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CompletedNCT02236754Updated Jul 23, 2024Results posted

Evaluation of 18 F-FP-DTBZ Pancreatic PET Scanning as a Tool to Measure Beta Cell Mass

An Early Phase 1 interventional study of 18 F-FP-DTBZ and PET Scanning in Healthy Volunteers and Diabetes Mellitus, Type 1, sponsored by Columbia University. Completed at 1 site in United States. Open to participants aged 18 Years to 70 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-23.

Sponsored by Columbia University · Early Phase 1, Interventional, and Basic science

From the registry’s dates

  • Registered 6 months after the study started (first participant enrolled Jul 2013, registered Jan 2014).
Phase
Early Phase 1
Study type
Interventional
Enrollment
23
Allocation
Non-randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

Type 1 diabetes mellitus (T1DM) develops when there is impaired insulin production due to loss of insulin producing cells (beta cells). The amount of insulin that can be produced is imperfectly correlated with beta cell mass (BCM). The development of a reliable method to noninvasively quantify the total amount of insulin producing beta cells would be of great benefit by providing an important endpoint for the development of new treatments of diabetes. The investigators have previously identified a specific marker on islet cells called vesicular monoamine transporter 2 (VMAT2) that the investigators now propose to use in positron emission tomography (PET) scanning to determine islet beta cell mass. The PET radiopharmaceutical 18 F-fluoropropyl(FP)-dihydrotetrabenazine(DTBZ) has been used previously in human subjects without adverse effects. It has shown promise in differentiating type 1 diabetes and non-diabetes. The investigators now hypothesize that repeat PET scans will be reproducible in the same subject. Subjects with normal BCM will be recruited from among normal weight non-diabetic people with plasma insulin levels within the normal range. Subjects with predicted reduced BCM will be recruited from among patients with T1DM who have low or non-measurable insulin levels. Two PET scan measurements will be taken in each subject and the amount of VMAT2 in the pancreas will be and compared for reproducible findings. Biochemical testing will also be performed and compared to PET scans as a potential indirect marker of beta cell mass.

Read the detailed description

Diabetes results when the insulin secretory capacity of the beta cell population is lost or severely compromised.Plasma insulin levels have been used as a surrogate marker of beta cell mass (BCM) but insulin levels often do not correlate well. A "gold standard of measurement" to obtain BCM would be of great value. The aim of the proposed study is to evaluate an islet imaging technique using PET scanning to directly measure BCM and thus provide valuable information for monitoring disease progress and response to therapy in people with diabetes and in people at high risk for diabetes. Type 1 diabetes (T1DM) occurs when the beta cells are selectively destroyed by a T cell mediated autoimmune process. People at high risk for developing T1DM, such as first degree relatives of patients with T1DM, can sometimes be identified before the disease develops by measuring autoantibodies to beta cells, however this test is neither sensitive nor specific. Little is known about the natural history of BCM, turnover and cell lifetime, or the course of inflammation in diabetes. This is principally because the pancreas is a highly heterogeneous organ that is difficult to biopsy without significant complications, and BCM only comprises 1 to 2% of the total volume. Accurate assessment of BCM in human diabetes is limited to autopsy studies, which usually suffer from inadequate clinical information; thus, the development of non-invasive means of BCM measurement could be important for interventional therapies of T1DM, islet regeneration/stem cell therapy and islet transplantation.

02

Conditions studied

  • Healthy Volunteers
  • Diabetes Mellitus, Type 1

Keywords

  • dihydrotetrabenazine
  • beta cell mass
  • diabetes mellitus
03

In context

Diabetes Mellitus, Type 1

3,614 studies on the registry are indexed under Diabetes Mellitus, Type 1; 586 are open to participants now.

This study's enrollment of 23 is below the median of 40 across 2,718 interventional studies indexed under Diabetes Mellitus, Type 1.

Browse Diabetes Mellitus, Type 1 studies →

Lead sponsor

Columbia University is the lead sponsor of 1,135 studies on the registry; 195 are open to participants now.

