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CompletedNCT02384889Updated Sep 5, 2021

DFMO in Children With Type 1 Diabetes

A Phase 1 interventional study of Difluoromethylornithine and Placebo in Type 1 Diabetes, sponsored by Indiana University. Completed at 3 sites in United States. Open to participants aged 12 Years to 40 Years. Per ClinicalTrials.gov, last updated 2021-09-05.

Sponsored by Indiana University · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
41
Allocation
Randomized
Ages
12 Years to 40 Years
Sex
All
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Study summary

This study is a multicenter, double-blind, placebo-controlled, 2:1 randomly assigned, phase 1 clinical trial for individuals with type 1 diabetes. It is a blinded dose-ranging study enrolling patients with new onset type 1 diabetes with documented continued residual C-peptide production. After a 4 week screening and run-in period during which eligibility will be determined and glycemic control optimized, subjects will have a 3-month double-masked treatment period with either DFMO or placebo. After a 3 month wash-out period the durability of effect will be assessed. Subjects will be randomly assigned (6 to DFMO; 3 to placebo in each cohort) to 1 of 4 sequential dose cohorts.

Read the detailed description

This study is repurposing alpha difluoromethylornithine (DFMO) in order to characterize its effects in persons with new onset type 1 diabetes. In preliminary studies in mice, inhibition of polyamine synthesis with DFMO preserved β-cell insulin production and delayed diabetes onset. Polyamine modulation has the potential to improve β cell health in persons with T1D. The investigators propose that decreasing polyamine synthesis in persons with new onset T1D will improve markers of ß cell health and function.

This double-masked, placebo-controlled dose-finding randomized multiple ascending dose study will include a 1-month screening period; a 3-month double-masked treatment period; and a 3-month follow-up period. Subjects will be randomly assigned to 1 of 4 sequential dose cohorts: DFMO at nominal (starting) doses of 125 mg/m2 per day, 250 mg/m2 per day, 500 mg/m2 per day, and then 750 mg/m2 per day. Dose escalation will be done based upon whether any dose limiting toxicities are observed and whether any suggestion of effect on biomarkers of β-cell stress is observed. At a maximum dose, the cohort will be expanded in order to estimate biomarker activity. If there is no suggestion of effect and no dose-limiting toxicity 750 mg/m2 per day, a 750 mg per day group will be enrolled. Regardless of the dose we expand, the investigators will evaluate efficacy of treatment on the primary and secondary outcomes. The primary outcome endpoint in this study will be the safety of the doses. In particular, the dose-limiting toxicities known to be potential side effects of DFMO (thrombocytopenia, neutropenia, anemia, audiometric impairment) will be reviewed and monitored by an internal safety review committee before each cohort is enrolled. Secondary outcomes will include biomarkers of beta cell stress, measures of insulin production/glycemia. Exploratory outcomes will include flow cytometry assessment of B- and T-cell subsets, quantification of polyamine intake and excretion, and pharmacokinetic DFMO concentrations. Completion of this study will facilitate future work in studies of DFMO or other inhibitors of pathways that influence intracellular polyamine levels, including non-steroidal inflammatory agents, and novel polyamine transport inhibitors. .

02

Conditions studied

03

In context

Diabetes Mellitus

10,925 studies on the registry are indexed under Diabetes Mellitus; 1,319 are open to participants now.

This study's enrollment of 41 is below the median of 80 across 8,367 interventional studies indexed under Diabetes Mellitus.

Browse Diabetes Mellitus studies →

Lead sponsor

Indiana University is the lead sponsor of 958 studies on the registry; 200 are open to participants now.

Of its 142 completed or terminated interventional studies of FDA-regulated products, 112 (79%) have results posted.

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

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Who can participate

Ages eligible
12 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Males and females 12-40 years of age with a clinical diagnosis of T1D within 2 - 8 months after diagnosis at the time of visit 2.
  2. Random non-fasting C-peptide level of >0.2 pmol/mL at visit 1.
  3. Positive for any one of the following diabetes-related autoantibodies (mIAA, GADA, IA-2A, or ZnT8A)
  4. Treatment naïve of any immunomodulatory agent
  5. Normal hearing at screening, defined as acceptable results of pure-tone audiometry (\<20 decibel [dB] baseline thresholds for frequencies 250, 500, 1000, and 2000 Hz

Exclusion criteria

Exclusion Criteria:

  1. Presence of severe, active disease that interferes with dietary intake or requires the use of chronic medication, with the exception of well-controlled hypothyroidism and mild asthma not requiring oral steroids. Presence of any psychiatric disorder that will affect ability to participate in study.
  2. Diabetes other than T1D
  3. Chronic illness known to affect glucose metabolism (e.g. Cushing syndrome, polycystic ovarian disorder, cystic fibrosis) or taking medications that affect glucose metabolism (e.g. steroids, metformin)
  4. Inability to swallow pills
  5. Psychiatric impairment or current use of anti-psychotic medication
  6. Any condition that, in the investigator's opinion, may compromise study participation or may confound the interpretation of the study results.
  7. Hematologic abnormalities at screening (anemia, leukopenia (particularly neutropenia), or thrombocytopenia)
  8. Impaired renal function (assessed by history and BUN/Creatinine, DFMO is renally excreted)
  9. Female participants of child-bearing age must not be pregnant and agree to use an effective form of birth control or be abstinent during the study period.
  10. BMI >95% for age and sex
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Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Single group
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
41 participants (actual)

Study arms

  • Experimental
    Difluoromethylornithine

    Subjects may be given daily dose of DFMO

    Drug: Difluoromethylornithine

  • Placebo comparator
    Placebo

    Subjects may be given daily dose of placebo

    Drug: Placebo

Interventions

  • DrugDifluoromethylornithine

    Active Therapy with DFMO

    Also known as: DFMO

  • DrugPlacebo

    Placebo Comparitor

    Also known as: Comparitor

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What researchers measure

Primary outcomes

  1. Number of Participants with Dose Limiting Toxicities

    Low platelet counts, low white blood cell counts, low hemoglobin, severe abdominal pain/diarrhea, hearing loss

    Time frame: 6 month

Other outcomes

  1. Changes in Serum Markers of Beta Cell Stress

    Observed Changes in pro-insulin and c-peptide measured from blood

    Time frame: 6 months

07

Study locations

3 sites
  • Riley Hospital for Children
    Indianapolis, Indiana 46202, United States
  • Women and Children's Hospital of Buffalo
    Buffalo, New York 14222, United States
  • Children's Hospital of Wisconsin
    Wauwatosa, Wisconsin 53226, United States
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References and documents

Publications

  • Robertson MA, Padgett LR, Fine JA, Chopra G, Mastracci TL. Targeting polyamine biosynthesis to stimulate beta cell regeneration in zebrafish. Islets. 2020 Sep 2;12(5):99-107. doi: 10.1080/19382014.2020.1791530. Epub 2020 Jul 25. PubMed 32715853 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 5, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02384889
Lead sponsor
Indiana University
Responsible party
Linda DiMeglio, MD (Professor, Indiana University) — Principal investigator
First posted
Mar 10, 2015
Start date
Apr 2015
Primary completion
Oct 7, 2019
Completion
Jan 6, 2020
Last update
Sep 5, 2021

Oversight

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

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This study is completed, as verified in Sep 2021. You cannot join it, but the record below documents what was studied.

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