prevention trial: immune-tolerance with alum-gad (diamyd) and vitamin d3 to children with multiple islet autoantibodies

Conditions: Diabetes Mellitus, Type 1; Prediabetic State

Summary: the purpose of this study is to evaluate if immune-tolerance with alum-formulated gad (diamyd), in combination with high dose vitamin d3, may delay or stop the autoimmune process leading to clinical type 1 diabetes in non-diabetic children with ongoing beta-cell autoimmunity as indicated by positive islet autoantibodies.

the primary objective of this study is to evaluate if immune-tolerance with alum-formulated gad (diamyd), combined with high dose vitamin d3, may delay or stop the autoimmune process leading to clinical type 1 diabetes (diagnosed according to american diabetes association criteria) in non-diabetic 4-17.99 year old children with ongoing beta-cell autoimmunity as indicated by positive islet autoantibodies. the secondary objective is to demonstrate that treatment with diamyd is safe in children at risk for type 1 diabetes. the children will be followed for 5 years in the study. primary endpoint is proportion of subjects diagnosed with type 1 diabetes in each treatment arm. secondary endpoints are 1) safety, 2) change in metabolic status from normal to impaired glucose metabolism in the group of children with normal glucose metabolism at baseline screening.

Eligibility criteria:
inclusion criteria: * children 4-17.99 years of age with positive autoantibodies to glutamate decarboxylase (gada) and at least one additional type 1 diabetes associated autoantibody (to insulinoma associated protein 2 (ia-2a), zinktransporter 8 (znt8r/q/wa) or insulin (iaa)). * written informed consent from the child and the childs legal representative(s). exclusion criteria: 1. ongoing treatment with immunosuppressant therapy. 2. diabetes. 3. treatment with any oral or injected anti-diabetic medications 4. significantly abnormal hematology results at screening. 5. clinically significant history of acute reaction to vaccines or other drugs 6. treatment with any vaccine within one month prior to the first dose of the study drug or planned treatment with vaccine up to three months after the last injection with the study drug. 7. a history of epilepsy, serious head trauma or cerebrovascular accident, or clinical features of continuous motor unit activity in proximal muscles 8. participation in other clinical trials with a new chemical entity within the previous 3 months. 9. history of hypercalcemia. 10. unwilling to abstain from other medication with vitamin d during the study period. 11. significant illness within 2 weeks prior to first dosing. 12. known human immuno deficiency virus infection or hepatitis. 13. presence of associated serious disease or condition. 14. diabetes-protective human leucocyte antigen (hla) dq6. 15. females who are lactating or pregnant. 16. males or females not willing to use adequate contraception, if sexually active, until 1 year after the last diamyd administration.

Keywords: type 1 diabetes islet autoantibodies glutamate decarboxylase autoantibodies (gada) immune tolerance prediabetes glucose tolerance glutamate decarboxylase prevention children