MedPath

INfluenza VaccInation To Mitigate typE 1 Diabetes

Phase 4
Recruiting
Conditions
Diabetes Mellitus, Type 1
Interventions
Biological: Vaxigrip Tetra Sanofi Pasteur Europe
Registration Number
NCT05585983
Lead Sponsor
Aarhus University Hospital
Brief Summary

In a multicenter, prospective, randomized, controlled clinical trial to compare influenza vaccination and placebo in sustaining β cell function in early type 1 diabetes mellitus.

Detailed Description

Type 1 diabetes (T1D) is an autoimmune disease in which T cells attack and destroy the insulin-producing β cells in the pancreatic islets. In theory, immunotherapies aimed at re-programming the immune system to avoid β cell destruction is a promising strategy to prevent T1D or delay onset of overt disease.

In this trial we test the hypothesis that influenza vaccination is superior to no influenza vaccination in sustaining β cell function in early T1D. Secondary outcome measures include change in autoantibodies directed against antigens present in the pancreatic islets, measures of severity of disease, change in inflammatory markers, and antibody titers against the four viruses included in the vaccine.

Despite improvements in care, T1D is a leading cause of debilitating complications and early death globally. Children with residual β cell function are at lower risk for severe hypoglycemia, have better diabetes regulation, and have lower insulin requirements compared to children without residual β cell function. Thus, a simple, cheap treatment to mitigate T1D is highly warranted.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Patients hospitalized with newly diagnosed type 1 diabetes mellitus.
  • Written informed consent (parents, legal guardian).
Exclusion Criteria
  • Influenza vaccination during the current influenza season.
  • Strong indication for influenza vaccination for non-diabetic disease.
  • Severe allergy to eggs or previous allergic reaction to influenza vaccine.
  • Suspicion of febrile illness or acute, ongoing infection.
  • Hypersensitivity to the active substances or ingredients of Vaxigrip Tetra or against any residues, such as eggs (ovalbumin or chicken proteins), neomycin, formaldehyde and octoxinol.
  • Patients with endogenic or iatrogenic immunosuppression that may result in reduced immunization response.
  • Inability to provide informed consent from a parent or legal guardian.
  • Age <7 or ≥18 years.
  • Previous randomization in the INVITED trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboVaxigrip Tetra Sanofi Pasteur EuropePlacebo, 0.5 mL saline.
Influenza vaccinationVaxigrip Tetra Sanofi Pasteur EuropeInfluenza vaccine, 0.5 mL.
Primary Outcome Measures
NameTimeMethod
Change in fasting residual β cell (C-peptide) function.12 months

Measured as the area under the concentration-time curve (AUC) for mixed-meal tolerance test-stimulated C-peptide concentration over 4 hours relative to baseline (AUC 0-4 h, C-peptide, 12 months/ AUC 0-4 h, C-peptide, baseline)

Secondary Outcome Measures
NameTimeMethod
Change in fasting residual β cell (C-peptide) function.6 months.

Measured as the area under the concentration-time curve (AUC) for mixed-meal tolerance test-stimulated C-peptide concentration over 4 hours relative to baseline (AUC 0-4 h, C-peptide, 6 months/ AUC 0-4 h, C-peptide, baseline)

Change in insulin requirements.12 months.

Measured as total insulin dose per kg body weight per day as a mean for the last 14 days.

Time-In-Range of blood glucose.12 months.

Defined as percentage time in range (3.9-10.0 mmol/L) of continuous glucose monitoring over 14 days.

Variation of blood glucose.12 months.

Determined as percent coefficient of variation of blood glucose over 14 days.

Change in HbA1c12 months.

Measured as standard laboratory test in mmol/mol

Trial Locations

Locations (10)

Aalborg University Hospital

🇩🇰

Aalborg, Denmark

Aarhus University Hospital

🇩🇰

Aarhus, Denmark

Sjællands Universitetssygehus

🇩🇰

Roskilde, Denmark

Slagelse Hospital

🇩🇰

Slagelse, Denmark

Steno Diabetes Center Copenhagen

🇩🇰

Copenhagen, Denmark

Gødstrup Hospital

🇩🇰

Herning, Denmark

Holbaek Sygehus

🇩🇰

Holbæk, Denmark

Nykoebing F Sygehus

🇩🇰

Nykøbing Falster, Denmark

Randers Regional Hospital

🇩🇰

Randers, Denmark

Viborg Regional Hospital

🇩🇰

Viborg, Denmark

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