A Phase 2 interventional study of Ladarixin and Placebo in Recent Onset type1 Diabetes, sponsored by Dompé Farmaceutici S.p.A. Terminated at 57 sites in 8 countries. Open to participants aged 14 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-08-31.
Sponsored by Dompé Farmaceutici S.p.A · Phase 2, Interventional, and Treatment
Objectives The objective of this clinical trial is to assess whether ladarixin treatment has an effect to preserve β-cell function and delay the progression of T1D in adolescent and adult patients.
The safety of ladarixin in the specific clinical setting will be also evaluated.
The study will be a phase 2, multicenter, double-blind, placebo-controlled study. It will randomize approximately 130-140 patients (with up to an estimated 15-20% adolescents), with recent onset (within 180 days from 1st insulin administration) type 1 diabetes (T1D), assigned (2:1) to receive either oral ladarixin treatment (400 mg b.i.d. for 13 cycles of 14 days on/14 days off - treatment group) or placebo (control group). Recruitment will be competitive among the study sites, until the planned number of patients is randomized.
Ladarixin and placebo will be both administered for 1 year. All patients will be followed-up for 24 months from the 1st administration of the study medication. After the initial 12-m treatment period, all patients will enter into a 12-month follow-up (total period 24-month after first IMP administration). The study database (DB) will be locked when the last randomized patient has completed the month 12 visit (or being lost in follow-up), and relative data have been fully reconciled and cleaned; at that point, the DB will be unblinded and all endpoints, including the 6-month primary endpoint, will be analyzed, and the follow-up will continue under open-label conditions up to month 24.
Exclusion Criteria:
400 mg b.i.d. for 13 cycles of 14 days on/14 days off
Drug: Ladarixin
matching placebo b.i.d. for 13 cycles of 14 days on/14 days off
Drug: Placebo
Oral ladarixin twice a day for 13 cycles
Also known as: allosteric inhibitor of CXCL8 (IL-8), CXCR1 and CXCR2 receptors
Oral placebo twice a day for 13 cycles
Change From Baseline in 2-hour Area Under the Concentration-time Curve (AUC) of C-peptide Response to the Mixed Model Tolerance Test (MMTT)
Change from baseline in the 2-hour C-peptide Area Under the Curve (AUC) following a Mixed-Meal Tolerance Test (MMTT) at Month 6. The analysis used an adjusted ANCOVA model with the change from baseline in log(AUC + 1) as the dependent variable. Qualitative independent variables included treatment group, age group, sex, and BMI group, with the baseline value as a quantitative covariate. Missing data at Month 6 were handled via multiple imputation using a retrieved dropout approach. Missing values were imputed using a regression model based on the participant's allocated treatment arm and baseline value, utilizing data from participants who discontinued treatment but completed the Month 6 measurement. Baseline is defined as the last visit prior to randomization. Change from Baseline is defined as post-baseline visit value minus baseline visit value. The adjusted mean along with its the corresponding 95% confidence interval (CI) has been presented.
Time frame: Baseline and at Month 6
Change From Baseline in 2-hour AUC of C-peptide Response to the MMTT at Months 12, 18, and 24
Change from baseline in the 2-hour C-peptide AUC following a MMTT at Months 6, 12, and 18. The analysis used an adjusted ANCOVA model with the change from baseline in log(AUC + 1) as the dependent variable. Qualitative independent variables included treatment group, age group, sex, and BMI group, with the baseline value as a quantitative covariate. Missing data at Months 12, 18 and 24 were handled via multiple imputation using a retrieved dropout approach. Missing values were imputed using a regression model based on the participant's allocated treatment arm and baseline value, utilizing data from participants who discontinued treatment but completed the measurement at the timepoint of interest. Intermediate timepoints were included as covariates in the model. Baseline is defined as the last visit prior to randomization. Change from Baseline is defined as post-baseline visit value minus baseline visit value.
Time frame: Baseline and at Months 12, 18, and 24
Change in Glycated Hemoglobin (HbA1c) From Baseline
The change from baseline in HbA1c was analyzed using an adjusted ANCOVA model. The dependent variable is the change from baseline in HbA1c at each respective time point, with treatment, age group, sex, and BMI group as qualitative independent variables and the baseline value as a quantitative covariate. . Missing data are addressed via Multiple Imputation (MI) using a retrieved dropout approach, where values are imputed based on a regression model incorporating treatment arm, baseline value, and intermediate assessments as covariates. Baseline is defined as the last visit prior to randomization. Change from Baseline is defined as post-baseline visit value minus baseline visit value. The adjusted mean along with its the corresponding 95% confidence interval (CI) has been presented.
