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The purpose of this study is to determine whether teplizumab slows the loss of β cells and preserves β cell function in children and adolescent 8-17 years old who have been diagnosed with T1D in the previous 6 weeks..
Subjects will receive two courses of either teplizumab or placebo treatment 6 months apart.
This is a Phase 3, randomized, double-blind, placebo-controlled, multinational, multi-center study to evaluate the efficacy and safety of teplizumab, a humanized, anti-CD3 monoclonal antibody, in children and adolescents ages 8 through 17 recently diagnosed with type 1 diabetes (within 6 weeks of diagnosis). Approximately 300 participants will be randomized at a ratio of 2:1 to either the teplizumab group or the placebo group.
Teplizumab or matching placebo will be administered in two courses 6 months apart. Each course of treatment will include daily infusions for 12 days. The total study duration for each participant will be up to 86 weeks.
The primary objective is to determine whether two courses of teplizumab administered 6 months apart slows the loss of β cells and preserves β cell function over 18 months (78 weeks) in children and adolescents 8-17 years old who have been diagnosed with T1D in the previous 6 weeks.
The secondary objectives are to evaluate improvements in key clinical parameters of diabetes management, to determine the safety and tolerability of teplizumab, and to evaluate the pharmacokinetics (PK) and immunogenicity of teplizumab
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Teplizumab | Experimental | Teplizumab was administered via intravenous infusion in two courses, with the first course starting on Day 1 (Week 1) and the second course approximately 6 months later at Day 182 (Week 26). Participants who were unable to receive the second 12-day course due to COronaVIrus Disease of 2019 (COVID-19) pandemic restrictions were given the second course at approximately 12 months (Week 52 visit). Each course of treatment included daily infusions for 12 days. Each course included:
|
|
| Placebo | Placebo Comparator | Placebo was administered via intravenous infusion in two courses, with the first course starting on Day 1 (Week 1) and the second course approximately 6 months later at Day 182 (Week 26). Participants who were unable to receive the second 12-day course due to COronaVIrus Disease of 2019 (COVID-19) pandemic restrictions were given the second course at approximately 12 months (Week 52 visit). Each course of treatment included daily infusions for 12 days. The placebo solution consisted of the same formulation as the study drug but without teplizumab. Placebo was administered in the same dose volume and by the same treatment schedule as the active drug. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| teplizumab | Biological | Treatment |
| |
| Placebo |
| Measure | Description | Time Frame |
|---|---|---|
| Change in C-peptide ln(AUC+1) Standardized by Duration of the Mixed Meal Tolerance Test (MMTT) | The area under the concentration-time curve (AUC) of C-peptide was measured after a 4-hour mixed meal tolerance test (MMTT) and is a measure of endogenous insulin production and β cell function. The AUC was computed using the trapezoidal rule and standardized by the duration of the MMTT test, i.e., AUC was divided by the last blood sample collection time (240 minutes or the last collection time for 4h MMTT). | Baseline to Week 78 |
| Measure | Description | Time Frame |
|---|---|---|
| Average Daily Exogenous Insulin Use | The average daily insulin use was calculated based on participants who have at least 3 days of insulin use recorded in the dairy for the Week 78 visit. | Week 78 |
| Change in Glycated Hemoglobin (HbA1c) Levels (%) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chief Medical Officer, MD | Provention Bio, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rady Children's Hospital-San Diego (Site 004) | San Diego | California | 92123 | United States | ||
| UCSF Medical Center (Site 001) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37861217 | Result | Ramos EL, Dayan CM, Chatenoud L, Sumnik Z, Simmons KM, Szypowska A, Gitelman SE, Knecht LA, Niemoeller E, Tian W, Herold KC; PROTECT Study Investigators. Teplizumab and beta-Cell Function in Newly Diagnosed Type 1 Diabetes. N Engl J Med. 2023 Dec 7;389(23):2151-2161. doi: 10.1056/NEJMoa2308743. Epub 2023 Oct 18. | |
| 39735417 | Derived |
| Label | URL |
|---|---|
| New England Journal of Medicine publication of the study results | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| Individual Participant Data Set | View IPD |
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient levels data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org.