Of its 179 completed or terminated interventional studies of FDA-regulated products, 146 (82%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients with type 1 diabetes may be enrolled if they meet all of the following criteria:

    1. Are males or females between 18 and 70 years of age, inclusive
    2. Have a diagnosis of type 1 diabetes mellitus as defined by the American Diabetes Association (ADA) criteria or by diagnosed as per their endocrinologist; duration >5 years; Insulin dose requirements \<0.8 units/kg/day
    3. HbA1c level between 5% and 8.5%
    4. Have fasting C-Peptide \< 0.1 ng/ml
    5. Have a body mass index (BMI) between 18 and 32 kg/m2
    6. Able to tolerate PET imaging
    7. In the judgment of the physician, are capable of fasting 4 to 6 hours prior to screening and Day 1 imaging procedures
    8. Give informed consent

Healthy volunteers may be enrolled if they meeting all of the following criteria:

  1. Are males or females between 18 and 70 years of age, inclusive
  2. Have no history of type 1 or type 2 diabetes in a first degree relative
  3. Fasting blood glucose less than 100 mg/dL
  4. HbA1c level less than 6%
  5. Normal Mixed Meal Tolerance test at screening visit
  6. BMI between 18 and 32 kg/m2
  7. Able to tolerate PET imaging
  8. In the judgment of the physician, are capable of fasting 4 to 6 hours prior to screening and Day 1 imaging procedures, and
  9. Give informed consent

Exclusion criteria

Exclusion Criteria:

  • Potential participants must not have any of the following exclusion criteria:

    1. Clinically significant renal dysfunction
    2. Clinically significant liver dysfunction as determined by history, physical examination, and standard liver function testing at screening (aspartate aminotransferase (AST), alanine aminotransferase (ALT), Total/Direct Bilirubin, Alkaline Phosphatase)
    3. Coagulopathy
    4. Use medications known to affect dopaminergic function, including monoamine oxidase (MAO) inhibitors, tetrabenazine, or levodopa
    5. Recent (within 3 months) or current treatment with drugs influencing beta cell function or insulin sensitivity (e.g. glucocorticoids, reserpine) medications known to affect dopaminergic function, including MAO inhibitors, tetrabenazine, or levodopa
    6. Have polycystic ovarian syndrome
    7. History of movement disorder such as Parkinson's Disease, Huntington's Disease
    8. Clinically significant psychiatric disease or history of psychiatric illness such as depression, bipolar disease, anxiety or schizophrenia
    9. Current use (within past year) of cocaine, methamphetamine, and/or ecstasy (3,4methylenedioxymethamphetamine (MDMA))
    10. Have a recent history of alcohol or substance abuse or dependence
    11. Clinically significant cardiovascular disease or clinically significant abnormalities on screening electrocardiogram (ECG) (including but not limited to QT-interval time corrected > 450 msec)
    12. Clinically significant pulmonary, renal or hepatic impairment, or cancer
    13. Have clinically significant infectious disease, including acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection or previous positive test for hepatitis B, hepatitis C, or HIV.
    14. Are women of childbearing potential not refraining from sexual activity or not using adequate contraception.

      Women must not be pregnant (negative serum human chorionic gonadotropin (hCG) at the time of screen) or breastfeeding at screening, and must agree to take appropriate steps not to become pregnant during for 30 days following the clinical trial

    15. Require medications with a narrow therapeutic window (e.g., warfarin), are receiving any investigational medications, or have participated in a trial with investigational medications within the last 30 days
    16. Weigh more than the manufacturer recommended limit for the PET/computed tomography (CT) camera being used
    17. Any prior participation in other research protocols within the past month that involved radiation, with the exception of plain radiography studies (i.e., chest x-rays); And
    18. Have received a diagnostic or therapeutic radiopharmaceutical within the past week
05

Study design

Phase
Early Phase 1
Primary purpose
Basic science
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
23 participants (actual)

Study arms

  • Other
    Healthy Controls

    Pancreatic 18 F-FP-DTBZ uptake will be measured with PET scanning in healthy controls: subjects with predicted normal BCM (healthy, normal weight, non-diabetic individuals who have stimulated insulin and c-peptide levels within the normal range).

    Drug: 18 F-FP-DTBZ · Radiation: PET Scanning

  • Other
    Patients with T1D

    Pancreatic 18 F-FP-DTBZ uptake will be measured with PET scanning in patients with longstanding T1D: subjects with predicted reduced beta cell mass (subjects with established T1DM who have low or no measurable stimulated insulin and c-peptide levels).

