Diabetes Mellitus, Insulin-Dependent
Conditions
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
Placebo oral capsule
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Area Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 13 | week 13±1 | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52 | Follow-ups at Weeks 26±2 and 52±2 | 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. |
| Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | Follow-ups at Weeks 13±1, 26±2 and 52±2 | 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. |
| Change From Screening in Average (Previous 3 Days) Insulin Requirement | Follow-ups at Weeks 13±1, 26±2 and 52±2 | 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. |
| Change From Screening in Glycated Haemoglobin (HbA1c) Levels | Follow-ups at Weeks 13±1, 26±2 and 52±2 | 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. |
| Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Baseline, follow-ups at Weeks 13±1, 26±2, and 52±2 | 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. |
| Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | Follow-ups at Weeks 13±1, 26±2 and 52±2 | 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. |
| Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Baseline, follow-ups at Weeks 13±1, 26±2, and 52±2 | 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. |
| Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | Follow-ups at Weeks 13±1, 26±2 and 52±2 | 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. |
| C-peptide AUC(15 to 120 Mins) Above Fasting Value | Follow-ups at Weeks 13±1 26±2 and 52±2 | 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 |
| Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | Follow-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 Value | Follow-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 Value | Follow-up at Weeks 13±1, 26±2, and 52±2 | 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. |
| Proportion of Patients Maintaining a Residual β-cell Function | Follow-ups at Weeks 13±1, 26±2 and 52±2 | 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. |
Countries
Belgium, Germany, Italy
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Ladarixin Ladarixin oral capsule
Ladarixin: Ladarixin oral capsule | 50 |
| Placebo Placebo oral capsule
Placebo: Placebo oral capsule | 26 |
| Total | 76 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | 3 agreed dates for the final visit missed | 1 | 0 |
| Overall Study | Consent withdrawal | 1 | 1 |
Baseline characteristics
| Characteristic | Placebo | Ladarixin | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 26 Participants | 50 Participants | 76 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 26 Participants | 49 Participants | 75 Participants |
| Region of Enrollment Belgium | 11 participants | 20 participants | 31 participants |
| Region of Enrollment Germany | 5 participants | 13 participants | 18 participants |
| Region of Enrollment Italy | 10 participants | 17 participants | 27 participants |
| Sex: Female, Male Female | 10 Participants | 21 Participants | 31 Participants |
| Sex: Female, Male Male | 16 Participants | 29 Participants | 45 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 50 | 0 / 26 |
| other Total, other adverse events | 37 / 50 | 21 / 26 |
| serious Total, serious adverse events | 3 / 50 | 1 / 26 |
Outcome results
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)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Ladarixin | Area Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 13 | 4.026 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.4852 |
| Placebo | Area Under the Curve (AUC)(0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Week 13 | 3.886 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.7446 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | FU Week 13 | 3.8085 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.45692 |
| Ladarixin | Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | FU Week 26 | 3.8202 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.48142 |
| Ladarixin | Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | FU Week 52 | 3.3796 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.68616 |
| Placebo | Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | FU Week 13 | 3.4543 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.86632 |
| Placebo | Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | FU Week 26 | 3.3178 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.91906 |
| Placebo | Area Under the Curve (AUC) (0-2 h) of C-peptide MMTT in Patients With Screening C-peptide < Median Value | FU Week 52 | 3.1562 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.9713 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52 | FU week 26 | 3.9351 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.5171 |
| Ladarixin | Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52 | FU week 52 | 3.6371 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.75222 |