After drug approval
Qualified researchers
Of 422 assessed for eligibility, 328 met inclusion criteria and were randomized to treatment.
The first participant was enrolled on April 5, 2019, and the last participant was enrolled on November 4, 2021.
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | Placebo: Control Placebo was administered via intravenous infusion in two courses, with the first course starting on Day 1 (Week 1) and the second course approximately 6 months later at Day 182 (Week 26). Participants who were unable to receive the second 12-day course due to COronaVIrus Disease of 2019 (COVID-19) pandemic restrictions were given the second course at approximately 12 months (Week 52) in a modified dosing schedule. Each course of treatment included daily infusions for 12 days. The placebo solution consisted of the same formulation as the study drug but without teplizumab. Placebo was administered in the same dose volume and by the same treatment schedule as the active drug. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Dec 10, 2020 | Mar 22, 2024 |
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Phase 3, randomized, double-blind, placebo-controlled, multinational, multicenter study
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| Biological |
Control |
|
Change in percentage (%) glycated hemoglobin (HbA1c)
| Baseline to Week 78 |
| Time in Range for Glycemia Control | Time in range (%) for glycemia control was assessed using Continuous Glucose Monitoring (CGM). Time in range was defined as daily average percentage of time a participant's glucose is >= 70 mg/dL and <=180 mg/dL. Time in range was calculated based on participants who had at least 3 days of CGM data recorded for Week 78 visit with a range of at least 8 hours on a given day. | Week 78 |
| Rate of Clinically Important Hypoglycemic Events | Rate = clinically important hypoglycemic events/patient-year. A clinically important episode was defined as a blood glucose value of <54 mg/dL (3.0 mmol/L) (i.e., Level 2 Hypoglycemia, International Hypoglycemia Study Group, 2017) or a hypoglycemia event of severe cognitive impairment requiring external assistance (such as seizure, syncope, severe confusion with or without a confirmatory low blood glucose reading) (i.e., Level 3 Hypoglycemia, International Hypoglycemia Study Group 2017). Event rate was calculated for each participant as number of events / total study follow-up time. Total study follow-up time was calculated as (the date of last study contact - the first dose date + 1)/365.25. The summary is based on the data reported post-baseline in the Hypoglycemic Events Electronic Diary (eDiary). | During the entire study (from the first dose to the last study contact, up to 78 Weeks) |
| Number of Participants With Adverse Events of Special Interest (AESIs) | AESIs are defined in the protocol and categories in the statistical analysis plan. Participants with multiple events are counted only once for each preferred term and category. | During the entire study (from the first dose to the last study contact, up to 78 Weeks) |
| Teplizumab Serum Concentrations | PK samples were collected prior to dosing except for Day 9 in Course 1. An additional PK sample was collected 45 minutes after infusion on Day 9 in Course 1. Concentration values below Lower Limit of Quantification (2.50 ng/mL) were set to zero for summary statistics. Course 2 day numbers were set relative to the first day of dosing, regardless of normal or modified dosing schedule. | Pre-dose samples collected on Days 1, 4, 9, 12 and 28 for each of the two treatment courses, and one post-dose sample collected on Day 9 during the first treatment course. |
| Anti-teplizumab Antibody (ADA) Titers After Treatment Courses | Baseline was defined as the most recent value collected prior to the first dose of study drug. Week 26 Day 187 and Weeks 27 and 34 are planned for subjects under the normal dosing schedule. Week 52 Day 369 and Weeks 53, 56, and 60 are planned for subjects under the modified dosing schedule. | Baseline through 78 Week |
