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A Phase 2, Multicentre, Randomized, Double-blind, Placebo-controlled Study in Patients With New-onset Type 1 Diabetes

A Phase 2, Multicentre, Randomized, Double-blind, Placebo-controlled Study to Assess the Efficacy and Safety of 400 mg Twice a Day Oral Ladarixin in Patients With New-onset Type 1 Diabetes

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02814838
Enrollment
76
Registered
2016-06-28
Start date
2016-08-31
Completion date
2019-05-15
Last updated
2024-04-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus, Insulin-Dependent

Keywords

Diabetes mellitus Type 1, Beta cells function

Brief summary

The objective of this clinical trial is to investigate whether ladarixin has sufficient activity (preservation of β-cell function and slow-down of the progression of T1D) to warrant its further development (proof of concept trial). The safety of ladarixin in the specific clinical setting will be also evaluated. The study is a phase 2, multicentre, double-blind study. 72 patients with new-onset type 1 diabetes (T1D) were planned to be involved, randomly (2:1) assigned to receive either ladarixin treatment (400 mg b.i.d. for 3 cycles of 14 days on/14 days off - treatment group) or placebo (control group). Recruitment was competitive among the study sites, until the planned number of patients was enrolled. A total of 76 patients were actually recruited.

Detailed description

T1D is an organ-specific autoimmune disease in which the immune system attacks the insulin-producing β-cells. The onset of the disease typically occurs before adulthood and seriously affects a person's quality of life. T1D is treated with life-long daily exogenous insulin injections and monitoring of blood glucose levels. However, even optimization of glucose control through the most recent technologies cannot adequately substitute for the finely tuned normal balance of the glucose levels. Therefore, despite marked improvements in diabetes care in recent years, insulin-dependent diabetes results in secondary long-term complications and is one of the leading causes of end-stage renal disease, blindness and amputation. Additionally, hypoglycaemia unawareness is a serious consequence of recurrent hypoglycaemia often requiring emergency care. Maintenance of residual β-cell function (as measured by C-peptide response) was demonstrated to be associated with reduced rate of microvascular complications and hypoglycaemia, improved quality of life, and overall reduction in morbidity and associated management costs. Therefore, pharmacological approaches aimed at controlling the autoimmune response and restoring self-tolerance to pancreatic β-cells had attracted the clinical/scientific interest. Among these, rituximab, CD3-specific monoclonal antibodies, GAD65, DiaPep277 have progressed to phase III clinical trials. Other agents, including cytokines modulators such as anti-TNF or anti-IL1, are under clinical evaluation. Unfortunately, even if safe preservation of β-cell function and improvement of glycaemic control have been evidenced for some of the pharmacological approaches evaluated so far, none has been definitely approved for the treatment of diabetes onset. New strategies are being evaluated which combine agents targeting sequential arms of the immune and inflammatory response involved in β-cell disruption. In this regard, IL-8 appears to be an important mediator in the progression of type 1 diabetes. Production and secretion of pro-inflammatory IL-8 has been demonstrated from human pancreatic islets upon enterovirus infections, and LPS-induced production of IL-8 by neutrophils is increased in type 1 pre-diabetic and diabetic patients. In parallel, circulating levels of IL-8 were elevated in children with T1D compared to non-diabetic controls. Specifically, levels of IL-8 correlate with glycaemic control, higher level being associated to poorer or unfavorable glucose control. As a result of these findings, the modulation or inhibition of IL8 activity is considered a valid target for the development of innovative treatments aimed to control the progression of T1D. Results obtained with ladarixin in mouse models of T1D, and particularly reversal of diabetes in the NOD mice, clearly showed the ability of this CXCR1/2 inhibitor to protect β-cells and either prevent or delay the progression of hyperglycaemia. The positive effects of ladarixin, coupled with the safety shown in phase 1 studies, provided a sound rationale for a clinical study aimed at evaluating the effect of ladarixin in patients with new onset diabetes and supported the conduct of the present study.

Interventions

Ladarixin oral capsule

DRUGPlacebo

Placebo oral capsule

Sponsors

Dompé Farmaceutici S.p.A
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No

Inclusion criteria

1. Male and female patients aged 18-45 years, inclusive; 2. New-onset T1D (randomization within 100 days from 1st insulin administration); 3. Positive for at least one diabetes-related auto-antibody (anti-GAD; IAA, if obtained within 10 days of the onset of insulin therapy; IA-2 antibody; ZnT8); 4. Require, or has required at some time, insulin, with the exclusion of patients taking twice daily pre-mixed insulin or on insulin pump; 5. Residual β-cell function as per peak stimulated (MMTT) C-peptide level \>0.6ng/mL (0.2nmol/L); MMTT should not be performed within one week of resolution of a diabetic ketoacidosis event; 6. Patient able to comply with all protocol procedures for the duration of the study, including scheduled follow-up visits and examinations; 7. Patients who have given written informed consent prior of any study-related procedure not part of standard medical care.

