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FrexalimAB in Preservation of Endogenous insULIN Secretion Compared to Placebo in adUlts and Adolescents on Top of inSulin Therapy (FABULINUS)
NCT06111586 · Sanofi
In plain English
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Official title
A 52-week Randomized, Double-blind, Placebo-controlled, Multi-center Phase 2b Study With a 52-week Blinded Extension and an Optional Open-label Extension - Assessing Safety and Efficacy of Frexalimab, a CD40L-antagonist Monoclonal Antibody, for Preservation of Pancreatic β-cell Function in Adults and Adolescents With Newly Diagnosed Type 1 Diabetes on Insulin Therapy
About this study
This is a randomized, parallel group, double-blind Phase 2 study with a 52-week blinded extension evaluating the safety and efficacy of 3 dose levels of frexalimab in comparison with placebo in participants with newly diagnosed T1D on insulin treatment.
Study details include:
Screening period: at least 3 weeks and up to 5 weeks
Double-blind treatment period (104 weeks):
* Main treatment period: 52 weeks
* Blinded extension: 52 weeks Optional Open Label Extension: 104 weeks Safety follow-up: up to 26 weeks The treatment duration will be up to 104 weeks, the total study duration will be up to 135 weeks.
Eligibility criteria
Inclusion Criteria:
* Participants who meet the criteria of T1D according to American Diabetes Association
* Initiated exogenous insulin replacement therapy not longer than 90 days prior to screening visit at which random C-peptide will be assessed (V1).
* Receiving at least one of the following T1D standard of care (SOC), insulin hormone replacement therapy
* one or multiple daily injections (MDI) of basal insulin, prandial insulin and/or premixed insulin, or
* continuous subcutaneous insulin infusion (CSII)
* Participants must be positive for at least 1 of the following T1D autoantibodies confirmed by medical history and/or obtained at study screening:
* Glutamic acid decarboxylase (GAD-65)
* Insulinoma Antigen-2 (IA-2)
* Zinc-transporter 8 (ZnT8) or
* Insulin (if obtained not later than 10 days after exogenous insulin therapy initiation)
* Have random C-peptide levels ≥ 0.2 nmol/L determined at screening visit.
* Be vaccinated according to the local vaccination schedule. Any vaccinations should take place at least 28 days prior to randomization for non-live vaccines and at least 3 months prior to randomization for live vaccines.
* Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
Exclusion Criteria:
* Serious systemic viral, bacterial or fungal infection (eg, pneumonia, pyelonephritis), infection requiring hospitalization or IV antibiotics or significant chronic viral (including history of recurrent or active herpes zoster, acute or active cytomegalovirus (CMV), Epstein-Barr Virus (EBV) as determined at screening), bacterial, or fungal infection (eg, osteomyelitis) 30 days before and during screening.
* Participants with a history of invasive opportunistic infections, such as, but not limited to histoplasmosis, listeriosis, coccidioidomycosis, candidiasis, pneumocystis jirovecii, and aspergillosis, regardless of resolution.
* Evidence of active or latent tuberculosis (TB) as documented by medical history and examination, chest X-rays (posterior anterior and lateral), and/or TB testing. Blood testing (eg, QuantiFERON® TB Gold test) is strongly preferred; if not available, any local approved TB test is allowed.
* Evidence of any clinically significant, severe or unstable, acute or chronically progressive, uncontrolled infection, medical or surgical condition (eg, but not limited to, cerebral, cardiac, pulmonary, renal, hepatic, gastrointestinal, neurologic, acquired or inherited bone/skeletal disorders including repeated bone fractures for unknown reason, juvenile osteoporosis, osteogenesis imperfecta, osteochondropathies, or any known immune deficiency), or any condition that may affect participant safety in the judgment of the Investigator (including vaccinations which are not updated based on local regulation).
* History or current hypogammaglobulinemia.
* History of a systemic hypersensitivity reaction or significant allergies, other than localized injection site reaction, to any humanized mAb. Clinically significant multiple or severe drug allergies, intolerance to topical corticosteroids, or severe post-treatment hypersensitivity reactions (including, but not limited to, erythema multiforme major, linear IgA dermatosis, toxic epidermal necrolysis, and exfoliative dermatitis).
* Has other autoimmune diseases (eg, rheumatoid arthritis \[RA\], polyarticular juvenile idiopathic arthritis \[pJIA\], psoriatic arthritis \[PsA\], ankylosing spondylitis \[AS\], MS, SLE), that require treatment with biologic drugs (mono or polyclonal antibodies) or systemic corticosteroid therapy (at discretion of investigator).
* History, clinical evidence, suspicion or significant risk for thromboembolic events, as well as myocardial infarction, stroke, antiphospholipid syndrome, other prothrombotic disorders and/or participants requiring antithrombotic treatment.
