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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00336674
Registration number
NCT00336674
Ethics application status
Date submitted
12/06/2006
Date registered
14/06/2006
Titles & IDs
Public title
Trial of Intranasal Insulin in Children and Young Adults at Risk of Type 1 Diabetes
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Scientific title
A Randomised, Double-blind, Placebo-controlled Trial of Intranasal Insulin (440 IU) in Children and Young Adults at Risk of Type 1 Diabetes: Intranasal Insulin Trial II
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Secondary ID [1]
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INIT II
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Universal Trial Number (UTN)
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Trial acronym
INITII
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 Diabetes
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Condition category
Condition code
Metabolic and Endocrine
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Intranasal insulin
Other interventions - Placebo
Active comparator: DV001 - Recombinant human intranasal insulin formulation in a buffered solution of benzalkonium chloride and glycerol presented in multi-dose nasal spray devices with actuators (Pfeiffer) designed to deliver 100ul spray doses to nasal mucosa. The product is formulated at a dose strength of 1100 IU / mL (40mg/mL) manufacturing formulation. The product will be self administered by eligible participants as two 100 microlitre spray doses per nostril. Treatment will be administered daily for 7 consecutive days then on one day each week for 12 months. Participants will be followed until they develop diabetes or until 5 years after the last participant has been randomised (maximum period of follow up is expected to be 10 years.
Placebo comparator: Placebo - Placebo insulin carrier solution of benzalkonium chloride and glycerol presented in multi-dose nasal spray devices with actuators (Pfeiffer) designed to deliver 100ul spray doses to nasal mucosa. The product will be self administered by participants as two 100 microlitre spray doses per nostril. Treatment will be administered daily for 7 consecutive days then on one day each week for 12 months. Participants will be followed until they develop diabetes or until 5 years after the last participant has been randomised (maximum period of follow up is expected to be 10 years.
Treatment: Other: Intranasal insulin
440IU Insulin
Other interventions: Placebo
Placebo insulin carrier solution containing benzalkonium chloride and glycerol
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Diagnosis of Diabetes AT 5 years according to American Diabetes Association / World Health Organization (ADA/WHO) criteria.
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Assessment method [1]
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Defined as the presence of 2 or more of the following diagnostic criteria including diabetic fasting blood glucose level, diabetic 2 hour postprandial blood glucose level, diabetic HbA1c and symptoms
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Timepoint [1]
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1 year of treatment 9 years follow up
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Secondary outcome [1]
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B cell function
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Assessment method [1]
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Measured as glucose and insulin responses in Oral glucose tolerance test (OGTT) 6 monthly
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Timepoint [1]
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1 year of treatment 9 years follow up
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Secondary outcome [2]
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Insulin Action
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Assessment method [2]
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Insulin resistance measured by Homeostasis of model assessment - resistance (HOMA-R) 6 monthly
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Timepoint [2]
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1 year of treatment 9 years follow up
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Secondary outcome [3]
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Immune function
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Assessment method [3]
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Measured by levels of circulating antibodies to insulin, Glutamic acid decarboxylase (GAD) and Tyrosine phosphatase - like insulinoma antigen (IA-2) and T cell responses to proinsulin, denatured insulin, GAD and tetanus at 5 years
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Timepoint [3]
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1 year of treatment 9 years follow up
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Eligibility
Key inclusion criteria
1. First-degree or second-degree relative of a person with Type 1 diabetes (T1D) diagnosed before age 40.
2. Age 4-30 years if first-degree relative; age 4-20 years if second-degree relative.
3. Confirmed serum antibodies to two or more islet antigens.
4. Normal oral glucose tolerance test (OGTT).
5. First phase insulin response (FPIR) at or above threshold - Primary Stratum - greater than or equal to 10th percentile for siblings, offspring and second-degree relatives of person with T1D (greater than or equal to 100uU/ml if aged 8 or more years OR greater than or equal to 60 uU/ml if aged less than 8) and greater than or equal to the 1st percentile for parents of someone with T1D (greater than ore equal to 60uU/ml). Secondary Stratum: Greater than or equal 1st percentile, less than 10th percentile for siblings, offspring and second-degree relatives of someone with T1D (greater than or equal to 50uU/ml less than 100 uU/ml if aged greater than or equal to 8 years or greater than or equal to 20 uU/ml less than 60uU/ml if aged less than 8 years)
6. Provision of written consent. -
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Minimum age
4
Years
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Maximum age
30
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. History of treatment with insulin or oral hypoglycemic agents
2. Known diabetes by ADA/WHO criteria
3. Pregnant or lactating or of child-bearing potential not using an adequate method of contraception
4. Concomitant disease or treatment which may interfere with assessment or cause immunosuppression, as judged by the investigators.
5. Uncorrected vitamin D deficiency
6. Known alcohol or drug abuse, psychiatric or other condition that could be associated with poor compliance.
7. Known liver disease, or persisting elevation of plasma Aspartate transaminase (AST) or Alanine transaminase (ALT) levels.
8. Impaired renal function
9. Any defect or pathology of nasal passage which would preclude application of the intranasal spray.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/12/2006
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
13/11/2019
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Sample size
Target
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Accrual to date
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Final
110
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [2]
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Mater Children's Hospital - Brisbane
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Recruitment hospital [3]
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Womens and Childrens Hospital - North Adelaide
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Recruitment hospital [4]
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Royal Melbourne Hospital - Melbourne
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Recruitment hospital [5]
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Princess Margaret Hospital - Subiaco
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Recruitment postcode(s) [1]
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2145 - Westmead
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Recruitment postcode(s) [2]
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4101 - Brisbane
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Recruitment postcode(s) [3]
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5006 - North Adelaide
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Recruitment postcode(s) [4]
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3050 - Melbourne
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Recruitment postcode(s) [5]
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6840 - Subiaco
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Primary sponsor type
Other
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Name
Melbourne Health
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
In people with type 1 diabetes the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed the beta cells. It is thought that exposure of the mucous membranes to insulin may cause act like a vaccine effect whereby protective immune cells are stimulated and these then counteract the "bad" immune cells that damage the beta cells. This study aims to determine if intranasal insulin can protect beta cells and stop progression to diabetes in individuals who are at risk.
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Trial website
https://clinicaltrials.gov/study/NCT00336674
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Trial related presentations / publications
Jacobsen LM, Schatz DA. Insulin immunotherapy for pretype 1 diabetes. Curr Opin Endocrinol Diabetes Obes. 2021 Aug 1;28(4):390-396. doi: 10.1097/MED.0000000000000648.
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Public notes
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Contacts
Principal investigator
Name
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Leonard C Harrison, MBBS MD DSc
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Address
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Melbourne Health
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00336674