Exclusion criteria

1. Patients taking twice daily pre-mixed insulin or on insulin pump; 2. Any other chronic disease, including type 2 diabetes, apart from autoimmune hypothyroidism requiring thyroid hormone replacement only; patients with severe (myxedema) disease potentially requiring immunosuppressive therapy will be excluded; 3. Moderate to severe renal impairment as per calculated creatinine clearance (CLcr) \< 60 mL/min according to the Cockcroft-Gault formula (Cockcroft-Gault, 1976); 4. Hepatic dysfunction defined by increased ALT/AST \> 3 x upper limit of normal (ULN) and increased total bilirubin \> 3 mg/dL \[\>51.3 μmol/L\]; 5. Hypoalbuminemia defined as serum albumin \< 3 g/dL; 6. QTcF \> 470 msec; 7. Complete Left Bundle Branch Block (LBBB), atrio-ventricular block (mobitz II 2nd degree or 2:1 atrio-ventricular block), complete heart block; 8. Electronic pacemaker positioned or implanted defibrillator; 9. History of significant cardiovascular disease; 10. Known hypersensitivity to non-steroidal antiinflammatory drugs; 11. Concomitant treatment with phenytoin, warfarin, sulphanylurea hypoglycemics (e.g. tolbutamide, glipizide, glibenclamide/glyburide, glimepiride, nateglinide) and high dose of amitriptyline (\> 50 mg/day); 12. Previous (within 2 weeks prior to randomization) and concomitant treatment with metformin, sulfonylureas, glinides, thiazolidinediones, exenatide, liraglutide, DPP-IV inhibitors or amylin, or any medications known to influence glucose tolerance (e.g. β-blockers, angiotensin-converting enzyme inhibitors, interferons, quinidine antimalarial drugs, lithium, niacin, etc.); 13. Past (within 1 month prior to randomization) or current administration of any immunosuppressive medications (including oral, inhaled or systemically injected steroids) and use of any investigational agents, including any agents that impact the immune response or the cytokine system; 14. Pregnant or breast feeding women. Unwillingness to use effective contraceptive measures up to 2 months after the end of study drug administration (females and males). Effective contraceptive measures include an hormonal birth control (e.g. oral pills, long term injections, vaginal ring, patch); the intrauterine device (IUD); a double barrier method (e.g. condom or diaphragm plus spermicide foam).

Design outcomes

Primary

MeasureTime frameDescription
Area Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 13week 13±1C-peptide level is a widely used measure of pancreatic beta-cell function. The MMTT is one of the methods for its estimation. The MMTT was performed after an overnight fast, at baseline (within 1 week prior to randomization), and at each follow-up visit on weeks 13±1, 26±2, and 52±2. Prior to the test, patients withheld long-acting insulin on the morning of the test. Rapid-acting and short-acting insulin were allowed up to 6hrs and 2 hrs, respectively, before the test. The test was rescheduled if the patient had a capillary glucose value of \>200mg/dL or \<70mg/dL. After 2 pre-meal basal samples had been drawn between -20 to 0 min (basal 1 and basal 2), patients were given 6mL/kg of Boost® High Protein Nutritional Drink up to a maximum of 360mL, to be drunk within 5 min. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at week 13+/-1 The 2-hour C-peptide AUC after the MMTT at Week 13±1 was transformed as log(x+1) values.