* Diabetes of forms other than autoimmune T1D that include but is not limited to genetic forms of diabetes, maturity-onset diabetes of the young (MODY), latent autoimmune diabetes of the adult (LADA), secondary to medications or surgery, type 2 diabetes by judgement of the investigator.
* History of malignancy of any organ system, treated or untreated, within 5 years of screening, regardless of whether there is evidence of local recurrence or metastases.
* Systemic corticosteroids (duration \> 7 days), adrenocorticotropic hormone 1 month prior to screening.
* Any IV, IM or SC administered biologic treatments, \< 3 months or \< than 5 half-lives (whichever is longer), prior to randomization.
* Any live (attenuated or viral-vector) vaccine (including but not limited to varicella zoster, oral polio, nasal influenza, rabies) within 3 months prior to randomization.
* Any non-live (inactivated, mRNA, recombinant, conjugate, toxoid) vaccine administered less than 28 days prior to randomization.
* Other medications not compatible or interfering with IMP at discretion of investigator.
* Any immunosuppressive therapy within 12 weeks prior to randomization.
* Course of Thymoglobulin®, teplizumab or other immunomodulatory treatments at any time.
* Any drugs that may be used for treatment of T1D and type 2 diabetes other than insulin including but not limited to metformin, glucagon-like peptide 1 (GLP-1) agonists and sodium-glucose co-transporter-2 and 1 (SGLT2/1) inhibitor and verapamil within 2 weeks prior to screening.
* Abnormal laboratory test(s) at screening.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Study design
Enrollment target: 192 participants
Allocation: randomized
Masking: triple
Age groups: child, adult
Timeline
Starts: 2023-12-11
Estimated completion: 2030-10-29
Last updated: 2026-04-08
Interventions
Drug: FrexalimabDrug: PlaceboDrug: Insulin
Primary outcomes
- • Change from baseline to W52 in mean 2h mixed meal tolerance test (MMTT) stimulated C-peptide concentration (Baseline to Week 52)
Sponsor
Sanofi · industry
Contacts & investigators
ContactTrial Transparency email recommended (Toll free number for US & Canada) · contact · contact-us@sanofi.com · 800-633-1610
All locations (80)
University of California San Francisco - Mission Bay- Site Number : 8400012Recruiting
San Francisco, California, United States
University of Colorado - Anschutz Medical Campus- Site Number : 8400003Recruiting
Aurora, Colorado, United States
University of Florida College of Medicine- Site Number : 8400010Recruiting
Gainesville, Florida, United States
University of Miami Hospital- Site Number : 8400013Recruiting
Miami, Florida, United States
AdventHealth Orlando- Site Number : 8400002Recruiting
Orlando, Florida, United States
Rocky Mountain Diabetes and Osteoporosis Center- Site Number : 8400009Recruiting
Idaho Falls, Idaho, United States
NorthShore University Health System - Endeavor Health Medical Group - Skokie - Woods Drive- Site Number : 8400007Recruiting
Skokie, Illinois, United States
Joslin Diabetes Center - Boston- Site Number : 8400015Recruiting
Boston, Massachusetts, United States
University at Buffalo - Downtown Campus- Site Number : 8400004Recruiting
Buffalo, New York, United States
University of North Carolina at Chapel Hill- Site Number : 8400001Recruiting
Chapel Hill, North Carolina, United States
Cincinnati Children's Hospital Medical Center- Site Number : 8400019Recruiting
Cincinnati, Ohio, United States
The Children's Hospital of Philadelphia Site Number : 8400005Recruiting
Philadelphia, Pennsylvania, United States
University of Texas - Southwestern Medical Center- Site Number : 8400011Recruiting
Dallas, Texas, United States
Benaroya Research Institute at Virginia Mason- Site Number : 8400016Recruiting
Seattle, Washington, United States
Investigational Site Number : 0400002Recruiting
Graz, Austria
Investigational Site Number : 0400004Recruiting
Linz, Austria
Investigational Site Number : 0400001Recruiting
Vienna, Austria
Investigational Site Number : 0560002Recruiting
Brussels, Belgium
Investigational Site Number : 0560001Recruiting
Leuven, Belgium
Investigational Site Number : 1240001Recruiting
Vancouver, British Columbia, Canada
Investigational Site Number : 1240007Recruiting
London, Ontario, Canada
Investigational Site Number : 1240005Recruiting
Montreal, Quebec, Canada
Investigational Site Number : 1240004Recruiting
Montreal, Quebec, Canada
Investigational Site Number : 1240003Recruiting
Montreal, Quebec, Canada