| Incidence of Anti-drug Antibodies (ADA) After Treatment Courses | Baseline is defined as the most recent value collected prior to the first dose of study drug. Week 26 Day 187 and Weeks 27 and 34 are planned for subjects under the normal dosing schedule. Week 52 Day 369 and Weeks 53, 56, and 60 are planned for subjects under the modified dosing schedule. | From baseline through Week 78 |
| San Francisco |
| California |
| 94158 |
| United States |
| Diablo Clinical Research, Inc. (Site 002) | Walnut Creek | California | 94598 | United States |
| University of Colorado-Barbara Davis Center for Childhood Diabetes (Site 005) | Aurora | Colorado | 80045 | United States |
| Yale University of Medicine (Site 020) | New Haven | Connecticut | 06520 | United States |
| UF Clinical and Translation Research Building (Site 015) | Gainesville | Florida | 32610 | United States |
| Nemours Children's Specialty Care-Endocrinology (Site 047) | Jacksonville | Florida | 32207 | United States |
| University of Miami Health System (Site 028) | Miami | Florida | 33136 | United States |
| All Children's Hospital-Johns Hopkins Medicine (Site 048) | St. Petersburg | Florida | 33701 | United States |
| University of South Florida Diabetes and Endocrinology Center (Site 011) | Tampa | Florida | 33612 | United States |
| Atlanta Diabetes Associates (Site 009) | Atlanta | Georgia | 30318 | United States |
| Centricity Research (Site 006) | Columbus | Georgia | 31904 | United States |
| St. Luke's Children's Endocrinology (Site 052) | Boise | Idaho | 82712 | United States |
| Rocky Mountain Diabetes and Osteoporosis Center (Site 007) | Idaho Falls | Idaho | 83404 | United States |
| University of Chicago Medical Center (Site 017) | Chicago | Illinois | 60637 | United States |
| Indiana University Hospital and Riley Hospital for Children (Site 014) | Indianapolis | Indiana | 46202 | United States |
| U. Iowa Children's Hospital (Site 023) | Iowa City | Iowa | 52242 | United States |
| Capital Diabetes & Endocrine Associates (Site 029) | Camp Springs | Maryland | 20746 | United States |
| Baystate Pediatric Endocrinology & Diabetes (Site 040) | Springfield | Massachusetts | 01199 | United States |
| U. Minnesota Health Clinical Research Unit (Site 031) | Minneapolis | Minnesota | 55454 | United States |
| Children's Mercy Hospitals & Clinics (Site 026) | Kansas City | Missouri | 64108 | United States |
| Washington University School of Medicine (Site 018) | St Louis | Missouri | 63110 | United States |
| Women and Children's Hospital of Buffalo (Site 010) | Buffalo | New York | 14203 | United States |
| UNC Hospitals Children's Specialty Clinic (Site 038) | Chapel Hill | North Carolina | 27599 | United States |
| Rainbow Babies & Children's Hospital (Site 049) | Cleveland | Ohio | 44106 | United States |
| Cleveland Clinic (Site 051) | Cleveland | Ohio | 44195 | United States |
| Endocrinology Service Northwest, LLC (Site 034) | Bend | Oregon | 97702 | United States |
| Childrens Hospital of Philadelphia - Endocrinology (Site 021) | Philadelphia | Pennsylvania | 19104 | United States |
| Sanford Diabetes and Thyroiid Clinical (Site 013) | Sioux Falls | South Dakota | 57105 | United States |
| AM Diabetes & Endocrinology Center (Site 008) | Bartlett | Tennessee | 38133 | United States |
| Vanderbilt University Medical Center (Site 024) | Nashville | Tennessee | 37232 | United States |
| Children's Medical Center Dallas (Site 033) | Dallas | Texas | 75235 | United States |
| Benaroya Research Institute at Virginia Mason (Site 016) | Seattle | Washington | 98101 | United States |
| MultiCare Institute for Research & Innovation (Site 003) | Tacoma | Washington | 98405 | United States |
| UZ Brussel - Campus Jette (Site 202) | Brussels | Brussels Capital | 1090 | Belgium |
| UZ Gent (Site 206) | Ghent | Oost-Vlaanderen | 9000 | Belgium |
| CHU UCL Namur, site Clinique Sainte-Elisabeth (Site 205) | Namur | 5000 | Belgium |
| Alberta Diabetes Institute Clinical Research Unit Li Ka Shing Centre for Health Research Innovation (Site 103) | Edmonton | Alberta | T6G 2J3 | Canada |
| BC Diabetes (Site 102) | Vancouver | British Columbia | Canada |
| Montreal Children's Hospital-McGill (Site 101) | Montreal | Quebec | Canada |
| Fakultni nemocnice v Motole (Site 301) | Prague | 150 06 | Czechia |