Time frame: Baseline and at Months 6, 12, 18 and 24
Percentage of Participants With HbA1c <7% Who Did Not Experience Severe Hypoglycemic Events During Treatment
The proportion of participants with HbA1c \< 7% was calculated by timepoint: the numerator was the number of participants with events occurring at a specific timepoint (month X visit), without cumulating participants with events up to that timepoint. Participants with severe hypoglycemic events were considered cumulatively and only events up to month 12 were considered (condition was evaluated by considering treatment period only). If HbA1c ≥ 7% or the participant had experienced a severe hypoglycemic event, then the endpoint was equal to "No" even in the case of one missing component. If either the HbA1c or severe hypoglycemic event data was missing, but the other satisfied the criteria for the endpoint, then the response to the endpoint was missing.
Time frame: At Months 6, 12, 18, and 24
Average (Previous 3 Days) Daily Insulin Requirement International Units Per Kilogram Per Day (IU/kg/Day)
The average daily insulin requirement at each visit was calculated from the daily insulin requirement measured at the 3 days prior to the visit.
Time frame: At Months 6, 12, 18, and 24
Percentage of Participants With HbA1c <7% and Daily Insulin Requirement <0.5 IU/kg/Day
Percentage of participants with HbA1c \<7% and daily insulin requirement \<0.5 (IU/Kg/day) was calculated for each time point, the numerator is the number of participants in each treatment group with events occurring at a specific timepoint, and the denominator is the number of participants in each treatment group reaching the specific visit.
Time frame: At Months 6, 12, 18, and 24
Number of Self-reported Episodes of Severe Hypoglycemia
This outcome assessed the total number of self-reported episodes of severe hypoglycemia occurring across all participants.
Time frame: Post-baseline up to Month 24
Percentage of Patients Not Requiring Insulin Therapy
This outcome assessed the percentage of participants who did not require an insulin therapy at the timepoint of interest.
Time frame: Months 6, 12, 18 and 24
Estimated Glucose Disposal Rate (eGDR)
Estimated Glucose Disposal Rate (eGDR) is a marker for the Assessment of Insulin Resistance and a validated clinical tool for estimating insulin sensitivity in type 1 diabetes. The eGDR was calculated using a formula incorporating Glycated Hemoglobin (HbA1c), hypertension status (blood pressure), and the Waist-to-Hip Ratio (WHR), with results expressed in milligrams per kilogram per minute (mg/kg/min).
Time frame: Months 6, 12, 18, and 24
A total of 141 participants were randomized in the study and 140 participants received treatment.
| Milestone | Ladarixin | Placebo | Run-in |
|---|---|---|---|
| Started | 0 | 0 | 289 |
| Completed | 0 | 0 | 141 |
| Not completed | 0 | 0 | 148 |
| Withdrew: Failure to meet continuation criteria | 0 | 0 | 131 |
| Withdrew: Lost to follow-up | 0 | 0 | 1 |
| Withdrew: Physician decision | 0 | 0 | 1 |
| Withdrew: Protocol-specific withdrawal criterion met | 0 | 0 | 1 |
| Withdrew: Withdrawal by subject | 0 | 0 | 14 |
| Milestone | Ladarixin | Placebo | Run-in |
|---|---|---|---|
| Started | 95 | 46 | 0 |
| Completed | 65 | 26 | 0 |
| Not completed | 30 | 20 | 0 |
| Withdrew: Discontinuation criteria met | 2 | 0 | 0 |
| Withdrew: Lost to follow-up | 3 | 2 | 0 |
| Withdrew: Withdrawal by subject | 14 | 12 | 0 |
| Withdrew: Physician decision | 1 | 1 | 0 |
| Withdrew: Pregnancy | 2 | 0 | 0 |
| Withdrew: Unavailable due to travel (abroad) | 1 | 3 | 0 |
| Withdrew: Study terminated by sponsor | 7 | 2 | 0 |
Change from baseline in the 2-hour C-peptide Area Under the Curve (AUC) following a Mixed-Meal Tolerance Test (MMTT) at Month 6. The analysis used an adjusted ANCOVA model with the change from baseline in log(AUC + 1) as the dependent variable. Qualitative independent variables included treatment group, age group, sex, and BMI group, with the baseline value as a quantitative covariate. Missing data at Month 6 were handled via multiple imputation using a retrieved dropout approach. Missing values were imputed using a regression model based on the participant's allocated treatment arm and baseline value, utilizing data from participants who discontinued treatment but completed the Month 6 measurement. Baseline is defined as the last visit prior to randomization. Change from Baseline is defined as post-baseline visit value minus baseline visit value. The adjusted mean along with its the corresponding 95% confidence interval (CI) has been presented.
