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Trial Review
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
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Trial registered on ANZCTR
Registration number
ACTRN12609000192280
Ethics application status
Approved
Date submitted
1/04/2009
Date registered
20/04/2009
Date last updated
5/07/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Encapsulated islets as a therapy for type 1 diabetes
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Scientific title
Safety and Function of Encapsulated Human Islets Transplanted Into People With Diabetes
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Universal Trial Number (UTN)
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Trial acronym
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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
4844
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Islets inside microcaspules, made from alginate that is extracted from seaweed, are infused into the peritoneal cavity to overcome the need for exogenous insulin administration. Up to 4 infusions are carried out per patient, with each infusion the maximum number of islets obtained from a human pancreas donated after death. Average is 178,200 islet equivalents per infusion.
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
The patients are their own controls. All are C-peptide negative, so any production of C-peptide must be a result of the transplant. Glycaemic control and insulin requirments post transplant are compared with individual patient values pre-transplantation.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To normalize blood glucose levels in people with type 1 diabetes patients and no previous evidence of beta cell function, without the need for exogenous insulin. Method used for assessment: 1. Blood glucose monitoring by patients 2. Daily exogenous insulin requirements.
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Assessment method [1]
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Timepoint [1]
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Daily for up to 12 months after islet infusion
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Secondary outcome [1]
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The dynamics of insulin production from the grafted cells. This is assessed in two ways: 1. 24 hour urinary C-peptide and creatinine (C-peptide index = 100 x [C-peptide (pmol/mL)] / [creatinine (mol/mL)]. All patients are initially C-peptide negative. 2. serum C-peptide after 5g intravenous arginine up to 12 months, or longer if there is insulin production from the graft
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Assessment method [1]
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Timepoint [1]
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Urinary C-peptide: at 1,3 & 5 days, 1, 2, 3 & 4 weeks, 2,3, 4 5, 6 8,10,12, and 3 monthly thereafter if the graft is functioning. Each time point relates to time from each islet infusion. Arginine stimulation test: at 1 week, 1, 3, 6, 12, 18 & 24mo, yearly thereafter, if the graft is functioning. Final endpoint is October 2008, a total of 33 months after the first infusion.
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Secondary outcome [2]
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Safety (a) the safety of injecting encapsulated human islets into people with type 1 diabetes (pain and infection are the assessment criteria) (b) if cytotoxic antibodies are produced (c) if there is recurrence of autoimmune activation
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Assessment method [2]
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Timepoint [2]
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(a) Safety of injecting encapsulated islets: on day of infusion and daily over the next week. (b) cytotoxic antibodies: monthly (c) islet cell antibodies: at 1 week, 1, 3, 6, 12, 18 & 24mo, yearly thereafter, if the graft is functioning. Final endpoint is October 2008, a total of 33 months after the first infusion.
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Eligibility
Key inclusion criteria
normal body weight, that is, body mass index < 30, but ideally <25.
(b) age 18-50 years
(c) no insulin production from their pancreas
(d) (i) difficulty in controlling blood glucose levels despite compliance with insulin injections, physical activity and food intake. This difficulty is impacting on the quality of life.
(ii) unable to recognise the symptoms of low blood glucose levels for whom no other strategy has been successful.
(iii) special situations, e.g., rapid falls in blood glucose levels resulting in epilepsy and where anti-epileptic medication is unsuitable.
Each case will be considered on its merit, but the benefit must exceed the risk.
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Minimum age
18
Years
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Maximum age
50
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. Does not fit the above criteria.
2. Residual function of recipient’s pancreatic beta cells, as assessed by C-peptide production.
3. Body mass index > 30.
4. Pregnancy.
5. Non-agreement by patient’s endocrinologist.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/02/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
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Actual
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Sample size
Target
6
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Government body
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Name
South Eastern Sydney Illawarra Area Health Service
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Address
Research Office, Prince of Wales Hospital, High Street, Randwick, NSW 2031
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Eastern Sydney Illawarra Area Health Service Human Research Ethics Committee, Northern Division
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Ethics committee address [1]
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Research Office, Prince of Wales Hospital, High Street, Randwick, NSW 2031
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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28/06/2005
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Ethics approval number [1]
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05/151
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Summary
Brief summary
The aim of this pilot study is to examine the efficacy of transplanting encapsulated human islets into individuals with type 1 diabetes in the absence of anti-rejection drugs.
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Trial website
NIL..but info on www.diabetes.unsw.edu.au
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Trial related presentations / publications
207. Tuch BE, Vaithilingam V, Keogh GW, Williams LW, Lui S, Foster JL, Chen K, Jaydev V, DeBlieck C. Pilot clinical trial with human islets in barium alginate microcapsules. Endocrine Soc Aust 2007; 50: 137 [Endocrine Journal 2007; 54 Suppl: 101]
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Public notes
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Contacts
Principal investigator
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 public queries
Name
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Ms Nola Camden
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Address
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c/- Diabetes Transplant Unit, Prionce of Wales Hospital, High Street, Randwick, NSW 2031
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Country
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Australia
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Phone
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+61 409 652 650
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Bernie Tuch
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Address
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P.O. Box 821, Maroubra, NSW 2035
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Country
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Australia
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Phone
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+61 411 461 604
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Safety and Viability of Microencapsulated Human Islets Transplanted Into Diabetic Humans
2009
https://doi.org/10.2337/dc09-0744
Embase
Paving the way for successful islet encapsulation.
2019
https://dx.doi.org/10.1016/j.drudis.2019.01.020
Embase
Pluripotent stem cells as a therapy for type 1 diabetes.
2023
https://dx.doi.org/10.1016/bs.pmbts.2023.03.001
N.B. These documents automatically identified may not have been verified by the study sponsor.
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