    Drug: 18 F-FP-DTBZ · Radiation: PET Scanning

Interventions

  • The drug, no carrier added \[18 F\]-FP-DTBZ, is formulated in 5% (v/v) ethanol in 0.9% sterile saline solution to produce \[18 F\]-FP-DTBZ for injection. Subjects will receive a single i.v. administration of no more than 7.6 millicuries (mCi) of \[18 F\]-FP-DTBZ for injection immediately prior to imaging. The specific activity at time of injection will less than 1.0 mCi/microgram and thus for a 7.6 mCi dose the maximal mass dose will be less than 10 microgram.

  • RadiationPET Scanning

    Individuals will be imaged continuously (i.e. dynamically) for 2 hours.

    Also known as: Positron Emission Tomography

06

What researchers measure

Primary outcomes

  1. Mean VMAT2 Functional Binding Capacity in the β Cells to 18 F-FP-DTBZ

    The VMAT2 functional binding capacity in the body and tail of the pancreas is calculated as BPND (VMAT2 binding potential) × PET ROI (region-of-interest) Volume. BPND is unitless, and ROI unit is mL. Higher values of the VMAT functional binding capacity indicates greater β cell mass.

    Time frame: Up to 2 months from enrollment

07

Results

Posted Jul 23, 2024

Participant flow

Potential subjects with diabetes were recruited at the Naomi Berri Diabetes Center. The physician ascertained from the patient that he/she is willing to discuss the study with the research team before the investigators approach the patient. Non-diabetic subjects were either be referred by their physicians, by word of mouth, or by flyer.

Participant flow — Overall Study
MilestoneHealthy ControlsPatients With T1D
Started158
Completed148
Not completed10
Withdrew: Withdrawal by subject10

Outcome measures

PrimaryMean VMAT2 Functional Binding Capacity in the β Cells to 18 F-FP-DTBZ

The VMAT2 functional binding capacity in the body and tail of the pancreas is calculated as BPND (VMAT2 binding potential) × PET ROI (region-of-interest) Volume. BPND is unitless, and ROI unit is mL. Higher values of the VMAT functional binding capacity indicates greater β cell mass.

Time frame:
Up to 2 months from enrollment
Reported as:
Mean · unitless
Mean VMAT2 Functional Binding Capacity in the β Cells to 18 F-FP-DTBZ
unitlessStudy ControlsLongstanding T1D
Mean VMAT2 Functional Binding Capacity in the β Cells to 18 F-FP-DTBZ103 ± 1238 ± 5

Adverse events

Collected over Throughout study period, up to 2 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Study Controls0/14 (0%)0/14 (0%)0/14 (0%)
Longstanding T1D0/8 (0%)0/8 (0%)0/8 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Healthy ControlsPatients With T1DTotal
<=18 years000
Between 18 and 65 years14822
>=65 years000
Sex: Female, Male
Sex: Female, Male(Participants)Healthy ControlsPatients With T1DTotal
Female549
Male9413
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Healthy ControlsPatients With T1DTotal
Hispanic or Latino000
Not Hispanic or Latino000
Unknown or Not Reported14822
08

Study locations

1 site
  • Naomi Berrie Diabetes Center
    New York, New York 10032, United States
09

References and documents

Publications

  • Goland R, Freeby M, Parsey R, Saisho Y, Kumar D, Simpson N, Hirsch J, Prince M, Maffei A, Mann JJ, Butler PC, Van Heertum R, Leibel RL, Ichise M, Harris PE. 11C-dihydrotetrabenazine PET of the pancreas in subjects with long-standing type 1 diabetes and in healthy controls. J Nucl Med. 2009 Mar;50(3):382-9. doi: 10.2967/jnumed.108.054866. Epub 2009 Feb 17. PubMed 19223416 ↗
  • Freeby MJ, Kringas P, Goland RS, Leibel RL, Maffei A, Divgi C, Ichise M, Harris PE. Cross-sectional and Test-Retest Characterization of PET with [(18)F]FP-(+)-DTBZ for beta Cell Mass Estimates in Diabetes. Mol Imaging Biol. 2016 Apr;18(2):292-301. doi: 10.1007/s11307-015-0888-7. Epub 2015 Sep 14. PubMed 26370678 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 23, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02236754
Responsible party
Sponsor
First posted
Sep 11, 2014
Start date
Jul 2, 2013
Primary completion
Apr 23, 2014
Completion
Apr 23, 2014
Results posted
Jul 23, 2024
Last update
Jul 23, 2024

Study contacts

Paul Harris, PhD
principal investigator · Columbia University

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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