| Hopitaux Pediatriques de Nice CHU-Lenval service de diabetologie et d'endocrinologia (Site 508) | Nice | Alpes-Maritimes | 6200 | France |
| CHU Hopital de la Timone-Hopital d'Enfants (Site 512) | Marseille | Bouces-du-Rhone | 13005 | France |
| CHU DIJON hopital d'enfant (Site 504) | Dijon | cote-d'Or | 21079 | France |
| Centre Hospitalier Regional (CHR) d'Orleans-Service de pediatrie (Site 513) | Orléans | Loiret | 45100 | France |
| Groupe hospitalier Est-Hopital Femme, Mere, Enfant (Site 509) | Bron | Rhone | 69677 | France |
| Centre hospitalier de Pau (Site 501) | Pau | 64046 | France |
| Groupe Hospitalier Necker Enfants Malades (site 502) | Paris | ÃŽle-de-France Region | 75015 | France |
| Universitätsklinikum Freiburg (Site 603) | Freiburg im Breisgau | Baden-Wurttemberg | 79106 | Germany |
| Universitätsklinikum Heidelberg (Site 608) | Heidelberg | Baden-Wurtternberg | 69120 | Germany |
| Universitätsklinikum Augsburg (Site 606) | Augsburg | Bayem | 86156 | Germany |
| Evangelisches Klinikum Bethel Kinderklinik (Site 602) | Bielefeld | North Rhine-Westphalia | 33617 | Germany |
| Universitatsklinikum Carl Gustav Carus (Site 601) | Dresden | Sachson | -1307 | Germany |
| Kinderkrankenhaus Auf Der Bult (Site 604) | Hanover | 30173 | Germany |
| Békés Megyei Központi Kórház Pándy Kálmán Tagkórház ( Site 705) | Gyula | Hungary |
| Uniwersyteckie Centrum Kliniczne Warszawskiego Uniwersytetu (Site 804) | Warsaw | Masovian Voivodeship | 01-184 | Poland |
| Instytut Diabetologii Sp. z o.o. (Site 802) | Warsaw | 02-117 | Poland |
| Instytut "Pomnik - Centrum Zdrowia Dziecka" (Site 801) | Warsaw | 04-730 | Poland |
| Uniwersyteckie Centrum Kliniczne (Site 803) | Warsaw | 80-952 | Poland |
| Northwick Park Hospital - Paediatrics (site 904) | London | City of London | HA1 3UJ | United Kingdom |
| Cardiff and Vale NHS Trust - University Hospital of Wales (Site 902) | Cardiff | CF14 4XN | United Kingdom |
| Sheffield Children's NHS Foundation Trust Western Bank (Site 903) | Sheffield | s10 2TH | United Kingdom |
| Ajmal N, Bogart MC, Khan P, Max-Harry IM, Healy AM, Nunemaker CS. Identifying Promising Immunomodulators for Type 1 Diabetes (T1D) and Islet Transplantation. J Diabetes Res. 2024 Dec 20;2024:5151171. doi: 10.1155/jdr/5151171. eCollection 2024. |
| 37158990 | Derived | Novograd J, Frishman WH. Teplizumab Therapy to Delay the Onset of Type 1 Diabetes. Cardiol Rev. 2024 Nov-Dec 01;32(6):572-576. doi: 10.1097/CRD.0000000000000563. Epub 2023 May 9. |
Qualified researchers can submit a research proposal that includes specific information about the purpose of the research, the objectives, the analysis plan, the publication plan, etc. Qualified researchers may request access to patient level data and related study documents. Patient level data will be anonymized, and study documents will be redacted to protect the privacy of trial participants. |
| FG001 | Teplizumab | Teplizumab: Treatment Teplizumab was administered via intravenous infusion in two courses, with the first course starting on Day 1 (Week 1) and the second course approximately 6 months later at Day 182 (Week 26). Participants who were unable to receive the second 12-day course due to COronaVIrus Disease of 2019 (COVID-19) pandemic restrictions were given the second course at approximately 12 months (Week 52) in a modified dosing schedule. Each course of treatment included daily infusions for 12 days. Each course included:
|
| COMPLETED |
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| NOT COMPLETED |
|
|
Intent-to-treat population
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | Placebo: Control |
| BG001 | Teplizumab | Teplizumab: Treatment |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||
| Peak C-peptide at screening | Count of Participants | Participants |
| ||||||||||||||||
| Age group at randomization | Count of Participants | Participants |
| ||||||||||||||||
| Number of positive type 1 diabetes (T1D) autoantibodies | Count of Participants | Participants |
| ||||||||||||||||
| History of diabetic ketoacidosis (DKA) | Count of Participants | Participants |
| ||||||||||||||||
| Human leukocyte antigen (HLA) genotyping - DR3 | Populations differs due to missing values. | Count of Participants | Participants |
