraception during the study. Acceptable birth control methods are those with a failure rate of less than 1% per year when used consistently and correctly. Such methods include (in "Recommendations related to contraception and pregnancy testing in clinical trials", supplied from www.hma.eu/):
Combined (estrogen and progestogen containing hormonal contraception associated with inhibition of ovulation.
progestogen-only hormonal contracption associated with inhibition of ovulation
intrauterine device (IUD)
intrauterine hormone-releasing system (IUS)
bilateral tubal occlusion
total abstinence or vasectomized partner.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Per-Ola Carlsson, MD, PhD | NextCell Pharma | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karolinska Trial Alliance, Fas 1 enheten, Karolinska Universitetssjukhuset Huddinge | Stockholm | 141 86 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37221247 | Derived | Carlsson PO, Espes D, Sisay S, Davies LC, Smith CIE, Svahn MG. Umbilical cord-derived mesenchymal stromal cells preserve endogenous insulin production in type 1 diabetes: a Phase I/II randomised double-blind placebo-controlled trial. Diabetologia. 2023 Aug;66(8):1431-1441. doi: 10.1007/s00125-023-05934-3. Epub 2023 May 24. |
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| Placebos | Drug | Placebo treatment |
|
|
| Number of patients with daily insulin needs <0.25U/kg at days 187 and 372 |
Insulin doses and measured plasma glucose values are written down in the subject's diary every day by the subject. Amount of insulin, recorded plasma glucose values, time and date will be included |
| Days 187 and 372 following WJMSC/Placebo infusion |
| Insulin requirement/kg BW at days 187 and 372 | Insulin doses and measured plasma glucose values are written down in the subject's diary every day by the subject. Amount of insulin, recorded plasma glucose values, time and date will be included | Days 187 and 372 following WJMSC/Placebo infusion |
| HbA1c at days 187 and 372. | Measurements of HbA1c will be performed to assess metabolic control during study. | Days 187 and 372 following WJMSC/Placebo infusion |
| Glucose variability at day 372 | Measurements of HbA1c will be performed to assess metabolic control during study. | Day 372 following WJMSC/Placebo infusion |
| Delta change of levels of fasting C-peptide at day 372 | Measured at day 372 compared to before start of treatment | Day 372 following WJMSC/Placebo infusion |
| Numbers of patients with peak C-peptide >0.20 nmol/l, in response to the MMTT, at day 372 | Measured at day 372 compared to before start of treatment | Day 372 following WJMSC/Placebo infusion |