| Placebo | Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52 | FU week 26 | 3.8076 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.76473 |
| Placebo | Area Under the Curve (AUC) (0-2 h) of C-peptide Response to the Mixed Meal Tolerance Test (MMTT) at Weeks 26 and 52 | FU week 52 | 3.6380 log(ng*hr/ml [0-2 h]+1) | Standard Deviation 0.81268 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value | FU week 13 | 3.1590 log(ng*hr/ml [15-120 min] +1) | Standard Deviation 0.56135 |
| Ladarixin | Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value | FU week 26 | 27.7841 log(ng*hr/ml [15-120 min] +1) | Standard Deviation 15.10337 |
| Ladarixin | Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value | FU week 52 | 2.7993 log(ng*hr/ml [15-120 min] +1) | Standard Deviation 0.82214 |
| Placebo | Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value | FU week 13 | 2.7959 log(ng*hr/ml [15-120 min] +1) | Standard Deviation 1.07745 |
| Placebo | Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value | FU week 26 | 18.6842 log(ng*hr/ml [15-120 min] +1) | Standard Deviation 15.46837 |
| Placebo | Area Under the Curve (AUC) (15-120 Min) of C-peptide MMTT Above Fasting Value in Patients With Screening C-peptide < Median Value | FU week 52 | 19.9415 log(ng*hr/ml [15-120 min] +1) | Standard Deviation 16.95597 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - Basal average | 0.212 nmol/L | Standard Deviation 0.0941 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 90 min | 0.613 nmol/L | Standard Deviation 0.2467 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 15 min | 0.278 nmol/L | Standard Deviation 0.1294 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 15 min | 0.300 nmol/L | Standard Deviation 0.1385 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 30 min | 0.391 nmol/L | Standard Deviation 0.1857 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 15 min | 0.294 nmol/L | Standard Deviation 0.1621 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 60 min | 0.534 nmol/L | Standard Deviation 0.2463 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 30 min | 0.427 nmol/L | Standard Deviation 0.2048 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 90 min | 0.569 nmol/L | Standard Deviation 0.2606 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 120 min | 0.620 nmol/L | Standard Deviation 0.2559 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 120 min | 0.592 nmol/L | Standard Deviation 0.2703 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 60 min | 0.571 nmol/L | Standard Deviation 0.266 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 180 min | 0.504 nmol/L | Standard Deviation 0.2189 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 60 min | 0.545 nmol/L | Standard Deviation 0.2631 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - Basal average | 0.168 nmol/L | Standard Deviation 0.107 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 90 min | 0.620 nmol/L | Standard Deviation 0.2859 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 15 min | 0.228 nmol/L | Standard Deviation 0.1606 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 180 min | 0.527 nmol/L | Standard Deviation 0.2252 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 30 min | 0.321 nmol/L | Standard Deviation 0.2231 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 120 min | 0.637 nmol/L | Standard Deviation 0.2869 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 60 min | 0.430 nmol/L | Standard Deviation 0.2693 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 30 min | 0.422 nmol/L | Standard Deviation 0.2126 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 90 min | 0.463 nmol/L | Standard Deviation 0.2806 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 180 min | 0.518 nmol/L | Standard Deviation 0.2302 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 120 min | 0.503 nmol/L | Standard Deviation 0.3085 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - Basal average | 0.231 nmol/L | Standard Deviation 0.1136 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 180 min | 0.426 nmol/L | Standard Deviation 0.2341 |
| Ladarixin | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - Basal average | 0.218 nmol/L | Standard Deviation 0.1087 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 180 min | 0.443 nmol/L | Standard Deviation 0.2441 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - Basal average | 0.225 nmol/L | Standard Deviation 0.1416 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 15 min | 0.299 nmol/L | Standard Deviation 0.1779 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 30 min | 0.452 nmol/L | Standard Deviation 0.3036 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 60 min | 0.537 nmol/L | Standard Deviation 0.2354 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 90 min | 0.581 nmol/L | Standard Deviation 0.2486 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 120 