Investigational Site Number : 2030003Recruiting
Ostrava, Czechia
Investigational Site Number : 2030002Recruiting
Prague, Czechia
Investigational Site Number : 2030001Recruiting
Prague, Czechia
Investigational Site Number : 2080005Recruiting
Herlev, Denmark
Investigational Site Number : 2460001Recruiting
Helsinki, Finland
Investigational Site Number : 2460004Recruiting
Oulu, Finland
Investigational Site Number : 2460003Recruiting
Tampere, Finland
Investigational Site Number : 2460002Recruiting
Turku, Finland
Investigational Site Number : 2500004Recruiting
Corbeil-Essonnes, France
Investigational Site Number : 2500005Recruiting
Mont-de-Marsan, France
Investigational Site Number : 2500006Recruiting
Paris, France
Investigational Site Number : 2500007Recruiting
Pontoise, France
Investigational Site Number : 2500003Recruiting
Saint-Herblain, France
Investigational Site Number : 2760003Recruiting
Dresden, Germany
Investigational Site Number : 2760001Recruiting
Hanover, Germany
Investigational Site Number : 2760002Recruiting
Oldenburg in Holstein, Germany
Investigational Site Number : 2760004Recruiting
Ulm, Germany
Investigational Site Number : 3480001Recruiting
Balatonfüred, Hungary
Investigational Site Number : 3480004Recruiting
Budapest, Hungary
Investigational Site Number : 3480002Recruiting
Nyíregyháza, Hungary
Investigational Site Number : 3480003Recruiting
Nyíregyháza, Hungary
Investigational Site Number : 3480006Recruiting
Székesfehérvár, Hungary
AOU delle Marche - Ospedale G. Salesi-Site Number : 3800008Recruiting
Torette, Ancona, Italy
Azienda Ospedaliera Universitaria Meyer IRCCS-Site Number : 3800003Active Not Recruiting
Florence, Firenze, Italy
IRCCS Ospedale San Raffaele-Site Number : 3800006Recruiting
Milan, Milano, Italy
Azienda Ospedaliera Universitaria 'Federico II'-Site Number : 3800009Active Not Recruiting
Naples, Napoli, Italy
Ospedale Pediatrico Bambin Gesu IRCCS-Site Number : 3800007Active Not Recruiting
Rome, Roma, Italy
Azienda Ospedaliero-Universitaria Maggiore Della Carità-Site Number : 3800001Recruiting
Novara, Italy
Azienda Socio Sanitaria Territoriale Dei Sette Laghi - Ospedale Filippo del Ponte-Site Number : 3800002Completed
Varese, Italy
Azienda Ospedaliera Universitaria Integrata Verona - Centro regionale di Diabetologia Pediatrica-Site Number : 3800004Recruiting
Verona, Italy
Investigational Site Number : 6160005Recruiting
Lodz, Lódzkie, Poland
Investigational Site Number : 6160006Recruiting
Warsaw, Masovian Voivodeship, Poland
Investigational Site Number : 6160004Recruiting
Warsaw, Masovian Voivodeship, Poland
Investigational Site Number : 6160001Recruiting
Warsaw, Masovian Voivodeship, Poland
Investigational Site Number : 6160007Recruiting
Warsaw, Masovian Voivodeship, Poland
Investigational Site Number : 6160008Recruiting
Bialystok, Podlaskie Voivodeship, Poland
Investigational Site Number : 6160002Recruiting
Katowice, Silesian Voivodeship, Poland
Investigational Site Number : 6160009Recruiting
Szczecin, West Pomeranian Voivodeship, Poland
Investigational Site Number : 7050001Recruiting
Ljubljana, Slovenia
Investigational Site Number : 7240001Recruiting
Barcelona, Barcelona [Barcelona], Spain
Investigational Site Number : 7240002Recruiting
Esplugues de Llobregat, Barcelona [Barcelona], Spain
Investigational Site Number : 7240005Recruiting
Oviedo, Principality of Asturias, Spain
Investigational Site Number : 7240003Recruiting
Seville, Sevilla, Spain
Investigational Site Number : 7240004Recruiting
Málaga, Spain
Investigational Site Number : 7240006Recruiting
Valencia, Spain
Investigational Site Number : 7240007Recruiting
Vitoria-Gasteiz, Álava, Spain
Investigational Site Number : 7520002Recruiting
Solna, Sweden
Investigational Site Number : 7520001Recruiting
Stockholm, Sweden
Investigational Site Number : 7520003Recruiting
Stockholm, Sweden
Investigational Site Number : 8260001Active Not Recruiting
Cambridge, Cambridgeshire, United Kingdom
Investigational Site Number : 8260009Recruiting
Dundee, Dundee City, United Kingdom
Investigational Site Number : 8260003Recruiting
Birmingham, England, United Kingdom
Investigational Site Number : 8260007Active Not Recruiting
Birmingham, England, United Kingdom
Investigational Site Number : 8260010Active Not Recruiting
Glasgow, Glasgow City, United Kingdom
Investigational Site Number : 8260004Recruiting
Leicester, Leicestershire, United Kingdom
Investigational Site Number : 8260006Active Not Recruiting
Harrow, London, City of, United Kingdom