Secondary

MeasureTime frameDescription
Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52Follow-ups at Weeks 26±2 and 52±2C-peptide level is a widely used measure of pancreatic beta-cell function. The MMTT is one of the methods for its estimation. The MMTT was performed after an overnight fast, at baseline (within 1 week prior to randomization), and at each follow-up visit on weeks 13±1, 26±2, and 52±2. Prior to the test, patients withheld long-acting insulin on the morning of the test. Rapid-acting and short-acting insulin were allowed up to 6hrs and 2 hrs, respectively, before the test. The test was rescheduled if the patient had a capillary glucose value of \>200mg/dL or \<70mg/dL. After 2 pre-meal basal samples had been drawn between -20 to 0 min (basal 1 and basal 2), patients were given 6mL/kg of Boost® High Protein Nutritional Drink up to a maximum of 360mL, to be drunk within 5 min. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at week 13+/-1. The 2-hour C-peptide AUC after the MMTT at Week 13±1 was transformed as log(x+1) values.
Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFollow-ups at Weeks 13±1, 26±2 and 52±2C-peptide level is a widely used measure of pancreatic beta-cell function. The MMTT is one of the methods for its estimation. The MMTT was performed after an overnight fast, at baseline (within 1 week prior to randomization), and at each follow-up visit on weeks 13±1, 26±2, and 52±2. Prior to the test, patients withheld long-acting insulin on the morning of the test. Rapid-acting and short-acting insulin were allowed up to 6hrs and 2 hrs, respectively, before the test. The test was rescheduled if the patient had a capillary glucose value of \>200mg/dL or \<70mg/dL. The test was initiated before 10 a.m. After 2 pre-meal basal samples had been drawn between -20 to 0 min (basal 1 and basal 2), patients were given 6mL/kg of Boost® High Protein Nutritional Drink (Nestlé Nutrition) up to a maximum of 360mL, to be drunk within 5 min. Post-meal samples were drawn at 15±5, 30±5, 60±10, 90±10, 120±15, 180±15 min after the meal.
Change From Screening in Average (Previous 3 Days) Insulin RequirementFollow-ups at Weeks 13±1, 26±2 and 52±2Insulin requirement (IU/kg/day averaged over the previous 3 days) was to be recorded in the interval from randomization to Week 13±1, Week 13±1 to Week 26±2, and Week 26±2 to Week 52±2. From enrolment, patients were admitted to intensive diabetes management, according to current ADA recommendation \[2014\]. Patients were instructed to self-monitor their glucose values at least 4 times a day and to report (glucose meter/log) outcome to the diabetes management team. Insulin intake was adjusted to target HbA1c levels of less than 7% and self-monitored (fingerstick): * pre-prandial blood glucose of 70-130 mg/dL * post-prandial blood glucose \< 180 mg/dL * bed-time blood glucose of 110-150 mg/dL Telephone calls (outside scheduled visits) were scheduled on a regular basis to ensure optimization of metabolic control.
Change From Screening in Glycated Haemoglobin (HbA1c) LevelsFollow-ups at Weeks 13±1, 26±2 and 52±2HbA1c measurement can be used as a diagnostic test for diabetes providing that stringent quality assurance tests are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement. An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes. A value of less than 6.5% does not exclude diabetes diagnosed using glucose tests.
Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTBaseline, follow-ups at Weeks 13±1, 26±2, and 52±2Time points at each visit are Basal 1 and Basal 2 (samples collected at -20 and 0 min, respectively; Here are reported the following timepoints: Basal average (which is the average of Basal 1 and Basal 2), 15, 30, 60, 90, 120, and 180 minutes after the meal. For values at each time point see below.
Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFollow-ups at Weeks 13±1, 26±2 and 52±2A severe hypoglycaemic event was defined as an event with one of the following symptoms: memory loss, confusion, uncontrollable behaviour, irrational behaviour, unusual difficulty in awakening, suspected seizure, seizure, loss of consciousness, or visual symptoms, in which the patient was unable to treat him/herself and which was associated with either a blood glucose level \<54 mg/dL or prompt recovery after oral carbohydrate, i.v. glucose, or glucagon administration.
Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTBaseline, follow-ups at Weeks 13±1, 26±2, and 52±2Time points at each visit are Basal 1 and Basal 2 (samples collected at -20 and 0 min, respectively). Here are reported the following timepoints: Basal average (which is the average of Basal 1 and Basal 2), 15, 30, 60, 90, 120, and 180 minutes after the meal. For values at each time point see below.
Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFollow-ups at Weeks 13±1, 26±2 and 52±2A severe hypoglycaemic event was defined as an event with one of the following symptoms: memory loss, confusion, uncontrollable behaviour, irrational behaviour, unusual difficulty in awakening, suspected seizure, seizure, loss of consciousness, or visual symptoms, in which the patient was unable to treat him/herself and which was associated with either a blood glucose level \<54 mg/dL or prompt recovery after oral carbohydrate, i.v. glucose, or glucagon administration. Proportion is reported as percentage of patients. Events per patient are calculated from the date of randomisation.
C-peptide AUC(15 to 120 Mins) Above Fasting ValueFollow-ups at Weeks 13±1 26±2 and 52±2The means are all adjusted means. The MMTT over the study: logAUC(15-120 min) of C-peptide above fasting value at Weeks 13±1, 26±2, and 52±2 is reported. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at weeks 13+/-1, 26±2 and 52±2
Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFollow-up at Weeks 13±1, 26±2, and 52±2.A subgroup analysis of efficacy endpoints by fasting C-peptide at Screening was performed. The reported data specifically refers to fasting C-peptide at Screening \<median value. All the AUC analyses were based on actual rather than scheduled timings and were calculated using the trapezoidal rule. If the actual time was not recorded, the scheduled time was used instead. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal. The 2-hour C-peptide AUC after the MMTT was transformed as log(x+1) values.
Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFollow-up at Weeks 13±1, 26±2, and 52±2.A subgroup analysis of efficacy endpoints by fasting C-peptide at Screening was performed. The reported data specifically refers to fasting C-peptide at Screening \<median value. All the AUC analyses were based on actual rather than scheduled timings and were calculated using the trapezoidal rule. If the actual time was not recorded, the scheduled time was used instead. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at Weeks 13±1, 26±2, and 52±2.
Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFollow-up at Weeks 13±1, 26±2, and 52±2A severe hypoglycaemic event was defined as an event with one of the following symptoms: memory loss, confusion, uncontrollable behaviour, irrational behaviour, unusual difficulty in awakening, suspected seizure, seizure, loss of consciousness, or visual symptoms, in which the patient was unable to treat him/herself and which was associated with either a blood glucose level \<54 mg/dL or prompt recovery after oral carbohydrate, i.v. glucose, or glucagon administration. Proportion is reported as percentage of patients, despite the measure type indicated is number. Events per patient are calculated from the date of randomisation.
Proportion of Patients Maintaining a Residual β-cell FunctionFollow-ups at Weeks 13±1, 26±2 and 52±2Maintenance of a residual ß-cell function is defined as at least one MMTT C-peptide value \> 0.2 nmol/L. Proportion is reported as Percentage of patients.

Countries

Belgium, Germany, Italy

Participant flow

Participants by arm

ArmCount
Ladarixin
Ladarixin oral capsule Ladarixin: Ladarixin oral capsule
50
Placebo
Placebo oral capsule Placebo: Placebo oral capsule
26
Total76

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall Study3 agreed dates for the final visit missed10
Overall StudyConsent withdrawal11

Baseline characteristics

CharacteristicPlaceboLadarixinTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
26 Participants50 Participants76 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants1 Participants1 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
26 Participants49 Participants75 Participants
Region of Enrollment
Belgium
11 participants20 participants31 participants
Region of Enrollment
Germany
5 participants13 participants18 participants
Region of Enrollment
Italy
10 participants17 participants27 participants
Sex: Female, Male
Female
10 Participants21 Participants31 Participants
Sex: Female, Male
Male
16 Participants29 Participants45 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 500 / 26
other
Total, other adverse events
37 / 5021 / 26
serious
Total, serious adverse events
3 / 501 / 26

Outcome results

Primary

Area Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 13

C-peptide level is a widely used measure of pancreatic beta-cell function. The MMTT is one of the methods for its estimation. The MMTT was performed after an overnight fast, at baseline (within 1 week prior to randomization), and at each follow-up visit on weeks 13±1, 26±2, and 52±2. Prior to the test, patients withheld long-acting insulin on the morning of the test. Rapid-acting and short-acting insulin were allowed up to 6hrs and 2 hrs, respectively, before the test. The test was rescheduled if the patient had a capillary glucose value of \>200mg/dL or \<70mg/dL. After 2 pre-meal basal samples had been drawn between -20 to 0 min (basal 1 and basal 2), patients were given 6mL/kg of Boost® High Protein Nutritional Drink up to a maximum of 360mL, to be drunk within 5 min. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at week 13+/-1 The 2-hour C-peptide AUC after the MMTT at Week 13±1 was transformed as log(x+1) values.

