The study is a prospective, randomized, 52-week double-blind, placebo-controlled, multicenter trial in subjects with Type 1 diabetes (T1D) followed by a 2-year safety follow-up.
The SUNRISE study is a prospective, multi-center, double-blind, randomized, placebo-controlled trial in subjects aged 12.0 to \<41.0 years diagnosed with type 1 diabetes (T1D), as defined by American Diabetes Association (ADA) criteria, and within 5 years of diagnosis. Time of diagnosis is defined as the first day of insulin administration. Subjects will be stratified by duration (zero up to 1 year and 1 year up to five years) to ensure balance of disease duration across treatment and placebo groups in each strata. For analytical purposes, all subjects12-\<41 will be considered cohort A, subjects aged 12-\<18 will considered cohort B and subjects aged 18-\<41 will be considered cohort C. For subjects aged 12-\<18 (Cohort B), dosing will be staggered with an initial 6 subjects aged 14-\<18 being enrolled with the last subject a having a minimum of 2 injections with at least 1 week follow-up after the 2nd injection. Safety data from this cohort will be evaluated before opening the study to subjects 12 and older. Subjects should be randomized no sooner than 6 weeks after diagnosis, unless glycemic range is adequately controlled as confirmed by time in glycemic range (70-180 mg/dL) \>55% by continuous glucose monitoring (CGM) recording over 3 or more consecutive or non-consecutive days. Screening assessments will include a physical examination, a fundoscopic photograph, chemistry and hematology safety labs, urinalysis, 24-hour urine protein and creatinine, hemoglobin A1c (HbA1c), presence of T1D antibodies, and a 4-hour mixed meal tolerance test (MMTT). Approximately 99 qualified subjects who meet all selection criteria will be randomized in a 2:1 ratio to treatment with TOL-3021 or placebo and treated for 52 weeks. Study drug treatments will be administered via an intramuscular (IM) injection into a large muscle every week for 52 weeks. CGM will be initiated within 5 days prior to the screening MMTT visit and continued through Week 52. Subjects will agree to diabetes management during the study with the goal of maintaining HbA1c levels of approximately 7.0% without frequent episodes of hypoglycemia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
78
TOL-3021 1 mg is a bacterial plasmid expression vector containing the coding sequences for the human proinsulin (hINS) gene.
TOL-3021 Placebo
Altman Clinical and Translational Research Institute UCSD
San Diego, California, United States
Change From Baseline on Log-transformed Mixed Meal Tolerance Test (MMTT) C-peptide Area Under the Curve (AUC)
The primary outcome is the TOL-3021 treatment effect as determined by a repeated measures analysis of change from baseline in the log-transformed MMTT C-peptide AUC at 12, 16, and 24 weeks
Time frame: Baseline,12,16 and 24 weeks
Hypoglycemia - % Time Continuous Glucose Monitor (CGM) Reading < 54 mg/dL
Rates of clinically important hypoglycemia events as defined by total measured glucose value of \<54 mg/dL (3.0 mM/L) over each approximately 12-week period ending at Week 24.
Time frame: Baseline, Weeks 1-12, Weeks 13-24
Hypoglycemia -Time CGM < 70 mg/dL
% Time that CGM measured glucose \<70 mg/dL during each time interval
Time frame: Baseline, Weeks 1-12, Weeks 13-24
Severe Hypoglycemic Events Lasting at Least 15 Minutes
Number of hypoglycemic events during interval that CGM \< 54 mg/dL for at least 15 consecutive minutes
Time frame: Baseline, Weeks 1-12, Weeks 13-24
Treatment Effect on Daily Insulin Requirements
Change from baseline in mean number of insulin units administered each day
Time frame: Baseline, Weeks 1-12 and Weeks 13-24
Effect on Hemoglobin A1c (HbA1c)
Change from baseline in Hemoglobin A1c
Time frame: Baseline, 12, 16, 24 weeks
Number of Participants With Adverse Events (AEs)
Summary of AEs by MedDRA System Organ Class (SOC) and Preferred Term
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University of California San Francisco
San Francisco, California, United States
Mills-Peninsula Medical Center
San Mateo, California, United States
Stanford University
Stanford, California, United States
Barbara Davis Center - University of Colorado Denver
Denver, Colorado, United States
Yale University
New Haven, Connecticut, United States
University of Florida
Gainesville, Florida, United States
Baptist Health Research Institute
Jacksonville, Florida, United States
University of Miami Diabetes Research Institute
Miami, Florida, United States
University of South Florida Diabetes Center
Tampa, Florida, United States
...and 13 more locations
Time frame: Baseline to 24 Weeks
Summary of Treatment Emergent Adverse Events (TEAEs)
Summary of Related Adverse Events by MedDRA System Organ Class (SOC) and Preferred Term (PT)
Time frame: Baseline to 24 Weeks
Summary of Adverse Events by Severity
Summary of AEs by Category of Severity (Mild, Moderate, Severe)
Time frame: Baseline to 24 Weeks
Serious Adverse Events (SAEs) and Deaths
Summary of Serious Adverse Events (SAEs) and Deaths
Time frame: Baseline to 24 Weeks