min | 0.656 nmol/L | Standard Deviation 0.2923 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | Screening - 180 min | 0.550 nmol/L | Standard Deviation 0.2277 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - Basal average | 0.210 nmol/L | Standard Deviation 0.1315 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 15 min | 0.285 nmol/L | Standard Deviation 0.1956 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 30 min | 0.392 nmol/L | Standard Deviation 0.2418 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 60 min | 0.523 nmol/L | Standard Deviation 0.2729 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 90 min | 0.594 nmol/L | Standard Deviation 0.3176 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 120 min | 0.601 nmol/L | Standard Deviation 0.305 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 13 - 180 min | 0.527 nmol/L | Standard Deviation 0.2778 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - Basal average | 0.207 nmol/L | Standard Deviation 0.1192 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 15 min | 0.260 nmol/L | Standard Deviation 0.1426 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 30 min | 0.368 nmol/L | Standard Deviation 0.215 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 60 min | 0.511 nmol/L | Standard Deviation 0.2967 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 90 min | 0.552 nmol/L | Standard Deviation 0.3101 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 120 min | 0.552 nmol/L | Standard Deviation 0.2907 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 26 - 180 min | 0.466 nmol/L | Standard Deviation 0.2362 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - Basal average | 0.178 nmol/L | Standard Deviation 0.1068 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 15 min | 0.249 nmol/L | Standard Deviation 0.1616 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 30 min | 0.314 nmol/L | Standard Deviation 0.1826 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 60 min | 0.440 nmol/L | Standard Deviation 0.2671 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 90 min | 0.465 nmol/L | Standard Deviation 0.2881 |
| Placebo | Basal to 180 Minutes Time Course of C-peptide Concentration Derived From the MMTT | week 52 - 120 min | 0.492 nmol/L | Standard Deviation 0.2717 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - Basal average | 7.496 mmol/L | Standard Deviation 2.0261 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 90 min | 12.350 mmol/L | Standard Deviation 3.4122 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 15 min | 8.750 mmol/L | Standard Deviation 2.0827 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 15 min | 8.231 mmol/L | Standard Deviation 2.1415 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 30 min | 10.927 mmol/L | Standard Deviation 2.3901 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 15 min | 8.108 mmol/L | Standard Deviation 1.8453 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 60 min | 13.494 mmol/L | Standard Deviation 2.8623 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 30 min | 10.727 mmol/L | Standard Deviation 2.5691 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 90 min | 13.665 mmol/L | Standard Deviation 3.8399 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 120 min | 11.400 mmol/L | Standard Deviation 3.4561 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 120 min | 13.240 mmol/L | Standard Deviation 4.1302 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 60 min | 12.614 mmol/L | Standard Deviation 3.1536 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 180 min | 10.956 mmol/L | Standard Deviation 4.2031 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 60 min | 12.146 mmol/L | Standard Deviation 2.9387 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - Basal average | 7.457 mmol/L | Standard Deviation 2.3045 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 90 min | 12.553 mmol/L | Standard Deviation 3.7998 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 15 min | 8.939 mmol/L | Standard Deviation 2.721 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 180 min | 9.478 mmol/L | Standard Deviation 3.632 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 30 min | 11.374 mmol/L | Standard Deviation 2.6806 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 120 min | 11.773 mmol/L | Standard Deviation 4.099 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 60 min | 14.315 mmol/L | Standard Deviation 3.1205 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 30 min | 10.438 mmol/L | Standard Deviation 2.2282 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 90 min | 14.911 mmol/L | Standard Deviation 3.5768 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 180 min | 9.761 mmol/L | Standard Deviation 3.9834 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 120 min | 14.354 mmol/L | Standard Deviation 3.9162 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - Basal average | 7.074 mmol/L | Standard Deviation 1.9973 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 180 min | 12.148 mmol/L | Standard Deviation 4.0817 |
