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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
24
The drug is a cell suspension with allogeneic mesenchymal stromal cells derived from umbilical cord tissue.
Placebo treatment
Karolinska Trial Alliance, Fas 1 enheten, Karolinska Universitetssjukhuset Huddinge
Stockholm, Sweden
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.
Time frame: 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.
Time frame: Day 372
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
Time frame: Days 187 and 372 following WJMSC/Placebo infusion
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
Time frame: 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
Time frame: Days 187 and 372 following WJMSC/Placebo infusion
HbA1c at days 187 and 372.
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Measurements of HbA1c will be performed to assess metabolic control during study.
Time frame: 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.
Time frame: 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
Time frame: 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
Time frame: Day 372 following WJMSC/Placebo infusion