| |||||||||||||||
| Human leukocyte antigen (HLA) genotyping - DR4 | Populations differs due to missing values. | Count of Participants | Participants |
| |||||||||||||||
| Anti-glutamic acid decarboxylase 65 (GAD65) autoantibody | Count of Participants | Participants |
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| Anti-islet antigen 2 (IA-2) autoantibody | Count of Participants | Participants |
| ||||||||||||||||
| Anti-zinc transporter 8 (ZnT8) autoantibody | Count of Participants | Participants |
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| Anti-insulin autoantibody | Count of Participants | Participants |
| ||||||||||||||||
| Anti-islet cell cytoplasmic antibody (ICA) | Count of Participants | Participants |
| ||||||||||||||||
| Height | Mean | Standard Deviation | cm |
| |||||||||||||||
| Weight | Mean | Standard Deviation | kg |
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| Body mass index (BMI) | Mean | Standard Deviation | kg/m^2 |
| |||||||||||||||
| Body mass index (BMI) z-score | The body mass index (BMI) z-score is a measure of the relative BMI adjusted for child's age and sex and describes the distance the BMI measurement falls from the mean in standard deviation units. A z-score of 0 represents the mean BMI for that age and sex, and a positive score indicates a BMI is higher than the mean, and a negative z-score indicates a BMI is lower than the mean. Z-scores were derived using the growth chart from the general population (e.g., Centers for Disease Control and Prevention (CDC) Growth Charts, https://www.cdc.gov/growthcharts/clinical\_charts.htm). | Mean | Standard Deviation | z-score |
| ||||||||||||||
| C-peptide area under concentration-time curve standardized by mixed meal tolerance test duration | The area under concentration-time curve (AUC) of C-peptide was measured after a 4-hour (4h) mixed meal tolerance test (MMTT). The AUC was computed using the trapezoidal rule and standardized by the duration of the MMTT test, i.e., AUC was divided by the last blood sample collection time (240 minutes or the last collection time for 4h MMTT). | Mean | Standard Deviation | pmol/mL |
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| Insulin use | Insulin use at baseline was calculated as the average daily use for participants who had at least 3 days of data recorded on the insulin diary before the start of the study. | Insulin use at baseline was not calculated for participants who did not have at least 3 days of data recorded on the insulin diary before the start of the study. | Mean | Standard Deviation | U/kg/day |
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| Glycated hemoglobin (HbA1c) | Population differs due to missing value for one participant. | Mean | Standard Deviation | Percentage of glycated hemoglobin |
| ||||||||||||||
| Time from type 1 diabetes (T1D) diagnosis to randomization | Mean | Standard Deviation | weeks |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in C-peptide ln(AUC+1) Standardized by Duration of the Mixed Meal Tolerance Test (MMTT) | The area under the concentration-time curve (AUC) of C-peptide was measured after a 4-hour mixed meal tolerance test (MMTT) and is a measure of endogenous insulin production and β cell function. The AUC was computed using the trapezoidal rule and standardized by the duration of the MMTT test, i.e., AUC was divided by the last blood sample collection time (240 minutes or the last collection time for 4h MMTT). | Intent-to-treat (ITT) and Per Protocol (PP). The main reason participants were excluded from the PP population was for treatment compliance <80% (15 of 16 excluded participants in the placebo group and 32 of 37 in the teplizumab group). Other reasons included took prohibited medication (1 in placebo group, 3 in teplizumab group), received incorrect treatment (2 in teplizumab group), and pregnancy (1 in teplizumab group). | Posted | Least Squares Mean | 95% Confidence Interval | pmol/mL | Baseline to Week 78 |
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| Secondary | Average Daily Exogenous Insulin Use | The average daily insulin use was calculated based on participants who have at least 3 days of insulin use recorded in the dairy for the Week 78 visit. | Intent-to-treat and Per Protocol | Posted | Least Squares Mean | 95% Confidence Interval | Units/kg/day | Week 78 |