Time frame: week 13±1

Population: ITT population: all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo)

ArmMeasureValue (MEAN)Dispersion
LadarixinArea Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 134.026 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.4852
PlaceboArea Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 133.886 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.7446
Comparison: Transformed AUC was analyzed with Student t-test for unpaired data using PROC TTEST within SAS® to compare Ladarixin and placebo groups. The estimated treatment difference between Ladarixin and placebo was also presented together with the corresponding 95% confidence interval.p-value: 0.330395% CI: [-0.14, 0.42]Student's t test for unpaired samples
Secondary

Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value

A subgroup analysis of efficacy endpoints by fasting C-peptide at Screening was performed. The reported data specifically refers to fasting C-peptide at Screening \<median value. All the AUC analyses were based on actual rather than scheduled timings and were calculated using the trapezoidal rule. If the actual time was not recorded, the scheduled time was used instead. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal. The 2-hour C-peptide AUC after the MMTT was transformed as log(x+1) values.

Time frame: Follow-up at Weeks 13±1, 26±2, and 52±2.

Population: ITT population: all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinArea Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFU Week 133.8085 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.45692
LadarixinArea Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFU Week 263.8202 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.48142
LadarixinArea Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFU Week 523.3796 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.68616
PlaceboArea Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFU Week 133.4543 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.86632
PlaceboArea Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFU Week 263.3178 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.91906
PlaceboArea Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median ValueFU Week 523.1562 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.9713
Comparison: At week 13p-value: =0.111495% CI: [-0.09, 0.75]t-test, 2 sided
Comparison: At week 26p-value: =0.041195% CI: [0.02, 0.98]t-test, 2 sided
Comparison: At week 52p-value: =0.450695% CI: [-0.37, 0.82]t-test, 2 sided
Secondary

Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52

C-peptide level is a widely used measure of pancreatic beta-cell function. The MMTT is one of the methods for its estimation. The MMTT was performed after an overnight fast, at baseline (within 1 week prior to randomization), and at each follow-up visit on weeks 13±1, 26±2, and 52±2. Prior to the test, patients withheld long-acting insulin on the morning of the test. Rapid-acting and short-acting insulin were allowed up to 6hrs and 2 hrs, respectively, before the test. The test was rescheduled if the patient had a capillary glucose value of \>200mg/dL or \<70mg/dL. After 2 pre-meal basal samples had been drawn between -20 to 0 min (basal 1 and basal 2), patients were given 6mL/kg of Boost® High Protein Nutritional Drink up to a maximum of 360mL, to be drunk within 5 min. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at week 13+/-1. The 2-hour C-peptide AUC after the MMTT at Week 13±1 was transformed as log(x+1) values.

Time frame: Follow-ups at Weeks 26±2 and 52±2

Population: ITT population: all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinArea Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52FU week 263.9351 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.5171
LadarixinArea Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52FU week 523.6371 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.75222
PlaceboArea Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52FU week 263.8076 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.76473
PlaceboArea Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52FU week 523.6380 log(ng*hr/ml [0-2 h]+1)Standard Deviation 0.81268
Comparison: at FUP week 26p-value: 0.51795% CI: [-0.2028, 0.3995]Mixed Models Analysis
Comparison: At FUP week 52p-value: 0.799995% CI: [-0.4294, 0.3322]Mixed Models Analysis
Secondary

Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value

A subgroup analysis of efficacy endpoints by fasting C-peptide at Screening was performed. The reported data specifically refers to fasting C-peptide at Screening \<median value. All the AUC analyses were based on actual rather than scheduled timings and were calculated using the trapezoidal rule. If the actual time was not recorded, the scheduled time was used instead. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at Weeks 13±1, 26±2, and 52±2.

Time frame: Follow-up at Weeks 13±1, 26±2, and 52±2.

Population: ITT population: all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinArea Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFU week 133.1590 log(ng*hr/ml [15-120 min] +1)Standard Deviation 0.56135
LadarixinArea Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFU week 2627.7841 log(ng*hr/ml [15-120 min] +1)Standard Deviation 15.10337
LadarixinArea Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFU week 522.7993 log(ng*hr/ml [15-120 min] +1)Standard Deviation 0.82214
PlaceboArea Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFU week 132.7959 log(ng*hr/ml [15-120 min] +1)Standard Deviation 1.07745
PlaceboArea Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFU week 2618.6842 log(ng*hr/ml [15-120 min] +1)Standard Deviation 15.46837
PlaceboArea Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median ValueFU week 5219.9415 log(ng*hr/ml [15-120 min] +1)Standard Deviation 16.95597
Comparison: Week 13 Analysis is based on a linear mixed model for repeated measures with log(AUC(15-120 minutes)+1) of C-peptide above fasting value as dependent variable, treatment, visit and treatment by visit interactionp-value: 0.184795% CI: [-0.1817, 0.908]Mixed Models Analysis
Comparison: Week 26 Analysis is based on a linear mixed model for repeated measures with log(AUC(15-120 minutes)+1) of C-peptide above fasting value as dependent variable, treatment, visit and treatment by visit interactionp-value: 0.03195% CI: [0.0609, 1.1998]Mixed Models Analysis
Comparison: Week 52 Analysis is based on a linear mixed model for repeated measures with log(AUC(15-120 minutes)+1) of C-peptide above fasting value as dependent variable, treatment, visit and treatment by visit interactionp-value: 0.629995% CI: [-0.5202, 0.8479]Mixed Models Analysis
Secondary

Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT

Time points at each visit are Basal 1 and Basal 2 (samples collected at -20 and 0 min, respectively; Here are reported the following timepoints: Basal average (which is the average of Basal 1 and Basal 2), 15, 30, 60, 90, 120, and 180 minutes after the meal. For values at each time point see below.