| Ladarixin | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - basal average | 6.965 mmol/L | Standard Deviation 1.6858 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 180 min | 13.148 mmol/L | Standard Deviation 3.9136 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - basal average | 6.855 mmol/L | Standard Deviation 1.9507 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 15 min | 8.013 mmol/L | Standard Deviation 2.0941 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 30 min | 10.096 mmol/L | Standard Deviation 2.4694 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 60 min | 12.068 mmol/L | Standard Deviation 2.9204 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 90 min | 12.076 mmol/L | Standard Deviation 3.9156 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 120 min | 11.827 mmol/L | Standard Deviation 4.0204 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Screening - 180 min | 9.652 mmol/L | Standard Deviation 4.0549 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - Basal average | 6.644 mmol/L | Standard Deviation 2.1145 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 15 min | 7.836 mmol/L | Standard Deviation 2.2409 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 30 min | 10.224 mmol/L | Standard Deviation 2.36 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 60 min | 12.871 mmol/L | Standard Deviation 2.6908 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 90 min | 13.092 mmol/L | Standard Deviation 3.1608 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 120 min | 12.260 mmol/L | Standard Deviation 3.759 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 13 - 180 min | 9.984 mmol/L | Standard Deviation 3.8597 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - Basal average | 7.600 mmol/L | Standard Deviation 2.6387 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 15 min | 9.058 mmol/L | Standard Deviation 2.7026 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 30 min | 11.240 mmol/L | Standard Deviation 2.6187 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 60 min | 14.222 mmol/L | Standard Deviation 2.8795 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 90 min | 15.020 mmol/L | Standard Deviation 3.4469 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 120 min | 14.424 mmol/L | Standard Deviation 3.7761 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 26 - 180 min | 12.028 mmol/L | Standard Deviation 3.8832 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - Basal average | 8.163 mmol/L | Standard Deviation 2.2251 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 15 min | 9.544 mmol/L | Standard Deviation 2.223 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 30 min | 11.688 mmol/L | Standard Deviation 2.6411 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 60 min | 14.725 mmol/L | Standard Deviation 2.9631 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 90 min | 15.276 mmol/L | Standard Deviation 3.7144 |
| Placebo | Basal to 180 Minutes Time Course of Glucose Concentration Derived From the MMTT | Week 52 - 120 min | 15.140 mmol/L | Standard Deviation 3.7514 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Change From Screening in Average (Previous 3 Days) Insulin Requirement | FU week 13 | -0.067 IU/kg/day | Standard Deviation 0.1774 |
| Ladarixin | Change From Screening in Average (Previous 3 Days) Insulin Requirement | FU week 26 | -0.011 IU/kg/day | Standard Deviation 0.2625 |
| Ladarixin | Change From Screening in Average (Previous 3 Days) Insulin Requirement | FU week 52 | 0.025 IU/kg/day | Standard Deviation 0.2507 |
| Placebo | Change From Screening in Average (Previous 3 Days) Insulin Requirement | FU week 13 | -0.018 IU/kg/day | Standard Deviation 0.1314 |
| Placebo | Change From Screening in Average (Previous 3 Days) Insulin Requirement | FU week 26 | 0.032 IU/kg/day | Standard Deviation 0.1699 |
| Placebo | Change From Screening in Average (Previous 3 Days) Insulin Requirement | FU week 52 | 0.101 IU/kg/day | Standard Deviation 0.2411 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Change From Screening in Glycated Haemoglobin (HbA1c) Levels | FU week 13 | -1.40 percentage of glycated haemoglobin | Standard Deviation 1.674 |
| Ladarixin | Change From Screening in Glycated Haemoglobin (HbA1c) Levels | FU week 26 | -1.19 percentage of glycated haemoglobin | Standard Deviation 2.003 |
| Ladarixin | Change From Screening in Glycated Haemoglobin (HbA1c) Levels | FU week 52 | -0.69 percentage of glycated haemoglobin | Standard Deviation 2.225 |
| Placebo | Change From Screening in Glycated Haemoglobin (HbA1c) Levels | FU week 13 | -1.18 percentage of glycated haemoglobin | Standard Deviation 1.352 |
| Placebo | Change From Screening in Glycated Haemoglobin (HbA1c) Levels | FU week 26 | -0.63 percentage of glycated haemoglobin | Standard Deviation 1.141 |