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| Secondary | Change in Glycated Hemoglobin (HbA1c) Levels (%) | Change in percentage (%) glycated hemoglobin (HbA1c) | Intent-to-treat and Per Protocol | Posted | Least Squares Mean | 95% Confidence Interval | Percentage of glycated hemoglobin | Baseline to Week 78 |
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| Secondary | Time in Range for Glycemia Control | Time in range (%) for glycemia control was assessed using Continuous Glucose Monitoring (CGM). Time in range was defined as daily average percentage of time a participant's glucose is >= 70 mg/dL and <=180 mg/dL. Time in range was calculated based on participants who had at least 3 days of CGM data recorded for Week 78 visit with a range of at least 8 hours on a given day. | Intent-to-treat and Per Protocol | Posted | Least Squares Mean | 95% Confidence Interval | Percentage of time in range | Week 78 |
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| Secondary | Rate of Clinically Important Hypoglycemic Events | Rate = clinically important hypoglycemic events/patient-year. A clinically important episode was defined as a blood glucose value of <54 mg/dL (3.0 mmol/L) (i.e., Level 2 Hypoglycemia, International Hypoglycemia Study Group, 2017) or a hypoglycemia event of severe cognitive impairment requiring external assistance (such as seizure, syncope, severe confusion with or without a confirmatory low blood glucose reading) (i.e., Level 3 Hypoglycemia, International Hypoglycemia Study Group 2017). Event rate was calculated for each participant as number of events / total study follow-up time. Total study follow-up time was calculated as (the date of last study contact - the first dose date + 1)/365.25. The summary is based on the data reported post-baseline in the Hypoglycemic Events Electronic Diary (eDiary). | Intent-to-treat and Per Protocol | Posted | Mean | 95% Confidence Interval | Events/patient-year | During the entire study (from the first dose to the last study contact, up to 78 Weeks) |
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| Secondary | Number of Participants With Adverse Events of Special Interest (AESIs) | AESIs are defined in the protocol and categories in the statistical analysis plan. Participants with multiple events are counted only once for each preferred term and category. | Safety population = all randomized study participants receiving any exposure to study drug. | Posted | Count of Participants | Participants | During the entire study (from the first dose to the last study contact, up to 78 Weeks) |
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| Secondary | Teplizumab Serum Concentrations | PK samples were collected prior to dosing except for Day 9 in Course 1. An additional PK sample was collected 45 minutes after infusion on Day 9 in Course 1. Concentration values below Lower Limit of Quantification (2.50 ng/mL) were set to zero for summary statistics. Course 2 day numbers were set relative to the first day of dosing, regardless of normal or modified dosing schedule. | The Pharmacokinetic (PK) population includes all randomized participants who received at least one dose of teplizumab with at least one valid pharmacokinetic sample. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng/mL | Pre-dose samples collected on Days 1, 4, 9, 12 and 28 for each of the two treatment courses, and one post-dose sample collected on Day 9 during the first treatment course. |
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| Secondary | Anti-teplizumab Antibody (ADA) Titers After Treatment Courses | Baseline was defined as the most recent value collected prior to the first dose of study drug. Week 26 Day 187 and Weeks 27 and 34 are planned for subjects under the normal dosing schedule. Week 52 Day 369 and Weeks 53, 56, and 60 are planned for subjects under the modified dosing schedule. | The Immunogenicity population includes all randomized participants who received at least one dose of teplizumab with at least one valid serum Anti-teplizumab Antibody (ADA) sample. | Posted | Geometric Mean | Geometric Coefficient of Variation | Titer | Baseline through 78 Week |
