Purpose

The purpose of this study is to assess the safety and tolerability of different doses of AG019 administered alone or in combination with teplizumab in participants with recent-onset type 1 diabetes (T1D).

Condition

Eligibility

Eligible Ages
Between 12 Years and 40 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Male or non-pregnant, non-lactating females, 18 - 40 years of age (both inclusive) or 12-17 years of age (both inclusive) - Diagnosis of diabetes according to the American Diabetes Association (ADA) recommended criteria - Evidence of auto-antibodies to at least 1 β-cell autoantigen - Stimulated C-peptide measured during 4h Mixed Meal tolerance Test (MMTT) > 0.2 nmol/L - The first administration of AG019 should occur no later than 150 days post diagnosis of diabetes - Body weight ≥ 33kg - Written informed consent obtained and documented (participant, parent, guardian as applicable)

Exclusion Criteria

  • Previous history of serious cytokine release syndrome to teplizumab or other humanized anti-CD3 monoclonal antibodies with no or minimal capacity to bind Fc receptors. (Participants enrolled in the second phase of the trial in either Combination Cohort 1 or Combination Cohort 2, only) - Use of immunosuppressive or immunomodulatory therapies, including systemic steroids within 1 month prior to randomization - Participation in another investigational drug trial within 12 weeks prior to the first study drug intake and during participation in this study - History of recurrent infections, other autoimmune diseases, cardiac disease, malignancy, or any other (chronic) medical condition which, in the investigator's opinion, could compromise participant safety - Documented history of human immunodeficiency virus (HIV), Hepatitis Virus Type C (HCV), Hepatitis Virus Type B (HBV) infection - Evidence of active infection with Epstein-Barr Virus (EBV) or cytomegalovirus (CMV) - Evidence of active or latent tuberculosis (TB) - Administration of anti-CD3 antibody in past year - Current therapy with any other anti-diabetic agents other than insulin (MDI, CSII or analogue). Current or planned therapy with experimental (i.e., unapproved) insulin. Patients on therapy for type 2 diabetes (e.g. metformin) should stop their therapy in order to be eligible for study participation. - Use of medications known to influence glucose tolerance - Daily use of non-steroidal anti-inflammatory agents - Compromised GI mucosal integrity or motility, not attributable to T1D (i.e., recent diarrhea, gluten sensitive enteropathy, inflammatory bowel disease, irritable bowel syndrome), or current use of medications known to influence GI motility - Positive result of SARS-Cov2 PCR test at screening or within 3 days before randomization

Study Design

Phase
Phase 1/Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Sequential Assignment
Intervention Model Description
The phase 1b part of the study will enroll 4 sequential AG019 cohorts of up to 6 participants, in ascending dose cohorts and descending age cohorts. All participants in these cohorts will be treated with AG019 in an open label fashion. The phase 2a part of the study will evaluate 2 cohorts of participants administered AG019 and teplizumab. The first 2 participants will be treated with active treatment in an open label fashion. Participants 3-12 will be randomized (4:1) to receive active treatment or placebo in a double-blind fashion.
Primary Purpose
Treatment
Masking
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description
For the randomized participants in the combination cohorts, blinding will be accomplished by arranging for AG019 and placebo components as well as teplizumab and placebo components to have identical packaging.

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
AG019 Cohort 1 - Low Dose/Adults
  • Biological: AG019 - Low Dose
    Solid, orally administered capsule - 2 capsules per day for 1 day (single dose) or 8 weeks (repeat dose)
Experimental
AG019 Cohort 2 - High Dose/Adults
  • Biological: AG019 - High Dose
    Solid, orally administered capsule - 6 capsules per day for 1 day (single dose) or 8 weeks
Experimental
AG019 Cohort 3 - Low Dose/Adolescents
  • Biological: AG019 - Low Dose
    Solid, orally administered capsule - 2 capsules per day for 1 day (single dose) or 8 weeks (repeat dose)
Experimental
AG019 Cohort 4 - High Dose/Adolescents
  • Biological: AG019 - High Dose
    Solid, orally administered capsule - 6 capsules per day for 1 day (single dose) or 8 weeks
Experimental
Combination Cohort 1 - Adults
  • Drug: Teplizumab
    Daily IV infusions of Teplizumab during the first 12 days of AG019 treatment. Total cumulative dose is approximately 17mg (dose calculation based on body surface area).
  • Drug: Placebo-AG019
    Formulated identically to AG019 with the active ingredient removed.
  • Drug: Placebo-Teplizumab
    Formulated identically to teplizumab with the active ingredient removed.
  • Biological: AG019 - High Dose
    Solid, orally administered capsule - 6 capsules per day for 8 weeks.
Experimental
Combination Cohort 2 - Adolescents
  • Drug: Teplizumab
    Daily IV infusions of Teplizumab during the first 12 days of AG019 treatment. Total cumulative dose is approximately 17mg (dose calculation based on body surface area).
  • Drug: Placebo-AG019
    Formulated identically to AG019 with the active ingredient removed.
  • Drug: Placebo-Teplizumab
    Formulated identically to teplizumab with the active ingredient removed.
  • Biological: AG019 - High Dose
    Solid, orally administered capsule - 6 capsules per day for 8 weeks.

More Details

Status
Completed
Sponsor
Precigen Actobio T1D, LLC

Study Contact

Detailed Description

This Phase 1b/2a, multi-center study will be conducted in participants with clinical recent-onset type 1 diabetes (T1D). The primary objective of this study is to assess the safety and tolerability of different doses of AG019 alone as well as AG019 in combination with teplizumab. The secondary objectives of this study are: to obtain pharmacodynamic (PD) data of AG019 alone as well as AG019 in combination with teplizumab; and to determine the potential presence of AG019 in systemic circulation (safety - systemic exposure) and the presence of L. lactis bacteria in fecal excretion (local exposure): Pharmacokinetic (PK) profile. This study consists of 2 phases: Phase 1b: this open-label part of the study will investigate the safety and tolerability of 2 different doses of AG019 in 2 age groups (18-40 years of age and 12-17 years of age). Phase 2a: this randomized, double-blind part of the study will investigate the safety and tolerability of AG019, in combination with teplizumab, in 2 age groups (18-40 years of age and 12-17 years of age).

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.