| Placebo | Change From Screening in Glycated Haemoglobin (HbA1c) Levels | FU week 52 | -0.76 percentage of glycated haemoglobin | Standard Deviation 1.333 |
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.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Ladarixin | C-peptide AUC(15 to 120 Mins) Above Fasting Value | FU Week 13 | 3.3736 log(ng*hr/ml [15-120 min]+1) |
| Ladarixin | C-peptide AUC(15 to 120 Mins) Above Fasting Value | FU week 26 | 3.2419 log(ng*hr/ml [15-120 min]+1) |
| Ladarixin | C-peptide AUC(15 to 120 Mins) Above Fasting Value | FU week 52 | 2.9733 log(ng*hr/ml [15-120 min]+1) |
| Placebo | C-peptide AUC(15 to 120 Mins) Above Fasting Value | FU Week 13 | 3.2334 log(ng*hr/ml [15-120 min]+1) |
| Placebo | C-peptide AUC(15 to 120 Mins) Above Fasting Value | FU week 26 | 3.0649 log(ng*hr/ml [15-120 min]+1) |
| Placebo | C-peptide AUC(15 to 120 Mins) Above Fasting Value | FU week 52 | 2.9282 log(ng*hr/ml [15-120 min]+1) |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | FU week 13 | 0.0 events | Standard Deviation 0 |
| Ladarixin | Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | FU Week 26 | 0.0 events | Standard Deviation 0.14 |
| Ladarixin | Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | FU Week 52 | 0.1 events | Standard Deviation 0.32 |
| Placebo | Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | FU week 13 | 0.0 events | Standard Deviation 0 |
| Placebo | Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | FU Week 26 | 0.0 events | Standard Deviation 0.2 |
| Placebo | Cumulative Severe Hypoglycaemic Events Occurring From Randomisation by Visit | FU Week 52 | 0.0 events | Standard Deviation 0.2 |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Ladarixin | Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | FU week 13 | 5.7818 percentage of change | Standard Deviation 36.74477 |
| Ladarixin | Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | FU week 26 | -0.8701 percentage of change | Standard Deviation 42.93044 |
| Ladarixin | Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | FU week 52 | -22.2532 percentage of change | Standard Deviation 38.84672 |
| Placebo | Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | FU week 13 | -6.0734 percentage of change | Standard Deviation 38.22179 |
| Placebo | Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | FU week 26 | -13.7347 percentage of change | Standard Deviation 37.419 |
| Placebo | Percent Change From Baseline of 2-hour AUC of C-peptide Response to the MMTT | FU week 52 | -24.2215 percentage of change | Standard Deviation 42.67277 |
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)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Ladarixin | Proportion of Patients Maintaining a Residual β-cell Function | FU Week 13 | 96.0 Percentage of patients |
| Ladarixin | Proportion of Patients Maintaining a Residual β-cell Function | FU week 26 | 86.0 Percentage of patients |
| Ladarixin | Proportion of Patients Maintaining a Residual β-cell Function | FU Week 52 | 78.0 Percentage of patients |
| Placebo | Proportion of Patients Maintaining a Residual β-cell Function | FU Week 13 | 88.5 Percentage of patients |
| Placebo | Proportion of Patients Maintaining a Residual β-cell Function | FU week 26 | 84.6 Percentage of patients |
| Placebo | Proportion of Patients Maintaining a Residual β-cell Function | FU Week 52 | 76.9 Percentage of patients |
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)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Ladarixin | Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | FU Week 13 | 90.0 Percentage of patients |
| Ladarixin | Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | FU week 26 | 78.0 Percentage of patients |
| Ladarixin | Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | FU Week 52 | 62.0 Percentage of patients |
| Placebo | Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | FU Week 13 | 73.1 Percentage of patients |
| Placebo | Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | FU week 26 | 50.0 Percentage of patients |
| Placebo | Proportion of Patients With HbA1c <7% and Absence of Episodes of Severe Hypoglycaemia From the Previous Visit | FU Week 52 | 53.8 Percentage of patients |
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Ladarixin | 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 | FU week 13 | 88.5 Percentage of patients |
| Ladarixin | 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 | FU week 26 | 88.5 Percentage of patients |
| Ladarixin | 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 | FU week 52 | 65.4 Percentage of patients |
| Placebo | 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 | FU week 13 | 63.6 Percentage of patients |
| Placebo | 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 | FU week 26 | 36.4 Percentage of patients |
| Placebo | 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 | FU week 52 | 45.5 Percentage of patients |