Time frame: Baseline, follow-ups at Weeks 13±1, 26±2, and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - Basal average0.212 nmol/LStandard Deviation 0.0941
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 90 min0.613 nmol/LStandard Deviation 0.2467
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 15 min0.278 nmol/LStandard Deviation 0.1294
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 15 min0.300 nmol/LStandard Deviation 0.1385
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 30 min0.391 nmol/LStandard Deviation 0.1857
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 15 min0.294 nmol/LStandard Deviation 0.1621
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 60 min0.534 nmol/LStandard Deviation 0.2463
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 30 min0.427 nmol/LStandard Deviation 0.2048
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 90 min0.569 nmol/LStandard Deviation 0.2606
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 120 min0.620 nmol/LStandard Deviation 0.2559
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 120 min0.592 nmol/LStandard Deviation 0.2703
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 60 min0.571 nmol/LStandard Deviation 0.266
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 180 min0.504 nmol/LStandard Deviation 0.2189
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 60 min0.545 nmol/LStandard Deviation 0.2631
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - Basal average0.168 nmol/LStandard Deviation 0.107
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 90 min0.620 nmol/LStandard Deviation 0.2859
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 15 min0.228 nmol/LStandard Deviation 0.1606
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 180 min0.527 nmol/LStandard Deviation 0.2252
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 30 min0.321 nmol/LStandard Deviation 0.2231
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 120 min0.637 nmol/LStandard Deviation 0.2869
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 60 min0.430 nmol/LStandard Deviation 0.2693
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 30 min0.422 nmol/LStandard Deviation 0.2126
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 90 min0.463 nmol/LStandard Deviation 0.2806
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 180 min0.518 nmol/LStandard Deviation 0.2302
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 120 min0.503 nmol/LStandard Deviation 0.3085
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - Basal average0.231 nmol/LStandard Deviation 0.1136
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 180 min0.426 nmol/LStandard Deviation 0.2341
LadarixinBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - Basal average0.218 nmol/LStandard Deviation 0.1087
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 180 min0.443 nmol/LStandard Deviation 0.2441
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - Basal average0.225 nmol/LStandard Deviation 0.1416
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 15 min0.299 nmol/LStandard Deviation 0.1779
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 30 min0.452 nmol/LStandard Deviation 0.3036
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 60 min0.537 nmol/LStandard Deviation 0.2354
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 90 min0.581 nmol/LStandard Deviation 0.2486
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 120 min0.656 nmol/LStandard Deviation 0.2923
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTScreening - 180 min0.550 nmol/LStandard Deviation 0.2277
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - Basal average0.210 nmol/LStandard Deviation 0.1315
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 15 min0.285 nmol/LStandard Deviation 0.1956
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 30 min0.392 nmol/LStandard Deviation 0.2418
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 60 min0.523 nmol/LStandard Deviation 0.2729
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 90 min0.594 nmol/LStandard Deviation 0.3176
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 120 min0.601 nmol/LStandard Deviation 0.305
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 13 - 180 min0.527 nmol/LStandard Deviation 0.2778
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - Basal average0.207 nmol/LStandard Deviation 0.1192
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 15 min0.260 nmol/LStandard Deviation 0.1426
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 30 min0.368 nmol/LStandard Deviation 0.215
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 60 min0.511 nmol/LStandard Deviation 0.2967
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 90 min0.552 nmol/LStandard Deviation 0.3101
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 120 min0.552 nmol/LStandard Deviation 0.2907
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 26 - 180 min0.466 nmol/LStandard Deviation 0.2362
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - Basal average0.178 nmol/LStandard Deviation 0.1068
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 15 min0.249 nmol/LStandard Deviation 0.1616
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 30 min0.314 nmol/LStandard Deviation 0.1826
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 60 min0.440 nmol/LStandard Deviation 0.2671
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 90 min0.465 nmol/LStandard Deviation 0.2881
PlaceboBasal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTTweek 52 - 120 min0.492 nmol/LStandard Deviation 0.2717
Comparison: at week 13p-value: 0.252795% CI: [-0.0174, 0.0658]Mixed Models Analysis
Comparison: at week 26p-value: 0.274395% CI: [-0.0188, 0.066]Mixed Models Analysis
Comparison: at week 52p-value: 0.785695% CI: [-0.0485, 0.0367]Mixed Models Analysis
Secondary

Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT

Time points at each visit are Basal 1 and Basal 2 (samples collected at -20 and 0 min, respectively). Here are reported the following timepoints: Basal average (which is the average of Basal 1 and Basal 2), 15, 30, 60, 90, 120, and 180 minutes after the meal. For values at each time point see below.