| nanomole*hour/Liter (nmol*hr/L) | Ladarixin | Placebo |
|---|---|---|
| Change From Baseline in 2-hour Area Under the Concentration-time Curve (AUC) of C-peptide Response to the Mixed Model Tolerance Test (MMTT) | -0.284 (-0.453 to -0.114) | -0.151 (-0.373 to 0.071) |
Change from baseline in the 2-hour C-peptide AUC following a MMTT at Months 6, 12, and 18. The analysis used an adjusted ANCOVA model with the change from baseline in log(AUC + 1) as the dependent variable. Qualitative independent variables included treatment group, age group, sex, and BMI group, with the baseline value as a quantitative covariate. Missing data at Months 12, 18 and 24 were handled via multiple imputation using a retrieved dropout approach. Missing values were imputed using a regression model based on the participant's allocated treatment arm and baseline value, utilizing data from participants who discontinued treatment but completed the measurement at the timepoint of interest. Intermediate timepoints were included as covariates in the model. Baseline is defined as the last visit prior to randomization. Change from Baseline is defined as post-baseline visit value minus baseline visit value.
| nmol*hr/L | Ladarixin | Placebo |
|---|---|---|
| Month 12 | -0.426 (-0.767 to -0.084) | -0.447 (-0.948 to 0.054) |
| Month 18 | -0.574 (-0.991 to -0.157) | -0.524 (-1.163 to 0.114) |
| Month 24 | -0.661 (-8.201 to 6.880) | -0.843 (-14.345 to 12.660) |
The change from baseline in HbA1c was analyzed using an adjusted ANCOVA model. The dependent variable is the change from baseline in HbA1c at each respective time point, with treatment, age group, sex, and BMI group as qualitative independent variables and the baseline value as a quantitative covariate. . Missing data are addressed via Multiple Imputation (MI) using a retrieved dropout approach, where values are imputed based on a regression model incorporating treatment arm, baseline value, and intermediate assessments as covariates. Baseline is defined as the last visit prior to randomization. Change from Baseline is defined as post-baseline visit value minus baseline visit value. The adjusted mean along with its the corresponding 95% confidence interval (CI) has been presented.
| percentage of glycosylated hemoglobin | Ladarixin | Placebo |
|---|---|---|
| Month 6 | 0.500 (-0.668 to 1.667) | 0.032 (-1.881 to 1.944) |
| Month 12 | -0.267 (-0.681 to 0.148) | -0.280 (-0.779 to 0.219) |
| Month 18 | -0.031 (-0.713 to 0.652) | -0.180 (-1.074 to 0.714) |
| Month 24 | -0.007 (-1.383 to 1.369) | 0.080 (-1.823 to 1.982) |
The proportion of participants with HbA1c \< 7% was calculated by timepoint: the numerator was the number of participants with events occurring at a specific timepoint (month X visit), without cumulating participants with events up to that timepoint. Participants with severe hypoglycemic events were considered cumulatively and only events up to month 12 were considered (condition was evaluated by considering treatment period only). If HbA1c ≥ 7% or the participant had experienced a severe hypoglycemic event, then the endpoint was equal to "No" even in the case of one missing component. If either the HbA1c or severe hypoglycemic event data was missing, but the other satisfied the criteria for the endpoint, then the response to the endpoint was missing.
| percentage of participants | Ladarixin | Placebo |
|---|---|---|
| Month 6 | 44.3 | 55.6 |
| Month 12 | 46.2 | 39.4 |
| Month 18 | 44.1 | 48.3 |
| Month 24 | 41.0 | 40.9 |
The average daily insulin requirement at each visit was calculated from the daily insulin requirement measured at the 3 days prior to the visit.
| IU/Kg/Day | Ladarixin | Placebo |
|---|---|---|
| Month 6 | 0.39 ± 0.23 | 0.34 ± 0.17 |
| Month 12 | 0.41 ± 0.23 | 0.39 ± 0.18 |
| Month 18 | 0.43 ± 0.22 | 0.47 ± 0.27 |
| Month 24 | 0.47 ± 0.20 | 0.46 ± 0.23 |
Percentage of participants with HbA1c \<7% and daily insulin requirement \<0.5 (IU/Kg/day) was calculated for each time point, the numerator is the number of participants in each treatment group with events occurring at a specific timepoint, and the denominator is the number of participants in each treatment group reaching the specific visit.
