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Efficacy of Extracorporeal Photopheresis (ECP) in the Treatment of Type 1 Diabetes Mellitus

Early Phase 1
Recruiting
Conditions
Type 1 Diabetes
Interventions
Combination Product: ECP regular-intensity arm
Combination Product: ECP accelerated-intensity arm
Biological: T1DM standard of care
Registration Number
NCT05413005
Lead Sponsor
Abu Dhabi Stem Cells Center
Brief Summary

OPERA Study is a randomized, open-label, prospective, pilot, and a monocentric clinical trial involving outpatients within Abu Dhabi Stem Cells Center (ADSCC) with a confirmed diagnosis of type 1 diabetes mellitus (T1DM). The patients will be randomly allocated (1:1) in a parallel assignment involving two groups of participants: Group A (Regular-intensity arm): Extracorporeal Photopheresis (ECP) on a regular-intensity regimen described in the Protocol as add-on T1DM standard of care, or Group B (Accelerated-intensity arm): ECP on an accelerated regimen plus T1DM standard of care.

Detailed Description

The standard of care is defined as per the "DOH Standards for diagnosis, management and data reporting for diabetes" in combination with the DOH recommended NICE (UK National Institute for Health and Care Excellence) guidelines "Type 1 diabetes in adults: diagnosis and management (NG17)". OPERA Study will be fully conducted in ADSCC, including the patient assessment and inclusion, randomization, ECP procedures, and follow-up consultations, according to this Protocol and GCP principles. All patients will receive T1DM standard of care, plus additional ECP protocols on two regimens of investigational interventions. The primary objective is the safety assessment of ECP, to be assessed by the tolerability to the ECP procedures, incidence of treatment-emergent adverse events (TEAEs), adverse events of special interest (AESIs), and serious adverse events (SAEs) assessed by the CTCAE v5.0, and the WHO-UMC causality assessment system. The other primary objective is the preliminary efficacy assessment of the ECP as an add-on treatment to the standard of care for T1DM patients, assessed by the exogenous insulin use, HbA1c levels, C-peptide levels, and clinically important hypoglycemic episodes. The secondary objective is the assessment of the immune response profile in T1DM patients receiving standard of care and additional ECP procedures. The trial is approved by the institutional ADSCC Research Ethics Committee (REC) and written informed consent will be obtained from all patients. OPERA Study will be conducted following the principles of the Declaration of Helsinki and ICH-GCP guidelines.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
10
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group A (ECP regular-intensity arm)ECP regular-intensity armECP in a regular-intensity arm plus T1DM standard of care
Group A (ECP regular-intensity arm)T1DM standard of careECP in a regular-intensity arm plus T1DM standard of care
Group B (ECP accelerated-intensity arm)T1DM standard of careECP in an accelerated-intensity arm plus T1DM standard of care
Group B (ECP accelerated-intensity arm)ECP accelerated-intensity armECP in an accelerated-intensity arm plus T1DM standard of care
Primary Outcome Measures
NameTimeMethod
Tolerability to ECP proceduresWeeks 0 - 24

Rate of tolerability of the ECP will be assessed by the number of ECP discontinuation due to adverse events (AE), or withdrawal of participants of the Study due to serious adverse events (SAEs)

Exogenous insulin useBaseline, months 3, 6, and 12

Rate of modification in exogenous insulin requirements compared with baseline. Marker for efficacy of treatment: reducing insulin dose

Clinically important hypoglycemic episodesBaseline - Month 12

Frequency of clinically important hypoglycemic episodes (described in Protocol).

Marker for efficacy of treatment: requiring decrease of insulin dose)

C-peptide levelsBaseline, months 3, 6, and 12

Rate of modification in C-Peptide levels compared with baseline. Marker for efficacy of treatment: increasing C-Peptide levels of ≥ 0.7 ng/mL

Incidence of adverse events (AEs)Weeks 0 - 24

Incidence of treatment-emergent adverse events (TEAEs), adverse events of special interest (AESIs), and serious adverse events (SAEs): Proportion of participants with AEs as assessed by CTCAE v5.0

HbA1c levelsBaseline, months 3, 6, and 12

Rate of modification in HbA1c levels compared with baseline. Marker for efficacy of treatment: decreasing for a target HbA1c level of 48 mmol/mol \[6.5%\]

Secondary Outcome Measures
NameTimeMethod
Immune response profile (cellular)Baseline, months 3, 6, and 12

CD3, CD4, CD8, CD11c, CD14, CD16, CD19, CD20, CD25, CD27, CD28, CD38, CD45, CD45RA, CD45RO, CD56, CD57, CD66b, CD123, CD127, CD161, CD294, CCR4, CCR6, CCR7, CXCR3, CXCR5, will be assessed for identification of immune cells and subsets analyses

Serum IgG levelsBaseline, months 3, 6, and 12

Serum IgG concentration will be assessed for characterization of the humoral response profile

Serum IgM levelsBaseline, months 3, 6, and 12

Serum IgM concentration will be assessed for characterization of the humoral response profile

Serum IgA levelsBaseline, months 3, 6, and 12

Serum IgA concentration will be assessed for characterization of the humoral response profile

Trial Locations

Locations (1)

Abu Dhabi Stem Cells Center

🇦🇪

Abu Dhabi, United Arab Emirates

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