Time frame: Baseline, follow-ups at Weeks 13±1, 26±2, and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - Basal average7.496 mmol/LStandard Deviation 2.0261
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 90 min12.350 mmol/LStandard Deviation 3.4122
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 15 min8.750 mmol/LStandard Deviation 2.0827
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 15 min8.231 mmol/LStandard Deviation 2.1415
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 30 min10.927 mmol/LStandard Deviation 2.3901
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 15 min8.108 mmol/LStandard Deviation 1.8453
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 60 min13.494 mmol/LStandard Deviation 2.8623
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 30 min10.727 mmol/LStandard Deviation 2.5691
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 90 min13.665 mmol/LStandard Deviation 3.8399
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 120 min11.400 mmol/LStandard Deviation 3.4561
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 120 min13.240 mmol/LStandard Deviation 4.1302
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 60 min12.614 mmol/LStandard Deviation 3.1536
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 180 min10.956 mmol/LStandard Deviation 4.2031
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 60 min12.146 mmol/LStandard Deviation 2.9387
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - Basal average7.457 mmol/LStandard Deviation 2.3045
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 90 min12.553 mmol/LStandard Deviation 3.7998
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 15 min8.939 mmol/LStandard Deviation 2.721
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 180 min9.478 mmol/LStandard Deviation 3.632
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 30 min11.374 mmol/LStandard Deviation 2.6806
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 120 min11.773 mmol/LStandard Deviation 4.099
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 60 min14.315 mmol/LStandard Deviation 3.1205
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 30 min10.438 mmol/LStandard Deviation 2.2282
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 90 min14.911 mmol/LStandard Deviation 3.5768
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 180 min9.761 mmol/LStandard Deviation 3.9834
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 120 min14.354 mmol/LStandard Deviation 3.9162
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - Basal average7.074 mmol/LStandard Deviation 1.9973
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 180 min12.148 mmol/LStandard Deviation 4.0817
LadarixinBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - basal average6.965 mmol/LStandard Deviation 1.6858
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 180 min13.148 mmol/LStandard Deviation 3.9136
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - basal average6.855 mmol/LStandard Deviation 1.9507
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 15 min8.013 mmol/LStandard Deviation 2.0941
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 30 min10.096 mmol/LStandard Deviation 2.4694
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 60 min12.068 mmol/LStandard Deviation 2.9204
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 90 min12.076 mmol/LStandard Deviation 3.9156
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 120 min11.827 mmol/LStandard Deviation 4.0204
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTScreening - 180 min9.652 mmol/LStandard Deviation 4.0549
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - Basal average6.644 mmol/LStandard Deviation 2.1145
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 15 min7.836 mmol/LStandard Deviation 2.2409
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 30 min10.224 mmol/LStandard Deviation 2.36
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 60 min12.871 mmol/LStandard Deviation 2.6908
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 90 min13.092 mmol/LStandard Deviation 3.1608
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 120 min12.260 mmol/LStandard Deviation 3.759
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 13 - 180 min9.984 mmol/LStandard Deviation 3.8597
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - Basal average7.600 mmol/LStandard Deviation 2.6387
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 15 min9.058 mmol/LStandard Deviation 2.7026
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 30 min11.240 mmol/LStandard Deviation 2.6187
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 60 min14.222 mmol/LStandard Deviation 2.8795
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 90 min15.020 mmol/LStandard Deviation 3.4469
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 120 min14.424 mmol/LStandard Deviation 3.7761
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 26 - 180 min12.028 mmol/LStandard Deviation 3.8832
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - Basal average8.163 mmol/LStandard Deviation 2.2251
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 15 min9.544 mmol/LStandard Deviation 2.223
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 30 min11.688 mmol/LStandard Deviation 2.6411
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 60 min14.725 mmol/LStandard Deviation 2.9631
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 90 min15.276 mmol/LStandard Deviation 3.7144
PlaceboBasal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTTWeek 52 - 120 min15.140 mmol/LStandard Deviation 3.7514
Comparison: at week 52p-value: 0.043295% CI: [-1.1775, -0.0184]Mixed Models Analysis
Comparison: at week 13p-value: 0.930795% CI: [-0.5986, 0.548]Mixed Models Analysis
Comparison: At week 26p-value: 0.013995% CI: [-1.2989, -0.1483]Mixed Models Analysis
Secondary

Change From Screening in Average (Previous 3 Days) Insulin Requirement

Insulin requirement (IU/kg/day averaged over the previous 3 days) was to be recorded in the interval from randomization to Week 13±1, Week 13±1 to Week 26±2, and Week 26±2 to Week 52±2. From enrolment, patients were admitted to intensive diabetes management, according to current ADA recommendation \[2014\]. Patients were instructed to self-monitor their glucose values at least 4 times a day and to report (glucose meter/log) outcome to the diabetes management team. Insulin intake was adjusted to target HbA1c levels of less than 7% and self-monitored (fingerstick): * pre-prandial blood glucose of 70-130 mg/dL * post-prandial blood glucose \< 180 mg/dL * bed-time blood glucose of 110-150 mg/dL Telephone calls (outside scheduled visits) were scheduled on a regular basis to ensure optimization of metabolic control.

Time frame: Follow-ups at Weeks 13±1, 26±2 and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinChange From Screening in Average (Previous 3 Days) Insulin RequirementFU week 13-0.067 IU/kg/dayStandard Deviation 0.1774
LadarixinChange From Screening in Average (Previous 3 Days) Insulin RequirementFU week 26-0.011 IU/kg/dayStandard Deviation 0.2625
LadarixinChange From Screening in Average (Previous 3 Days) Insulin RequirementFU week 520.025 IU/kg/dayStandard Deviation 0.2507
PlaceboChange From Screening in Average (Previous 3 Days) Insulin RequirementFU week 13-0.018 IU/kg/dayStandard Deviation 0.1314
PlaceboChange From Screening in Average (Previous 3 Days) Insulin RequirementFU week 260.032 IU/kg/dayStandard Deviation 0.1699
PlaceboChange From Screening in Average (Previous 3 Days) Insulin RequirementFU week 520.101 IU/kg/dayStandard Deviation 0.2411
Comparison: at week 13p-value: 0.222595% CI: [-0.1257, 0.0298]Mixed Models Analysis
Comparison: at week 26p-value: 0.55195% CI: [-0.1596, 0.0858]Mixed Models Analysis
Comparison: at week 52p-value: 0.250195% CI: [-0.1712, 0.0453]Mixed Models Analysis
Secondary