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| Secondary | Incidence of Anti-drug Antibodies (ADA) After Treatment Courses | Baseline is defined as the most recent value collected prior to the first dose of study drug. Week 26 Day 187 and Weeks 27 and 34 are planned for subjects under the normal dosing schedule. Week 52 Day 369 and Weeks 53, 56, and 60 are planned for subjects under the modified dosing schedule. | The Immunogenicity population includes all randomized participants who received at least one dose of teplizumab with at least one valid serum Anti-teplizumab Antibody (ADA) sample. | Posted | Count of Participants | Participants | From baseline through Week 78 |
|
|
Treatment-emergent adverse events = from the first dose of study drug administration through the end of the study, up to 78 weeks
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Placebo | Safety population | 0 | 111 | 6 | 111 | 88 | 111 |
| EG001 | Teplizumab | Safety population | 0 | 217 | 12 | 217 | 212 | 217 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Concussion | Injury, poisoning and procedural complications | 26.0 | Systematic Assessment |
| |
| Palpitation | Cardiac disorders | 26.0 | Systematic Assessment |
| |
| Syncope | Nervous system disorders | 26.0 | Systematic Assessment |
| |
| Cytokine release syndrome | Immune system disorders | 26.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | 26.0 | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | 26.0 | Systematic Assessment |
| |
| Dermatitis atopic | Skin and subcutaneous tissue disorders | 26.0 | Systematic Assessment |
| |
| Suicidal ideation | Psychiatric disorders | 26.0 | Systematic Assessment |
| |
| Suicide attempt | Psychiatric disorders | 26.0 | Systematic Assessment |
| |
| Anxiety | Psychiatric disorders | 26.0 | Systematic Assessment |
| |
| Nephrolithiasis | Renal and urinary disorders | 26.0 | Systematic Assessment |
| |
| Device related bacteraemia | Infections and infestations | 26.0 | Systematic Assessment |
| |
| Gastroenteritis | Infections and infestations | 26.0 | Systematic Assessment |
| |
| Hypoglycaemia | Metabolism and nutrition disorders | 26.0 | Systematic Assessment |
| |
| Hyperglycaemia | Metabolism and nutrition disorders | 26.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hypotension | Vascular disorders | 26.0 | Systematic Assessment |
| |
| Pyrexia | General disorders | 26.0 | Systematic Assessment |
| |
| Fatigue | General disorders | 26.0 | Systematic Assessment |
| |
| Chills | General disorders | 26.0 | Systematic Assessment |
| |
| Cytokine release syndrome | Immune system disorders | 26.0 | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | 26.0 | Systematic Assessment |
| |
| Nasal congestion | Respiratory, thoracic and mediastinal disorders | 26.0 | Systematic Assessment |
| |
| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | 26.0 | Systematic Assessment |
| |
| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | 26.0 | Systematic Assessment |
| |
| Lymphocyte count decreased | Investigations | 26.0 | Systematic Assessment |
| |
| White blood cell count decreased | Investigations | 26.0 | Systematic Assessment |
| |
| Neutrophil count decreased | Investigations | 26.0 | Systematic Assessment |
| |
| Alanine aminotransferase increased | Investigations | 26.0 | Systematic Assessment |
| |
| Aspartate Aminotransferase increased | Investigations | 26.0 | Systematic Assessment |
| |
| Tachycardia | Cardiac disorders | 26.0 | Systematic Assessment |
| |
| Headache | Nervous system disorders | 26.0 | Systematic Assessment |
| |
| Dizziness | Nervous system disorders | 26.0 | Systematic Assessment |
| |
| Lymphopenia | Blood and lymphatic system disorders | 26.0 | Systematic Assessment |
| |
| Neutropenia | Blood and lymphatic system disorders | 26.0 | Systematic Assessment |
| |
| Leukopenia | Blood and lymphatic system disorders | 26.0 | Systematic Assessment |
| |
