Islet cell transplantation in type 1 diabetes: an analysis of efficacy outcomes and considerations for trial designs

Am J Transplant. 2012 Jul;12(7):1898-907. doi: 10.1111/j.1600-6143.2012.04038.x. Epub 2012 Apr 5.

Abstract

To estimate treatment effect size and other parameters required for planning the designs and analyses of future phase 3 islet transplant trials, we analyzed key clinical and laboratory outcomes of 347 allogeneic islet transplant recipients, using data from the Collaborative Islet Transplant Registry (CITR). At 1 year, approximately 59% of all transplant recipients were free of severe hypoglycemic events and maintained hemoglobin A1c (HbA1c) level of ≤ 6.5%. The Kaplan-Meier (KM) survival analyses showed that 69%, 54% and 44% of these 1-year responders maintained this composite endpoint at 2, 3 and 4 years, respectively. Ninety-one percent of all recipients were free of severe hypoglycemic episodes at 1 year. Furthermore, the KM survival estimates showed that 91%, 85% and 80% of these subjects maintained this clinical benefit at 2, 3 and 4 years, respectively. These results can be very useful in developing framework for study designs, sample size estimates, and statistical analysis plans for future pivotal trials of islet cell transplantation in type 1 diabetes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / surgery*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Islets of Langerhans Transplantation*
  • Male
  • Registries
  • Survival Analysis
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human