Change From Screening in Glycated Haemoglobin (HbA1c) Levels

HbA1c measurement can be used as a diagnostic test for diabetes providing that stringent quality assurance tests are in place and assays are standardised to criteria aligned to the international reference values, and there are no conditions present which preclude its accurate measurement. An HbA1c of 6.5% is recommended as the cut point for diagnosing diabetes. A value of less than 6.5% does not exclude diabetes diagnosed using glucose tests.

Time frame: Follow-ups at Weeks 13±1, 26±2 and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinChange From Screening in Glycated Haemoglobin (HbA1c) LevelsFU week 13-1.40 percentage of glycated haemoglobinStandard Deviation 1.674
LadarixinChange From Screening in Glycated Haemoglobin (HbA1c) LevelsFU week 26-1.19 percentage of glycated haemoglobinStandard Deviation 2.003
LadarixinChange From Screening in Glycated Haemoglobin (HbA1c) LevelsFU week 52-0.69 percentage of glycated haemoglobinStandard Deviation 2.225
PlaceboChange From Screening in Glycated Haemoglobin (HbA1c) LevelsFU week 13-1.18 percentage of glycated haemoglobinStandard Deviation 1.352
PlaceboChange From Screening in Glycated Haemoglobin (HbA1c) LevelsFU week 26-0.63 percentage of glycated haemoglobinStandard Deviation 1.141
PlaceboChange From Screening in Glycated Haemoglobin (HbA1c) LevelsFU week 52-0.76 percentage of glycated haemoglobinStandard Deviation 1.333
Comparison: at FU week 13p-value: 0.625295% CI: [-0.7514, 0.4526]Mixed Models Analysis
Comparison: At FU week 26p-value: 0.36695% CI: [-0.8904, 0.3297]Mixed Models Analysis
Comparison: At FU week 52p-value: 0.502695% CI: [-0.3992, 0.8118]Mixed Models Analysis
Secondary

C-peptide AUC(15 to 120 Mins) Above Fasting Value

The means are all adjusted means. The MMTT over the study: logAUC(15-120 min) of C-peptide above fasting value at Weeks 13±1, 26±2, and 52±2 is reported. Post-meal samples were drawn at 15, 30, 60, 90, 120 min after the meal at weeks 13+/-1, 26±2 and 52±2

Time frame: Follow-ups at Weeks 13±1 26±2 and 52±2

Population: ITT population: all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)
LadarixinC-peptide AUC(15 to 120 Mins) Above Fasting ValueFU Week 133.3736 log(ng*hr/ml [15-120 min]+1)
LadarixinC-peptide AUC(15 to 120 Mins) Above Fasting ValueFU week 263.2419 log(ng*hr/ml [15-120 min]+1)
LadarixinC-peptide AUC(15 to 120 Mins) Above Fasting ValueFU week 522.9733 log(ng*hr/ml [15-120 min]+1)
PlaceboC-peptide AUC(15 to 120 Mins) Above Fasting ValueFU Week 133.2334 log(ng*hr/ml [15-120 min]+1)
PlaceboC-peptide AUC(15 to 120 Mins) Above Fasting ValueFU week 263.0649 log(ng*hr/ml [15-120 min]+1)
PlaceboC-peptide AUC(15 to 120 Mins) Above Fasting ValueFU week 522.9282 log(ng*hr/ml [15-120 min]+1)
Comparison: At week 13p-value: 0.416395% CI: [-0.2015, 0.4819]Mixed Models Analysis
Comparison: At week 26p-value: 0.357595% CI: [-0.2039, 0.558]Mixed Models Analysis
Comparison: At week 52p-value: 0.838695% CI: [-0.3948, 0.4851]Mixed Models Analysis
Secondary

Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit

A severe hypoglycaemic event was defined as an event with one of the following symptoms: memory loss, confusion, uncontrollable behaviour, irrational behaviour, unusual difficulty in awakening, suspected seizure, seizure, loss of consciousness, or visual symptoms, in which the patient was unable to treat him/herself and which was associated with either a blood glucose level \<54 mg/dL or prompt recovery after oral carbohydrate, i.v. glucose, or glucagon administration.

Time frame: Follow-ups at Weeks 13±1, 26±2 and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinCumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFU week 130.0 eventsStandard Deviation 0
LadarixinCumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFU Week 260.0 eventsStandard Deviation 0.14
LadarixinCumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFU Week 520.1 eventsStandard Deviation 0.32
PlaceboCumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFU week 130.0 eventsStandard Deviation 0
PlaceboCumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFU Week 260.0 eventsStandard Deviation 0.2
PlaceboCumulative Severe Hypoglycaemic Events Occurring From Randomisation by VisitFU Week 520.0 eventsStandard Deviation 0.2
Secondary

Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT

C-peptide level is a widely used measure of pancreatic beta-cell function. The MMTT is one of the methods for its estimation. The MMTT was performed after an overnight fast, at baseline (within 1 week prior to randomization), and at each follow-up visit on weeks 13±1, 26±2, and 52±2. Prior to the test, patients withheld long-acting insulin on the morning of the test. Rapid-acting and short-acting insulin were allowed up to 6hrs and 2 hrs, respectively, before the test. The test was rescheduled if the patient had a capillary glucose value of \>200mg/dL or \<70mg/dL. The test was initiated before 10 a.m. After 2 pre-meal basal samples had been drawn between -20 to 0 min (basal 1 and basal 2), patients were given 6mL/kg of Boost® High Protein Nutritional Drink (Nestlé Nutrition) up to a maximum of 360mL, to be drunk within 5 min. Post-meal samples were drawn at 15±5, 30±5, 60±10, 90±10, 120±15, 180±15 min after the meal.