| percentage of participants | Ladarixin | Placebo |
|---|---|---|
| Month 6 | 59.3 | 61.1 |
| Month 12 | 58.2 | 48.5 |
| Month 18 | 57.4 | 44.8 |
| Month 24 | 43.8 | 37.5 |
This outcome assessed the total number of self-reported episodes of severe hypoglycemia occurring across all participants.
| Number of events | Ladarixin | Placebo |
|---|---|---|
| Number of Self-reported Episodes of Severe Hypoglycemia | 278 | 76 |
This outcome assessed the percentage of participants who did not require an insulin therapy at the timepoint of interest.
| percentage of participants | Ladarixin | Placebo |
|---|---|---|
| Month 6 | 1.2 | 0 |
| Month 12 | 0 | 2.8 |
| Month 18 | 0 | 3.2 |
| Month 24 | 0 | 4.0 |
Estimated Glucose Disposal Rate (eGDR) is a marker for the Assessment of Insulin Resistance and a validated clinical tool for estimating insulin sensitivity in type 1 diabetes. The eGDR was calculated using a formula incorporating Glycated Hemoglobin (HbA1c), hypertension status (blood pressure), and the Waist-to-Hip Ratio (WHR), with results expressed in milligrams per kilogram per minute (mg/kg/min).
| mg/kg/min | Ladarixin | Placebo |
|---|---|---|
| Month 6 | 9.56 ± 3.01 | 8.26 ± 4.52 |
| Month 12 | 9.37 ± 3.14 | 7.89 ± 4.77 |
| Month 18 | 9.64 ± 2.87 | 8.78 ± 2.34 |
| Month 24 | 9.29 ± 3.36 | 8.72 ± 3.17 |
Collected over Up to Month 24. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Ladarixin | 0/94 (0%) | 1/94 (1.1%) | 71/94 (75.5%) |
| Placebo | 0/46 (0%) | 1/46 (2.2%) | 33/46 (71.7%) |
| Run-in | 0/289 (0%) | 0/289 (0%) | 10/289 (3.5%) |
| Event | Ladarixin | Placebo | Run-in |
|---|---|---|---|
| GastroenteritisInfections and infestations | 0/94 | 1/46 | 0/289 |
| Abortion spontaneousPregnancy, puerperium and perinatal conditions | 1/94 | 0/46 | 0/289 |
| Event | Ladarixin | Placebo | Run-in |
|---|---|---|---|
| COVID-19Infections and infestations | 25/94 | 9/46 | 1/289 |
| NasopharyngitisInfections and infestations | 17/94 | 3/46 | 1/289 |
| DyspepsiaGastrointestinal disorders | 17/94 | 1/46 | 0/289 |
| PyrexiaGeneral disorders | 11/94 | 2/46 | 1/289 |
| HypoglycaemiaMetabolism and nutrition disorders | 11/94 | 3/46 | 5/289 |
| Upper respiratory tract infectionInfections and infestations | 10/94 | 3/46 | 0/289 |
| Oropharyngeal painRespiratory, thoracic and mediastinal disorders | 9/94 | 0/46 | 0/289 |
| CoughRespiratory, thoracic and mediastinal disorders | 5/94 | 4/46 | 0/289 |
| InfluenzaInfections and infestations | 8/94 | 2/46 | 0/289 |
| HeadacheNervous system disorders | 8/94 | 3/46 | 0/289 |
Full analysis set (FAS), consisting of all participants who were randomized and received at least one dose of investigational product.
| Age, Continuous(years) | Ladarixin | Placebo | Total |
|---|---|---|---|
| Mean | 26.4 ± 8.1 | 26.2 ± 8.8 | 26.4 ± 8.3 |
| Sex: Female, Male(Participants) | Ladarixin | Placebo | Total |
|---|---|---|---|
| Female | 37 | 9 | 46 |
| Male | 57 | 37 | 94 |
| Race/Ethnicity, Customized(Participants) | Ladarixin | Placebo | Total |
|---|---|---|---|
| Black or African American | 2 | 0 | 2 |
| White | 92 | 42 | 134 |
| Other | 0 | 1 | 1 |
| Multiple | 0 | 2 | 2 |
| American Indian or Alaska Native | 0 | 1 | 1 |
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Dompé Farmaceutici S.p.A