| Anaemia | Blood and lymphatic system disorders | 26.0 | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | 26.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Abdominal pain | Gastrointestinal disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Abdominal pain upper | Gastrointestinal disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | 26.0 | Systematic Assessment |
| |
| Rash maculo-papular | Skin and subcutaneous tissue disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Rash macular | Skin and subcutaneous tissue disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Dermatitis | Skin and subcutaneous tissue disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Erythema | Skin and subcutaneous tissue disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Proteinuria | Renal and urinary disorders | 26.0 | Systematic Assessment |
| |
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA 26.0 | Systematic Assessment |
| |
| COVID-19 | Infections and infestations | MedDRA 26.0 | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | MedDRA 26.0 | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA 26.0 | Systematic Assessment |
| |
| Gastroenteritis | Infections and infestations | MedDRA 26.0 | Systematic Assessment |
| |
| Hypoglycaemia | Metabolism and nutrition disorders | 26.0 | Systematic Assessment |
| |
| Decreased appetite | Metabolism and nutrition disorders | MedDRA 26.0 | Systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 26.0 | Systematic Assessment |
|
Enrollment into the study was temporarily suspended due to COronaVIrus Disease of 2019 (COVID-19) pandemic restrictions. Participants who were unable to receive the second 12-day treatment course at 6 months due to COVID-19 pandemic restrictions were given the second course at approximately 12 months (modified dosing schedule).
Sponsor has right to publish multi-center study results first, then PI may publish/present study results after Sponsor had at least 60 days and up to 105 days to review/comment/obtain intellectual property protection, PI has deleted all sponsor-requested references to confidential information, and PI has considered the Sponsor's proposed revisions in good faith and meets with the Sponsor to discuss/ resolve any disagreements regarding accuracy, data analyses or confidential information.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical and Translational Medicine Lead | Sanofi | 1-703-344-2992 | laura.knecht@sanofi.com |
| Prot_002.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Mar 17, 2023 | Mar 22, 2024 | SAP_003.pdf |
Not provided
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C502540 | teplizumab |
Not provided
Not provided
Not provided
| Between 18 and 65 years |
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| >=65 years |
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| Belgium |
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| United States |
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| Czechia |
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| Poland |
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| United Kingdom |
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| France |
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| Germany |
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| >12 - 17 years |
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| One |
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| Two |
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| Three |
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| Four |
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| Five |
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| Per Protocol |
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| Superiority |
| ANCOVA | <0.001 | PP: The ANCOVA model included treatment, age group at randomization, and baseline C-peptide ln(AUC+1) as independent variables. Missing data at Week 78 were multiply imputed using a pattern-mixture model under the missing not at random assumption. | Mean Difference (Net) | 0.1385 | 2-Sided | 95 | 0.0994 | 0.1776 | Least squares mean (LSmean) difference = teplizumab - placebo | Superiority |
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| Participants |
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