Time frame: Follow-ups at Weeks 13±1, 26±2 and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (MEAN)Dispersion
LadarixinPercent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFU week 135.7818 percentage of changeStandard Deviation 36.74477
LadarixinPercent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFU week 26-0.8701 percentage of changeStandard Deviation 42.93044
LadarixinPercent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFU week 52-22.2532 percentage of changeStandard Deviation 38.84672
PlaceboPercent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFU week 13-6.0734 percentage of changeStandard Deviation 38.22179
PlaceboPercent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFU week 26-13.7347 percentage of changeStandard Deviation 37.419
PlaceboPercent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTTFU week 52-24.2215 percentage of changeStandard Deviation 42.67277
Comparison: at week 13p-value: 0.222495% CI: [-7.3823, 31.4644]Mixed Models Analysis
Comparison: At week 26p-value: 0.393195% CI: [-11.0935, 28.0541]Mixed Models Analysis
Comparison: At week 52p-value: 0.766495% CI: [-22.5476, 16.6473]Mixed Models Analysis
Secondary

Proportion of Patients Maintaining a Residual β-cell Function

Maintenance of a residual ß-cell function is defined as at least one MMTT C-peptide value \> 0.2 nmol/L. Proportion is reported as Percentage of patients.

Time frame: Follow-ups at Weeks 13±1, 26±2 and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo)

ArmMeasureGroupValue (NUMBER)
LadarixinProportion of Patients Maintaining a Residual β-cell FunctionFU Week 1396.0 Percentage of patients
LadarixinProportion of Patients Maintaining a Residual β-cell FunctionFU week 2686.0 Percentage of patients
LadarixinProportion of Patients Maintaining a Residual β-cell FunctionFU Week 5278.0 Percentage of patients
PlaceboProportion of Patients Maintaining a Residual β-cell FunctionFU Week 1388.5 Percentage of patients
PlaceboProportion of Patients Maintaining a Residual β-cell FunctionFU week 2684.6 Percentage of patients
PlaceboProportion of Patients Maintaining a Residual β-cell FunctionFU Week 5276.9 Percentage of patients
Comparison: at week 13p-value: 0.1171Fisher Exact
Comparison: At week 26p-value: 0.6586Fisher Exact
Comparison: At week 52p-value: 0.5056Fisher Exact
Secondary

Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit

A severe hypoglycaemic event was defined as an event with one of the following symptoms: memory loss, confusion, uncontrollable behaviour, irrational behaviour, unusual difficulty in awakening, suspected seizure, seizure, loss of consciousness, or visual symptoms, in which the patient was unable to treat him/herself and which was associated with either a blood glucose level \<54 mg/dL or prompt recovery after oral carbohydrate, i.v. glucose, or glucagon administration. Proportion is reported as percentage of patients. Events per patient are calculated from the date of randomisation.

Time frame: Follow-ups at Weeks 13±1, 26±2 and 52±2

Population: ITT population = all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo)

ArmMeasureGroupValue (NUMBER)
LadarixinProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFU Week 1390.0 Percentage of patients
LadarixinProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFU week 2678.0 Percentage of patients
LadarixinProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFU Week 5262.0 Percentage of patients
PlaceboProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFU Week 1373.1 Percentage of patients
PlaceboProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFU week 2650.0 Percentage of patients
PlaceboProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous VisitFU Week 5253.8 Percentage of patients
Comparison: at week 13p-value: 0.0779Fisher Exact
Comparison: At week 26p-value: 0.0248Fisher Exact
Comparison: At week 52p-value: 0.4504Fisher Exact
Secondary

Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median Value

A severe hypoglycaemic event was defined as an event with one of the following symptoms: memory loss, confusion, uncontrollable behaviour, irrational behaviour, unusual difficulty in awakening, suspected seizure, seizure, loss of consciousness, or visual symptoms, in which the patient was unable to treat him/herself and which was associated with either a blood glucose level \<54 mg/dL or prompt recovery after oral carbohydrate, i.v. glucose, or glucagon administration. Proportion is reported as percentage of patients, despite the measure type indicated is number. Events per patient are calculated from the date of randomisation.

Time frame: Follow-up at Weeks 13±1, 26±2, and 52±2

Population: ITT population: all patients who were randomised and received at least 1 dose of study treatment (either ladarixin or placebo).~Please note that the number of participants analysed represents the number of patients contributing to summary statistics.

ArmMeasureGroupValue (NUMBER)
LadarixinProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFU week 1388.5 Percentage of patients
LadarixinProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFU week 2688.5 Percentage of patients
LadarixinProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFU week 5265.4 Percentage of patients
PlaceboProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFU week 1363.6 Percentage of patients
PlaceboProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFU week 2636.4 Percentage of patients
PlaceboProportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit in Patients With Screening C-peptide < Median ValueFU week 5245.5 Percentage of patients
Comparison: Week 13p-value: 0.163Fisher Exact
Comparison: Week 26p-value: 0.0074Fisher Exact
Comparison: Week 52p-value: 0.4437Fisher Exact

Source: ClinicalTrials.gov · Data processed: Feb 18, 2026