The IMPACT study is a study to test a new experimental drug, IMCY-0098, for the treatment of type 1 diabetes (T1D). In most people with type 1 diabetes, the pancreas loses its ability to make insulin because some cells of the body's own immune system mistakenly attack and destroy the cells in the pancreas that produce insulin (islet beta-cells). The study drug IMCY-0098 is being developed to stop the body's own immune system attacking and destroying the insulin-producing cells. When injected, it will induce new immune cells that will specifically destroy the bad immune cells responsible for the damage to the pancreas. IMCY-0098 has previously been tested on recently diagnosed type 1 diabetes patients in the first clinical study between 2017 and 2019 to collect information on the safety of IMCY-0098. The next step is to test the best dose and the best number of injections that show the drug can give a benefit. Two doses of IMCY-0098 will be tested and they will be compared to a placebo. Safety information will also be collected during the study for all the participants.
The main study will include 84 HLA DR4+ patients. In addition, up to 24 HLA DR4-/DR3+ patients will be included in a mechanistic substudy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
110
Small synthetic peptide for SC admin. Solvent: alum hydroxide
Small synthetic peptide for SC admin. Solvent: alum hydroxide
Solvent: alum hydroxide
University of Alabama at Birmingham
Birmingham, Alabama, United States
Barbara Davis Center
Aurora, Colorado, United States
University of Chicago
Chicago, Illinois, United States
Joslin Diabetes Center
Boston, Massachusetts, United States
Princess Alexandra Hospital
Brisbane, Australia
Royal Melbourne Hospital
Melbourne, Australia
St. Vincent's Hospital
Melbourne, Australia
Royal North Shore Hospital
Sydney, Australia
Université Libre de Bruxelles - Hôpital Erasme - ULB
Brussels, Belgium
UZ Brussels
Brussels, Belgium
...and 19 more locations
Change in stimulated C-peptide response during the first two hours of a mixed meal tolerance test (MMTT) from baseline to 48 weeks between IMCY-0098 and placebo groups
The area under the stimulated C-peptide response curve over the first two hours of a MMTT
Time frame: From baseline to 48 weeks
Changes in stimulated C-peptide response during the first two hours of a MMTT for the two doses of IMCY-0098 versus placebo
The area under the stimulated C-peptide response curve over the first two hours of a MMTT
Time frame: From baseline to 24 months
Difference in Dried Blood Spots (DBS) fasted C-peptide between treatment and placebo groups
DBS C-peptide measurements
Time frame: From baseline to 48 weeks
Changes in DBS C-peptide measurements at each visit comparing each dose with placebo
The DBS C-peptide responses at each visit
Time frame: From baseline to 24 months
Effects of each dose of IMCY-0098 on HbA1c
Change in HbA1c
Time frame: From baseline to 24 months
Effects of each dose of IMCY-0098 on hypoglycaemic events
Number of treatment-emergent severe hypoglycaemic episodes
Time frame: From baseline to 24 months
Effects of each dose of IMCY-0098 on diabetic ketoacidosis (DKA) episodes
Number of treatment-emergent episodes of DKA
Time frame: From baseline to 24 months
Effects of each dose of IMCY-0098 on daily total insulin dose
Change in insulin requirements as the daily total dose (three days average) in units per kg body weight
Time frame: From baseline to 24 months
Effects of each dose of IMCY-0098 on Continuous Glucose Monitoring (CGM) measures
CGM time in range (70-180 mg/dL, 3.9- 10.0 mmol/L), time above range (\>180 mg/dL, \>10.0 mmol/L), time below range (\<70 mg/dL, \< 3.9 mmol/L) during 10 days compared to the reference period (first 10 days after randomization)
Time frame: From baseline to 24 months
Impact of IMCY-0098 at each dose on autoantibodies against GAD65, IA 2, ZnT8 and insulin over time
Change in T1D associated autoantibodies (GADA, IAA, IA-2A and ZnT8A)
Time frame: From baseline to 24 months
To evaluate the safety features of IMCY-0098 during treatment period
Occurrence, intensity and relationship of any listed injection site and systemic AEs during a 7-day follow-up period after each dose
Time frame: Up to 7 days after the last dose
To evaluate the safety features of IMCY-0098 during the whole study duration
Occurrence, intensity and relationship of any unlisted injection site and AEs and occurrence and relationship of all SAEs and abnormality in physical examination, vital signs, 12-lead ECG
Time frame: Up to 48 weeks
To evaluate the safety features of IMCY-0098 on lymphocytes ratio
Measure of CD4+/CD8+ lymphocytes ratio
Time frame: Up to 48 weeks
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